The science of food addiction is clearer now than ever before. A powerful study published in the American Journal of Clinical Nutrition proves that higher-sugar, higher-glycemic foods are addictive in the same way as cocaine and heroin. In this groundbreaking study, Dr. David Ludwig and his colleagues at Harvard proved that foods with more sugar—those that raise blood sugar quickly or have what is called a high glycemic index—trigger a special region in the brain called the nucleus accumbens known to be ground zero for conventional addictions such as gambling and drug abuse. When this pleasure center becomes activated, it makes us feel good and drives us to seek out more of that feeling. Previous studies have shown how this region of the brain lights up in response to images or when someone eats a sugary, processed, or junk food. However, many of these studies compared very different foods. If you compare cheesecake to boiled vegetables, the pleasure center will light up to the cheesecake and not to the vegetables for many reasons. Maybe the cheesecake tastes better or looks better. In other words, interesting data, but not hard proof of addiction. This newer study took on the hard job of proving the biology of sugar addiction. To confirm their results, the researchers did a randomized, blind crossover study using the most rigorous research design. They took 12 overweight or obese men between 18 and 35 and gave each a low-sugar, low-glycemic-index (37 percent) milkshake. Four hours later, they measured the nucleus accumbens, the brain area that controls addiction. They also measured blood sugar and hunger levels. Days later, researchers had the same subjects back for another round of milkshakes. This time, they switched them. The new milkshakes tasted and looked exactly the same as the first round— except in how much and how quickly they spiked blood sugar. In contrast to the first shakes, this second batch of milkshakes contained more sugar with a high glycemic index (84 percent). Not only were the two sets of shakes engineered to deliver precisely the same flavor and texture, they also had exactly the same amount of calories, protein, fat, and carbohydrate. Think of them as trick milkshakes. Participants didn’t know which milkshake they were getting, and their mouths couldn’t tell the difference, but according to the study results, their brains sure could. Each participant received a brain scan and blood tests for glucose and insulin after drinking each version of the milkshake. Without exception, they all experienced the same response: The high-sugar, high-glycemic-index milkshake caused a much greater spike in blood sugar and insulin levels, and also yielded reports of increased hunger and cravings four hours after they consumed it. This part of the study findings was not surprising and had actually been shown in many previous studies. The breakthrough finding: When the high-glycemic shake was consumed, the nucleus accumbens lit up like a Christmas tree. By contrast, the low-glycemic shake triggered no response in the nucleus accumbens. This pattern occurred in every single participant and was statistically highly significant. This study proved two things.

• The body responds quite differently to different calories, even if the protein, fat, and carbs (and taste) are exactly the same.
• Foods that spike blood sugar are biologically addictive.

In other words, this study proved food addiction is very real. In fact, it’s the root cause of why so many people are overweight and sick. They become stuck in a vicious cycle of cravings. They eat sugary foods that spike their blood sugar, and their brain’s pleasure center lights up. This triggers more cravings, driving them to seek out more and more of the substance that gives them this “high.” These people become powerless against their brain’s hardwired response to seek out pleasure. It’s no wonder so many people feel trapped! How Do You Know Whether You’re Addicted? My friend and colleague Kelly Brownell, PhD, while at Yale’s Rudd Center for Food Policy and Obesity, created a scientifically validated food questionnaire to help you determine whether you are a food addict. Here are some clues you may be addicted to sugar, flour, and processed food. The more intensely or more frequently you experience these feelings and behaviors, the more addicted you are:

• You consume certain foods even if you are not hungry, because of cravings.
• You worry about cutting down on certain foods.
• You feel sluggish or fatigued from overeating.
• You have spent time dealing with negative feelings after overeating certain foods, instead of spending time in important activities such as time with family, friends, work, or recreation.
• You have had withdrawal symptoms such as agitation and anxiety when you cut down on certain foods (do not include caffeinated drinks such as coffee, tea, and energy drinks here).
• Your behavior with respect to food and eating causes you significant distress.
• Issues related to food and eating decrease your ability to function effectively (daily routine, job/ school, social or family activities, health difficulties), yet you keep eating the way you do despite these negative consequences.
• You need more and more of the foods you crave to experience any pleasure or to reduce negative emotions.

If you find yourself nodding to these clues, don’t worry— you’re far from alone. Millions of people in every corner of the world have fallen into the food addiction trap. Lack of Willpower isn't the Problem The important thing to remember is that food addiction is not your fault. It is not because you are lazy or lack willpower to resist sugary, processed foods. It makes me furious to see patient after patient blame himself or herself for his or her weight problems and diabesity. The real blame for our weight and health problems lies less with the individuals who’ve inadvertently become addicted to processed foods than with the food companies that designed food products with highly addictive properties in the first place. Yes, we all have choices, and personal empowerment and responsibility play roles here, but they are not enough if we are trapped in a food coma induced by the toxic influences of sugar and processed foods. No one chooses to be fat. Think about it. If you grew up not being able to identify a vegetable because you never ate one, if your school had only deep-fried food or the kind that came out of a box or a can and was stocked with vending machines full of sweetened sports drinks, juices, or sodas, or was ringed by convenience stores where you could buy a 64-ounce Big Gulp on your way home every day, it’s no surprise that your habits and taste buds got wired that way. If nearly every restaurant chain near you serves jumbo portions of sugar and fat and salt (what David Kessler, MD, calls “hyper-palatable” foods), if your workplace lunchroom is a toxic food dump, good luck staying healthy. If, unbeknownst to you, your yogurt contains more sugar than a Coke, and the main ingredient in your barbecue sauce is high-fructose corn syrup, how can the food industry point the finger at you for not taking personal responsibility? Peer pressure to fit in is strong, and Big Food knows this. Big Food preys on people’s desire to be eating and drinking the “in” thing and uses manipulation to get customers hooked. Remember the Coca-Cola ad, “I’d like to buy the world a Coke”? Let’s get the whole world hooked! Now North Korea and Cuba are the only countries to which Coke is not distributed. Mission accomplished! There are specific biological mechanisms that drive addictive behavior. Nobody chooses to be a heroin addict, cokehead, or drunk. Nobody chooses to have a food addiction either. These behaviors arise from primitive neurochemical reward centers in the brain that override normal willpower and, in the case of food addictions, overwhelm the ordinary biological signals that control hunger. Why is it so hard for obese people to lose weight despite the social stigma, despite the health consequences such as high blood pressure, diabetes, heart disease, arthritis, and even cancer, and despite their intense desire to lose weight? It is not because they want to be fat. It is because in the vast majority of cases, certain types of food— processed foods made of sugar, fat, and salt combined in ways kept secret by the food industry— are addictive. We are biologically wired to crave these foods and eat as much of them as possible. The Science of Addiction While some of us may be more genetically predisposed to the addictive properties of food (or heroin or alcohol), if you examine your own behavior and your relationship to sugar in particular, you will likely find that your behavior around sugar matches up perfectly with why you can’t control your diabesity. Based on psychological criteria and new neurological research, many of us, including most obese children, are “addicted” to industrial food. Let’s review some of the scientific findings confirming that food can, indeed, be addictive:

• Sugar stimulates the brain’s pleasure or reward centers through the neurotransmitter dopamine exactly like other addictive drugs.
• Brain imaging (PET scans) shows that high-sugar and high-fat foods work just like heroin, opium, or morphine in the brain.
• Brain imaging (PET scans) shows that obese people and drug addicts have lower numbers of dopamine receptors, making them more likely to crave things that boost dopamine. This is, in part, genetically determined.
• Foods high in fat and sweets stimulate the release of the body’s own opioids (chemicals like morphine) in the brain.
• Drugs we use to block the brain’s receptors for heroin and morphine (naltrexone) also reduce the consumption and preference for sweet and high-fat foods in both normal-weight and obese binge eaters.
• People (and rats) develop a tolerance to sugar— they need more and more of the substance to satisfy themselves; this is true of drugs such as alcohol or heroin.
• Obese individuals continue to eat large amounts of unhealthy foods despite severe social and personal negative consequences, just like addicts and alcoholics.
• Animals and humans experience “withdrawal” when suddenly cut off from sugar, just like addicts detoxifying from drugs. Just like drugs, after an initial period of “enjoyment” of the food, the user consumes it not to get high but to feel normal.

If you want to understand more about how the food industry keeps us addicted, please read The End of Overeating. In this riveting book, Kessler, the former head of the Food and Drug Administration (FDA), describes the science of how food is made into drugs by the creation of hyper-palatable foods that leads to neurochemical addiction. 12 Ways to Curb Cravings and Crush Food Addiction I hope you’re beginning to understand the science of food addiction and why it is not your fault. Far from succumbing to being an addict and feeling doomed, you can take control to regain your health and taste buds while reversing your diabesity risk with these 12 strategies:

1. Balance your blood sugar. Swings in blood sugar are the major driver of cravings, so keep your blood sugar stable. Eliminate sugar and artificial sweeteners 100 percent and your cravings will go away.

2. Go cold turkey. Pinpoint specific foods or drinks like sodas and fruit juices that hold you addicted. An excellent place to start is with The Blood Sugar Solution 10-Day Detox Diet. You might become surprised how quickly you can break food addiction with this easy-to-implement, effective elimination diet.

3. Bring out the good. Combine these foods at every meal:

• Good protein – fish, organic eggs, small amounts of lean poultry, nuts, whole soy foods, and legumes
• Good fats – fish, extra virgin olive oil, unrefined coconut oil, olives, nuts (other than peanuts), seeds, and avocado
• Good carbs – beans, vegetables, whole grains, and fruit at each meal to balance your blood sugar

4. Don’t drink your calories. Liquid calories drive up your appetite and your waist size more than anything else. I’m talking about soda and fruit juice here but also milk and so-called healthy flavored waters. You will pour on the pounds and feed your addiction!

5. Eat a nutritious protein breakfast. Studies repeatedly show eating a healthy protein-containing breakfast helps people lose weight, reduce cravings, and burn calories. Good proteins include eggs, nuts, seeds, nut butters, or a protein shake. You will find easy, delicious breakfast recipes here.

6. Eat small, smart, and frequently. Have small, frequent, fiber-rich meals throughout the day. Eat every 3– 4 hours and have some protein with each snack or meal (lean animal protein, nuts, seeds, or beans).

7. Avoid eating within 3 hours of bedtime. It drives up insulin before you sleep, which makes you store more belly fat. Belly fat drives cravings and addiction through inflammatory and hormonal triggers.

8. Manage your stress. Anything stressful can trigger hormones that activate cravings. If you have the urge to eat, ask yourself two questions: “What am I feeling, and what do I need?” Is there something besides food that will help you get what you need? Adopt a daily stress management program that includes deep-breathing exercises, meditation, and other relaxation techniques. Try my UltraCalm CD to melt away stress and anxiety.

9. Target food allergies. We often crave the very foods we are allergic to, including dairy and gluten. Getting off them is not easy, but after two to three days without them, you will have renewed energy and relief from cravings and symptoms.

10. Get moving. Exercise helps control and regulate your appetite. Whether you are a beginner or seasoned athlete, you can get a comprehensive but easy-to-apply exercise plan here.

11. Get 7 to 8 hours of sleep. Not getting enough sleep drives sugar and carb cravings by affecting your appetite hormones. I've provided 19 strategies for a better night's sleep in this blog.

12. Optimize your nutrient levels:

• Optimize omega-3 fat. Omega-3 fatty acids are important for controlling insulin function.

• Optimize your vitamin D level. Low vitamin D can impair appetite control and increase cravings. Consider taking natural supplements (vitamin D3, or cholecalciferol) for cravings control.

• L-glutamine, PGX (a super fiber), chromium, alpha-lipoic acid, dl-phenylalanine, N-acetyl-cysteine, and other natural dietary supplements can help reduce cravings. This multivitamin combines many blood-sugar balancing nutrients, including chromium and alpha-lipoid acid, in efficacious doses.

Take the Blood Sugar Solution Challenge Is there a way out of food addiction? Is there a way to free yourself from the control that processed food and sugar have over your behavior and wellbeing? Yes, there is. If we can agree that there is biological addiction, then the only solution is to detox to break the cycle. Try asking a cocaine or heroin addict to “cut down.” Forget it. I wish it weren’t so, but I am simply the messenger for the science of food addiction. This is why I decided to write The Blood Sugar Solution 10-Day Detox Diet: to give people powerful tools to painlessly detox from sugar and processed food and reset, reboot, and restore their body to health. Just to be clear, the Blood Sugar Solution 10-Day Detox Diet is not a magic cure or a gimmicky weight loss scheme. It is a comprehensive, science-based approach to ending food addiction and creating rapid, safe weight loss and long -term optimal health. The Blood Sugar Solution 10-Day Detox Diet is for anyone who wants to experience what true wellness feels like, and for most people, that realization is just 10 days away. Wishing you health and happiness, Mark Hyman, MD. References Brownell KD, et al. The public health and economic benefits of taxing sugar-sweetened beverages. N Engl J Med. 2009 Oct 15; 361( 16): 1599– 605. Epub 2009 Sep 16. Colantuoni C, Schwenker J, McCarthy P, et al. Excessive sugar intake alters binding to dopamine and mu-opioid receptors in the brain. Neuroreport. 2001;12( 16): 3549– 52. Gearhardt AN , Corbin WR, Brownell KD. Preliminary validation of the Yale Food Addiction Scale. Appetite. 2009;52( 2): 430– 36. Gearhardt AN, et al. Food addiction, an examination of the diagnostic criteria for dependence. J Addict Med. 2009;3: 1– 7. Lenners BS, et al. Effects of dietary glycemic index on brain regions related to reward and craving in men. Am J Clin Nutr. 2013 Sep;98(3):641-7. doi: 10.3945/ajcn.113.064113. Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006 Aug; 84( 2): 274– 88. Review. Volkow, ND, Wang, GJ, Fowler, JS, et al. “Nonhedonic” food motivation in humans involves dopamine in the dorsal striatum and methylphenidate amplifies this effect. Synapse. 2002;44( 3): 175– 80.