Alisa Turner - Integrative Health Coaching

Food, Sex, Alcohol/Drugs, and the binging proclivity.  

If you have struggled with substance abuse, and also find yourself struggling to consistently make healthy choices with food, it’s not a surprise, you’re not alone, and it’s not your fault— 

  1. Neurobiology:

Food addiction and substance abuse share overlapping and inter-related layers at neurobiological and metabolic levels, and one compulsive behavior can make you vulnerable to the other (1,6). 

The consumption of either elicits similar adaptations in brain reward and withdrawal circuitry making them impactful on (while at the same time being regulated by) the same metabolic hormones and metabolic statuses such that intake or withdrawal from one can impact behavioral sensitivity to the other.  (1).  

I’ll expand on this and give you a simple first step to circumvent the neurocircuitry trap, but first let’s cover why the food issues aren’t your fault.  

  •   EVOLUTION:  

The desire for calorie-dense food was intentionally hard-wired in us because it was the best chance for species survival when food scarcity was common (2).  In order for something to act as a reward or positive reinforcement, there must be a positive value attached to it (pleasure).  (3).  

Food, sex, and alcohol/drugs, all work with the brain to release neurotransmitters like dopamine, GABA, and opioid peptides (4,5), the release of which feels good (reward ) to help ensure we desire more which was necessary for species survival  (at least for food and sex) (6).  But we are no longer faced with food scarcity, and this process is definitely no longer serving us.  

Ultra-processed, highly palatable foods are precisely engineered with optimal taste and presentation (added sugar, fat, flavor enhancers and salt) to achieve this reward/desire for more, and they are more abundant and representing a larger percentage of overall calories than ever (7).  These foods are extremely calorie-dense compared to whole foods, meaning they have many more calories per gram, and significantly less nutrients (8).  So, they don’t fill you up.  Of course they are delicious — they’re engineered to be that way!  BUT (contrary to what Snicker’s wants you to believe) they actually DECREASE feelings of satiety (2) and perpetuate a desire for more (cravings) (9).  And “more” is a big problem because the increase in their consumption is a leading direct contributor to the obesity epidemic and a litany of chronic health problems. (11-14,16)  

  • EARLY ENVIRONMENT:  

How long were you exposed to these ultra-processed foods?  This can make a big difference!  Early and long-term exposure alters our perceived value of those foods and weakens our control over their consumption on a neurochemical level (2).   Over time, we begin to experience reward-driven learning around food and other substances — we associate certain food cues (seeing or smelling, packaging, marketing, or any cues or situations associated with food-related memories) with their subsequent “reward” which motivates us to acquire more and starts predicting eating behavior (2). 

This once-adaptive (even necessary) survival mechanism has now become maladaptive.  The increased exposure, availability and intake of these energy-dense foods are not only adding more energy (calories), but also “altering functions of brain systems involved in nutrient sensing as well as in hedonic, motivational and cognitive processing” (10).  And guess what…those same systems are altered with substance abuse. (1, 4, 5, 6, 15)

I’ve journeyed through a lot of disordered eating.  I’ve also journeyed through addiction.  I would never suggest they were the same experience or same intensity, but there are inarguably a lot of similarities in both cycles of cue/crave/binge.  

  • HORMONES

Beyond the abundance of food and alcohol cues, in both binge eating and substance abuse disorder, the dysregulation of appetite, metabolic, and stress hormones like ghrelin and leptin, insulin, cortisol, etc. is common   (1, 4, 6, 10, 17,18).  This is part of the neurobiology issue I touched on in the beginning.  

I’ll dive deeper into these in a later blog post because I could write pages on each of them, but very simply put – the disruption of appetite hormones is an especially key contributing factor to cravings in people with substance abuse disorder because their signals interface with dopaminergic regions of the brain to modulate your reaction to those cues ( if/how much to eat, drink, or use), so their imbalance can cause worsened cravings and an overconsumption of food, drugs, and alcohol (1, 4, 6, 10, 17, 18) — not to mention the impactful association between these hormones and other common substance abuse comorbidities like depression and anxiety.   

And what can happen when one of these things that interfaces with “feel-good” dopamine is removed if we aren’t mindful?  We risk filling it with something that feels equally good, but which could possibly be equally unhealthy.  A palpable, complicated, often messy, and dysfunctional relationship with food and substances has slowly developed over time; these things served a purpose physically, emotionally, and spiritually or they wouldn’t have had such a hold on us.  So, we need to address all 3 angles.  

It is only natural that we might unconsciously seek out something else to replace the dopamine response we received from something else when it’s gone; that is driven at a biochemical cellular level and reinforced at an emotional level.  But that doesn’t mean nothing can be done to change it.  

But Here’s the Best News:  You don’t have to stay in this cycle.  Having gone through this myself, I understand this is a challenging process so please don’t misunderstand this suggestion for a “simple” first step as being even in the vicinity of easy.  These highly palatable food consumption habits are deeply entrenched, long-standing, and reinforced by neurobiology and extremely powerful emotions.  Changing them takes dogged commitment, a lot of grace with yourself, and possibly outside guidance and accountability.  It’s simple, but it is far from easy. 

But you have to start somewhere, and depending where you are in your journey, one of the first steps to cultivating SUSTAINABLE habit change with ultra-processed foods is often to focus less on “CUTTING OUT” and more on “ADDING IN”.  As opposed to calorie-dense ultra-processed food, whole foods are nutrient-dense, and they take up a lot more volume per calorie (8,9).  So, the more you eat, the less physical space you have for the “other stuff”  

Additionally — we crave what we eat, and you can change what you crave by eating more of what you WANT to crave.  You may not recognize it at first, and it may not happen as quickly as it did with sugar or added fat/flavor enhancers (remember, they were engineered to keep you coming back for more); but when you flood your body with nutrients consistently, over time it begins to crave more nutrient-dense food.  The more of those you put in your body, the more your body will respond with better energy, digestion, sleep, mood, etc., and the more positive associations you will build with those foods (albeit maybe not the same as a Snickers) which will reinforce the healthy habits.  

AND…as you eat more cleanly and get healthier, your body will naturally start to resist when you put less healthy foods in.  You have to be paying a little bit of attention because it’s a new language, but your body will send you signals.  You won’t feel as well, which further reinforces your decision to put less of those things into your body.  This a very organic process if you just start adding in more good.  Don’t feel pressure to cut the bad, because in my experience, that’s when things stop being sustainable. 

So, it’s not a surprise, you’re not alone, and it’s not your faut.  Now what do you want to do about it?

Converging vulnerability factors for compulsive food and drug use https://pubmed.ncbi.nlm.nih.gov/33862029/

Integration of reward signaling and appetite regulating peptide systems in the control of food‐cue responses https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5341214/

Motivation concepts in behavioral neuroscience https://pubmed.ncbi.nlm.nih.gov/15159167/

How can drug addiction help us understand obesity? https://pubmed.ncbi.nlm.nih.gov/15856062/ 

What is the role of dopamine in reward: hedonic impact, reward learning, or incentive salience? https://sites.lsa.umich.edu/berridge-lab/wp-content/uploads/sites/743/2019/10/BerridgeRobinsonBrResRev1998.pdf

Integration of reward signaling and appetite regulating peptide systems in the control of food‐cue responses https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5341214/

Environmental contributions to the obesity epidemic https://pubmed.ncbi.nlm.nih.gov/9603719/

Processed and ultra-processed foods: coming to a health problem? https://www.tandfonline.com/doi/abs/10.1080/09637486.2020.1807476?journalCode=iijf20

Minimally processed foods are more satiating and less hyperglycemic than ultra-processed foods: a preliminary study with 98 ready-to-eat foods https://pubmed.ncbi.nlm.nih.gov/27125637/

The neurobiology of food intake in an obesogenic environment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617987/

Food cue reactivity and craving predict eating and weight gain: a meta-analytic review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042864/

Dietary energy density and weight regulation https://pubmed.ncbi.nlm.nih.gov/11518179/

The epidemiology of obesity https://pubmed.ncbi.nlm.nih.gov/17498505/

Ultra-processed food consumption and indicators of obesity in the United Kingdom population (2008-2016) https://pubmed.ncbi.nlm.nih.gov/32357191/

Role of addiction and stress neurobiology on food intake and obesity https://www.sciencedirect.com/science/article/abs/pii/S030105111730087X?casa_token=9h9pShPa2wEAAAAA:C4ZDeG1IG2yRZoSbddEFcd6JpSFicOdOz96jXQvBXHat5QZ6vSKljGfc8iiaRzPTLRXlQyohSg

Food Cues and Obesity: Overpowering Hormones and Energy Balance Regulation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5959777/

Neurobiology of craving, conditioned reward, and relapse https://pubmed.ncbi.nlm.nih.gov/15661620/

The Neural Basis of Drug Stimulus Processing and Craving: An Activation Likelihood Estimation Meta-Analysis  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827617/

Stress as a common risk factor for obesity and addiction
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658316/