The Disease Concept of Food Addiction: A Story for People Interested in Recovery

The first edition of this book was developed from the files of Philip Werdell, M.A.,

from his early years as a food addiction counselor.

Mr. Werdell has worked professionally with over

5,000 late-stage food addicts. He is the founder of ACORN Food Dependency

Recovery Services and the Food Addiction Institute.

This paper was first published

on the Food Addiction Institute website in 2009.

COPYRIGHT PAGE

First Edition 1989

Second Edition 2021

© Philip R. Werdell, M.A.

with Mark Cheren, Ed.D.; Mary Foushi, B.S.;

Esther Helga Guðmundsdóttir, M.S.; Colleen Hillock, M.A.;

Michael Prager, B.S.; Mary Rice, B.A.;

Louisa Walsh, M.D.; and other members

of the first International Advisory Board of Food Addiction Institute

Print ISBN: 978-1-09838-994-9

ebook ISBN: 978-1-09838-995-6

Printed in the United States of America

ACKNOWLEDGMENT

Thank you to all the food addicts and professionals with whom I have worked, and to Mary DiSanzo, the editor of this edition.

Contents

INTRODUCTION TO THE SECOND EDITION

INTRODUCTION TO ORIGINAL MANUSCRIPT (1989)

Learning about treatment

The language of food disorders

A disease of powerlessness

Food Addiction: The Disease Concept

Powerlessness

The State of the Art

A physical, emotional and spiritual disease

Alcoholics react to alcohol differently

A similar reaction to food

A biochemical theory of food addiction

Powerlessness is subtle

A difference between alcohol, drug and food addiction

Food abuse is very common

Addiction Is Different from Abuse

Loss of control: four stories

The cunning problem of denial

My own experience of being in denial

More lies and denial

A riddle begins to be solved

The characteristics of food addiction

I

Food Addiction Is a Primary Disease

Spiritual problems which are secondary

II

Food Addiction Is a Progressive Disease

Simple progressive Weight Gain

Progression of binge/restrict cycle

Internal Progression

The progression of my disease

Every food addict’s progression is unique

Secrecy about the progression

The most dangerous progression

Parallels with the progression of other addictions

Sample progression chart.

III

Food Addiction Is a Chronic Disease

Possible early food addition

More commonly observed food addiction

Late developing food addiction

Relapse, consequence of denying addiction is chronic

Visualizing chronic food addiction

Possible reasons for chronicity

Practical implications of chronicity

Chronic mental obsession

IV

Food Addiction Is Fatal

The Case of Morphine

Death from secondary complications of food addiction

My own experience with heart problems

Other secondary problems caused by food

Another personal story

Complications build on complications

Purgers get worse faster

Anorexia is most dangerous

Freak accidents related to food addiction?

Slow Death is most common

V

Food Addiction Is Treatable

Food sensitivities: Stage I

Early addiction: Stage II

Advanced food addiction: Stage III

The final stage of food addiction: Stage IV

Common food addiction: a common solution

A personal Little Miracle

Practical advice for common garden-variety food addicts

BIBLIOGRAPHY

I. Primary Recovery Resources

II. Secondary Sources on Food Addiction

OTHER BOOKS AND ARTICLES ON FOOD ADDICTION

by Phil Werdell MA

INTRODUCTION TO PHYSICAL CRAVING AND FOOD ADDICTION

PHYSICAL CRAVING AND FOOD ADDICTION: A SCIENTIFIC REVIEW

ABSTRACT

ABOUT THE AUTHORS

ENDNOTES

INTRODUCTION TO THE SECOND EDITION

WHY I WROTE THIS BOOK

In 1987, with just two years of stable recovery myself, I was hired as a frontline therapist by a residential treatment program in food addiction based at Glenbeigh Psychiatric Hospital of Tampa. Besides carrying a caseload of about twelve late-stage food addicts and leading several therapy groups, I began to be the go-to staff person for lectures on the science of food addiction.

At that time, almost no peer-reviewed scientific research validating food addiction existed, so I would begin the lectures with this fact and follow it by saying that the best we could do was to consider ourselves as data for future research. I explained there were usually about 25 or 30 food-addicted clients in the community, and I shared with them that each of our stories was important for our own recovery, but that science itself saw our stories as only anecdotal evidence. One of the first lectures I developed was called Sugar Blues, the Disease Concept of Food Addiction. Sugar Blues was the title of a 1975 book by William Dufty based on the idea that sugar is

Dufty himself learned of the problem caused by sugar and the idea of abstaining from sugar from his good friend, the movie actress Gloria Swanson. In one of the book’s chapters, he describes his own personal experience going through his kitchen and eliminating all the food that contained sugar. There was almost nothing left. The chapter also contains his difficult three- or four-day experience of detoxification; and then it was over, and his own cravings for sugar, which had motivated him to do such a radical exercise, disappeared almost completely.

Dufty’s book was also a polemic on the history of sugar—from the favored spice of kings and the very rich, to a regular part of the diet of common men and women in Europe and the US. Sugar Blues was already becoming an underground favorite in recovering circles for alcoholism and other drug addictions, so some of the patients in the lecture, usually those who had been in Alcoholics Anonymous or Narcotics Anonymous, were already familiar with the book and its message. Often, those who had read it suggested it to others in the community.

Rather than dwell on Dufty’s book, I told them that Dufty, just like us, was just presenting anecdotal evidence of himself and others he knew as being food addicted. The focus of the lecture, I suggested, would be to see if his and our own personal data corresponded with what we already knew from substantial science to be the major characteristics of alcoholism and other addictions.

I put an outline up on the board:

A disease of powerlessness over addictive substances.

A primary disease rather than just a symptom of other diseases.

Physical craving develops and overrides healthy hunger.

Mental obsessions make it difficult to tell the true from the false.

Addiction different from abuse because of loss of control.

A disease of denial; those with addiction claim they are not addicts.

A progressive disease with several stages that keep getting worse.

Tolerance: it takes more of the addictive substance to get the same high.

A chronic disease that continues to progress, even in remission.

There is withdrawal when addictive foods are completely removed.

A disease of frequent relapse and often eventually fatal.

And, importantly, a disease that is treatable.

I would say that the focus of this lecture would be finding out whether their experience included some or all of these characteristics.¹ If so, there was a case to be made that they were food addicted.

I began discussing each characteristic by giving an example that showed how my own experience fit into a category. Quickly some of the others in the room would say that they had their own experience with powerlessness or loss of control or progression, etc. We would put this evidence up on the board and then discuss questions people had about whether or not they fit the pattern. I quickly learned that this was not only a good way of teaching patients something about the nature of addiction, but also that the process was one that helped many further challenge their own denial.

I started sharing with staff and with other food addicts in my own recovery community that we needed a book that developed this material so those who were interested in it could study it in more depth. My sponsor in my own Twelve Step program said it sounded to him like I should write the book myself. I was used to taking his suggestions as requirements. It took about a year, but this book, The Disease Concept of Food Addiction, was the result. I shared it in Xerox form with many new in recovery and suggested that they, too, use it as a catalyst for finding out if their own experience correlated with the scientific characteristics of alcoholism and other addictions.

The lecture seemed to work quite well in book form. However, the patients, when they took the copy of the book home for their physicians or therapists, reported that these medical people wanted more than anecdotal evidence. At the same time, a cluster of self-help books arrived on the scene: Judi Hollis, Food Is a Family Affair; Kay Sheppard, Food Addiction: The Body Knows; Ann Katherine, Anatomy of a Food Addiction: Brain Chemistry of Overeating; Joan Ifland, Sugars and Flours: How they make us crazy, sick and fat and what to do about it; Nancy Appleton, Lick the Sugar Habit; Debbie Danowski and Pedro Lazaro, Why Can’t I Stop Eating: Recognizing, Understanding, and Overcoming Food Addiction. These books all presented a good introduction to food as an addiction and had the bonus of including some of the first scientific research on food addiction. We started using these books in the treatment program, and I put my writing on ice in the back of my file.

Recently, in sessions I led with members of the ACORN Food Addiction Professional Training Program, I casually shared this writing with several recovering food addicts who were abstinent themselves and in training to help other food addicts professionally. Each person said they enjoyed the reading and that I should publish the version for wider distribution. I decided to take their advice in hopes that the abundance of anecdotal experiences, both mine and those of many other food addicts, organized in terms of established characteristics of addiction, will help others, as this material used to help patients at Glenbeigh Psychiatric Hospital of Tampa. Thus, the second edition of The Disease Concept of Food Addiction (2021).

Note: The footnotes in the second edition usually do not cite new scientific references, but rather, comment on changes that we know since the first edition, which was written in 1989. I have added the Food Addiction Institute White Paper, Food Addiction and Physical Craving: A Review of the Science, which is a good summary of the more current science on food addiction. All of the scientific references are included. —PW

INTRODUCTION

TO ORIGINAL MANUSCRIPT (1989)

I am a recovering food addict. For the last three and a half years, I have been working as a counselor for an in-patient food addiction treatment program. I work with individual patients, lead process groups, and give lectures on the disease concept of food addiction.

After doing this work for a while, I realized that many in food-related Twelve Step programs did not have access to some of the information which I was presenting in treatment. Some do not have insurance and can’t afford treatment. Others are doing well without professional help. However, I sensed that lectures in treatment sometimes helped food addicts understand and accept their disease more completely, so I have looked for ways of sharing this information with a larger audience.

I would like to begin with an important qualification: I do not consider myself to be an expert in the area of food addition, at least not in the usual ways we think of experts in our society. While I do have an M.A. in Human Services and have taught counseling in college and other settings, this was before I was in recovery myself. More specifically, it was before I understood that I am a food addict.

Thus, I am very clear that it is not my academic knowledge or my professional training which is critical to my own recovery. It is rather the fellowship of Twelve Step programs and the experience, strength and hope of other compulsive eaters and food addicts who saved, and continue to save, my life.

I present here information I learned from others. It seems true to me today, meaning that it fits my own experience as a food addict and seems to be useful to the other food addicts with whom I talk. I am attempting to share it as closely as I can to the way I share it in person, using examples, as often as possible, from my own experience. The only authority I claim is that it is as honest an expression of my own thinking and experience as I can express at this time.

As a counselor, I always try to begin by sharing that I got my initial recovery through a Twelve Step program, and I continue to get help from Twelve Step fellowships to remain in recovery.

Before I came to recovery a little over five years ago, I was trained as a counselor – even taught counseling in college. When I work with a client now, I try to begin by saying, I trust my recovery in my Twelve Step program much more than I trust my counseling skills. Counseling didn’t help me deal with my food problems. In fact, I was teaching a graduate course where most of the students were professionals in the field of addiction, most recovering from alcoholism or drug addiction or both, and it didn’t even occur to me that my problems with food were similar. I only learned that when I myself went to a Twelve Step program.

Since I have been in recovery, I have gone to counselors. They have helped. Basically, they have helped me work my Twelve Step program. Even to do this, though, I have had to put my abstinence first and work the steps with my sponsor.

So now, as I am writing notes on food addiction which might be read by someone new to the disease concept, my recommendation is to go to a Twelve Step program. I suggest that you attend at least six meetings before you make up your mind; and, if you are looking for something to read, I suggest reading the first 164 pages of the book Alcoholics Anonymous and substitute the words compulsive overeating or food addiction for alcoholism. This is where I started.

My initial recovery from food addiction, which I then called compulsive overeating, came through a Twelve Step program. After years of struggling with my weight and coming to the realization myself that weight was just a secondary problem – my problem was with food – I found myself crying uncontrollably on the floor at a support group meeting. Another member of the group who was himself a recovering alcoholic sensed that my problem with food was much like his with alcohol. Alcoholics Anonymous (AA) had worked for him; he challenged me to attend a food-related support group. I agreed to go to six meetings.

It took me six months and 1500 miles to make good on my agreement; but finally, I did go to a Twelve Step food-related support group meeting. Almost immediately, I had the sense that I was home. I was in a room full of others who had been driven by food and attempts to control it – they had lied about food, stolen food, tried diet after diet, starved themselves, tried purging and all the latest fads, eaten out of the garbage, endangered their lives over food, thought of ending their lives because they felt so crazy and depressed, then rationalized it wasn’t too bad and they should just try again.

I was hopeless that first night and much of the first few months in the program; I didn’t believe the program would work for me. But