An Incurable Addiction: Food - blog post by Weight Management Expert Dr. Deena Solomon

The Incurable Addiction: Food

The search box in Wikipedia brought up this article after the word addiction was typed in. Replace the word Food instead of Opioid and/or drug in the following discussion.

Opioid dependence

From Wikipedia.

Opioid dependency is a medical diagnosis characterized by an individual’s inability to stop using opioids (morphine, heroin, codeine, hydrocodone, etc.) even when objectively it in his or her best interest to do so. In 1964 the WHO Expert Committee on “dependence” it was described as “A cluster of physiological, behavioral and cognitive phenomena of variable intensity, in which the use of a psychoactive drug (or drugs) takes on a high priority.

The necessary descriptive characteristics are preoccupation with a desire to obtain and take the drug and drug dependence may be biological, psychological, or social, and usually interact”. The core concept of the WHO definition of “drug dependence” requires the presence of a strong desire of a sense of compulsion to take the drug; and the WHO and DSM- IV-TR clinical guidelines for a definite diagnosis of “dependence” require that three or more of the following six characteristic features be experienced or exhibited:

  1.  a strong desire of sense of compulsion to take the drug;
  2.  difficulties in controlling drug-taking behaviour in terms of its onset, termination, or levels of use;
  3.  a physiological withdrawal state when drug use is stopped or reduced, as evidences by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms;
  4. evidence of tolerance, such that increased doses of the drug are required in order to achieve effects originally produced by lower doses;
  5.  progressive neglect of alternative pleasures or interests because of drug use, increased amount of time necessary to obtain or take the drug or to recover from its effects;
  6.  persisting with drug use despite clear evidence of overtly harmful consequences, such as harm to the liver, depressive mood states or impairment of cognitive functioning.

The article goes on to describe:

Symptoms of withdrawal

  •  Dysphoria
  •  Malaise
  •  Cravings
  •  Anxiety/Panic Attacks
  •  Paranoia
  •  Insomnia
  •  Dizziness
  •  Nausea
  •  Depression

Treatment

Opioid dependence is a complex health condition that often requires long-term treatment and care. The treatment of opioid dependence is important to reduce its health and social consequences and to improve the well-being and social functioning of people affected. The main objectives of treating and rehabilitation persons with opioid dependence are to reduce dependence on illicit drugs; to reduce the morbidity and mortality caused by the use of illicit opioids, or associated with their use, such as infectious diseases; to improve physical and psychological health; to reduce criminal behavior; to facilitate reintegration into the workforce and education system and to improve social functioning. The ultimate achievement of a drug free state is the ideal and ultimate objective but this unfortunately not feasible for all individuals with opioid dependence, especially in the short-term.

As no single treatment is effective for all individuals with opioid dependence diverse treatment options are needed, including psychosocial approaches and pharmacological treatment.(1)

Relapse following detoxification alone is extremely common, and therefore detoxification rarely constitutes an adequate treatment of substance dependence on its own. However, it is a first step for many forms of longer-term abstinence-based treatment. Both detoxification with subsequent abstinence-oriented treatment and substitution maintenance treatment are essential components of an effective treatment system for people with opioid dependence. (2)

The previous article was taken from Wikipedia’s page on “Opioid Dependence” (redirected from its page on “Opioid Addiction”).

Going back to the WHO and DSM-IV-TR clinical guidelines for a definite diagnosis of “dependence” require that three or more of the six characteristics must be experienced or exhibited as a determinant for a diagnosis of “dependence.” The reader must consider factors when putting food into this category of.

First, food has as all the six characteristic features when defining “drug dependence.” Secondly, there must be a seventh characteristic added if food/eating is put into this diagnosis, and that is:

  1. 7.  If you give up this drug of choice, you’ll die.

Opioids can be given up completely. The previous article stated that both detoxification with subsequent abstinence-oriented treatment and substitution maintenance treatment are essential components of an effective treatment system for people with opioid dependence. The research attests to the fact that the probability for curing drug addictions is increased contingent upon the individual completely giving up the drug completely. Granted, the success rate is low, but, it is possible to “cure” opioid addictions.

It is unlikely, if not impossible, to “cure” the behaviors that contribute to obesity/overweight. Discover magazine, June,2011 had an article by Dan Hurley called; “The Hungry Brain”. In this article scientists consider obesity to be incurable. Kelly Brownell points out that if a strict definition of “cure” obesity is adopted (such as a reduction to an ideal weight and maintenance at that point for at least 5 years), an individual is more likely to recover from most forms of cancer than to satisfy that criterion.(3)

Every weight control system, up-to-date, puts the management of obesity/overweight within the protocol of the medical model, that is:

Obesity/overweight is a disease that has to be cured. The medical model puts food/eating in the same category for all other addictions and the treatment modality of obesity/overweight is based on the theory of Relapse Prevention. Relapse is the process of falling back to unhealthy habits or attitudes following a period of abstinence.(4)

The lack of longitudinal outcome data for losing weight and keeping it off leaves the consumer no options but to continually seek out methods that have been defined by the medical community as an “incurable disease.” It is this authors opinion that as long as the protocol for opioid addiction is used when dealing with obesity/weight loss, the medical model will continue to control how this national crisis is dealt with. William Weiss, a management professor as Seattle University states: “Obesity industries, including commercial weight-loss programs, weight-loss drug purveyors, and bariatric surgery centers will likely top $315 billion dollars this year alone-nearly 3% of the overall U.S. economy. the industry will continue to be the $315 billion dollar a year business, am industry with over a “95% failure rate.” (5)

It is time to take the field of obesity/overweight out from underneath the relapse prevention modality. Relapse prevention as the accepted protocol for weight loss must be re-directed towards a classification of behaviors that enables the consumer to take a manageable, and realistic approaches to weight loss. That is, when an individual deviates away from behaviors that are consistent with goal achievement, and deviations will occur, the preferred treatment must start, and end with strategies that enable one to recover from regressions. This approach to weight management must be the primary focus of future research towards permanent habit formations surrounding food choices. Learning how to recover from “counter-productive” behaviors will make it more likely that individuals will be better able to take responsibility for their relationship with food. Unlike heroin, weight loss, and its management is not something that can ever be cured. What must happen if this field, is giving consumers options. Options that will come about if the individual is able to research behavioral strategies that are necessary for unique needs to be met. The ultimate goal: the eternal management of food choices required for permanent habit formations.

  1. Substitution maintenance therapy in the management of opioid dependence and HIV/AIDS prevention. World Health Organization. 2004. ISBN 92-4-15911503
  2. Chen, Kevin W.; Banducci, Annie N.; Guller, Leila; MacAtee, Richard J.; Lavelle, Anna; Daughters, Stacey B.; Lejuez, C.W. (2011). “An examination of psychiatric co-morbidities as a function of gender and substance type within an impatient substance use treatment program”. Drug and Alcohol Dependence 118 (2-3):92-9.
  3. Dennis C. Daley, 1989. Relapse Prevention: Treatment Alternatives and counseling Aids
  4. Brownell, K.D. (1983). Obesity: understanding and treating a serious prevalent and refractory disorder. Journal of Consulting and Clinical Psychology,50, 820-840
  5.  Stunkard, A.J., and McLaren-Hume, J: The results of treatment for obesity. Arch. Inter. Med., 103: 79-85, 1959.
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