In September last year, Purdue Pharma, the manufacturer of the highly addictive painkiller OxyContin, was dissolved and the Sackler family agreed to pay $4.5 billion to end thousands of lawsuits and provide restitution for a public health crisis that has already led to the deaths of more than 500,000 people.
By comparison, according to research compiled by the School of Public Health and Health Services, the estimated cost of obesity in the United States is somewhere between $147 billion and $210 billion a year. Individuals bear some of these costs in medical expenses and lost wages, averaging $4,879 for women and $2,646 for men. But the rest is shouldered by employers, insurance companies, and the government. For example, obesity is responsible for $61.8 billion in Medicare and Medicaid spending annually.
Yet, despite the promoted awareness that obesity is a driving co-morbidity of COVID-19, our rates have only worsened since the pandemic began. A recent study done by the American Psychological Association tells us that in 2018, 42.4 percent of the population was obese. Now it seems that we have hit 50 percent a full nine years earlier than previous predictions. This is not a harmless statistic. According to the NIH, obesity-related illness kills 325,000 Americans every year. Meaning that we are literally eating ourselves to death. But what is it we are eating? It isn’t real food, it is the packaged, highly refined, chemically laden products marketed to us as “food” that are killing us, and will continue to do so until we reframe what is being perpetrated on consumers in terms of addiction.
As a formerly obese brain and cognitive scientist, and a recovering addict, I have made the understanding of the impact of processed food on the brain my life’s work. Looking for a weight loss role model in my early 20s, I wanted to understand why accomplished, successful people felt powerless to lose their excess weight and keep it off. What I learned is that established behavioral studies have shown that sugar can be more addictive than cocaine. Meaning that the nucleus accumbens, the seat of reward in the brain, downregulates its receptors to tolerate sugar’s onslaught of stimulation until, in repeated studies, mice willingly sustain strong electric shocks to get their fix — stronger than the ones they’re willing to endure to get cocaine. And it only takes a few weeks of eating the average American daily quantity, 22 teaspoons, for this to happen. Once it does, the brain rewires itself to seek more, relentlessly, regardless of satiety, regardless of the damage to the body. Indefinitely.
Personally, I can attest that the data aligns with my own experience. When I stopped using drugs, there was a framework for addiction recovery that I could step into, one that has helped keep me clean for over two decades. Not so for food, because too often science has hidden behind the truism that “we have to eat.” We do. But we don’t have to eat sugar and flour. They are just what is relentlessly marketed to us.
In order to feed the troops in World War II, the U.S. government turned to American manufacturing to solve the problem of mechanizing food production and creating meals that could survive unrefrigerated for months. When the war ended, dozens of manufacturers had factories that churned out this product — and no consumer base. So, they went to Madison Avenue and asked for packaged food to be re-branded to American homemakers as something modern and efficient. This messaging was woven into everything from sponsored cartoons, like the “Jetsons,” to sponsored shows, like “Bewitched.” Once we relinquished the control of our ingredients, our obesity levels began to rise from that point forward.
Now that “food” was a mass-produced product, it was a competition to make the tastiest, and yes, most addictive one on the market. These manufacturers knew what they were doing, hiring chemical engineers to continually refine their formula and gradually increasing the sugar in their products until most Americans are eating 30 percent more sugar every day than they did three decades ago. Meanwhile, not only did the manufacturers not seem to care about the health consequences, they sought to suppress them. Concerned about potential bad press, the Sugar Research Foundation sponsored studies by Harvard scientists that were published in the New England Journal of American Medicine in 1967 without any disclosure of the sugar sponsorship. Their findings downplayed the role of sugar in heart disease and highlighted fat, setting us off in the wrong direction for decades.
People became increasingly overweight and felt increasingly helpless. The average American tries to lose weight with a paid program 3.5 times a year. But without an addiction framework, these diets leave them essentially trying to “cut back” or “cut down” on using without ever giving their brains the opportunity to heal that consistent abstinence from sugar and flour would bring them. In just two months off sugar my research shows that participants experience reduced hunger, reduced cravings, and increased peace and serenity with food.
Imagine what the death toll from opioids would be if they had the marketing engine behind them that Big Food does. If they were advertised on every billboard, if addicts were told, “You deserve a break today,” if they could acceptably use in movie theaters, stadiums, and business meetings. That is what food addicts are up against, as well as a society that norms over-consumption and socializes food addiction. To conquer it we must have a system equally as strong in place.
In recovery, there is an expression that has crossed over into popular culture: The first step is admitting you have a problem. Your problem is that your brain has been rewired to prioritize acquiring that addictive substance over everything, even your own survival. When people are able to begin their weight-loss journey with that same awareness, the results are transformative. But for us to attain that, and begin to reverse the escalating trend, we must call eating ourselves to death what is; addiction.
Susan Peirce Thompson, PhD is an Adjunct Associate Professor of Brain and Cognitive Sciences at the University of Rochester, a New York Times bestselling author, and an expert in the psychology and neuroscience of weight loss, willpower, and food addiction. She is President of the Institute for Sustainable Weight Loss and Founder and CEO of Bright Line Eating, a company dedicated to helping 1 million people have their “Bright Transformations”—the full physical, mental, emotional, and spiritual change that accompanies healthy, permanent weight loss, by 2025.