Stages of Food Addiction
For those who already know they have a problem, and that problem is food addiction, an important question is: at what stage are they in the progression of the disease? This makes a difference in terms of what they might have to do to recover.
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In the early stage, food addicts are often unaware that they have a problem; food often seems more like the solution than the problem. The main problem usually begins with a lack of good education about food addiction.
By the middle stage, food addicts have tried a number of diets or other more extreme strategies to control their eating; they are suffering negative consequences – being overweight, depressed, leading a secret life, feeling guilt or shame about both – but the consequences do not seem severe enough to justify giving up entirely the foods they like the most, much less asking for help to do this.
In late stage, food addicts know their problem is critical but they find their situation hopeless; they know that they are powerless to stop by themselves, but commercial weight loss, therapy on underlying issues, and sometimes even 12-Step programs alone are not sufficient to get them abstinent and in stable recovery. Most food addicts at this stage need professional treatment.
In final stage there are usually very serious medical complications. This could be morbid obesity, failing joints, advanced diabetes, progressive heart disease, and much more – including a desire for death. Paradoxically, eating has often become the most important thing in their lives, and while it is causing an early and painful death, it can also be the only thing that they believe makes life worth living. Treatment at this stage must often be primary, follow the addiction model and be hospital-based. There currently are no such programs.
Tragically, knowing that food addiction is a serious, progressive disease is often insufficient to break food-addictive denial. The chart below visualizes the disease stage and the recommended action at each stage.
Pre-Disease
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No sign of abnormal eating or reactions to specific foods. If no dependency or pathology develops, this stage will continue through the person’s entire life.
Prevention:
Education about food addiction. Ongoing checks for signs of chemical dependency. Moderation in eating, especially commonly addictive foods, e.g. sugar, caffeine, excess fat, alcohol, drugs.
Early Stage
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Problems with weight management, cycles of weight gain followed by dieting, weight loss, and weight gain again. Occasionally binge eating on sugar, excess fat, or volume. Could be early-stage food addiction or a normal eater making unhealthy choices.
Detox and Abstinence:
Identify addictive foods. Eliminate binge and trigger foods. Move though detoxication. This often seems extreme if negative consequences are not yet severe, the beginning of addictive denial.
Middle Stage
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Frequent binge eating and grazing. Purging or severe reactions may begin. Rationalizing before eating, guilt afterward. Could be advancing food addiction or emotional problem eater with a psychologically based eating disorder.
Twelve Step / Peer Support Group / Counselor:
Participation in a food-related Twelve Step program, e.g., Overeaters Anonymous, and/or work with a food addiction counselor. Assistance with addressing blocks to physical abstinence, especially denial. Develop feeling skills, resolve trauma.
Late Stage
Serious consequences from overeating – morbid obesity. Type II diabetes, chronic depression and/or spiritual disillusionment, and eating anyway. Food no longer provides comfort, escape, oblivion, etc. Loss of control, increasing tolerance.
More Structure and Support:
Participation in a highly structured Twelve Step program, e.g., Food Addicts in Recovery Anonymous, Compulsive Eaters Anonymous – HOW. Outpatient treatment and/or workshops such as those offered by SHiFT. Abstinence as a spiritual path.
Final Stage
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Severe consequences – hospitalization for heart attacks, suicide attempts, lost jobs or inability to work, ruined relationships, treatment and/or intestinal surgery followed by relapse, housebound or confined to nursing homes.
Primary Inpatient or Residential Treatment:
Given the lack of any hospital-based inpatient treatment for food addiction, alternatives include Turning Point of Tampa, Milestones, Shades of Hope, SHiFT Acorn Intensive program. This is sometimes insufficient.
The last stage of food addiction is death.
The death rates for food addicts are probably similar to those for obesity: statistically, active food addicts can expect to die five to ten years before their healthier counterparts, and more importantly, the last stages of life for the active food addicts can be very painful physically, emotionally and spiritually.