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Can you be addicted to food?

Most of us overindulge now and then. We have an extra piece of birthday cake or a few too many potato chips. But for some people having "just a few" is never possible. Are they addicted to food? In this season debut of White Coat, Black Art Dr. Brian Goldman explores the idea of food addiction and visits the only residential treatment program in Canada that treats food addicts right alongside drug and alcohol addicts.
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Most of us have, at one time or another, struggled to say 'no thanks' when it comes to food. It's difficult to close the bag of chips or refuse the extra cookie. It's no wonder that more than 14 million Canadians are considered overweight or obese.

But is it possible that some of us are actually addicted to food, in the same way that a drug addict is addicted to cocaine? And if we are, would going to food rehab help? 

Annie Rosenberg of Vancouver thinks so. She is a self-confessed addict. Her drug of choice is refined and processed food. 
Annie Rosenberg. (Submitted by Annie Rosenberg)

But today, she's says she's in recovery. 

"I don't eat refined food, packaged foods. I don't even consider those foods. To me, those are drugs," Rosenberg tells Dr. Brian Goldman, host of White Coat, Black Art. 

She describes having uncontrollable cravings that led her to eat bags of Halloween candy, entire boxes of chocolate and even retrieving food she'd thrown away. 

"I  can remember trying to stop. I would take half a bag of Oreos and I would pour dish liquid into the bag. And I would take the bag and put it into the garbage. And sure enough I would go back out there when it was dark and I would get it and I would wash off the Oreos," she says, adding that her actions led her into a spiral of shame.

"I would crash." 

After years of trying all kinds of diets, she answered the questions in the Yale Food Addiction Scale and determined she was an addict. The survey, created in 2009, takes questions about alcohol and drug use and adapts them to food. 

Rosenberg entered a 12-step residential recovery program and was treated for addiction alongside other residents who were there for alcoholism and drug addiction. 

The program is operated by Renascent, a not-for-profit private facility which is Ontario's largest residential treatment provider. 
Dr.Vera Tarman, medical director of Renascent

The food addiction program was developed by Dr. Vera Tarman, a former family MD, Renascent's medical director, and the author of the book Food Junkies: The Truth About Food Addiction. 

Tarman also has a personal stake in the treatment. She tells Dr. Goldman she is a food addict in recovery. 

"I was a hefty family practice doctor, feeling very guilty about telling people to not eat, when there I was eating just as badly as they were.  When I got into addiction medicine and started reading about the concepts, it was like the light (went off)." 

She says Renascent is the first place in Canada to try a residential rehab program for women with food addiction. They rely on a 12-step program similar to the one developed by Alcoholics Anonymous. In a pilot project last year, they treated about 80 food addicts in three-to-four-week periods, side by side with those addicted to drugs.

Tarman wanted to find out if they would "merge" well. She says it was a success. 

"The struggles are the same. Family dynamics are the same. People would talk about, 'I would go to a meeting and I would think to myself, when they say alcohol, I substitute food, and it's the same feeling.'"

Tarman takes what she calls "Big Food" to task for manufacturing unhealthy addictive processed food, but she's careful to point out that just because most of us consume it, it doesn't mean we are all food addicts. 

"I don't think everybody in the world is a food addict. But there is a subsection of the population - we say 10 percent... I think it's 20 or 30 percent, who are alcoholics... and similarly with food, they cannot ever learn to have only a few."

But Tarman admits that the science on food addiction is not quite there yet.

Research is only at what she calls "the rat stage." She's referring to a 2010 study in which researchers made rats obese by feeding them unlimited amounts of cheesecake and chocolate. The rats gorged even when given electric shocks, which means they behaved as if addicted. They also found food rich in sugar and fat stimulate the release of the pleasure chemical dopamine inside the rat's brain --  just like crack and opioids do. 

Tarman would like to do a clinical trial at Renascent his fall when the program begins to accept more clients. 

Many obesity experts are becoming more open to the idea that sugar can be addictive, but they aren't sold on the idea of food addiction. 

Dr. Arya Sharma is one of them. 

"If you are going to talk food addiction, the question is really are you addicted to food or are you addicted to a food behaviour... in  the way that gambling or watching Internet porn is a behavioural addiction, not a substance addiction," Sharma says. 

He concedes that binge eaters can experience a loss of control, but questions whether they go through withdrawal, and whether abstinence - the method Dr. Tarman believes in - is an effective, sustainable treatment. 

The food addiction program at Renascent costs about $14,000 and isn't covered by provincial plans. Rates of success vary, but most addiction programs - residential and otherwise -  have a success rate of  about 20 per cent, according to Dr. Tarman. While Renascent does not yet have any studies to evaluate its food addiction program, Dr. Tarman estimates it would likely fall in line with those numbers, although based on the pilot, she says clients who complete the program and continue with follow up care have better than a 50 per cent success rate when it comes to controlling their addiction. 

The biggest danger for her clients, like Annie Rosenberg, is that once they detox in the tightly-controlled rehab environment, they have to navigate a world in which their drug surrounds them. 

Annie Rosenberg says the tools she learned in rehab have helped her "stay clean" - so far. 

"All I know is I've tried my entire life to change this behaviour and when I personally understood I was dealing with an addiction I could make changes by eliminating addictive substances."