Addiction--to food?

 It seems that everywhere you turn--dinner parties, your best friend's kitchen, bookstores, even talk shows--someone is confessing to having a food addiction. For years, experts scoffed at the notion that you could be hooked on chocolate or chips. Some still do. But recently, high-tech medical scans have revealed surprising similarities in the brain chemistry of drug addicts and chronic overeaters--resemblances that have caught the attention of the National Institute on Drug Abuse.

  The behavior of compulsive eaters also lends credence to the idea of food addiction--the cravings and preoccupation with food, the guilt, the way these overeaters use food to relieve bad feelings, and the fact that binges are frequently conducted at night or in secret. Now some addiction and obesity experts have started to use the "A" word in connection with food and even to speculate that it may be partly responsible for America's rising obesity rate.

 "Food might be the substance in a substance-abuse disorder that we see today as obesity," says Mark Gold, MD, chief of addiction medicine at the University of Florida College of Medicine. "If you ask some of the questions that are used to diagnose drug abuse--for instance, 'Do you continue to use the substance despite its negative effects?' or 'Do you have a preference for more refined substances?'--and then replace substance with food, it's not all that difficult to imagine that food addictions exist."

 In 2001, Wang and his colleagues, Volkow among them, compared the brain scans of obese and normal-weight volunteers, counting up dopamine receptors. Obese people, Wang realized, had fewer dopamine receptors--and the more obese they were, the fewer of these crucial receptors they had. In fact, he says, the brains of obese people and drug addicts look strikingly similar: "Both have fewer dopamine receptors than normal subjects."

 It's possible that drug use or compulsive overeating actually lowers the number of dopamine receptors. But it's also possible that some people are born with fewer--and if that's the case, say researchers, it could explain a lot. If overeaters or drug addicts are short on receptors for the aah chemical, they might not respond as readily to social interaction, art, sex, and other pleasures that ought to make them feel good. And that could be the reason they're driven to consume things that prompt dopamine's release--like illicit drugs (the most potent activator) or foods high in fat, sugar, and possibly salt.

 "If you have someone who is not responsive to natural reinforcers, that person may be more vulnerable to taking drugs," Volkow says. "If you get stimulated only by food, guess what happens? You can easily fall into patterns of compulsive eating."

  "Like cocaine addicts who can't leave any cocaine behind, food addicts eat until no food is available," says Gold. "You might say, 'Yeah, I did that on Thanksgiving.' But food addicts do this all the time."

 Is It Nature...or Nurture?

 If that's the case, we live in an environment perfectly designed to nurture food addiction. For decades, food-industry scientists have been working hard to figure out how better to hook people, claims David L. Katz, MD, MPH, director of the Yale-Griffin Prevention Research Center in Derby, CT, and author of The Flavor Point Diet.

 Manufacturers now excel at hitting the sweet spot--making us crave more and more of a food. "In a supermarket recently, I actually found a pasta sauce that, serving for serving, contained more sugar than a chocolate fudge sauce, though the sweetness was hidden because the pasta sauce was so salty," Katz says. "The question is, why would anybody pour a packet of sugar over their pasta? And the answer is that if you get used to that much sugar, another pasta sauce will taste too bland. The food industry wants us to need more and more of the substance to feel satisfied, so we'll go out and buy more and more of it."

Getting Straight

 Whether you look outside or inside yourself for the determination to stop your destructive behavior, researchers agree that it's important to recognize that you can change. High-fat, high-sugar foods may trigger some of the same brain effects as drugs like cocaine or heroin, but their impact isn't as powerful.

 While it may feel at times like a runaway train,  here are eight steps you can take to get back on track.

 1. Don't go cold turkey Although treatment for life-threatening drug or alcohol addiction generally requires abstinence, an all-or-nothing approach is impossible for food addicts--everyone has to eat. Besides, some weight loss experts believe that such rigid thinking can make you crave the offending food more than ever. 

 2. Control your home environment Just as someone with an alcohol problem shouldn't buy a magnum of champagne, you shouldn't overstock your kitchen, says Gold. "You have to assume that every food or drink you buy will end up in your mouth. You'll see a TV commercial or some other trigger, and that food will end up in your mouth." Exercise purchase and portion control, Gold advises.

 3. Temper temptation Sometimes it's not just a food that sets you off but also the place in which you eat it--and that's why putting yourself in a situation where you used to eat excessively can be a recipe for trouble. Ex-drug addicts face this problem all the time, reports Marcia Levin Pelchat, PhD, a research scientist at Monell Chemical Senses Center in Philadelphia. "Going back to the old neighborhood often triggers a strong craving," she says.

 4. Retrain your brain In order to be satisfied with two cookies instead of an entire bag, you need to change the way your brain sees food on the plate, says Gold. First, switch to smaller plates and bowls to automatically reduce portion sizes. "This can make people very distraught because the brain looks at the smaller portions and decides they're not enough," says Gold. "But over time, the brain gets used to it."

 5. Adjust your tastebuds One of the best ways to gain control over your eating is to restore your sensitivity to flavors, says Katz. You can do it without depriving yourself: If sugar is your downfall, keep sugar cookies in your diet, but when picking prepared foods that aren't supposed to be sweet--such as pasta sauce, bread, and chips--look for ones without added sweeteners. Check ingredient labels for all the names that sugar goes by, including fructose, dextrose, and corn syrup (for a list of sugar's aliases, read "Find the Hidden Sugars").