Preface to the Third Edition Since I wrote the second edition of Food Junkies in 2019, much has changed -- and little has changed. This new edition includes the most promising current research and details the latest advances in clinical practices and treatments, including my own. We may still have a long way to go, but giant steps have been taken in some areas. And many of the people I interviewed earlier have successfully navigated the minefields of food sobriety. I also bring their stories up to date. First, the hopeful news: In the last thirteen years, our awareness of how specific foods (such as sugar) ensnare both the hormonal appetite regulators and the reward circuitry of the brain has grown exponentially. Studies highlighting how sugar can be addictive are cited continually in the media. Growing numbers of consumer groups are aghast at how the food industry is manipulating our appetites for its own profit.

Calls to regulate the food industry and legislate healthy eating are multiplying. There are Internet chat groups, summits, cookbooks, and public lectures offering to help people quit sugar and other addictive foods. I believe we will soon reach a tipping point, that moment of awareness when society recognizes the need to stem the tide of addictive foods. While we agree that some foods, such as sugar, are addictive, the bad news is that we are loath to recognize the dynamic of addiction that other foods ignite. Even clinicians scoff at this biological imperative, unwilling to accept the symptoms of withdrawal that eating some foods engender. This unwillingness means that diagnosis, research, and funding for the treatment of food addiction continues to flounder. When it comes to acknowledging the syndrome of food addiction, we remain in the dark ages. I am unable to be objective about food addiction.

I have struggled with this disease for decades, so, although my purpose in this book is to present a fact-based examination of food addiction, I can hardly be neutral. Many of us have struggled to control our addiction through diet pills, diet doctors, and even diet candy (1). We have spent thousands of dollars on Weight Watchers and Jenny Craig, therapists and psychiatrists, weight-loss vitamins and herbs. We have ingested diuretics, laxatives, and other substances to purge ourselves of extra food. We have so obsessively exercised for hours each day that we''ve eliminated the rest and relaxation most people enjoy on weekends and vacations. Our eating has been out of control; we''ve often ingested enough calories in an hour to fuel a two-hundred-pound male for days. We have repeatedly tried, and failed, to tame our appetites. We have enlisted people -- friends, family, professionals -- to help us by shaming, blaming, bribing, nagging, cajoling, ignoring, encouraging, comforting, and punishing.

As a recovering food addict myself, I am on a passionate mission to present vital information to the many individuals who struggle with unwanted eating behaviours. I want to give readers a better understanding of the continuum that begins with food compulsions and ends with full-blown addiction. For years, food addicts of all types tried to talk about this phenomenon, but all too often our disclosures were met with light-hearted dismissals (Oh, everyone eats a little too much sometimes) or blunt skepticism (It''s not a disease, you know; you just eat too much). Now that obesity, one of the hallmark symptoms of food addiction, has grown to epidemic proportions, scientists and medical professionals are no longer laughing. Instead, they are taking a closer look at what is really going on in the bodies and brains of those of us who struggle with our food intake. In Food Junkies, I present this information about the addictive nature of food in a format that can be understood by patients, clinicians, and, most importantly, the general public. And I introduce you to people who are struggling with this disease and tell their stories -- their tragedies and victories -- which have been for so long silenced, scoffed at, scorned. I don''t want the book to be drily academic, the sort written by experts dispensing prescriptive advice.

Though you will find helpful information here, much of it drawn from authoritative studies, the book also contains very personal stories -- moving accounts full of feeling and struggle. Given my history as both a food addict and a clinician in the addiction field, I am able to present this information in an authentic, accessible way. As yet, there have been no books like mine, written by an author who has both experienced food addiction and its recovery and who is also equipped to speak from the authoritative stance of a medical clinician in the field. In this book you will meet men and women suffering from food compulsions and addictions as well as those who have recovered. You will also meet people who are not addicted to food, but who have a tendency to overeat. Although their names have been changed, they are all real people whom I have met in my practice. You will meet Mary, who made the decision to lose weight when her scale indicated that she weighed more than two hundred pounds. She has managed to keep her weight off for many years.

And you''ll meet Janet, who insists that her lack of willpower is her real problem; she has lost weight and kept it off, but she is only able to do so as long as she sticks to her diet. And you''ll also meet Ellen, who, despite great willpower, simply cannot control her bingeing at night. She worries that she might be a food addict. You will be introduced to Laura, who is addicted to alcohol as well as food. While she no longer drinks, she simply cannot stop eating. As badly as she wants to stop, her cravings for food are even stronger than her cravings for alcohol. You''ll learn about Lawrence, a morbidly obese food addict, whose death marks the inevitable conclusion of this disease when left untreated. And you''ll meet Ruthann, suffering from another kind of food addiction.

Ruthann learns to control her anorexia by applying the same approaches I present for food addicts who overeat to her undereating patterns. I have interviewed clinicians who have stepped outside the box, experimenting with treatment approaches for eating disorders. Among them is Renae Norton, who has treated hundreds of anorexics and bulimics and has concluded that both groups achieved recovery only when they abstained from all drugs, alcohol, and specific trigger foods. (If they didn''t, she found, her clients would eventually relapse, with each relapse harder to recover from.) Connie Stapleton is another psychologist who works specifically with post-bariatric patients to ensure that the weight they lose through surgery is not regained by eating addictively in the months following the surgery. Finally, you will meet people who have found effective solutions for themselves. Martha, for example, has stopped eating sugar and flour, and now weighs and measures her food down to the last ounce. Despite inquiring looks from others, she brings a scale to every restaurant meal.

Once one hundred pounds overweight, she has kept the extra weight off for more than twenty years. More important, Martha has finally found a level of contentment with her eating. She provides a message of hope that freedom from food cravings is possible. For Martha, this freedom is so delicious that it overrides any pleasure that the food might have given her. My message is simple: If you see yourself as a food addict, you must treat your trigger foods as a drug. The most successful treatment for any drug addiction, from alcohol to drugs to food, is abstinence from the trigger substance. Our addicted brain -- whether it is for genetic, psycho- logical, or even environmental reasons -- is wired to crave more as soon as even the smallest amount has entered our system. Like a flame igniting kindling, trigger foods ignite a fiery and voracious appetite that makes us want to eat, eat, eat.

While the message in this book may be simple, it''s not always an easy one to apply. The message of abstinence from a drug of choice is a hard one to hear, especially since so many otherwise excellent diet programs give conflicting messages. The first phase of most diets is often very restrictive: no sugar, no starches . but the dieter is promised that in the second and third phases she will be able to eat all her desired foods, only in smaller portions. Clinicians for food addicts shake our heads at this advice. If a particular food is your drug, any portion, large or small, will ignite insatiable cravings. In this book, I will explain the physiology of this reaction so that you understand the critical importance of abstinence. There is good news.

Abstaining from problematic foods does not have to be a hardship. Instead, you will experience a freedom from obsession as well as all the negative consequences of addiction. If you think you really are addicted to food, you may never have felt this freedom. That''s why I invite you to take the first step: Keep an open mind and read this book. Overcome food addiction now and discover that freedom really does taste great.