FARAI CHIDEYA, host:

This is News & Notes. I'm Farai Chideya. We've got another listener favorite from 2008.

(Soundbite of NPR's News & Notes, September 18, 2008)

CHIDEYA: A bag of cookies after a long, hard day at work, a gallon of ice cream to celebrate that promotion, an extra helping of potato salad or macaroni and cheese. Many of us overindulge from time to time. But when do we cross the line from occasional overeating to food addiction? In a few minutes, we'll talk to a food addiction counselor and a recovering food addict. But first, we've got Marty Lerner. He directs the Milestones in Recovery Eating Disorders Program. Hi, Marty.

Doctor MARTIN LERNER (Executive Director, Milestones in Recovery Eating Disorders Program): Hello. Good afternoon.

CHIDEYA: So, when does someone cross the line between overeating and food addiction?

Dr. LERNER: It's very similar to other addictions. For instance, if I can borrow an analogy between a heavy social drinker and an alcoholic, there comes a time when someone wakes up in the morning, and they look back, and they realize instead of their controlling their consumption of alcohol, now the alcohol is controlling themselves.

So, one of the earmarks of food addiction, or any addiction, is to find yourself in the quagmire of wanting to not engage in a behavior or consume a substance and finding yourself compelled to do that despite the consequences. So, a loss of control is one earmark that delineates someone with a bad habit versus someone who has an addictive process they're involved with.

CHIDEYA: Give me a more concrete example of when you think someone has crossed that line.

Dr. LERNER: Well, it's very difficult when you talk about addictions, in terms of a diagnosis, if you're limited to diagnosing a problem in terms of frequency or amount, although many people have tried to do that. So for instance, when looking at eating disorders or food addiction, most people try to define the difference between someone with a weight disorder and an eating disorder, for instance, in terms of what they weigh.

And the truth of the matter is that there's a subjective perspective with all of this. And I would prefer to define an addiction in terms of someone continuing to engage in a behavior despite consequences and also despite the fact that they may want to stop but feel that they've crossed the line where they're not in control.

CHIDEYA: What does this do to your brain? If you are someone who, for example, has been spending years eating high-sugar, high-fat foods, does it change how your brain works?

Dr. LERNER: Well, one of the ways in which we delineate, you know, compulsions and addictions from folks that, you know, occasionally overindulge is that the brain chemistry - we don't know whether this predates the onset of the addiction or comes after - sort of chicken or the egg - but we do know from recent research - mostly PET scans, tomography, et cetera - then, when you look at the brain chemistry and you map the brain of addicts, there are similarities between, for instance, cocaine addicts and food addicts.

Specifically, the amount of the dopamine receptors in the brain are less amongst those with cocaine addiction, or in the throes of cocaine addiction, or those in the throes of compulsive overeating. And when you measure brain activity, when someone is ingesting cocaine or ingesting, for instance, sugar, refined carbohydrates, types of substances that radically change blood sugar levels, these are mood or mind altering.

And the evidence of that is you can see highlighted areas of the brain where available dopamine and serotonin levels skyrocket. And in addition to that, insulin levels also are elevated, which results in a rapid rise in blood sugar and then a rapid drop, which some people know as functional hypoglycemia.

CHIDEYA: Well, Marty, thanks for the information.

Dr. LERNER: Yes, you're welcome.

CHIDEYA: That was Marty Lerner. He's executive director of Milestones in Recovery Eating Disorders Program.

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