Saturday, April 3, 2010

This is your brain on bacon

Have you noticed lately the increasing effort by public health advocates to start regulating food in ways that are similar to tobacco and alcohol?  Building on the huge success of tobacco policies that reduced smoking rates dramatically over the past several years, public health advocates are now turning their attention to fat, salt and sugar.  The skyrocketing rates of obesity and concomitant health care costs make their case pretty compelling in my view.  In fact, my work place, The New York Academy of Medicine, is involved in campaign to tax sugar-sweetened beverages.  You can get involved by clicking here.

So I am not universally adverse to drawing parallels between food and drugs, but this new study pushes my critical sociologist buttons.  Check your animal cruelty sensibilities here and listen to the methods.  Rats were implanted with electrodes and then fed this:
The cafeteria diet consisted of bacon, sausage, cheesecake, pound cake, frosting and chocolate... 

Long story short...  the rats that had the junk food diet available to them all day, not only grew obese, but become compulsive eaters and continued to eat even when they received an electric shock for doing so.   Here's the part I object to (rat mistreatment aside):

These data demonstrate that overconsumption of palatable food triggers addiction-like neuroadaptive responses in brain reward circuits and drives the development of compulsive eating. Common hedonic mechanisms may therefore underlie obesity and drug addiction.

So it's not the equation of compulsive eating to addiction that really bothers me...  it's the reduction of both to neurochemical processes.  I am sure there are biological components to addiction and maybe for addictions of all types.  But what does it mean when we tell someone with an addiction that they have a brain disease or tell someone who is obese that eating bacon down regulates your striatal dopamine D2 receptors?  And what does it mean for our social and political responses to the problem of addiction?  

Stanton Peele and others have done some interesting critiques of the disease model of addiction (of which the brain disease model is just one subset).  As Granfield and McCloud discuss in their book about people who quit drugs on their own, Coming Clean, it turns out that a lot of people don't like being told they have a chronic, relapsing disease.  Not only does that model and rhetoric belie the reality that the vast majority of people who use drugs stop on their own, it isn't an empowering message for people who are trying to quit.  The disease model is not without it's advantages, however.  Sending people to treatment sure beats locking them up, and one can argue that having a disease is less stigmatizing than the other popular construct -  addiction is a failure of will.  But surely we can come up with a more nuanced model for addiction than either of those.  While you all figure that out, I am going to have a bacon cheeseburger. 


  1. Reinarman also has a good piece, connecting drug prohibition to what's happening with other forms of ingestion. The success of these control movements will hinge on people believing there are "skyrocketing rates of obesity" - public health folks continue to push this but there are some good (and somewhat damning) critiques of it. Check out The Obesity Myth (by Paul Campos).

  2. Thanks for the tip! I'll try to track down and post about the Reinerman piece