Food is essential for life, so how can you have food addiction?. NZ Food Addiction Symposium Christchurch, 6 September 2013 Prof Doug Sellman National Addiction Centre University of Otago, Christchurch. Acknowledgements. Ria Schroder Daryle Deering Jane Elmslie Frances Carter Jim Mann
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
NZ Food Addiction Symposium
Christchurch, 6 September 2013
Prof Doug Sellman
National Addiction Centre
University of Otago, Christchurch
25 fellow travellers
Journey out of skepticism addiction?
Colleen Barry (2012)
From the front lines addiction?
Philip Werdell (2012)
21 addiction services
20 eating disorder services
– a sister of a person who has a weight problem
Whangarei to Dunedin, Greymouth to Gisborne
Hullo, my name is Natalie Smith and I'm addiction?
ringing up on behalf of my sister Shiree.
The problem is that Shiree is about 110kg in weight
…and seems to have an addiction to food. She doesn't have any other addictions as far as I know
…and seems to have an eating disorder. She doesn't binge or purge as far as I know and has never been anorexic.
She just compulsively eats food.
I really want to find out what help your service can give her or where to go for help.
- 2 said yes, come for an assessment (12%)
- 6 declared it was an eating disorder (35%)
- 7 advised Overeaters Anonymous (41%)
- 10 advised GP consultation (59%)
- “We don’t deal with eating disorders, first place to go is to your GP who will refer you on to an appropriate service like a dietitian and an exercise regime”
- “It’s really an eating disorder so you’ll need to go to your GP and get a list of people who deal with eating disorders or get a referral for counselling”
- “Food addiction is similar to other addictions so it would be appropriate to come in for an assessment” (large city)
- “Not a normal focus for us but as it is an addiction there is no reason we couldn’t work with her” (small city)
- 1 said yes, come for an assessment (6%)
- 0 declared it was a food addiction (0%)
- 4 advised Overeaters Anonymous (24%)
- 12 advised GP consultation (71%)
- “We’re happy to help with overeating as well as undereating, just come in for an assessment” (small city)
- “You will be horrified to hear this, but as an eating disorder service we only treat people with undereating problems”
< 18.5 underweight
18.5 – 24 normal weight
25 – 29 overweight
30 – 34 obese
35 – 39 clinically obese
> 40 morbidly obese
Percentage of overweight people addiction?
in the Anglosphere
United States 74%
New Zealand 68%
United Kingdom 63%
2008/09 Adult Nutrition Survey
“In the event of a chocolate craving, please take care of your craving first before helping others with theirs.
Remove bar. Bite to release bubbles. Enjoy normally.
Be prepared! Ensure Aero Singles are stowed in close proximity”
Food Addiction: A Personal Story addiction?
Anne Rosenberg (2012)
Am I really and truly a “food addict?”
I am not a scientist and I am not too concerned with the exact label.
But I do know I could not eat just one of those Nestle Aero Singles. And I am not alone. Nestle is banking on that!
What is addiction? addiction?
Theodosius Dobzhansky, 1973 addiction? (1900 - 1975)
“Nothing in biologymakes sense,
Except in the light of evolution”
Charles Darwin addiction?1809 -1882
“I have called this principle, by whicheach slight variation, if useful, is preserved, by the term Natural Selection.”
(from ‘The Origin of Species’)
Approximate Time Estimates addiction?
ERA PERIOD EPOCH addiction?
Cenozoic Quaternary Holocene
(65 million - present) (10,000 - present)
(1.8 million – 10,000)
(248 - 65 million) Jurassic
(544 - 248 million) Carboniferous
A chronic relapsing disorder characterised by:
Compulsion to seek and take the drug
Loss of control in limiting intake
Emergence of a negative emotional state (dysphoria, anxiety, irritability)
NEURAL CIRCUITRY OF ADDICTION addiction?
In non-hungry, non-thirsty rats, sweetened water is more rewarding than intravenous cocaine, independent of prior cocaine history
Most heroin dependent rats eventually cut down heroin use to drink more sweet water
Ghrelin reward pathway
Neuropeptide Y (NPY)
Mouse (on the left) unable to produce leptin becomes obese
Peptide YY (PYY)
(Volkow & O’Brien, AJP 2007)
Alcohol addiction society and the urgent need to develop better therapeutic interventions that help mitigate the
Diagnosis of food addiction society and the urgent need to develop better therapeutic interventions that help mitigate the based on
DSM-IV SUBSTANCE DEPENDENCE
1. Consumption is often more than intended (quantity or time)
2. Unsuccessful attempts to cut down or control consumption
3. Much time is spent in consumption (time +++)
4. Important activities given up or reduced
5. Continued consumption despite knowledge of associated medical or psychological problems
6. Tolerance (acquired)
Use often more than intended 22%
Failed attempts to reduce or stop use 71%
Giving up other important activities 10%
Continued use despite 28%
54% met YFAS criteria for food addiction
Behind every addiction is an engineered moreish product according to the Yale Food Addiction Scale (YFAS)?
Dr Jane Elmslie
Dietitian - NAC
George Eman Vaillant, 1988 (NEEDNT) foods
(1934 - present)
“What is needed is that addicts alter
their whole pattern of living”
“Food can act on the brain as an addictive substance. Certain constituents of food, sugar in particular, may hijack the brain and override will, judgement and personal responsibility, and in so doing create a public health menace.
The foods most likely to trigger an addictive process appear to be those marketed most aggressively by industry, which manipulates its products to maximize palatability”
Kelly Brownell & Mark Gold (2012)
“Food is the most available and inexpensive drug around” Certain constituents of food, sugar in particular, may hijack the brain and override will, judgement and personal responsibility, and in so doing create a public health menace.
Elissa Epel, Janet Tomiyama, Mary DallmanStress and Reward – Neural Networks, Eating and Obesity (2012)