This article first appeared in the St. Louis Beacon, Jan. 16, 2011 - On her way up to more than 130 pounds above her ideal weight, social worker Jennifer Beavers, 36, of Crestwood, ate on the run as often as three times a day. Fried chicken sandwiches were her No. 1 choice, but she had many favorites.
"Every fast food restaurant seemed to call my name," Beavers said. "I knew I was totally out of control, but I didn't have any willpower."
Beavers is down 83 pounds and is determined to shed 50 more. Now she favors grilled chicken without a bun or tossed into a salad. She's been following the Weight Watchers plan since March.
"But I still have cravings; I still love pasta with Alfredo sauce. But if I do that once a month instead of two or three times a week, it's manageable," Beavers said.
Food Addiction Is Hard To Recognize
Many people who are overweight don't consider themselves addicted to food.
"I don't know why I was overeating," Beavers said.
It's difficult for people to realize and articulate their addiction, according to Saint Louis University dietician Rabia Rahman.
"If they have a preoccupation, a compulsion, and they're eating when they're not hungry, in my mind, I say OK, this person likely has some sort of food addiction --- and they may not even realize it," Rahman said.
Weight issues in the United States have reached epidemic proportions. Thirty-four percent of Americans are overweight and another 34 percent are obese, according to 2008 figures, the latest available from the Centers for Disease Control.
Programs like Weight Watchers help thousands of people lose extra pounds. But that's just half the battle. According to a UCLA study published in 2007, as many as two-thirds of all dieters will gain back more than they lost.
Beavers is determined not to let that happen this time.
"Before, I always looked at it as a time-limited thing, like I was 'on a diet.' This time I've incorporated it into my philosophy of life," Beavers said.
The difference between a food addict and someone who's not addicted can be explained by the desire for, say, a chocolate chip cookie, according to Rahman. A non-addict will forget about the urge if there's not a cookie available. But someone who's addicted is more apt to go out and buy one, with an urgency like a drug addict in search of a fix.
"It is similar, absolutely," Rahman said. "It's like a strong craving, and that's where you see that yo-yo dieting because people have figured out how to lose weight, but then those cravings are still there."
Weight-loss Drugs Are No Panacea
Everyone who's struggled to lose weight has wished for a magic "diet pill." Weight loss medications of the 1950s and '60s were nothing more than amphetamines, or speed. Doctors stopped prescribing them because they're addictive.
Remember Fen-Phen? In the late 1990s, this combination of two drugs was all the rage with its ability to trick the stomach into feeling full while also boosting metabolism. But its association with heart valve disease caused manufacturers to pull it, and similar drugs, from the market.
A more recent drug called sibutramine, better known by its brand name of Meridia, was yanked from the market last year over concerns about its effects on the cardiovascular system.
Today, scientists are zeroing in on medicines used to treat addictions to alcohol and other drugs to address the U.S. obesity epidemic.
"Because there is some evidence that foods and drugs of abuse exploit similar pathways, namely the dopamine and opiate systems, research is focusing on medications that might help disrupt that pathway," Rahman said.
The anti-craving drug naltrexone, used to treat alcohol abuse and smoking, is already being prescribed off-label for weight loss. A weight-loss pill that contains naltrexone and bupropion, commonly known as the antidepressant Welbutrin was endorsed last month by a U.S. Food and Drug Administration panel.
In clinical trials, the drug, with a proposed trade name of Contrave, has proven more effective in combination with a diet and exercise program than a placebo. But it, too, has worrisome side effects, including significant increases in blood pressure and pulse rate.
Bottom Line: Eat Less
As scientists look for pharmaceutical solutions to obesity, the field of epigenetics, which suggests you can change your DNA or the way it's expressed with your behaviors, is beginning to focus on eating habits.
Last month, a study of mice published in the journal Cell suggested that a father's eating habits affect the DNA inherited by his children. The University of Texas study findings support two large-scale human studies on eating behaviors and offspring.
"A lot of research is focusing on epigenetics as a possible answer," Rahman said. "There is some research that both caloric restriction and caloric excess during pregnancy can cause some changes, not in the DNA per se, but in the way the DNA functions and affects weight status and addictive behaviors."
Even so, epigenetic breakthroughs will likely not alter Rahman's program. No matter what genetic material you're handed, losing weight and keeping it off involve eating less, exercising more and figuring out what triggers your overeating.
That's how Steve Magoc, 54, lost 48 pounds through the SLU program he started last spring. Motivated by the fatal heart attack his relatively healthy older sister suffered a little over a year ago, Magoc knew he had to lose some of his 362 pounds.
"I took a look at what happened to her and where I was headed, and I decided to try to make a change," Magoc said.
Magoc, like all of Rahman's clients, kept a food journal to record not only what he ate and how much, but also his mood, hunger level and where he ate. That kind of documentation helps with understanding eating patterns.
Rahman also advises clients to shun fad diets such as those claiming that the calories from one source, such as carbohydrates, contribute to weight gain more than others.
"Every time they do research, it comes back to the same thing: A calorie is a calorie," Rahman said.
Resigned to that fact, Magoc is adjusting his lifestyle, using time-worn advice that's familiar to all successful dieters.
"I eat better portions and healthier food, and I try hard not to snack. When I go to the store, I read labels instead of just grabbing what I like off the shelf," he said. "And I make sure I'm active every day."
Nancy Fowler Larson, a freelance writer in St. Louis, will be joining the Beacon staff later this month.
