Why is it so difficult for so many people to even consider giving up sugar and sugar-containing foods, and refined carbohydrates?
It’s easier said than done. Dangle the carrot of better health, including weight loss, and still some people ponder which to choose, as if the choice is not obvious. In these cases, the real question is this: Why is sugar so addicting? Many people encounter great difficulty giving up sugar and items containing it. Foods don’t taste the same without sugar, they say. And because sugar is such a widely used ingredient found in many processed products, from so-called “healthy breads” to cereals and energy bars to even tomato sauce, finding out which foods don’t contain sugar or high-fructose corn syrup can be a nutritional challenge. The dependency on sugar consumption is an addiction; weaning oneself off sugar is not easy. For many years, studies have demonstrated that sugar triggers the brain’s pleasure and reward centers—areas in the emotional centers of the brain responsible for the release of “feel good” neurotransmitters called dopamine. These are the same brain areas stimulated by cocaine, nicotine, opiates (such as heroin and morphine), and alcohol. This addiction is not an imaginary thing in the minds of millions of sugar junkies—it’s associated with real physiological changes in the brain. And, perhaps because the brain’s pleasure areas are also very close to the pain centers, withdrawal from sugar has been described by many patients as being painful—like romantic pain or eliminating nicotine or caffeine.
After a big meal of pasta, bread, a sugary drink, and dessert, does your behavior change?
Do you observe this in others? Do you react to eating sugary foods by getting sleepy, moody, or losing concentration? When you avoid sugar or don’t eat it, do you experience cravings or uneasiness with strong desires to eat more? Do you tend to eat sugary foods even though you know you shouldn’t, and feel you should better control yourself? These questions about addiction are similar to indications of drug addiction, and the reason researchers and clinicians see an overlap between sweets and drugs.The cycle is perpetuated with the feeling of withdrawal when the drug, or sugar, is not available, followed by the urge to abuse the drug (sugar) again.Psychoactive compounds present in cocoa and chocolate, salsolinol being the main one, might be why chocolate can also so be addicting. But the high level of added sugar contained in most chocolate products is probably more addictive than the chocolate alone.There’s another aspect of sugar addiction to be aware of. Which of these statements applies to you when it comes to eating sugar-containing foods and other refined carbohydrates?
- Eating until feeling uncomfortably full.
- Eating large amounts when not physically hungry.
- Eating much more rapidly than normal.
- Often eat alone because you’re embarrassed by how much you’re consuming.
- Feeling guilty, depressed, or disgusted after overeating.
- Marked distress or anxiety regarding binge eating.
Binge-eating episodes are associated with 3 or more of these. These questions might provide criteria for a clinical diagnosis of binge eating with sugar. The 4th edition of Diagnostic and Statistical Manual of Mental Disorders (an American Psychiatric Association publication that provides descriptions and characteristic symptoms of different mental illnesses) defines binge eating as a series of recurrent binge episodes in which each is defined as eating a larger amount of food than normal typically during any two-hour period. Without exaggeration, I’ve been given similar histories by thousands of patients throughout my career—people who were not, in my opinion, mentally ill, but had sugar addiction that caused binge eating of it.There are far more sugar binge eaters who may not be diagnosed as having a clinical disorder, but the reality is that sugar addiction for these individuals may be very real. In fact, Nicole Avena and colleagues at Princeton University’s Department of Psychology, state that, “the physiological consequences of binge eating may be similar, whether engaged in naturally because of hunger, casually for social or hedonic reasons, or regularly enough to warrant a diagnosis.” In their study on addiction (“Sugar and Fat Bingeing Have Notable Differences in Addictive-like Behavior”), published in the Journal of Nutrition (2009), they state that, “Individuals with a preference for bingeing on sweet foods tend to binge more frequently.”
In addressing an obvious question—why don’t people binge on foods such as broccoli?—the authors state that, “There must be some property of palatable “dessert” and “snack” foods rich in sugar and/or fat that promotes binge eating. Sugars and fats are well known to have different effects on physiology and brain chemistry, which may be related to their different effects on behavior.” Baclofen is a medication known to reduce the intake of certain drugs of abuse. It’s been used to treat those addicted to morphine, heroin, cocaine, and alcohol. Since sugar has behavioral and brain chemical similarities to drug abuse, the reason some researchers say sugar can be addicting, the same Princeton research team sought to determine whether Baclofen would have an effect on binge eating. Specifically, would Baclofen reduce sugar bingeing? It didn’t. However, it did reduce binge eating of fats. Sugar, as millions of people already know, it a tough addiction. Still, many people have trouble accepting the notion that sugar is addicting. “More scientific studies are needed” is the mantra often voiced by the media, the sugar industry, and its lobbyists, and sugar addicts. This denial is a convenient cop-out—of those addicted and especially by those who reap monetary benefits from sugar and sugar-containing products. (To this day, the tobacco industry also claims that, “more studies are needed,” to determine whether cigarette smoking or second-hand smoke is harmful.) At the same time, many clinicians have struggled with trying to help patients who could not reduce or eliminate sugar because of its tenacious, unhealthy hold on them.
Millions of people have experienced the “pain” of sugar withdrawal—they can’t just stop eating it without being uncomfortable. They’ve enjoyed the brain’s pleasure effects while eating it, now the effects of withdrawal include a type of pain associated with intense craving and desire, and the inability to stop. Yet the fact that sugar is strongly addictive is knowledge put to use by the very companies who put the sweet stuff in our food and drinks. They carefully place sugar-laden foods in easy-to-access locations, such as at the checkout counter; many are also placed at eye level for children to see while sitting in the shopping cart; holidays are now based more on giving, buying and eating sugar than anything else, it seems. Halloween is the start of the so-called “holiday season.” It’s not just in North America, but the horrors of Halloween are experienced in most of Europe, China, Japan and elsewhere. For candy manufacturers, it’s their biggest money making holiday. New York City’s Economy Candy Store alone sells 6,000 pounds of so-called treats for Halloween. Surveys show that in the U.S. 36 million children age 5-13 collect candy. Of course, millions more children—and adults—of all ages gobble down pounds of sweets for days and weeks after Halloween, finishing just in time for the next holiday feeding frenzy. Thanksgiving, Christmas, New Year’s and other holidays leading to the Super Bowl parties are devastating. By the end of a span of about two months, many have gained weight, lost health, got the flu, and must visit their doctor for help.
Sugar may also be a primary issue in those with other “secondary” addictions. In this case, treating the sugar problem—getting a person off the white stuff—might be the first step in eliminating other substances such as alcohol, nicotine, caffeine or so-called harder drugs like heroin and cocaine. Other modalities such as hypnosis, acupuncture, behavior modification, and psychotherapy may also be useful. In my clinical experience, when helping patients who were addicted to drugs—from alcohol to amphetamines and caffeine to cocaine—the most successful cases with a positive outcome were initiated by first eliminating sugar and other refined carbohydrates.