Tuesday, April 28, 2015

Can Sugar be Addicting?

by Michael Kuhar, PhD

Editor’s Note:
Dr. Kuhar is a Candler Professor at the Yerkes National Primate Research Center and Senior Faculty Fellow in the Center for Ethics at Emory University.  An expert in addiction, he is one of the most productive and highly cited scientists worldwide.  He has received a number of prestigious awards for his work, and is involved in many aspects of brain/behavioral research and education.

You might be interested in his book: The Addicted Brain

Recently, Constance Harrell facilitated an Emory Neuroethics Program Neuroscience and Neuroethics in the News Seminar on sugar and depression. Obesity became a topic and, not surprisingly, out of this discussion arose the question, “Can sugar be addicting?”  This is closely related to the question, “Can food be addicting?”

Somebody might say, we need sugar/food to be healthy, and we can’t do without them, so how can we say they are addicting?  Well, there is an answer to this.  Addiction, by definition, is seeking and taking a substance even though there are negative consequences.  Negative consequences are key. So if we take a substance but there are no negative consequences, addiction wouldn’t be in the discussion.  The question of danger for addiction and abuse might be, but definite addiction probably wouldn’t be (Kuhar 2012).

Consider taking opiates for pain.  Chronic pain patients repeatedly take morphine or similar medicines for a long time.  These patients are “dependent” because if they stop the drug, they go into painful withdrawal. But they are not “addicted” because they don’t compulsively seek out the drug and experience negative consequences.  This would be different from the addict who searches for heroin and in doing so breaks the law, ignores relationships, health, and work, etc.  So you can “need” something but yet not exhibit the key identifier of addiction, which is seeking and taking even though they are destructive.  We can need food, but yet not experience it as destructive, provided it is taken in moderate quantities and provides necessary nutrients. But perhaps some do experience the negative. As with drugs, there are interpersonal variations in how we experience sugar.  An extreme case would be a person with diabetes where taking sugar is more dangerous.

Also, the effects of drugs (and presumably sugary foods) will depend on the dose or amount taken.  High doses of drugs can have effects that low doses do not.  So having high doses of sugary foods can have effects in the body that low doses do not really produce. So sugar is not always sugar.  The dose or quantity that you consume, and how often you consume it, can have unique effects that you won’t necessarily experience at lower doses and frequencies. Such dose-response relationships are well known and well-studied in pharmacology and research (Kuhar 2012).

Drug abuse studies show that most people can walk away from drugs like heroin, but some don’t (maybe 1-13 % by some estimates depending on the substance) and become or are addicts. Translating that to sugar, only a small percentage of sugar “users” would be “addicted.”

What is the official position on sugar and food as addicting?  At this point in time, many feel that there are not enough peer reviewed studies that show food is addicting (DSM-5, 2013).  The studies just haven’t been done yet.  Some suspect that once the research has been conducted, sugar and food will fit the criteria for being addicting in some people.  We will see.

There is some evidence that is compatible with sugar being addicting (Schreiber et al 2013; Hone-Blanchet and Fectaeu, 2014; Ahmed et al 2013;Kenny et al 2013; Hadad and Knackstedt 2014; Tau and Potenza 2013). Some people eat sugary foods in ways and quantities that are not healthy, and therefore they have negative consequences.  Obesity is on everyone’s mind. Eating sugary foods regularly can also result in craving and a loss of control, hallmarks of addictive behavior.  Sugar can make you feel good, just like addicting drugs can. Sugar can be taken in binges, just like drugs. Stress can precipitate both drug taking and eating. Some research even suggests that sugar can be more rewarding than cocaine (Lenoir et al 2007). Brain scans of dopamine receptors in obese subjects are similar to those from drug addicts (Kenny et al 2013). And more can be said. At this point in time, many feel that sugary foods can be addicting in some, and that this eventually will be proven in rigorous ways.

What makes a sugar/food addict?  Well, again extrapolating from findings in drug abuse and addiction, there could be several factors that increase our vulnerability for addiction.  We don’t know enough to say for sure when and how a specific person will be an addict.  We can only consider large populations of addicts and look at how they are and how they behave.  The main vulnerability conferring factors include genetics, environmental factors including personal support, conditioning, and stress.  Also, there are protective factors such as a very supportive environment (Kuhar 2012).

What do we do if we are in trouble?  Get counseling.  Pay attention to risk factors and work to counteract them. In drug addiction, the more time spent in rehab gives a better outcome by staying away from drugs.  It takes work and a significant time commitment, and many people have been and will continue to be helped.

Selected Readings

Ahmed SH, Guillem K, Vandaele Y. Sugar addiction: pushing the drug-sugar analogy to the limit. Curr Opin Clin Nutr Metab Care. 2013 Jul;16(4):434-9. doi: 10.1097/MCO.0b013e328361c8b8.

DSM-5. American Psychiatric Association.  2013. P 481. “ …groups of repetitive behaviors, which some term behavioral addictions, with such subcategories  as sex addiction (and presumably food addiction)… are not included because at this time there is insufficient peer reviewed evidence…to identify these behaviors as mental disorders.”

Hadad NA, Knackstedt LA. Addicted to palatable foods: comparing the neurobiology of Bulimia Nervosa to that of drug addiction. Psychopharmacology (Berl). 2014 May;231(9):1897-912. doi:10.1007/s00213-014-3461-1.

Hone-Blanchet A, Fecteau S. Overlap of food addiction and substance use disorders definitions: analysis of animal and human studies. Neuropharmacology. 2014 Oct;85:81-90. doi:10.1016/j.neuropharm.2014.05.019. Epub 2014 May 24.

Kenny PJ, Voren G, Johnson PM. Dopamine D2 receptors and striatopallidal transmission in addiction and obesity. Curr Opin Neurobiol. 2013 Aug;23(4):535-8.

Kuhar, MJ.  The Addicted Brain.  FT press. Upper Saddle River, NJ. 2012.

Lenoir M, Serre F, Lauriane L, and Ahmed SH. Intense Sweetness Surpasses Cocaine Reward. PLoS ONE. 2007; 2(8): e698. Published online 2007 Aug 1. doi:10.1371/journal.pone.0000698.

Yau YH, Potenza MN. Stress and eating behaviors. Minerva Endocrinol. 2013 Sep;38(3):255-67.

Want to cite this post?

Kuhar, M. (2015). Can Sugar be Addicting? The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2015/04/can-sugar-be-addicting.html

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