Can food really be as addictive as drugs? In an impassioned lecture at Rockefeller University on Wednesday, Dr. Nora Volkow, director of the National Institute on Drug Abuse, made the case that the answer is yes and that understanding the commonal
Can food really be as addictive as drugs? In an impassioned lecture at Rockefeller University on Wednesday, Dr. Nora Volkow, director of the National Institute on Drug Abuse, made the case that the answer is yes and that understanding the commonalities between food and drug addictions could offer insights into all types of compulsive behavior.
Volkow began by acknowledging that the idea is controversial. “This is a concept that is rejected by many people,” she said. “It has polarized the [addictions] field.”
Many experts dismiss food as an addictive substance because it doesn’t lead to most people behaving like addicts — compulsively seeking food despite negative consequences. So, the reasoning goes, food can’t be as addictive as a drug like crack cocaine.
What that fails to recognize, however, is that crack cocaine itself isn’t as addictive as is commonly believed. “If you look at people who take drugs, the majority are not addicted,” Volkow said. Indeed, even for drugs like crack and heroin, fewer than 20% of users become addicted.
In contrast, if you look at the proportion of people who are currently obese — some 34% of adults over 20 — it’s a significantly larger group. Add in those who are overweight, and fully two-thirds of Americans clearly have significant difficulties controlling their food intake. So, measured by the proportion of those who behave in health-risking ways with each substance, food could actually be considered several times more “addictive” than crack.
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Volkow went on to describe the common dysfunctions in the areas of the brain involved in pleasure and self-control that are seen in both food and drug addictions. These systems rely on the neurotransmitter dopamine; in both drug addictions and obesity, reductions in the number of dopamine D2 receptors are common.
In brain areas associated with self-control, the loss of D2 receptors is linked with a weaker ability to resist temptation. In regions that process pleasure, a reduction in receptors is associated with diminished enjoyment of food or drugs. “You can create animals that do not produce dopamine,” said Volkow. “They die of starvation. They don’t eat. It’s as dramatic as that.”
Drugs were once thought to be uniquely addictive because of their outsized effect on the brain: they can raise dopamine levels far higher than natural experiences like sex and food, at least in the lab. This was believed to create chemical imbalances that the brain isn’