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Guest Post: What’s wrong with obesity (and addiction)?

Written by Anke Snoek

Macquarie University

Many of us experience failure of self-control once in a while. These failures are often harmless, and may involve alcohol or food. Because we have experiences with these failures of self-control, we think that something similar is going on in cases of addiction or when people who can’t control their eating on a regular basis. Because we fail to exercise willpower once in a while over food or alcohol, we think that people who regularly fail to control their eating or substance use, must be weak-willed. Just control yourself.

This little animation by Andreas Hykade, however, shows that addiction is quite different from regular, everyday failures of self-control. Addiction is not about self-indulgence and failure of will-power. Rather, one becomes fixated on the substance, whether one wants it or not, and despite knowing that the substance isn’t having the expected effect anymore. It shows that the lives of people with addiction are characterised by anhedonia (a lack of pleasure) rather than hedonism. In the bleakness of that unhappy world, the substance still seems salient, even when one knows better.

Recent neuroscientific research has shown that foods that are high in sugar, fat or salt have a similar effect on our brains as addictive substances like heroin and alcohol. Both addictive food and addictive substances overtake our reward and control systems. Both result in cue sensitisation, and one becomes, without wanting it, fixated by the substance. Both result in anhedonia.

This anhedonia is partly caused by the overloading of our brains with dopamine, which resets the thresholds of the neurotransmitters so that we fail to experience reward from everyday pleasurable things. But the anhedonia is also partly caused by stigmatisation. Stigmatisation contributes negatively to the addiction disorder. Stigmatisation causes many negative emotions and a negative self-image, and these get in the way of self-control: one think that one is not worthy of help. For both addiction and obesity, one can ask how fair the stigmatisation is. In her fascinating book What’s wrong with fat?, Abigail Saguy describes the recent war against obesity as a war against women, who are generally more prone to obesity than men, especially poor, black women. She debunks the myth that obesity is just unhealthy, and shows that for some conditions, it is in fact a protective factor. Foddy and Savulescu have, in the same way, tried to destigmatise addiction by describing addiction as a stigmatisation of pleasure-orientated behaviour. The idea of addiction as a disease started to emerge when success in life became more dependent on self-control.

So is nothing wrong with addiction and obesity? In addiction, much is invested in trying to change the lay-view on addiction, which basically sees it as a moral failure. This view is slowly being replaced by a more scientifically-informed view. It is time that the same thing happens for obesity.

(If you are in Sydney at the moment, the Charles Perkins Centre is hosting a 2 days conference on addiction and obesity on 11&12 of June.

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