Food addiction doesn't exist.

There. I said it. Food addiction doesn't exist in the real meaning of the word "addiction." However, if by addiction you mean behavioral addiction--a series of obsessions which lead to the compulsion to eat--then I agree it does. Confusing? Let's look at the word more closely.

I will be addressing weight reduction through diet, not surgery. I believe there are very real differences between the two such that they can't be addressed here, and I'm not educated in bariatric surgery, only what I'm going to write about today.

Traditionally, "addiction" means a physical dependence on something, most likely a drug such as opiates (morphine, methadone, heroin, codiene, etc.); nicotine; alcohol, etc. These are drugs which cross the blood-brain barrier and have a direct action on the brain. For instance, our brains secrete naturally-occurring painkillers and pleasure-giving substances called endorphins. They fit into places in the brain precisely, like a key is meant to fit into a specific lock. There are some drugs, however, which fit even better than endorphins, and the opiates are one of them. When introduced to the brain, they will sort of push the endorphins out of their home and take their place. Their key fits the lock better than the brain's own key does.

Opiates come in various strengths, with Dilaudid one of the strongest man-made drugs, and heroin one of the strongest "natural" opiates. (Actually, heroin doesn't exist in nature. It's created from morphine, but it isn't a completely lab-based drug such as Dilaudid is.) These drugs cause physical addiction, substance tolerance and behavioral (psychological) addiction. Withdrawal from them has consistent symptoms in everyone who does, including sometimes great physical pain and/or other mild-to-severe physical problems. Sometimes medications are given over a limited period of time to mitigate these difficult to tolerate symptoms. The goal is to never use the addictive substance again for the rest of the patient's natural life. Tolerance to certain drugs, such as nicotine, is never lost.

The second meaning of the word addiction is a tolerance which is built up over time. This is commonly called substance dependence. Many medical researchers argue that this is not true addiction, for a variety of reasons. It refers to a person's unwillingness to withdraw from the drug and while a physical tolerance is built up, that tolerance is lost when the drug is discontinued. This class of drugs includes cocaine, marijuana, hallucinogens such as LSD, mushrooms, and others. They are so pleasurable that the user finds it difficult to give them up. While there are some physical symptoms across the board on withdrawal, they aren't usually severe and can vary from person to person. The biggest symptoms are psychological, and they can be quite severe. Because of the strong psychological component, treatment must address mental problems and use therapy as part of the treatment, although it's often for a short duration, depending on the school of thought.

The user can't use the drug again or tolerance will again be built up and the behavioral components re-established almost immediately.

All of the drugs which cause physical addiction also cause substance tolerance. It's complicated, and I can't get into it here, but there are academically-vetted sources of information available (not Yahoo or Wikipedia) on the web. Try the Mayo Clinic, National Institutes of Health/Mental Health, etc.

Finally, there is "behavioral addiction." This is where the layperson's use of the term food addict comes in. Tolerance is not built. A food addict doesn't need increased amounts of food weekly or every two weeks in order to get the same high. As they age and get less physically active due to the limiting effects of obesity itself, they will gain weight. However, that is not usually due to greatly increased tolerance. Users don't have across-the-board symptoms on reduction of food intake, although hunger is always a component of it, and is decidedly unpleasant. However, reduced calories do not cause physical pain, nor muscle spasms, heavy mucous production, inability to sleep, terrifying dreams, or death. (Withdrawal from some drugs, such as the barbiturates, is life-threatening and is often done in a hospital.) There is no physical dependence.

Constant thoughts and dreams of food occur nearly 100% of the time. The person will often be restless, weep, and withdrawal can cause a true depression in a person who is already at risk. Fatigue and weakness may occur, but usually not if calories are kept at a moderate level such as 1100 or above, which prevents muscle deterioration and stripping of muscle tissue by the body to use as calories. Calorie reduction below 1000 over a significant period of time can do that. What is significant? At least a month, but the semi-starvation diets of 500 calories a day are always done under medical supervision and may last longer.

Because food addiction is obsessional and compulsive, and nearly always contains a component of Binge Eating Disorder (BED), the person will often find it difficult to maintain a diet unless cognitive therapy or other specialized therapy addresses the behavior. Some obese individuals have flat-out OCD, but the majority do not.

Summing up this part, we see three types of addiction. Physical, which also has substance dependence and behavioral components; substance dependence, which also has behavioral aspects; and behavior addiction, which has neither of the other two. That's why I say that food addiction doesn't exist, since the primary meaning of the term (medically) and tightest definition, oldest definition, and most accurate definition of the word addiction doesn't apply to food.

The reason why I bring this up today is because I read a blog yesterday where the blogger was insisting that the reason why s/he had a more difficult time losing weight than other people was because s/he was a food addict. It irritates me when someone cops a plea like that to excuse his/her unwillingness to dedicate him/herself to getting healthy by losing weight. No one is commited to getting unhealthy, or if already in bad health, to getting worse. Even suicidal people aren't addicted to it, if you want to say the food addiction is someone's way of commiting slow suicide. There are real addicts fighting even as we speak, who are dedicating today to suffering through severe physical side effects in order to get well. To say that losing weight is akin to their struggles disrepects their hard work and suffering. It also disrespects those who are struggling mightly to lose weight without pleas for extra sympathy due to their addiction problem. Yes, food addiction does exist, but again--only in the layman's definition of addiction, or when talking about the very real problem of behavioral addiction.

I'd like to see the term food addiction thrown out and something more accurate put in its place. Just the psych term behavioral addiction? Food dependence? Eating disorder? (My favorite, and one which I believe in completely.) Food mental illness? There are many things we could think up for this, sex addiction, computer addiction, and other such "addictions" which wouldn't cloud the medical definition of addiction.

I didn't write this to hurt anyone's feelings or to mock anyone. I wrote it to praise those who don't excuse their behavior because of their addiction. I wrote it to stop watering down the definitions of addict and addiction. Those words should be reserved for their traditional meanings. I admire the English language, too. But not as much as I admire the people in the Challenge, those who've successfully gone through and live with bariatric surgery, people who are devoted to getting healthy and having some control over their lives of an important aspect in it, and more.

I know I'll piss some people off, but I want them to do their own research and think a little about what they're saying and why they're saying it. I'll say it again: Food addiction doesn't exist, and yes food addiction does, but not in those words. Let's agree to disagree if you don't find that scientifically accurate, because after my research, I'm not about to change my mind.