Is sugar “physically” addictive? Let’s assess the BS

Isabel Foxen DukeQ: “Dear Isabel—where do you stand on the concept of physical addiction to white sugar? I’ve seen pictures of how sugar lights up [pleasure centers] in the brain in the same way as cocaine…do you agree that sugar can be physically addictive, and not just emotional? Do you agree that for some of us, sugar can be as bad as heroin?

Here’s my response:

You are absolutely right that sugar, sex, music, and basically anything that’s “pleasurable” lights up pleasure centers in the brain, or more specifically, may trigger a dopamine response, which is one chemical response triggered by using cocaine.

Additionally, different people may have different chemical responses to different stimuli (e.g. sugar may trigger a more intense dopamine reaction in some, while others may have a more mild response).

That being said,

the clinical definition of “physical addiction” (which is different than “emotional  addiction,” or simply the feeling of compulsion towards a behavior) is not defined by physical pleasure or the intensity of a dopamine response. 

A related, but separate topic altogether, “physical addiction” is defined by physical dependence on a substance—that is, increased physical tolerance for a chemical substance accompanied by the experience of physical withdrawal symptoms when someone stops using.

If you know any heroin addicts they will tell you it is very *physically* painful to come off…and withdrawal from alcohol can physically kill you.

This is not the case with sugar. While some people report feeling temporarily lethargic or lackluster when they initially give up white sugar, physical withdrawal symptoms are mild to non-existent, and most people report feeling physically better when they eat less refined sugar, rather than the reverse.

Additionally, white sugar breaks down into the same chemical—glucose—as every other carbohydrate you ingest. While I guess you could say we’re all physically addicted to glucose (because we’d starve to death without it), it’s important to recognize that the primary difference between white sugar and other forms of carbohydrates is its refinement (i.e. the stripping away of fiber from the plant foods where sugar is found). While heavy refinement of sugar impacts the speed with which it turns into glucose in our bodies (which can temporarily screw with your hunger signals, and may cause health problems over time), glucose is not a foreign chemical that your body develops “tolerance” to, the way your body develops tolerance to certain psychoactive chemicals, like opiates or nicotine.  

Somewhere in the health and wellness blogosphere the medical community’s very specific definition of “physical addiction” was usurped and distorted by diet and health media professionals, and the results have created a lot of confusion for people struggling with binge-eating.

When researchers discovered that sugar triggers a dopamine response similar to that produced by cocaine (as well as a bunch of other stuff that makes you feel good, but whatever),

health media, and other arms of the diet-industry, interpreted this to mean that sugar must therefore be “physically addictive” (and that “quitting sugar” must be the answer to compulsive eating) despite the fact that this research has nothing to do with gauging physical withdrawal or dependency (aka the actual criteria of “physical addiction”).  

Now, before I discuss why this huge leap in reasoning has caused so many problems for binge-eaters, it’s important I address the deeper question underlying your concern—

Why do some people binge on sugar after a single bite, while others can easily moderate without much thought or effort? What causes the intense feeling of being “addicted to sugar” in some, but not others?

This is the real question on the table, and the “pleasure-centers” theory just doesn’t cut it as an answer.

When we dig deeper into the research, and look at those people who feel “out of control” around sugar, and compare them with those who moderate easily without much effort, there is one consistent common variable we see in the “out of control” group:

those who report feeling “addicted” to sugar, almost always have a history of feeling restricted or limited around food (and usually sugar in particular).

The more intensely someone restricts their intake of food (or certain foods), the more likely they are to binge-eat food in the long run. Similarly, “emotional eating”—that is, the tendency to turn towards food in moments of emotional duress—is directly correlated with restriction. You can read about this phenomenon (and a slew of related research) in this book.  

Given this information, you may see why traditional treatment models for “physical addiction” (which generally involve attempts at abstinence, regulation or control), might actually be harmful for those who struggle with binge-eating—and may, in fact, exacerbate binge-eating long-term.

Luckily, the “abstinence” model of treatment is not the only one being suggested in the treatment of binge-eating. More and more therapists and nutritionists are transitioning to an “intuitive eating” or non-restrictive model of treatment for binge-eating, recognizing the growing bounty of research linking binge-eating with previous restriction.

While research is pretty clear that the more someone restricts their food, the more likely they are to binge-eat in the long-run; similar research suggests that the cessation of dieting and restriction lessens binge-eating dramatically in the long-term as well.

I personally identified as a “sugar addict” for a large portion of my life—I felt completely “out of control” around sugar, and I would fall into wild binge-eating episodes whenever I would “let myself” have it.

For years it never occurred to me that my initial restriction of sugar might actually be causing these episodes, because I assumed (like most people assume) that humans are capable of long-term restrictionand that my inability to resist sugar at all times was a result of my own personal failing.

I eventually discovered the non-diet approach, and realized that no amount of therapy or efforts at self-improvement could possibly make restriction “work” —restriction was the root of the problem, and slowly but surely, as I let go of dieting (both physically and emotionally), the intense psychological pull food had over me—including my highly compulsive relationship with sugar—started to fall away.

If this approach is new to you, I highly recommend picking up a copy of Intuitive Eating, as well as checking out this video training series. It’s the best intro to some of the most important ideas I’ve learned on my journey towards healing with food and body. Here’s the link once more.