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.

Quick apology

Guys, I've been sick, so I haven't been able to post a few new things I found. It's not something I like to do--skip a day's writing--but I'll catch up tomorrow. I'll answer all of your excellent comments that you made on the last blog entry, too. Great stuff.

I also have to catch up on your blogs. I hate to miss anything you write about, because it's always so damn good. But I'll see you tomorrow.

A helping hand or not?

Sometimes, what looks like a helping hand is really a reaching out for help. Let's say that you see someone in need. They're in need of emotional support, love, a feeling that they're worth something, the strong need to not be alone, and so forth. So you reach toward them in order to help ease their pain. But it doesn't stop after a few times. A symbiotic relationship is set up, almost a parasitical living system. The helper feels terrific for doing a good deed, and the one who needs help, now has someone who cares enough about her that the helper will give up time and emotion, even food and money, to rescue the desperate one.

In the case of eating disorders, there's almost always going to be falling off the wagon by a dieter. She'll cry out for help. The readers will tell her she's a good person, don't hate yourself, everyone needs to break a diet now and again, get back on the wagon and start over. All very natural--the first two or three times. But with someone who's not invested in losing weight, the situation of need, rather than the weight loss, is what's wanted. So she reaches out continually. One by one supporters drop off, realizing that this is some sort of game the dieter is playing. Eventually, all who are left are those who play the game themselves. They are a living organism of pretty much eating whatever they want to, being "forgiven," and talking about how in the future--they'll name a date several days or weeks in the future--when they'll start the diet again. And the cycle repeats itself.

This thinking was triggered by one blogger in particular, but I've been reading a lot on the obesity ring and see that the game has other players. About a third of the bloggers on dieting aren't dieting to lose weight at all. They want to, but they won't do the real work it demands. Pleasure trumps health. Even when someone has had brushes with death, there's no change in behavior. It's baffling and irritating and sad, all at the same time.

The helpers are helping the dieter to kill herself out of their own need to be heroes. They also need to feel superior. Sound ugly? It is ugly. But it's the truth. It's like watching Maury Povich--you get to feel as though as bad as things are in your life, at least it's not the train wreck that's happening in others'. It's snobbery.

We have to learn when to pull back. You don't have to kick anyone in the ass, but you do have to stop saying it's all right to keep eating chips and chocolate for an afternoon snack. You have to stop saying that it was okay that she ate because her kid got sick, or her car broke down and cost a lot to fix, or her shoelaces came untied--any damn thing will do. Because eating won't fix it. You know the old saying: "If hunger isn't the problem, eating won't fix it." The only thing you've done when you eat a quart of ice cream because you're depressed is depress yourself further and make yourself feel like shit. You're basically saying that you're not worth losing weight, gaining health, gaining sexiness and beauty. Oh, yes you are! Sure, you might be awfully pretty, even though obese. But think how much more stunning you'll be at normal weight, most of all to yourself.

So the enablers have to stop doing that, and those who are playing a game of dieting have to stop allowing the enablers to keep them obese. If you truly can't lose--which means you really don't want to--join a fat acceptance group, stay fat, die young or live with blindness as your diabetes progresses.

I know this has been a rant, and rants usually aren't helpful. But I hope this one has added something to the dialogue. I know that it's changing my way of looking at this. I don't think I've ever enabled anyone, because I don't have the temperment, and don't interact with any of the gamers, just read their blogs. But it's a good warning sign to be aware of that all the time.

Selfish or helping?

Allan K. talked about enabling today. He essentially wrote that what seems to be support may actually be enabling, if it does nothing to help the person at risk. That if every mistake--particularly one made repeatedly--is forgiven, that person has no reason to change. I want to address this, although I'm not as clear or concise as he is.

I'm not talking about someone who's working toward their goal weight, and slips up every once in a while. I'm talking about people who, once a week or more, find themselves "having" to eat, trapped by recurrent thoughts of dancing burger patty melts. Then giving in. Night after night, or only twice a week. Whatever it is, they can't lose and will probably gain each week. An extra 500 calories a day, or 3,500 a week, translates into a pound of fat gained each week. Thus they're not only not losing, they're gaining--a lot.

The fact is that it's not difficult to slurp in an extra 500 calories, particularly for someone who's already obese. Maintaining 400 lbs. a day requires 4400 calories. That's an amazing amount of food, just to stay at the same weight. What's another 500 calories? Child's play. Anyone can do it.

If someone starts off their blog saying how they "cheated" all week (just who are they cheating?) and that they were "bad" (only children use the term that way, not adults), I know we're going to read a litany of overeating, usually crap. Crap tastes better than real food, for some reason. The same person who doesn't have the energy to walk or exercise indoors has the will to get dressed at 9 p.m., throw a coat on, then drive to a fast food place to pick up a four-patty In-and-Out Burger with double fries, and a maximum size cola.

Remember, this person has eaten like this all her life. She's thus given into her old habit, which is a hardcore neural pathway laid down by years of doing the same thing repeatedly. It's difficult to fight, very difficult. She feels awful: ashamed, guilty, sad, humiliated, and her self-esteem is in the toilet. Along come her friends to lift her spirits and help her to forgive herself. That needs to be done, at least the first few times. She's still learning how to set up new habits, such as how to fight the hunger, how to love herself enough to want to lose weight, how to lay down a new neural pathway so that hunger doesn't result in eating.

More to come. . .

Bring Your Own Crazy--Drazil's Friday Questions

Karen, owner of the Sunshine blog, turned me on to Drazil's Friday questions. They're to kickstart your blog if you're out of things to say, or just to help each of us know the other better. Just copy and paste the questions into your blog and let us see your answers.

1. If you could be a weather forecast, what would you be and why?

For the past week? Bright and sunny, turning to low clouds and overcast skies. Rain tonight, but sunny skies again tomorrow.

2. Would you break the law to save a loved one?

On a dime. Hell, I break the law every day over nothing but merely my wanting to (speeding). I'd surely break it to save a loved one, no questions asked, any risk taken.

3. If Happiness were the national currency, what would make you filthy rich?

To have my husband as healthy as he was 20 years ago.

4. Can you sum up your life in a six word sentence? (Example: My heart continuously expands in joy.)

Life is short: I am shorter.

5. Repeat question. Summarize your week in blogland and in real life.

I didn't blog as much as I wanted to--so many things unsaid. I enjoyed everyone who commented and appreciate their comments so very much. In real life, I had good news (a full time job starting next year) and a little down (my husband has been flu-ish and I'd rather it be me). Overall, everything balances.

Buddhist thoughts about food.

I was wandering around some of my favorite sites, and came across the Buddhist meditation on food:

This food I take
not for play,
not for fattening,
not for beautifying,
not for intoxication.
But only for the
continuation and
nourishment of
this body.
For keeping it unharmed,
for helping it to
lead a pure life.
Thinking, I shall
destroy hunger.
Thus will I be free
from bodily troubles
and live at ease.

It's beautiful, but you might be surprised to learn that I found it on a site for the EDs anorexia and bulimia. Yes, one of those infamous "pro-ana" sites you hear about. Now, I've been to them, but don't always like them. This one isn't what most people think it is, however. It's a support group for people struggling with these diseases. I can go two ways on it. It's mostly populated by teen girls, followed by young women in their early to mid-20's. Then there are boys of 16-18, and a very few young men.

They're all so desperate, and lonely. They talk of their families calling them "slimfast girl," "fatty-kins;" they speak of bullying by fellow students and older siblings (who are invariably prettier and thinner), and mockery by mothers, grandmothers, aunts, and other mostly female members of their families, who often have EDs themselves.

They need support, and they get it from each other. However, I get nervous about kids--and most are kids--in that mindset inspiring others to do the same. On another such site, I was in a chat with an older anorexic, and we were talking about recovery. We discussed threats by docs of involuntary hospitalization unless we'd eat or get our BMI's up to 17, 18, or so. A girl--I could tell she was very young--jumped on us like glue, begging us to tell her our "secret" of how to be so thin. She said she weighed something like 135 and would kill herself unless she got to 100. I told her she was a normal weight for her height (which was something like 5'3") and she should keep her weight normal, eat fresh vegetables, yadda-yadda, the whole nine yards. She became desperate--"Please, PLEASE, tell me what you do to lose weight. I need to know!" Finally, I just left the chat room after telling her the same thing several times. I couldn't take it anymore.

After I left, I wondered what happened. Did some young anorexic come in and tell her how to vomit efficiently? Did she give her the 2-4-8-2, or 2-4-6-8, or on-and-on diet? (Going from 200, to 400, to 800, and back to 200 calories a day.) Did they give her support to stay healthy and get even healthier, or did they "support" her in her dream of getting to 100 pounds?

That's what I mean about being of two minds about these places. You must let them come to their own decisions for them to accept who and what they are. However, they're still mostly children, and this can turn into eating-disordered children talking to other ED kids and getting into a world of trouble.

Just as I don't believe talking to obese people makes you obese, I don't think that a normal girl can be talked into anorexia. But a girl can learn how to fake out their doctor's office during weigh-ins; how to vomit easily; how to hide evidence of not eating from her parents (who usually aren't looking for it anyway), etc. So if they're on the path to anorexia or bulimia, they can be taught how to get there sooner and more efficiently.

I wish we were all like the Buddhist meditation, unattached to food. I wish we could all think of food as nourishment, and while it's a pleasure to nourish us, it's nothing more than that, like the pleasure of seeing a daffodil in spring. You recognize it and enjoy it, but you don't live for it. There are more important things to live for.

I haven't read my blogs today--it was a crazy one. I'll get to them by tomorrow, by hook or by crook.

All day hunger.

Potato chips were on my mind when I got up at 4:30 this morning. I didn't eat much the day before, so maybe that was it. I didn't eat or drink anything, except half a Coke, until after I got home at 3 p.m. For supper, half a cup of rice, half a cup of green beans, and a roasted chicken drumstick--no skin, average size or a little bigger. Not bad. Oh, forgot a full glass of ginger ale. Around 700 calories, give or take. Or that's my best estimate. I'll have to look up calories somewhere.

I have two cats who eat whatever they want. One eats wet food because he has no teeth from a hit-and-run driver. That's how we met. I picked him up off the boulevard and after nine surgeries, he became mine. Just what I needed, another cat. The other one, a tuxedo kitty, only eats dry food. Every once in a while she nibble on his wet stuff, but it's rare for her. She has become quite fat over the past two years. He, however, remains slender. She's more active than he is, and would love to play all day. He doesn't like it--he might not have played much before his extensive injuries, because he was very young, under a year, when he was hit. He's about 14 or so, right now.

So why is he slim when he's older and eats what he wants, including treats? Plus he doesn't exercise. And why is she fat (not obese yet)? I don't think they have eating disorders, a lack of self-esteem, or a feeling that they're not in control. I think this speaks to genetics, and probably environmental issues.

What do you guys think?