By far the most widespread area of confusion regarding addiction, especially food addiction, is that it's biochemistry that makes it difficult to break free; that the problem is one of physical dependence.  

Some addictions are driven primarily by physical dependence, such as certain medications for sleeping, painkillers or antidepressants. The body becomes accustomed to the drug, adapting to the repeated introduction of these toxins as best it can. After some time, there can be significant difficulty readjusting physically whenever they're removed, and that's why they can be referred to as addictions.  

Most, if not all, addictions have an element of physical dependence, but the addictive behaviours I'm most familiar with (nicotine and starchy carbohydrates) are mainly driven by something else: Pavlovian conditioning of the reward system. There is, of course, a biochemical aspect to this, but this is not the same as physical dependence. The far more important factor is the brain's reward system, and the crucial elements with this are pleasure, satisfaction and, especially, context.

Most people who overeat can see that they can control their eating in certain circumstances but not in others. For some, they're fine at home but tend to overeat in the context of social situations. For others it's the reverse, where their home is the context for endless snacking. Pavlovian conditioning sets you up to overeat in certain circumstances; it's the context that drives the behaviour. Physical dependence plays a part, but mostly the circumstance you are in creates an expectation of eating, based on what you've done in that context in the past. (1)

I cannot tell you how often this distinction between physical dependence and Pavlovian conditioning is confused. Food addiction in particular is usually not even acknowledged, but when it is, physical dependence is assumed.  

This is why I get excited when I read (relatively recent) studies on food addiction written by researchers using fMRI brain-scanning technology. They have been able to see inside active human brains, so they know more than anyone where the addictive process occurs. One such researcher, Dr N. D. Volkow, Director of the (US) National Institute on Drug Abuse, says:

"Once you create a conditioned memory, it's just like Pavlov's dogs; the response becomes a reflex. This conditioned response underlies the drive both in drug addiction and compulsive eating." (2)

This conditioned response and the drive it creates is usually thought of in terms of craving, but this term may not be helpful or entirely descriptive. Craving is a tough word to define, but any definition I've ever seen has included the words 'intense desire'. What is regarded as intense is going to differ from person to person, but the intensity of the desire often comes, not from the Pavlovian conditioning itself, but from the reaction to it, in particular as a result of the denial of choice.

This is why craving - at least as many people think of it - isn't a necessary part of eating less. And it's misleading because the Pavlovian conditioning can easily show up as feeling hungry or not feeling full:  

"Hunger caused by food cues is an adaptive mechanism for survival, and the learned cues can serve as a harmful force to promote over-indulgence in food despite satiety (fullness)." (3)

The conditioned desire can also show up quite simply as a preference for one item over another. For example, someone wanting a snack in the afternoon, faced with the option of an apple or a few chocolate biscuits, thinking that the apple doesn't stand a chance. Please note that I'm not telling you which one to choose; it's just that one of those options is more influenced by the processes of addiction than the other, for most people.  

Most people overeat starchy carbohydrates, and dealing with this is about resolving a conflict. This conflict is between the immediate gratification of the addictive desire (and the pleasure and sense of satisfaction that brings) and the more delayed rewards of improved health and self-esteem which come from eating less.

The good news is that you don't need to change your biochemistry in order to begin. You could simply think of this as a process of changing your values. You cannot escape having values, even though you might not consider them too much. For example, every time you buy something, no matter what it is, you are acting on your values. You say, "this bag of organic carrots is more valuable to me than my �1." Which is a choice I made (quite easily!) last week.

For many people, overeating comes from acting on the value they place on immediate pleasure and satisfaction, possibly at the expense of improved health and self-esteem. I don't want to tell you what your values should be. For one thing, the potential problem with your health and self-esteem may not be that great at this time. And anyway, if that's the way you want to live, I honestly don't think it's my place to judge that.  

My point is simply that you can, if you want, re-evaluate your values, any time. It's entirely possible, for example, that someone will overeat for years, prioritising immediate pleasure until they become unwell. That wake-up call means that they change their priorities, so their health then becomes more important to them than the satisfaction of their addictive desire.

This does depend on nutritional information regarding which foods are likely to be contributing to the poor health in the first place. And it certainly can depend on an ability to work through an addictive relationship with those foods, so that the intention to eat less - or eat less of certain things - can be successfully maintained.

This, of course, can be considerably more challenging than deciding to buy a few carrots for �1. The reason is that the addictive desire to eat (the Pavlovian conditioning) is produced in a different area of the brain than the area that connects you to your true values and intentions. These two areas of the brain evolved at different times in human history and are to some degree separate and mismatched. (4) 

Many people trying to control overeating feel that they are 'in two minds' - determined to start the diet one minute, binging on biscuits the next. And if you feel guilt, regret or low self-esteem in connection with overeating, these can also be signs that you're not acting in line with your values, because you don't have the best possible communication between these two areas in your brain.  

When you use the techniques I describe in EATING LESS, you build connections between these two areas, so that they work together in more integrated harmony. And that's why developing a peaceful, healthy and non-addictive relationship with food can be so very empowering.  

Some thoughts:  

• The glycemic index of carbohydrates is an important factor in addictive overeating, not so much in order to maintain blood glucose levels, but because they strongly reinforce Pavlovian conditioning. This is why, when a conditioned cue triggers your addictive desire to eat, you're more likely to fancy something containing sugar and/or wheat, rather than, say, raw vegetables.

• You don't need to be in poor health in order to make changes. For example, my health is excellent and my motivation about what I eat and don't eat is all about staying that way.

• Be as clear as you can about the specific benefits you hope to gain as a result of eating less. Often people just think, "I'm not supposed to be eating these..." and this can just be too vague to stand up against the Pavlovian conditioning.

NOTES

1. "Experimental extinction in Pavlovian conditioning: behavioural and neuroscience perspectives" A R Delamater (2004) Quarterly Journal of Experimental Psychology 57(2):97-132
2. "This is your brain on food" K L Ozelli (2007) Scientific American 297(3):84-85
3. "Food addiction and neuroimaging" Y Zhang, K M von Deneen (2011) Current Pharmaceutical Design 17:1149-1157
4. "Mindsight" Daniel Siegel, MD (Bantam, 2011) 

First off I'd just like to thank you for creating the Eating Less CD. I've bought both books and I'm now listening to the CD in the car, and on my MP3 player when I'm walking, and working.

I came across this special report today and your distinction between real food and food-like substances immediately came to mind:

"Obese people now outnumber the hungry globally... where 15% of humanity are hungry while 20% are overweight, something has gone wrong somewhere... excess nutrition now kills more than hunger."

"Excess nutrition"?? Would I be right in thinking the problem is not caused by an excess of nutrition but rather a deficit, in both the cases of the hungry and the obese? I've been trying to keep my diet whole and nutritionally dense and it requires a lot of vigilance - I don't imagine it an easy task to manage to consume excess nutrition. Excess volume, easy.

MY ANSWER:

Thanks for your email and the quote regarding 'excess nutrition' and world hunger. I absolutely agree with you that the problem is not one of excess nutrition. The similar term 'overnutrition' is sometimes used in the medical literature, meaning overeating. I suspect that it comes from the time when medical people thought only in terms of consuming too many calories, no matter where they came from, which is an outdated concept now. One very common finding is that obese people are often malnourished, deficient in a wide range of nutrients. 

I've just read a very exciting new book called WHEAT BELLY by Dr William Davis and I highly recommend it. It explains so much, including the addictive, 'more-ish' qualities of grains.

Pleased to hear you are finding my books and CD helpful.

I came with high expectations and the seminar exceeded them. The seminar content is experience and research based, all sessions interesting, and kept my attention throughout. I could listen to Gillian speak over and over again.

I had read the book almost a year ago and although I felt I had begun to make progress, the seminar made me realise I was still living in the deprivation, comply/rebel cycle.

I would not change a thing about the seminar. Perfect pitch, Gillian attentive and considerate when answering questions. I so enjoyed the whole weekend, and being able to speak freely about the issue with like-minded individuals.

The seminar exceeded my expectations. It brought to life, clarified and cemented the information and guidance in EATING LESS, and also brought some scientific-lead information smack up to date.

I wish I had met you when I was in my 30s, Gillian, as I think your approach would have helped to prevent a great many of my current health problems. But it's never, entirely, too late.

This is an excellent workshop that has changed my attitude to food. Anyone who has spent years obsessing about what they should and shouldn't do - go along. It may well change your life!

Gillian is very personable, supportive and made sure that everyone's voice was heard.

This was a fantastic introduction to address my addictive overeating. I loved the workshop. I have come away with great techniques not to overeat. The pace was great. Everyone was given ample time. A great trainer.

Really enjoyed it. Informative and challenging. Has given me lots of insights and made it very real.

Clear, precise, good material. Good listening and answers to any question. Good group work.

Lots of time allowed for the group to express thoughts and ideas. Gillian is a great advert for her product.

The seminar made the theory of the book clear and practical; how to use and apply it on a daily basis.     

I so enjoyed your seminar weekend, the content so logical, thought provoking, and presented in a calm relaxing way and in such lovely surroundings. I have not since the seminar overeaten to the extremes I had done previously. I don't feel the despair I had done previously and feel more accepting of myself.