A Guide to Sugar Addiction
Over the last century, Americans’ consumption of sugar has doubled, with adults taking in an average of 22 teaspoons per day. This has led to a marked increase in both obesity and type 2 diabetes. Despite these trends, medical professionals still debate whether sugar is addictive. The latest evidence, based on brain research that indicates a similar brain and neural response to sugar as to addictive drugs, suggests sugar is indeed addictive and that, in fact, the brain regards it as a reward. In this regard its overuse is both a substance addiction and a behavioral one, though we list it here as behavioral.
Most people associate sugar addiction with pastries, chocolate, candy and soft drinks even though sugar is in an alarming number of our everyday foods and drinks. It’s in carbohydrates like pasta, bread, cereal and alcohol. It’s also in 80% of all processed foods – those stripped of nutrients and filled with additives, artificial flavorings and chemicals used to make them taste better. These are the most dangerous products for food addicts because they override brain sensors that signal when to stop eating. The sugar thus has multiple effects: it creates a reward syndrome for the brain, it propels people to overeat, and it habituates the user to seek out more sugary substances.
How to Know When You’re Addicted to Sugar
Recent studies have shown people addicted to sugar experience the same physical withdrawals and effects within the brain that drug addicts feel after consuming their substance of choice. To measure your own level of sugar addiction, at least two of the following conditions must be present. The same test applies as clinical diagnosis for addiction to any substance:
- Strong cravings for the substance.
- Continued use despite negative personal consequences like loss of job or loved ones.
- Inability to fulfill work, school or home commitments.
- A need for more of the substance in order to achieve the desired effect or else a diminished effect from continued use of the same amount.
- Withdrawal symptoms.
- Consumption of greater amounts or consumption over a longer time period than intended, and sometimes bingeing on large amounts in a single episode.
- Persistent desire or unsuccessful efforts to cut down or control use of the substance.
- Spending a lot of time obtaining, using or recovering from use of the substance.
- Stopping or reducing important social, occupational or recreational activities.
- Continued use despite persistent or ongoing physical and psychological difficulties.
According to the fifth edition of the Diagnostic Statistical Manual (DSM-5), when two or three of these conditions exist, a person is mildly addicted. Four or five symptoms indicate a moderate addiction, and six or more show a severe addiction.
How Does Sugar Affect the Brain and Body?
Despite experts’ varying opinions on whether sugar should be medically classified as an addictive substance, they agree on one thing: the adverse effects on the body from foods containing sugar, particularly wheat-enriched carbohydrates, sweets and sugary drinks. More than others, these foods exhibit addictive qualities similar to those of illicit substances like heroin and cocaine.
Foods high in refined carbohydrates and sugar fuel the release of dopamine into the brain, which triggers a craving or physical need that must be fulfilled. By repeatedly satisfying these cravings, people become physically and emotionally addicted.
Dr. David Kessler, a professor of pediatrics at the University of California San Francisco Medical School and a former Food and Drug Administration commissioner, estimates that more than 70 million Americans suffer from food addictions. He maintains people are susceptible to “conditioned hypereating” when they habitually consume foods overloaded with sugar, fat and salt that calm them and make them feel good. This often leads to increased consumption of foods even higher in sugar and fat to fill the craving.
“We need to make a cognitive shift as a country and change the way we look at food. Instead of viewing that huge plate of nachos and fries as a guilty pleasure,” Kessler said. “We have to look at it and say, ‘That's not going to make me feel good. In fact, that's disgusting.’ ”
As for sugar’s effects on the body, when a person consumes sucrose, also known as table sugar, the digestive process mixes it with acids and enzymes in the stomach then breaks down the carbohydrates – or sugars and starches – into glucose. Next, the stomach and small intestine absorb glucose and release it into the bloodstream. Depending on physical activity and eating habits, glucose is either used immediately for energy or stored in the body as fat to be used later.
What’s not processed as glucose is broken down into fructose. Fructose – a sugar found naturally in many fruits and vegetables – varies from other sugars because it only metabolizes in the liver and produces more fat than glucose. Many processed foods are also high in fructose, which is why people who eat a lot of fast food are more likely to become overweight and develop obesity.
One recent Harvard University study of overweight and obese men ages 18 to 35 showed two things: The body reacts differently to different types of calories, and foods that spike blood sugar are biologically addictive.
The researchers served participants one milkshake low in sugar and noted their hunger four hours later by measuring blood sugar activity in a brain region called the nucleus accumbens. A few days later, participants were given another milkshake. Both shakes had the same amount of calories, protein, fat and carbohydrates and were identical in flavor, but the second shake had much more sugar. Four hours after consuming this shake, participants underwent a second blood test for glucose and insulin, as well as a scan of the nucleus accumbens. This milkshake with a high glycemic index caused a spike in blood sugar and insulin and an increase in hunger and cravings, supporting claims that sugar is addictive.
The milkshake study and many others that have used neuroimaging uncovered consistencies in the way the brain reacts to both food and controlled substances. Regardless of whether addicts were feeding a need for sugar or for drugs, the brain scan results were the same. The nucleus accumbens demonstrated increased levels of dopamine – a neurotransmitter linked to the body’s reward system. This supports the case for sugar addiction as a disease and not just a condition.
People who are addicted to sugar often crave foods and drinks with a high glycemic content, then build up a tolerance so more is needed over time to satisfy the cravings. As they overindulge in these foods – consuming as many as 5,000 calories over a two-hour period at least once a week – they experience withdrawal symptoms when sugar is completely restricted from their diet.
Warning signs for carbohydrate and sugar withdrawal include fatigue, lightheadedness, heart palpitations, headaches and cold sweats. These symptoms are often caused by excess secretion of insulin when blood sugar levels become too low, which causes discomfort.
Other signs of sugar withdrawal include:
- Constant hunger for sugar-heavy or sweet foods
- Mood fluctuations, particularly irritability
- Muscle aches and pain
- Nausea or vomiting
- Stomach cramps or diarrhea
- High blood pressure
- Inability to fall or stay asleep
In recent years, obesity has become the second-leading preventable cause of death in the United States, largely due to Americans’ addiction to sugar. Many who engage in unhealthy eating suffer from obesity – a disease that affects a large number of Americans.
One in three adults in the U.S. population are considered obese – which means their body fat makes up more than 40% of their overall weight – and another one-third are considered overweight, which is a precursor to obesity. The problem is growing at such a staggering rate that first lady Michelle Obama chose to tackle childhood obesity with the Let’s Move campaign.
In addition to obesity, sugar dependence leads to a host of other serious health problems such as:
- Type 2 diabetes
- Kidney disease
- Dementia and Alzheimer’s disease
- Depression and anxiety
- Tooth decay
- Stress due to elevated cortisol levels
Less common long-term effects include:
- Polycystic ovary syndrome (enlarged ovaries that contain cysts), which is caused by increased pressure from fat around the abdomen
- Heart and arterial disease and high blood pressure caused by fructose raising blood platelet stickiness and clotting
- Atherosclerosis (narrowing of arteries), which occurs when plaque develops on blood vessels’ inner lining and constricts blood flow
- Gout or inflammatory arthritis
Since people who are addicted to sugar frequently develop diabetes and obesity, doctors and nutritionists treat these conditions first by educating patients. Understanding the disordered eating habits that caused the disease and teaching patients simple facts about the sugar in foods helps patients accept and implement treatment.
One common misconception doctors often dispel is that all fruits are healthy; that’s not always the case. A slew of fruits – bananas, for instance – have a high glycemic content and can do more harm than good.
As for treatment, most experts agree abstinence is the best way to break the addiction to sugar by eliminating these foods from the diet:
- Sodas, juices and sports drinks that are loaded with fructose-based sugars
- Beer and soy milk
- Packaged snack bars that contain dried fruits and honey
- Desserts that include biscuits, cookies and cakes
- High-sugar breads such as bagels, white bread and sweet bread, especially with added raisins or fruit
- Carbohydrate-heavy foods like rice and pasta
- Breakfast cereals and muesli, most of which are loaded with sugar and dried fruit
- Condiments and sauces
- Chocolate and other candies
- Ice cream
Finally, doctors urge patients to follow a healthy exercise regimen, which helps increase metabolism and burns fat.
Because sugar addiction includes such an extensive list of effects, doctors use many tests and tools to determine whether a patient is at risk.
A body mass index test measures the percentage of body fat compared to overall weight and determines whether a person is obese. Anything higher than 30% is considered overweight. Folic acid and vitamin B12 tests can reveal difficulty metabolizing proteins, carbohydrates and fat, as well as problems with the body’s ability to absorb nutrients.
Other tests include a urinalysis – which tests kidney health, urine sugar and ketone levels – and an electrocardiogram, which detects heart irregularities. A complete blood count reveals iron deficiencies, infections, inflammations and immune system health by determining levels of white blood cells, red blood cells and platelets.
One psychological test doctors use is the Yale Food Addiction Scale, which examines signs of dependence or disordered eating habits.
And although it’s not a test, the glycemic index is another tool doctors have developed to measure how certain foods affect blood glucose levels a few hours after eating. Anything less than 50 is considered good and shows capability to control blood sugar naturally.
- The Fix staff