I am a food addict.
As the world's medical professionals grapple with the surging problem of obesity, they should take into account that there may be a lot of people out there like me.
We overeat year-round. But the holidays between Thanksgiving and New Year's are special. Our eating goes into overdrive.
I knew overeating was not good for me. I knew what was nutritious and what wasn't. Knowledge, however, availed me nothing.
I overate for emotional reasons, but I also had a voracious physical craving. I binged on candy, fried foods and just plain volume. Once started, the eating continued until I was in a food stupor. I didn't realize that my inability to stop could constitute an addiction.
Two-thirds of Americans are overweight, and one-third are obese. How many are food addicts? The science is relatively new, but the fact that the large majority of dieters regain their weight suggests the number could be quite large. Philip Werdell, director of professional training at the Food Addiction Institute in Sarasota, Fla., estimates that about half our obese population are food addicts.
I went on many diets over the years and topped out at 253 pounds, which for my frame was obese. But here's the kicker: Despite my food addiction, I no longer overeat. We call it "abstinence." After decades of big weight gains, I've been maintaining a healthy weight (170 to 175 pounds) since 2002.
Out of desperation to escape the agony of nightly overeating, I discovered an answer that worked for me: an Overeaters Anonymous program that uses the HOW format. HOW stands for honesty, openmindedness and willingness. The first step was a huge one: I admitted I was powerless over food.
The idea that overeating is an addiction has yet to gain general acceptance. A friend of mine once told me that the key to not overeating was to push oneself away from the dining-room table. Easier said than done; he was not a food addict.
In the scientific community, there's been a shift in thinking. In the early 1990s, there were only a handful of peer review articles suggesting that food substances can be addictive, Werdell says. "Today, we have move than 3,000 peer review articles and books substantiating the scientific basis for food addiction.
"There's evidence," he says, "that some people have a predisposition to drugs and an addiction, and now there's evidence that some people who are overweight and eating out of control have the same genetic markers. Brain scans show that a person develops a weakness in the brain in the dopamine receptors, which change when a person drinks alcohol or eats sugar."
Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, is outspoken on the subject. "I believe there is an addiction dimension to food intake," she said in an interview.
Whatever the cause, it's clear that food addicts' relationship with food is different from that of normal eaters.
Michelle Goldberger, program director of COR, a residential eating recovery program in Wayzata, says: "The food addict's body reacts differently to food than normal eaters, much like an alcoholic reacts differently to alcohol." But unlike alcoholics, who can quit drinking altogether, recovering overeaters still have to eat.
For an addict, says Goldberger, "once you put [food] in your body, you can't control the amount you take ... [Y]ou can't stop [overeating] for long without a 12-step program, which is a proven method. It works for addicts who have surrendered trying to do it on their own."
The 12-step program, based on the principles of Alcoholics Anonymous (AA), has been adopted by OA and other groups to combat addictions.
My food addiction went out of control 14 years ago. I lost 80 pounds on a commercial diet program, but found I could eat more if I also ran long distances. The more I ate, the more I ran -- up to 40 miles per week -- while I gorged myself with food. My evening meal alone, which could extend from 7 to 11 p.m., would frequently include a large plate of spaghetti and tomato sauce, half a pound of hamburger, nine or ten large pieces of fruit, a couple of large shots of bourbon, and seven or eight slices of bread with a lot of reduced-calorie margarine.
The quantities I consumed were hugely embarrassing, so I kept it a secret, even from my wife, who says she had little inkling how bad it was. My physician, Dr. Chris Armstrong, told me recently he was amazed at my stamina as a runner, until he realized I was simply racing against the food. Outsiders were impressed by my exercise, not knowing why I was doing it.
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Out of options, I walked into my first OA meeting, one using the HOW format, and found myself in a roomful of overeaters. What struck me was how many of them were losing weight with little or no exercise. There were overeaters, anorexics, bulimics and exercise bulimics like me.
OA is not a do-it-yourself program. In HOW, we create a food plan with the help of a dietitian. We call our sponsor every day to report what we are going to eat, and we stick to it. My binge foods, including sugar and potato chips, became history. I get a good-sized meal, but everything is weighed and measured precisely, according to my food plan.
I have met hundreds of people in the Twin Cities who have lost 50, 100 or several hundred pounds using the HOW format, and have kept the weight off. Werdell, who besides the Food Addiction Institute oversees ACORN Food Addiction Recovery Services, said he has counseled about 4,000 people with eating disorders. He says he's referred about 80 percent of them to HOW programs or other structured 12-step food addiction programs.
"Food addiction is a progressive disease," he says. For some who are not yet in a final, desperate stage, he recommends a traditional OA meeting where the serenity they gain from a 12-step program can stop their emotional overeating.
Traditional OA has kept Sarah, a fellow member of OA in the Twin Cities, from bingeing on sugary foods like cookies, candies and cakes for 22 years, she told me. "I don't need the precise nature of the HOW program, but I like that it's there," she says. "It's important that there are meetings that meet everyone's needs."
Theresa Wright, a dietitian from Norristown, Pa., says, "One of things that helped create the food addiction was the behavior of using certain foods to manage feelings." That can become a habit, she says, and "at some point the body may change and the absence of those foods causes a kind of physical or emotional pain.
"For some people, traditional OA is enough to manage the problem. Perhaps their illness has not advanced as far. Others need a more-structured program. In both cases, the spiritual growth process of the 12 steps is essential. I believe people should do whatever works to bring them to a sense of peace and healing, and I believe that is an individual choice."
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Twelve-step programs recommend that people do a "fearless moral inventory." We write down our resentments and our role in the conflicts that produce them and disclose this confidentially to another person, often our sponsor. We make amends to those we have harmed, except when to do so would hurt them or others. These steps are necessary to clean up our side of the street. Without resolving them, we can drift back into our addiction.
We addicts suffer from the misconception that we are the center of the universe. So, we're also encouraged to find a power greater than ourselves that can help us as we struggle to recover. For some, that high power is God, as one understands God. For others, it can be the group or a value system.
Joining a 12-step group was a recognition that my efforts to stop overeating had failed. "If you could have done it by yourself, you would have done it already," says Wright.
Dr. Armstrong says a key reason OAers can succeed is that they get positive vibes by reaching out to other overeaters, reinforcing their own recovery.
Bill Wilson, the cofounder of Alcoholics Anonymous, stressed how reaching out to others could keep him sober. Stuck in a hotel in Akron, fearful of getting drunk again, he sought out another alcoholic to help. It was Dr. Bob Smith. Together, they formed the AA fellowship and started the 12-step movement.
There are about 60 weekly OA meetings in Minnesota, 13 using the HOW format. Food addictions may appear to be in remission, but the addiction does not go away. That's why we keep going to meetings and do 12-step work within the program. We're all just one bite away from a binge, staying abstinent one day at a time.
It's nice to no longer live in hiding and denial. I have far better relationships with my wife and adult children, having made amends to them. I've also made good friends in the OA program, people I'd never have met were it not for our shared addiction. And I've become more empathetic to other points of view and far less prone to anger.
I'm no saint, of course, and like others in the program, I conduct a nightly review to see if I've developed new resentments and if I owe someone an apology. It's nice to feel "clean," no longer haunted by the food cravings and monstrous portions that left me overstuffed, guilty and ashamed.
If you think you may be one of us, stop in at a meeting. There are no dues. We pass the hat, and you can throw in $2 or $3, but it is not obligatory. And you will be anonymous.
To find an Overeaters Anonymous meetings in Minnesota that are near you, including meetings with the HOW format, go to overeaters.org and click on "Find a meeting."
The author of this commentary is an employee of the Star Tribune and a member of Overeaters Anonymous. He is writing this article without a byline because a basic tenet of OA is that members maintain their anonymity in the media.