Why was the meeting here in July historic?

This was one of the first times ever that experts from the nutrition and obesity fields came together with experts on addiction to talk about the topic of food and addiction.

There is considerable talk about food addiction in the popular culture. People speak about being “chocoholic” or being “addicted” to sugar. Popular books have been written on this with names like “carbohydrate addicts’ diet.” Patients we work with frequently use the language of addiction to discuss their relationship with food. They talk about cravings, withdrawal-type symptoms when they go on diets, and the like. There is enough science on this topic now to suggest something pretty powerful may be happening.

Was the meeting successful?

A number of new collaborative relationships came from the meeting and people in the obesity and addiction fields educated each other in a very positive way. The group agreed that this is an important topic that needs to be pursued aggressively.

What is the current known science related to food addiction?

Researchers at Princeton have found that animals on a high sugar diet withdrawn from that diet show activation of the same brain pathways one sees with classic addictive substances like morphine. There also is some evidence that animals exposed to a high-sugar diet will consume more and more of the sugar over time, which may be similar to tolerance that develops with some classic drugs of abuse. Such studies raise the possibility that the brain may respond to some foods as it does to some drugs.

Does this mean abstinence is the only alternative, or is it too early to say that?

It is too early to know the clinical, legal and policy implications because the science is relatively new. Groups like Overeaters Anonymous believe that abstinence from certain foods, just like abstinence from alcohol, is the only way to address an addiction. They recommend that people stay away from sugar and refined flour in particular. One can imagine how the legal and legislative landscape may change regarding issues such as marketing foods to children or selling certain foods in schools. A lot rides on the scientific questions.

How does this research dovetail with your position that we live in a toxic food environment?

The prevalence of obesity in the last 30 years has skyrocketed, not only in the U.S., but everywhere in the world. We must ask why. Biology is discussed as a player, but biology has not changed in ways that could explain rapidly rising prevalence. The food industry and its political allies often point to failing personal responsibility, but certainly we are not less responsible this year than we were last year and there is more obesity this year than last year.

This leaves one conclusion — that the environment is changing in profound ways. There are larger portion sizes and inexpensive, highly available, highly palatable foods, heavy marketing of food to children, record intake of sugared drinks and more. One possibility is that the food itself triggers some biological process that makes it hard for people to stop eating. We know very little about the dozens of chemicals that get added to food. The food industry refers to these as “flavor enhancers,” but they help increase consumption of the food. Whether these trigger some event in the brain that creates dependence, we just don’t know.

This line of research might be unwelcome news to the food industry. Can they make as much money selling healthy food?

If the population is to lose weight, the food industry would have to sell less food. The population must eat less. With that said, some players in the industry will benefit from changes to healthier foods, and others will get hurt. You can see the industry players lining up on different sides of this fence.

How so?

Some companies have been quite defiant and have introduced even more unhealthy foods. Other players have reformulated their foods, introduced healthier options and bought other companies that sell healthier foods.

Pepsico is an example of a progressive company. They sold off major units of their company that sold fast food and in their place bought companies like Tropicana and Quaker. Pepsico announced before they were pressured to do so that they were removing transfats from their Frito Lay products. Companies like this see health as a pressing social priority, and also as good business.

Any other progressive companies?

MacDonald’s is an interesting case study. They have introduced some healthier options — salads and yogurt with fruit are examples — and have resisted introducing larger burgers. Burger King has done the opposite. They have introduced items like a Triple Whopper.

What was the meeting about in Italy in June?

The topic was the law, nutrition and obesity. The law has had a powerful effect in some areas of public health. Tobacco is an example, but there are other issues like auto safety and gun safety that have been pushed by legal intervention. We had experts from Thailand, Finland, Peru, Brazil, England, South Africa and the United States. Brazil, for example, has very strong consumer protection laws, so there may be opportunities for approaches used outside the U.S. to be applied here in ways that could benefit the public’s health.

What can the government do?

Regulatory agencies like the Federal Drug Administration, U.S. Department of Agriculture and Federal Trade Commission can have a positive impact but have been slow to react thus far. There has been much more talk than action. Restrictions could be placed on marketing to children, agriculture subsidies could be changed to favor the production of fruits and vegetables, and more aggressive food labeling could be used. These are just a few examples.

There will also be important places for the judiciary to be involved, for example in interpreting just how much protection the First Amendment affords industry in promoting its products under the banner of free and protected speech. The question is how the law can be harnessed to improve public health.

Are we now at the same point with food that we were with tobacco?

There are some extremely interesting parallels between the tobacco history and what we see now with food. Clearly the substances are different — people don’t need to smoke and they must eat. But the health experts who fought against the tobacco industry learned some valuable lessons. The tobacco industry had a long history of saying that smoking is just a choice, that ill health comes about because of poor personal responsibility, that the industry just provides options and pleasure and if people overdo it and became ill, the product and the company is not to blame.

The food industry uses much the same arguments. It will be interesting to see how these are judged in the court of public opinion.

— By Jacqueline Weaver

T H I SW E E K ' SS T O R I E S

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Foster + Partners to design new SOM building

NIH grant aims to speed development of alcoholism treatment

‘Quiet on the set!’: Scenes for DeNiro-Pacino movie shot in employee’s home

ENDOWED PROFESSORSHIPS

• Anderson comes to Yale as Lanman Professor
  
  
• Harries appointed as first Ragen Professor
  
  
• Nägele is first incumbent of Mohr Professorship
  
  
• Smith has been named to Wells Professorship
  
  

Scholars named to joint posts at MacMillan Center

Abigail Rider to manage Yale’s real estate

Exhibit chronicles slavery and emancipation in Jamaica

Activist and author Gloria Steinem to visit as Chubb Fellow

Art, music of Tibetan monks to be featured in campus events

Architect-designed housewares produced by Swid Powell . . .

Award-winning play about conjoined twins to be presented

Brownell: Food addiction and nutrition

Part one of two-part conference will explore ‘Frontier Cities’

Tribute to Cleanth Brooks examines the topic ‘What is Close Reading?’

Show features paintings of city scenes by Constance LaPalombara

Getting saucy

Look at ‘Past Year in Admissions’ . . .

Campus Notes

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