Why do people who lose weight become addicted to something else?

Some patients with eating disorders may, when losing weight, mistake binge eating for addiction to drugs, alcohol, gambling, etc.

The classic weight loss advice is to “shut your mouth,” although this advice contains little truth and a lot of exaggeration. The basic premise for losing weight is a mathematical formula, in which you need to ingest fewer calories than your body uses, but the human being is made up of thoughts, cells, neurons and hormones that complicate the equation.

For this reason it is necessary to monitor a group of overweight people who suffer from so-called eating disorders because, believe it or not, there is a deeper imbalance in this story – and we are not talking about bloated cells.

“A person who suffers from binge eating associated with anxiety or a psychiatric disorder, or who has periodic binges, which are an eating disorder, is unlikely to have a normal weight. These people generally have a higher than normal weight, but one consequence is weight loss, which is usually not the only goal of treatment. So healthy weight loss occurs thanks to adequate treatment, but this is not the only goal in treating binge eating,” explains nutritionist Marcella Garcez, director and professor of the Brazilian Association of Nutrology (ABRAN).

Follow-up is necessary

These patients require multidisciplinary treatment and monitoring to avoid what is called “dependency transference” or cross-dependency.

“Some patients with eating disorders may, when they lose weight, exchange their binges for addictions to drugs, alcohol, gambling, (excessive) sports, shopping and even disorders with dermatological consequences such as skin picking and hair pulling. This happens because weight loss with diets only treats the consequence, which is excess weight, and not the cause, which often derives from a hormonal and/or psychological imbalance”, adds endocrinologist Deborah Beranger, post- degree in Endocrinology and Metabolism. from Santa Casa de Misericordia do Rio de Janeiro (SCMRJ).

One of the exponents of this debate is the American actor Josh Peck, best known for his role in the Nickelodeon series “Drake & Josh”. In a podcast interview, he discussed the pressures of growing up with fame as a “morbidly obese” teenager and the transition from addiction while losing weight to drug and alcohol abuse. “It’s as if the patient is looking for another source of pleasure,” says Marcella.

Emotional escape

According to doctors, people can develop addictions even after significant weight loss, and all of this serves as an emotional escape from the overwhelming lifestyle changes associated with weight loss.

“Compensation is primarily associated with people who undergo weight loss surgery, such as gastric bypass or sleeve gastrectomy, because the procedures lead to a dramatic reduction in food intake and body weight in a relatively short period of time,” he explains.

However, experts say this can also occur after natural weight loss and, potentially, after weight loss through drugs such as Ozempic, especially if there is no medical supervision during treatment.

“Every time people go through a major change in their body, there’s a psychological change that corresponds to that and it’s not always the positive change that people imagine it will be. When you lose a lot of weight, sometimes it happens very quickly and often in a way that seems out of people’s control,” comments Marcella.

Because the transference of dependence occurs

Similar to the American actor’s experience, many people believe that a slimmer body is the answer to their problems.

“But without treating the underlying cause of an existing compulsion, some risk replacing it with a potentially more dangerous addiction,” the nutritionist points out.

“This is why, generally, the treatment of an eating disorder is carried out in a multidisciplinary team, sometimes involving two or more doctors (nutrologists, psychiatrists, endocrinologists) and other health professionals, such as nutritionists, psychologists, physical educators, so that the person receives comprehensive treatment, identifying all the triggers that lead to binge eating and preventing these episodes from occurring or possibly treating the anxiety, depression or psychiatric disorder that leads to binge eating,” explains Marcella.

Endocrinologist Deborah reminds us that for many food is a great source of pleasure, in some cases the only one.

“When we eat, our brain releases chemicals related to pleasure, and that’s why we feel good. Drugs and alcohol, for example, have been shown to trigger reward responses in the brain similar to those of food, which helps explain why some people become addicted to substances when they can no longer derive satisfaction from their diet. If for some reason this patient does not have psychological support, he may experience the transference of dependence,” says the endocrinologist.

“Additionally, intoxication occurs more quickly and with less alcohol after weight loss surgery, increasing the risks of alcohol dependence. As tolerance reduces, people may experience the rewarding aspects of alcohol consumption earlier and more frequently, which can lead to a greater desire to consume more,” says Deborah Beranger.

The addiction simply changes places

Transference of addiction after rapid and significant weight loss can occur even in individuals with no history of addiction, whether to food, drugs, alcohol, or another substance or behavior.

“Some patients become dependent, for example, on physical activities. What may seem healthy at first glance, depending on the amount of training done (and there are often several during the day), can lead to a problem of overtraining and fatigue,” explains Deborah.

“In 2021, a study showed that patients with higher levels of ghrelin, the hunger hormone, tend to have more impulsive behaviors, including those related to monetary matters. They preferred an immediate but smaller reward, indicating impulsive behavior. So it may also happen that some patients have an addiction to betting and gaming,” says nutritionist Marcella Garcez.

Is food addiction a disorder?

The medical community has not yet recognized food addiction as a disorder. The concept of food addiction is controversial and is really only seen in the context of dieting and limiting food intake: the more people try to limit their consumption, the more out of control they feel around food.

This debate has made it difficult for researchers to understand and communicate risk factors for addiction transfer after weight loss.

“The best way to avoid the phenomenon completely is to work closely with a mental health professional, preferably one experienced in treating addictions and eating disorders, before, during and after your weight loss journey. The multidisciplinary team will provide the necessary care to avoid further problems for the patient”, concludes Marcella.

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Rose

Rose James is a Gossipify movie and series reviewer known for her in-depth analysis and unique perspective on the latest releases. With a background in film studies, she provides engaging and informative reviews, and keeps readers up to date with industry trends and emerging talents.