By Courtenay Smith
When Dr. Oz chose Brad Lamm’s book, Just 10 Pounds, to be the center of an anti-obesity initiative on his Dr. Oz Show, Lamm became one of the most famous interventionists openly talking about food addiction. As founder of the Change Institute, Lamm understands addiction in all of its forms. He recently toured the country, sharing his own story of bulimia, compulsive overeating, and drug and alcohol addiction. He urges people to break weight loss goals into manageable steps while addressing the emotions that drive overeating.
TOGETHER: Is food addiction responsible for obesity in America?
LAMM: No, that’s too easy an answer. Food addiction is a symptom of a culture that wants more. Our culture enables addiction in all different forms.
You just traveled around the country in support of your book, Just 10 Pounds, talking about food addiction. What has the reception been like?
The thing I was most nervous about turned out to be the most delicious part. I was at 12 high schools around the country talking about how food can get out of control and take away from the kind of life we want. After the talks, kids would cry and laugh and ask for help.
What were the kids crying about?
It was fat girls talking about being called “pig.” It was skinny girls talking about how their disease is the outgrowth of their mom’s eating disorder. It was kids that are heavy talking about how they’re not eating at home. Their meals are the crap that’s part of the school lunch program.
You have said that most food addicts will not identify themselves as food addicts. What do they call themselves?
They will say, “I’m addicted to sugar, I’m addicted to carbs,” but they won’t opt into being food addicts. So I try to couch the message in Just 10 Pounds as, first, starting with a love centered diet, and then, two, identifying the emotional triggers and the battleground beliefs that lead to binging and sideways eating behaviors.
Can you give me an example of an emotional trigger?
People will say, “I’m bored.” And “bored,” if you break it down, is a feeling of disconnect, a feeling of loneliness. We are all in some way emotional eaters. The most often heard complaint about why people overeat is that they are not mindful or they’re emotional. You can’t extract the feelings from the way we feed ourselves, just like you can’t take the butter out of a muffin.
Can food create a high similar to alcohol?
Oh my god, absolutely. I can think about a binge food right now — cherry pie, the buttery crust, the sugar in the ber-ries, the thick sauce and my mouth is watering. Now, just thinking about it, I’m having a response. If I ate some I would have an incredible response — I would have a dopamine rush [a brain hormone that focuses attention] and it would make me feel different.
You’ve also said most food addicts will resist going to a 12-step program. Can they find another way to recover?
Absolutely. The people who say the only way is 12-step, I think that comes from a place of fear. I have clients who have broken all sorts of addictions on routes that do not include a 12-step program. If you look at the statistics, I hope it’s not the only answer because it sure isn’t very effective.
Where else should food addicts look for help?
A goal would be to expand their spiritual lives. If you look at health and recovery as an integrative path, then it naturally leads in my mind to a spiritual community. You could go to the Y, find a church, join a synagogue. It might be yoga, it might be a movement that is with other people, so that you’re noticed, and so your story is heard, so that you’re not alone.
What does hitting bottom look like for a food addict?
For some people it will be death. I once met a girl who weighed 75 pounds and was on a feeding tube. Then I think of my mom: I picture her in a bed, having had her life ruined due to strokes, a direct response to the way that she treated her body. She had food disorders for 40 years. But I believe we can help people create a bottom. The idea that we have to wait for them to hit bottom is nonsense.
Complete this sentence: Alcoholics begin recovery by putting down alcohol. Food addicts begin recovery by …
Making a food plan and becoming abstinent. And abstinence means that they’re following the food plan. My definition of abstinence is that I’m not purging. Now, if I’m not on my food plan, if I’m eating trigger foods, it is likely to lead to thoughts of binging and purging. Having sugar is not something that breaks my abstinence. If I binge and purge, I’m no longer abstinent.
If there is some room for sugar in your food plan, does that mean moderation works in treating food addiction?
I don’t think so. My plan is pretty rigid, actually. I’m careful about what I eat. For breakfast this morning, I had three eggs, two ounces of yogurt, and fruit. For lunch I had four ounces of fish, broccoli, baked sweet potato and whole wheat cous cous. I have something similar almost every day. Most people would not consider that moderate.
Considering how most of America eats, you mean.
Yes. The truth is, I think sugar is a horror. If we didn’t eat it, we would be so much healthier and it would solve so many problems. I also think white flour is not healthy for us.
Food addiction treatment centers often lump bulimics and anorexics and compulsive overeaters together. Are they re-ally all the same?
I think that’s a treatment model that people have begrudgingly followed because of economics. In classic addiction terms, it’s the same problem. It’s the hole in the soul. But the hardest thing to treat is the compulsive overeater.
Why?
Because when a client comes in who has 100 or even 80 pounds to lose, that physical transformation takes a year or more. Treatment creates a firewall between them and the food until the weight stabilizes. People aren’t going into treat-ment for that long, and insurance won’t pay for it. If you’re tiny, meaning anorexic or bulimic, generally medical insurance covers your treatment. If you’re big, it won’t. It’s a shame and injustice.
And yet insurance has to pay the cost of all the heart disease treatments, diabetes mediations, the results of the extra weight caused by food addiction.
But they’re not viewing it as a cost effective approach.
The addiction community accepts food addiction as a real disease, but do nutritionists and weight loss professionals?
It’s still a real conversation. I just got a letter a couple of days ago from a professor taking great offense that I’m using the word addiction with food, saying that food addiction is not scientifically proven, and that I’m doing people with real addictions an injustice.
Is the word addiction offensive even to people who might be food addicts? Will they say, call me other things, but don’t call me an addict?
I think people would rather be termed mentally ill than they would an addict.
Do you really think that?
Oh yes. Parents are my first callers, the biggest group of people who ring my help line. They are horrified that their child, and it can be an adult child, is an addict. They would rather that there be a diagnosable disorder that could be treated with a pill, rather than an addiction, which implies a lifetime of work to get on the beam and stay on the beam.
Where are we in the national conversation about food addiction, and where do you think we need to go?
The next couple of years are going to be huge. I’m co-hosting a lifestyle intervention conference in September about food addiction. We’re just really starting to grapple with it in a new way. We’re going to get honest. Literally, it’s the num-ber one cause of death — if you include heart disease, stroke, hypertension, diabetes — that we really have a say in con-trolling.
Do you think food addiction, or just being overweight, is the number one cause of death?
If there are 72 million Americans who are overweight or obese, statistics say that maybe 12 percent of them are classi-fied as food addicts. I actually believe it’s half. You’ve still got hundreds of millions of years of lives that you’re cutting short.
What does recovery look like for a food addict after you’ve intervened?
I believe in a continuum of contact, so that means turning your food over to someone else. So it’s not happening just in your head, but it’s part of a plan. Because if I’m deciding on the spot with my tongue and my nose and my senses, and if my emotions are involved, then I’m unlikely to stay on the beam.
Do you need to find a like-minded person to turn your food over to?
I suggest in my book recruiting a “Just 10 Buddy,” somebody who is going to support you in the decision that you’re going to make changes 10 pounds at a time. The person doesn’t have to be healthy themselves, but they have to be hopeful. What you’re looking for is encouragement and inspiration.
Should you expect the person to make comments about what you’re eating?
First, share with them your food plan, so in turning over your food they become an accountability partner. If they know your story, and you say, “I had ice cream,” they know whether that deserves a conversation.
How do people find food plans?
I go back to this litmus test for what you put in yourself: is it loving and good? It doesn’t have to be fresh – I love frozen foods. It doesn’t have to be fancy. I’m the king of the fried egg.
Any final words?
I think food is the hardest addiction to tackle, because we have to eat every day, and it’s a constant battle. One client’s office is a horrible one for a food addict. There are always cookies and cupcakes. She’s surrounded by her trigger foods. You can suggest that she get another job, but the reality is a person’s primary trigger can be really tough to change.
Courtenay Smith is a health journalist and a former editor at Prevention, More, Fitness and Woman’s Day.
