Ask the Dietitian: Is Sugar Addictive?

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Ask the Dietitian: Is Sugar Addictive?

By now most of us know too much sugar isn’t good for us and that overdoing it on the sweet stuff is linked to obesity, Type 2 diabetes, metabolic disease, fatty liver and other chronic health conditions. For whatever reason though, most of us still find it hard to resist sweet treats, beverages and snacks.

I’m willing to bet many of us have experienced intense sugar cravings or have binged on sweets before — experiences that leave us feeling powerless in the presence of certain foods and questioning whether we have a sugar dependency. But is sugar addiction even real? This is one of the most common questions I hear as a dietitian — the answer to which boils down to whether sugar is an addictive substance or not.

Is sugar addictive?
Despite many similarities in addiction characteristics — like bingeing, tolerance and withdrawal — the Diagnostic and Statistical Manual of Mental Disorders, the manual by which mental-health professionals classify mental disorders in the United States, does not currently contain a clinical diagnosis specifically for sugar or food addiction. This is largely because there is little clinical research in humans to substantiate the idea that food or sugar addictions are real.

But just because we lack a diagnosis for sugar addiction doesn’t mean that sugar isn’t addictive.

Eric Stice, PhD, a neuroscientist who has extensively studied sugar’s effects on the brain, says consuming highly palatable foods — like those containing high amounts of sugar — activates the same key reward regions of the brain that are triggered when a person does drugs like cocaine. Biologically this makes sense since, back in our hunting and gathering days, sugar was a rare and valuable source of energy. Back then, a strong reward response to sugar was beneficial since it sent us seeking more. This also explains how the human body has adapted to almost effortlessly convert sugar into fat.

In addition to brain-imaging studies in humans, there is strong animal research to support the legitimacy of sugar addiction. “In regards to animal data, I can be a little more assured about a true addiction with intermittent sugar intake, which has been proven in animal models,” says Dr. James DiNicolantonio, a doctor of pharmacy. “Not because sugar activates similar neurochemical pathways but because rats fed intermittent sugar intake go through druglike withdrawals when sugar is removed from their diets. Not only that, giving rats who are consuming an intermittent sugar intake regime naloxone, an opiate antagonist, also produces withdrawals — the same withdrawals experienced if hooked on morphine or cocaine.”

When asked whether he thought sugar addiction was real, Dr. Robert Lustig, a childhood obesity expert and leading obesity researcher, said it certainly is in animals.“According to the DSM-5 criteria, sugar is addictive,” he says. “We have the data mechanistically in animals, we have the correlative data in humans and we certainly see this empirically in our patients.”

In practice, doctors and dietitians often look for addiction characteristics in a patient’s eating habits to determine whether food or sugar addiction may be present. Of those, bingeing and withdrawal are the easiest to identify, but Stice has found that people who consume high amounts of sugar can indeed develop tolerance, which further supports the notion that sugar is addictive.

What about sugar withdrawal?
Ask anyone who’s slashed added sugar from their diet cold turkey, and they’ll likely tell you sugar withdrawal is real. As is common with caffeine, nicotine and other addictive substances, people withdrawing from sugar typically feel pretty lousy during the process. The most common symptoms include irritability, fatigue, headaches, insomnia, cravings, malaise and feeling “foggy.” Of course, symptoms vary greatly and will depend upon regular sugar intake, individual physiology and whether you’re going cold turkey or using a tapering approach. If you happen to be the unfortunate person who experiences all of these symptoms simultaneously, know that it is temporary. Based on Lustig’s observations, sugar withdrawal usually lasts 4–5 days — after which patients generally report major improvements in both mood and energy levels.

5 Tips to Beat Sugar Addiction

1. Commit to cut back, and pick the approach that’ll work for you.
Leslie Lee, MS, RD, recommends abstinence and moderation as approaches to limiting sugar. Both approaches can work, but one might be better suited to your personality, eating habits and lifestyle. Quitting cold turkey requires more preparation up-front, Lee says, since you’ll have to “be prepared to manage the withdrawal symptoms, and pragmatically, one has to be prepared to eat in an entirely different manner.”

“If you’re just someone who thinks they might be overdoing it on sugar, then perhaps a gradual reduction is doable and can be accomplished with relative ease,” she adds.

Regardless of your approach, Lustig and the American Heart Association recommend a maximum of 100 calories (25 grams) of added sugar per day for women and 150 calories (37.5 grams) for men.

2. Keep your eye on the Nutrition Facts label and ingredient lists.
Being aware of hidden sources of added sugar is half the battle here. Soon Nutrition Facts labels will have to show the amount of sugar added to the packaged foods you buy, not just the total amount. That’s good news for those who may not know all of the nicknames for added sugar and have a hard time spotting it in the ingredient list.

3. Eat high-quality carbohydrates in place of added sugar.
Yes, you read that right! Love ’em or hate ’em, carbohydrates are not created equal. A diet low in added sugar doesn’t have to be low-carbohydrate, which is good news for those of us in the carb-lovers camp. A recent study led by Lustig showed that simply removing fructose (from added sugar) from the diet for just 10 days reduced liver fat, an indicator of metabolic disease, by nearly 30%. Wholesome carbohydrates to consider include sweet potatoes, brown rice, oatmeal and whole-grain bread made without added sugar.

4. Replace sugary treats with nonfood rewards.
If your idea of a reward is frozen yogurt topped with cookie crumbles and chocolate sauce, consider nonfood rewards instead. Treat yourself to a special group workout class, a manicure, a movie, even a lazy morning in bed. If you want a sweet treat, go for something nutritious and low-glycemic that won’t trigger a binge. Berries, kiwi and oranges (whole, not juiced) are great options.

5. Find better ways to manage stress
For many of us, eating palatable foods, like those high in sugar, is how we cope with stress. That’s because stress primes brain for addictive eating patterns and can create cravings for sugar, says Elissa Epel, PhD, an expert on the impact of stress on food intake and obesity. Some of her research at the University of California, San Francisco, also shows that sugar dampens the stress response — which can be a pretty powerful reinforcement to keep eating the sweet stuff when times get tense.

Instead of turning to sugar for solace, explore other ways to manage stress, like yoga, meditation, running or journaling.

Want more tips? Here are 15 simple hacks for eating less sugar.

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  • Timothy Fish

    It doesn’t matter what things were like “in our hunter gatherer days.” If what happened then caused the human body to adapt, then why don’t we see that same adaptation now? We don’t see people desiring sugar less because we have it in abundance. There’s no reason to think that a caveman with a sweet tooth is more likely to have children than a caveman who likes the food he is eating. It isn’t like sweets were not available. Honey has been around for a very long time.

    • Michelle

      The voice of reason! And when exactly were these vaunted cave man days? Some of us don’t hail from Europe so I’d love to hear a discussion of why divergent environments led to exactly the same adaptation.

  • Mamacita

    Es la verdad. Sugar is addictive. Not to mention it feeds cancer and other disorders. (Read Dr Mercola’s notes on sugar carefully). I had mild and brief sugar withdrawal while going through a whole body detox program. I’ve watched one of my own children experience the symptoms of SW and it is not fun. However our bodies do need the right kinds of sugar from whole fruits for energy and to function optimally. We actually have more longer lasting energy without convential sugar. Honey and stevia are tolerable sweeteners in moderation. You will definitely be able to tell the positive changes in your body when you crave whole fruits and vegatables instead of candy, pastries, sodas, etc. I’ve read that it’s best to get most of our sweet sources if needed, in the early part of the day to keep us balanced throughout the day. Awesome article! Enjoy getting fit and being healthy!

  • Robin Martinez Rice

    Using the mental health manual (DSM) to state if a food is addictive has a glitch. This diagnoses MENTAL health, not physical. One criteria needed in most of these diagnosis is the negative impact on daily functioning in the areas of such things as work, family relations etc. it could be that food, including sugar, just doesn’t rank with cocaine in its visible impact. But I would turn to the physical experts when determining sugar addiction.

  • Carbohydrate foods (sugar is only one carbohydrate food) causes a physical change in the body of over 60% of the adult population that has uncontrolled Metabolism B. Carbohydrate causes blood glucose to rise, over 60% of adults over-release the hormone insulin, excess insulin causes blood glucose to drop, cravings for more carb occur as the body/mind struggles to bring blood glucose up to the normal level. Carbs are eaten and the cycle begins again. End result? Insulin is a fat gain hormone. Most of the excess blood glucose is stored as fat on and in the body. Expect hypertension, increased cholesterol, LDL cholesterol, triglycerides, a tiring pancreas causing pre diabetes and then type 2 diabetes, overweight/obesity, low Vitamin D and so much more. Read The Metabolism Miracle, Revised edition and learn the truth and a scientifically proven solution.