Avoid or Alter?

I am frequently asked about whether certain foods should be completely avoided or if it is essential to learn to eat all foods responsibly. Individuals who believe they are “addicted” to certain foods (like sweets) or certain ingredients of food (like sugar) commonly ask this question, and it’s a great question. The most common method of dealing with addiction to substances such as nicotine, alcohol and cocaine is complete avoidance of the substance, referred to as abstinence. Abstinence from these types of substances, while difficult to achieve, is far easier than the alternative of trying to moderate one’s intake of the substance. In the case of nicotine, heroin, cocaine and “hard drugs,” nobody challenges this approach because there is no benefit in continuing to use them. These substances are just plain bad for you so abstinence is completely rational. Alcohol has often been shown to be healthy when consumed in moderation, but for people who have battled with alcohol abuse and dependence it’s just not worth it and once again, abstinence is the preferred approach. In the case of specific foods or certain food ingredients, the story can become much more complicated.

There is an ongoing battle as to whether or not certain foods or food ingredients are “addicting.” Is sugar an addictive substance in the same way as nicotine, cocaine and alcohol? Can someone actually be “addicted” to sweets or carbohydrates? The jury is still out, but a definitive answer may not be necessary. What’s important is for you to consider how you plan to change your behavior given that the environment seems to be making little effort to eliminate the availability of these foods.

Almost everyone has one or more foods that they are prone to eat compulsively, whether they consider themselves to be “addicted” to them or not. Often these foods include sweets that are high in sugar (like cake, cookies, or ice cream); however, many people struggle to control their intake of a variety of foods like deli meat, pizza, peanut butter, nuts or even beef jerky. For many people, sugar isn’t the big problem.

What is interesting to consider is that most people have trouble controlling their intake of foods that they believe they shouldn’t be eating. Over and over I hear stories of people who binge on exactly the foods that they were told they couldn’t have as a child. These are often called “forbidden foods.” Whether it is peanut butter, ice cream, potato chips, cookies, pizza, or cheese doodles, it may be their “forbidden-ness” that makes us eat them compulsively and not their content of sugar or other ingredients that’s the problem. The literature on binge eating lends some support to this hypothesis as a very high percentage of binge eaters describe a history of restrictive dieting and/or deprivation. Indeed, a overwhelming number of patients I have seen over the years who describe themselves as binge eaters describe histories of either chronic over-restrictive dieting or having grown up in homes where their parents or others denied their access to certain foods. Some patients jokingly referred to one or both their parents as the “food police.” Once they were free from such restrictions (either by moving out to live on their own or by going “off” the diet) their consumption of these foods seemingly became uncontrollable. It seems that avoidance or total abstinence from such foods might actually be causing the binge eating. There is an all-or-nothing quality to this behavior. One possible explanation for this pattern is that the individual has never actually had the opportunity to eat these foods in moderation but rather to be forced to avoid them or eat them like there was no tomorrow. They were never allowed to eat them, so when they were finally available, they overindulged. So again I ask: “Is this type of compulsive eating or bingeing due to an “addiction” or to over-restriction, and what should you do about it in either case?” Should you continue to avoid certain foods or food ingredients or try to learn alter your behavior?

The answer really depends on your personal philosophy and how much distress the whole matter is causing you. Do you want to learn to eat certain foods more responsibly or would you rather continue to try to avoid them? Does it cause you great distress to think of a life without your favorite foods? Does it cause you great distress to make constant efforts to avoid certain people, places and events because your “trigger foods” will be available? If you decide that you would like to learn to eat certain foods more responsibly, you need to accept that this will take some work. To be successful, you need to become a bit of a scientist and experiment with different approaches.

Perhaps you are experiencing anxiety about the proposition of trying to learn to eat your “trigger foods” responsibly because you have never had the ability to do. This is completely understandable. Also, consider that if the foods you find to be triggers are inherently unhealthy (like “junk food),” maybe abstinence isn’t such a bad idea. After all, like heroin and cocaine, it’s hard to make the argument that chocolate covered cheesecake is good for you. You could try to learn to eat chocolate covered cheesecake responsibly, but life will continue even if you permanently take it off the menu. However, many people believe that they shouldn’t have to live the rest of their lives without chocolate, peanut butter, cashews and other foods or perhaps they just don’t want to. They are aware that most people do not need to resort to such levels of restriction. If you think in this way, then you need to learn how to eat these foods responsibly. You have to practice a new way of eating to get better at it and strengthen your ability to do so just like you would any other skill.

One approach to strengthen new eating skills is to eat certain foods in a limited number of circumstances and in a different manner. For example, if you believe that cashews are a “trigger food” and you have no history of eating cashews responsibly, it would be silly to continue to buy the one-pound jar of cashews from the bulk food store. You know how that story is going to end. Similarly, it may not be wise to bring a gallon-sized container of ice cream into your home if ice cream is a “trigger food.” However, it may be possible for you to learn to eat a responsible amount of cashews or a single serving of ice cream if you buy a small container of either when you’re at a convenience store. This is a good way to learn with a much smaller chance of bingeing. You don’t have to completely avoid cashews or ice cream for the rest of your life. Just don’t buy them in large quantities and bring them home for the time being. Many people adopt this approach. They’re not averse to eating these foods and don’t avoid them completely; they just don’t bring large quantities of them into their home. Many a patient has told me a similar story about pizza. When they want pizza, they go to the pizza parlor and buy a slice or two. They just don’t have a whole pizza delivered to their home. These are examples of altering behavior rather than avoiding certain foods altogether. This is how you learn to eat responsibly…you practice.

Another approach gaining a great deal of attention is called “mindful eating.” There is a growing literature on the merits and effectiveness of mindful eating in the treatment of binge eating as well as for those who simply want to learn better eating habits even if they don’t have concerns about their weight or eating behavior. Mindful eating is an approach where one learns to be more present-focused while eating, and can be especially helpful when eating “trigger foods.” A primary objective of mindful eating is to learn to develop an ability to control one’s eating behavior. Mindful eating involves slowing down and focusing on the thoughts, feelings and sensations you are experiencing while eating to be in better control of your behavior. Mindful eating is the antithesis of avoidance. Much has been written about mindful eating, so do some research if you’re interested in learning a powerful method to alter your eating behavior so that you may be able to develop the ability to enjoy eating certain foods without experiencing distress and anxiety or leaving them off the menu completely.