Millions of Americans suffer from
addictions involving alcohol,
nicotine, and drugs. For some
individuals, food is also an
addiction. Recent studies found that
food addiction, drug abuse, and
other self-destructive behaviors
have similar underlying
neurochemical and behavioral
characteristics.
One of the most common behavioral
characteristics of individuals
suffering from self-destructive
addictions (overeating, drinking,
smoking, using drugs, etc.) is a
feeling of ‘not being good enough’.
Feelings of low self-worth, in turn,
may cause low self-esteem, a poor
body image, depression, anxiety, a
need to overachieve, and an intense
and chronic fear of failure.
The ‘addict’ not only has negative
feelings regarding themselves, but
also has failed to develop
appropriate stress coping behavior
to deal with such feelings. Instead
of confronting life stressors
directly or finding healthy ways to
manage emotions (exercise,
journaling, relaxation, spiritual
care, therapy, etc.), the ‘addict’
seeks to avoid unpleasant feelings
by eating, drinking alcohol,
smoking, using drugs, gambling, and
various other ways of escaping from
reality.
Emotional distress and avoidance
stress coping behavior can produce
neurochemical changes in the limbic
system of the brain, which is the
area of the brain that controls mood
and basic functions such as eating.
The addict often has overactive
stress hormone responses within the
limbic system that impair the
actions of specific brain
messengers, (i.e. serotonin,
dopamine) that, in turn, cause
depression, food cravings
(particularly for carbohydrates),
overeating, compulsive
behaviors (such as binge eating),
substance dependencies, and an
increased risk for multiple
addictions.
Reduced mood, caused by such
neurochemical defects, can be
reversed, at least temporarily, by
eating certain foods or by using
alcohol, nicotine, and drugs. Eating
carbohydrates (sweets in particular)
helps to improve mood by increasing
the neurochemical messenger,
serotonin. And, eating sweets, fat,
or even smelling one’s favorite food
improves mood by enhancing the
actions of another neurochemical,
dopamine, which is also responsible
for the ‘good feelings’ associated
with drugs and alcohol.
The food ‘addict’ may, therefore, be
overeating in an attempt to improve
their mood. But, overeating may,
similar to frequent use of drugs or
alcohol, blunt the responses of
these ‘feel good’ neurochemical
pathways to food, requiring the
individual to eat more to achieve
satisfaction. At this point, the
individual not only eats in an
effort to establish emotional
stability but also has a physical
need to do so and, thereby, feels
powerless over food.
Abstinence from the abused substance
helps to reverse or improve many of
the neurochemical defects associated
with addictions. Bariatric surgery,
by limiting the amount of food and
type of food that can be consumed,
and by enhancing mood through the
joy of weight loss, is also
effective in improving neurochemical
defects contributing to addictive
behavior. However, such improvements
are often short-lived. Food
cravings, as well as depression, may
reoccur over time, along with weight
gain.
The neurochemical defects
contributing to food dependency
among post-bariatric surgical
patients may reappear over time
because the behaviors responsible
for initiating the cascade of events
leading to such defects are not
resolved by the surgery, those being
low self-worth and poor stress
coping skills. It is, therefore, of
utmost importance for the overall
wellbeing and long-term weight loss
success of the bariatric patient
that aftercare bariatric programs be
designed to help individuals
recognize their own self-worth and
learn healthful ways of dealing with
emotional stress.
