31 May 2018 --- Obesity is serious, common and costly. More than one-third of US adults are obese and some of the lead causes of preventable deaths – such as stroke, diabetes and cancers – are obesity-related, as reported by the US Centers for Disease Control and Prevention. NutritionInsight speaks with Joan Ifland Ph.D., Doctor of Addictive Nutrition, about processed food addiction and, most importantly, how she thinks tackling it requires more than just cutting out certain foods. Community, understanding and inclusion are essential.
Joan Ifland is an innovator in the field of recovery from food addiction and author of the textbook: Processed Food Addiction: Foundations, Assessment and Recovery.
Processed food addiction is a hotly debated topic in scientific circles but it is arguably gaining traction as the addictive properties of processed foods and the behaviors that surround them become harder to ignore. One strong example would be the considerable prevalence of global obesity.
The Yale Food Addiction Scale (YFAS) is one example of a reputable source that has been cited in hundreds of studies and instated the use of terminologies of addiction around food. It has also furthered understandings over excessive or disordered eating in scientific and mainstream circles.
Processed food is the transformation of raw ingredients by physical or chemical means into food. Common examples include cereals, breads, meat products such as ham, cakes and many “convenience” foods such as ready meals. The premise of processed food addiction is that these foods - that can be high in salt, fat, sodium and sugar - can affect the brain in ways comparable to most addictive substances. In this way, they stimulate the overproduction of craving neurotransmitters in the brain, including dopamine, serotonin, opiate and endocannabinoid.
NutritionInsight: What is processed food addiction, and how does it manifest?
Ifland: “Food addiction is like any other addiction: there are changes in the brain that see the craving part over-stimulated and the rational side shutting down. For example, someone who is overweight may see a sugary snack and rationally understand that they should not take it, but the craving side is activated by the sugary snack, leading them to take it anyway.”
“Also like any other addiction, processed food addiction is conditioned. The behavior works from cues, for example, one time you may have eaten a gooey cake on a particular park bench, and walking past it at a later date may alight your cue for some processed foods. Call it a cue, reminder or an association – it is there.”
“The way the American Psychiatric Association defines addiction – through their 11 criteria – are all present when it comes to processed food addiction. The 11 criteria include cravings, activities being given up due to use, hazardous use and social or interpersonal problems related to use.”
“I have been working in the field for 22 years now. Before, doctors might laugh in my face when I spoke about processed food addiction. Now, I see them lean in and ask questions. Also, now with a very heavily documented and cited processed food addiction book, it is being taken more seriously. Once you know it is an addiction, you know what to do.”
NutritionInsight: How prevalent is the condition? How often do you see aspects of the 11 criteria (as defined by the American Psychiatric Association) expressed?
Ifland: “I would say that any country that has an obesity problem has a processed food addiction problem. For the masses, the addiction is present in cravings. For example, when I ran a health-food catering business, I worked with top Houston lawyers who were suffering from processed food withdrawal symptoms – it is across all levels of society. However, I would say it’s most prevalent among those with lower incomes and lower educations.”
“Across society, the severity ranges. It can be cravings, or it can lead to skipping family gatherings because you are frightened of losing control around the food, or about comments over your weight. Similarly, it could affect relationships in your life, such as someone trying to get you to stop, or not being able to sit on the floor with your kids because you are too large or too sick with diabetes to go to work. Or, it may result in reckless behavior such as being told you have a heart problem but you are still going against your recommended meal plan with junk-food.”
NutritionInsight: How do you suggest moving forward to tackle societal obesity?
Ifland: “This is a disease of the environment. If you fill the environment with enough addictive substances, people will become addicted. You don’t need to physically eat foods to be triggered: cues can be environmental, e.g., the park bench I mentioned earlier.”
“If you eat clean in the US, you are on the outside. Everywhere you go there is fast food, convenience stores open 24/7. Our culture is processed and many people are addicted. So, if you want to eat clean you can feel outside the ‘normal’ tribe: this is a scary place for people.”
“In this way, sufferers need an environment with other people who understand. A strong pathway in the brain is our ‘mimic or mirror’ pathway; we will copy what others do. So, we bring like-minded people together via an online channel. This gives people a ‘tribe’ where they feel on the inside.”
“We have an online community, foodaddictionreset.com, where our business model trains food addiction coaches. These coaches then gather up about 100 food-addicted clients and coach them through recovery. We also have webinars and connect with each other each day.”
“In these interactions, we address the stress that has been experienced. Stress activates the condition. Once they come to the program, they are often traumatized. Doctors and the media have often told them that they could easily lose weight by following certain diets, for example. We get them into the positive environment, which serves as a recovery community.”
NutritionInsight: Clearly, community is a critical factor in recovery. What about the food side of things?
Ifland: “The actual food is only about 20 percent of our program. Largely, we work on restoring a stable, calm and clear brain. In fact, getting over processed foClick to Enlargeod withdrawal symptoms (such as brain fog, upset stomach and fatigue) may only take four days and diabetes and high blood pressure can even go into remission. These things can happen very quickly once the processed food is cut out.”
“But, the process of reforming an environment and network of helpful people takes longer. But it is these areas that may determine the success of the recovering individual.”
NutritionInsight: What steps can be taken by society?
Ifland: “Processed foods are the worst health crisis in the world. Some global companies are marketing their sugary drinks to slums in developing countries and giving them out for free. It’s relentless. We are working on a business model for society to be food addiction conscious.”
“Healthy lives are experiencing a surge, partly in reaction to what I am speaking about. People are starting to understand the problem of processed foods. But I see still companies trying to maintain the illusion that the problem does not lie in the processed food. The finger is always being pointed somewhere else.”
“Recently some very important moves were made. San Francisco has passed a sugar tax on sodas, and so did the UK. People are fighting back. We need to see more of this.”
In a bid to curb obesity levels globally, Ifland is advocating the strength of community, inclusion and understanding. She also is encouraging global companies who should hold a stake in the health of their customers to respond with real-life moves. As obesity continues to grow, a multi-pronged approach is most likely required.
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