Food addiction: Retraining your brain to eat healthily

Why are so many of us hopelessly addicted to fatty and sugary foods that we know are bad for us? Why do we never get the same cravings for fruit, vegetables or brown rice that we do for chocolate, crisps and chips?

With 66 per cent of Irish adult men and 50.9 per cent of women now overweight or obese, it is obvious that many of us are consuming too much of the wrong kinds of foods.

It’s not that we can’t be bothered trying to eat healthier foods, or that we don’t know we should be eating more broccoli and less cake, according to Joanne Cooper, a psychologist who specialises in weight loss. In most cases, we know what we should be doing but there is a good reason we find it so incredibly hard to do.

Eating foods that are high in fat and refined sugars activate the pleasure and reward centres of the brain, causing an increase in the release of the neurotransmitter dopamine. This “feel-good” neurotransmitter creates feelings of soothing, pleasure and satiation, even while consuming foods we are fully aware we should not be eating.

“It’s a powerful neurotransmitter, overriding the sensible, logical part of the brain. The more we enjoy the activation of our pleasure-reward system, the longer we continue to engage in eating fatty and sugary foods; and the more we look to food as our source of pleasure and reward, the higher our chances of becoming addicted to eating these kinds of foods,” says Cooper.

New research from the US suggests the brain can be retrained to prefer healthy food to unhealthy high-calorie foods, using a diet that does not leave people hungry. Scientists from Tufts University in Boston say food addictions can be changed in this way even if they are well established.

Prof Susan B Roberts, senior study author and behavioural nutrition scientist at Tufts University, says: “We don’t start out in life loving French fries and hating, for example, wholewheat pasta. This conditioning happens over time in response to eating repeatedly what is out there in the toxic food environment.”

Her research, which was published in the journal Nutrition and Diabetes, involved a specially designed weight-loss programme that was high in fibre and protein and low in carbs but did not allow participants to become hungry because this is when food cravings take over.

The addiction centre in participants’ brains was scanned at the start and end of a six-month period and the results showed increased cravings for healthy, low-calorie foods in those on the special programme.

Cooper is particularly excited about this new study because it provides evidence to back up the work she has been doing with her clients using Cognitive Behavioural Therapy (CBT) to change the way they think about food.

“Eating foods that are high in fat and refined carbohydrates does have an effect on certain kinds of brain activity but, as this study demonstrates, we still possess the power to change some of this through a commitment to changed eating behaviour.

“In real-life terms, this means that when we stick to positive food choices in a sustained and committed way, we can start to alter how we perceive unhealthy foods that we previously found desirable. And when we perceive these kinds of foods as being somewhat less desirable, we reduce our cravings, increase our satisfaction with our new choices and maximise our chances of being able to sustain long-term weight loss,” she says.

Cooper points out that the function of eating food is to fuel the body, but many of us eat to stimulate or to soothe ourselves. For example, we will reach for a bar of chocolate because we feel we deserve a treat after a hard day or to satisfy some unmet emotional need.

She says: “I never intended to specialise in weight issues but given that so many people in Ireland are overweight or obese, many of the people presenting to me had weight problems that often overlapped with depression and anxiety.

“I began to realise that for many of these people, it was not just as simple as eating less and having more willpower, as there were other issues going on that needed to be addressed.

“I think a lot more awareness needs to be created around this area: these people are receiving messages all the time that it’s their own fault they are not losing weight because they are lazy or not trying hard enough.”

Controversial issue

The issue of food addiction is a controversial one. The inclusion of binge-eating disorder in the fifth edition of the

Diagnostic and Statistical Manual of Mental Disorders

is viewed by some as boding well for the eventual recognition of food addiction as a substance-use disorder in future editions of the manual, while sceptics question whether it is an actual disorder.

Ashley Gearheardt, assistant professor of psychology at the University of Michigan, has found that food addiction and substance dependence trigger similar brain activity and her work strengthens the hypothesis that some people are physically addicted to foods high in added fat and sugar.

She compares the struggles of people with food addiction to alcoholics trying – and failing – to keep their habit under control.

Gearheardt created the Yale Food Addiction Scale to identify people with symptoms of food addiction.

This scale found that people showed signs of being addicted to food regardless of their body type, whether they are lean, obese or in between.

It has been used in dozens of studies that demonstrate an estimated 5-10 per cent of the population in the US may have some degree of food addiction.

Several characteristics separate normal or occasional binge eating from a food addiction. Firstly, food addiction is maladaptive, so although people overeat to feel better, it often ends up making them feel worse. Secondly, people with food addiction overeat persistently.

We can all overeat from time to time, but people with food addiction often overeat every day, and they eat not because they are hungry, but as their main way of coping with stress.

Cooper is not suggesting that everybody who has a weakness for foods high in fats and sugar has a food addiction but she is aware that many people really struggle to cut down on these “hyperpalatable” foods.

Evidence-based practices

Her passion for helping people to change not only their eating behaviours but their whole mindset around food inspired Cooper to develop her Food for Thought programme which she has piloted in Dublin and plans to roll out in other areas.

The unique six-week group programme combines evidence-based practices from the fields of psychology, CBT and nutritional science and applies them to weight loss. Each week involves an hour of psychology and CBT and half an hour of nutritional therapy.

“I work with people on developing their own blueprint, in helping them to understand what comes into play each time they reach for the wrong food and to address it. It’s not enough to know what to eat.

“To make long-term and committed food choices, we must understand the processes underlying why we eat unhealthy foods,” she says.

While Cooper cannot promise that we will get as much pleasure from an apple as a Mars bar after retraining our brains around food, she can promise that the apple will be a lot more palatable to us afterwards.

See foodforthoughtireland.ie

'The plan was all about foods I love so I didn't feel deprived'

Niamh is 44 and a yo-yo dieter who had been "in every weight-loss programme possibly known to mankind" and battled with her weight for more than 15 years before going on the Food for Thought pilot programme in Dublin. "I did them all. Weight Watchers, Motivation, Lipotrim and many more. They all worked while I was on them but I put weight straight back on as soon as they finished. "What I liked about the Food for Thought programme was that there were no gimmicks or products being promoted, it was pure common sense and the plan was all about foods I love so I didn't feel deprived." Niamh found the nutritional aspect of the programme particularly enlightening, giving her a much better understanding of how certain foods make the body work better and how others do the opposite. She lost a stone within the first month without feeling that she had made a drastic change to her eating habits.

She has far more energy and strength now and has gone from doing virtually no exercise to joining a running club. "I was forced to challenge myself to think about why I wanted certain foods, which was something I had never done before. I realised that I was eating the wrong foods not because I liked them, but as my way of dealing with whatever emotions were overwhelming me at the time from something as simple as boredom to feelings of inadequacy."

Niamh says she felt grateful her issues around food were recognised as an addiction for the first time and not just down to a lack of willpower. "This is the first time that I think I could happily eat like this for the rest of my life. Not that I'm perfect; I do slip off the wagon, but it's much easier to get back on again.