Thursday, December 6, 2012

Random thoughts on addiction

I have a friend who is trying to quit smoking right now and having a hard time of it and, for my book, I wrote about my own mother-in-law dying from lung cancer as a result of smoking. This has got me thinking. I look at our attitudes towards addiction and realize that addiction and obesity have a lot in common, both in how the person dealing with them experiences it and how outsiders view it.

I know that at times I have been judgmental towards smokers. “Why don’t they just quit?” I think to myself.

“Um, why don’t you just push yourself away from the table?” I’m sure some of them would have fired back.

“It’s not the same!”

But is that true?
There are differences, of course, mostly because nicotine is one of the most physically addicting substances out there that’s legal. Food is more complicated. Some foods do cause physical reactions in the body that are similar to those caused by consuming other substances we know are physically addicting. But scientists say these foods don't meet all the scientific criteria for a physical addiction.

However, you can be addicted to anything, even shopping, so why not eating? It's certainly more rewarding to me than shopping, that's for sure!

When your body is making too much ghrelin and your brain is reacting to its presence by telling you that you are starving and are going to die if you don’t eat, the urge to eat is just as strong as the urge to smoke a cigarette is to someone addicted to caffeine. At some point, if the behavior and thought processes are the same, I just don’t think it matters if they aren’t the same at a clinical level. It’s interesting to me to understand the science behind it, but it doesn’t necessary illuminate anything important on a human level.

I think of it as being like the difference between a food intolerance and a food sensitivity. Science distinguishes between them but, in both cases, you eat a certain food and you feel bad. Likewise, you treat them both by avoiding that food. At some point, the medical differences don't matter to most people.

Some other aspects for how addiction and obesity are the same have to do with trying to change. Anyone who’s been on a diet knows how it goes. Something happens to motivate you to change. You start eating less and maybe moving more and you are fired up. This time you’ll do it! This time it will work! This time it will be different!

And, it is for a while. But eventually the urge to eat, whether physical or mental, is just too strong and you backslide and that puts you back on the path to gaining all your weight back and you start to berate yourself. What's wrong with me? Why can't I do this?

I've seen addicts go through the same process with their addiction. Something happens to push them to stop drinking/drugging/sexing/smoking/shopping/whatever. They are clean and it feels great. They are sure this time they are cured and they will never backslide. Until they do. Then the self-flagulation begins.

My maternal grandfather was an alcoholic for most of his life. He quit drinking many times only to backslide back into practicing alcoholism. But one time it did stick and he was clean and sober until he died. I have no idea why that one time worked. Was it that he finally found the right program? That's what he said. On the other hand, he spent 13 years at a mental institution and he was forced to be dry for that time. Maybe he just got out of the habit of drinking and when he got out, he couldn't resume his old life because it had passed him by.

I really don't know; I'm just glad he finally found his answer when the odds were against him and he got a second chance.

I think the current stats on treating addiction are something like a 23% success rate. That's better than dieting (1-5% success rate), but it's still pretty dismal.

And here's another way that beating addiction is like losing weight:

What's the success rate for quitting smoking? It's pretty good, right? I mean there are all those programs and drugs and I know a couple of people who have done it. Maybe your chances before Chantix sucked, but now they are probably over 70%!

Actually, according the American Cancer Society, your chances of quitting smoking from any one attempt are 7%. Drug programs have an average success rate of around 25% (so similar to other addiction cure rates) but combining drugs with therapy can increase that (thought they don't say by how much).

So with both addition and obesity, you have a problem that is very intractable to treatment that succeeds far, far less often than it fails but with the public thinking the success rate is significantly higher than it is or at least acting like they think that.

There are other aspects of having a weight problem that remind me of addiction. That's the part where sometimes to beat the problem, you have to be a little bit nuts.

If you are like me, the losing part is somewhat easy. You put your laser focus onto the goal and you head towards it like no tomorrow. Sure, sometimes you are so hungry you go to bed at 9:00 pm (or earlier) because you’ve used up all your calories for the day and you can’t take the stomach grumbling and starvation any more.

But for those with obsessive tendencies, the goal is what counts and every pound lost just reinforces the dieting behavior. In this way, you could say we’re “addicted” to losing weight. But more it’s likely that we’re nuts. (Lay person nuts, not clinically nuts.)

Our dieting is fueled by the exact same thought processes and behaviors as what makes us train for an Ironman, by the way.

It’s the same impulses that causes us to do things like ride our bike in the rain and crash and miss the rest of the season. Because bike riding was on our training plan that day and we were bound and determined not to “wimp out." Sane people would stay home because the risks outweigh the rewards but we aren't sane. It's that sort of insanity that really helps you succeed at losing weight and when I lost that insanity (when it came to weight, not when it came to doing other dumb things), is when dieting stopped being effect for me to lose weight.

This is dieting’s dark side. The side that leads to anorexia and bulimia in some.

Okay, so I have no idea where I'm going with this. Except maybe to realize I have been pretty judgmental towards addicts in the past even when my own issues weren't that much different. And also to wonder if maybe the reason it's so hard to cure these two problems is that we're approaching them all wrong.
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