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It’s not uncommon to encounter fellow runners on the path toward recovery from drug and alcohol addiction. I count myself among this cohort. Running has done as much for me as perhaps any other practice, but as someone who also suffers from an addiction to food, particularly sugar, it’s a complicated relationship—and one that the medical establishment is only just now beginning to understand.
Without a common framework to address or even discuss food addiction, it’s made it difficult to share this particular struggle outside of recovery groups. Early on, I stopped working with a coach because I didn’t know how to tell him what was really happening in the dark crevices of craving when I failed to log workouts or hit targets. I’ve gone it alone since, even avoiding building friendships with running partners. If for a socially anxious introvert drugs and alcohol had a communal aspect, overeating is the equivalent of being buried alive with tiny white granules of shame. But as science begins to explain the biological expression of food addiction and a growing number of runners publicly grapple with a spectrum of nuanced relationships to food, it’s time to talk openly with my trail family about the realities of being an ultrarunner and compulsive overeater, as we often refer to ourselves in 12-step meetings. Because if there is one thing I’ve learned over a lifetime of fleeing hungry ghosts of various shapes and sizes, it is this: they feed off isolation.
While society’s understanding of addiction has surely progressed from the days when sufferers were dismissed as weak-willed hedonists and prescribed little more than god and penance, food addiction is a nascent concept—and one that is leaden in controversy. “Most clinicians will say there is something where people go crazy with their food,” says Dr. Vera Tarman, the medical director at Renascent, a Toronto treatment center, and author of Food Junkies: Recovery From Food Addiction. “But what do we call this? Most doctors call this an obesity issue. Psychologists call it an eating disorder and treat the psychic distress. A and B can both be true, but we’re missing the third option, which is when food is used as a drug.”
A survey using the Yale Food Addiction Scale, the most widely accepted diagnostic tool, reports 15 percent of the US population—a cool 50 million people—meets the criteria for food addiction. It’s not a simple diagnosis, though. There can be a distinction between people with full-blown food addiction versus binge eating disorder or bulimia nervosa. What starts as emotional or disordered eating will sometimes, but not always, cross into both a chemical and behavioral dependency. Meanwhile, not all people who are overweight are addicted to food, and many food addicts aren’t overweight. A number of studies have shown a higher prevalence of maladaptive eating behaviors, including compulsive overeating, among endurance athletes than the general public.
The research hasn’t been able to demonstrate definitive cause or effect, but they do illustrate the delicate link between athletic striving, caloric consumption and strenuous physical activity. Running long hours serves at once as a salve to my discontent, to hide the external manifestation of my internal strife, and a source of rapacious hunger. Unlike with alcohol, which I never have to drink again, as a food addict I must let that demon out of the cage three times a day—or every 30-45 minutes on weekend trail excursions. Then, of course, there are the dessert buffets known as aid stations.
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I don’t remember eating as much of an issue as a kid. Food became more prominent in the aftermath of a traumatic sexual attack and as I continued to shed other numbing agents into adulthood. I’m what some would call a double—or, more accurately, quadruple—winner, playing a lifelong game of Whac-A-Mole with addiction. By 30, though, I’d been able to quit drugging and drinking, influenced partly by my deepening affair with running but more so by the knowing that I could still rely on my true drug of choice.
What started as the periodic evening of self soothing with a small bag of chips and pint of cookie dough ice cream grew into epic multi-thousand calorie binges. Many addicts and alcoholics can vividly recall their first high, but compulsive eaters don’t usually have the same ah-ha moment. Digesting food makes for a much slower and more subdued anesthetic than smoking, snorting or shooting, says Dr. Marty Lerner, the CEO of Milestones Eating Disorder Program in South Florida. Food dependency, with its sweet lullaby, is the Trojan horse: its victims don’t know they’re under attack until it’s too late.
Once in full-blown effect, though, it can look very similar to other addictions. We ingest greater quantities at greater speeds and go to ever greater lengths to get high. I’ve stolen food. Snuck into the bathroom at parties to gorge. Eaten out of the garbage. Eaten behind the wheel. Driven to half a dozen different restaurants and stores and spent hundreds of dollars to hit all the notes of my particular palette. I’ve trained diligently for months, only to show up to races bloated and sick, since it’s impossible to control when the compulsion will strike. Or, despite immense experiences of awe and accomplishment, I’ve crashed into binges on the other side of the finish line. Sometimes those benders last hours, others weeks.
Being an addict is often to be at the mercy of circumstance. It’s commonly said in recovery circles to be vigilant of people, places and things. In functional MRIs, the brains of compulsive eaters light up like a Whoville Christmas tree when exposed to food stimuli, and the longer we’re exposed to triggers the more fatigued the brain becomes and the more likely we are to succumb to temptation. But “It’s basically impossible to shield yourself from food cues,” says Cynthia Bulik, distinguished professor of eating disorders at University of North Carolina, Chapel Hill School of Medicine. “We are bombarded.”
While many dieticians and psychotherapists instruct that binge eaters try to practice moderation, addiction experts advise avoiding trigger foods entirely. The idea—validated by an emergent understanding of how dopaminergic scales operate—is that a single crumb can trigger the phenomenon of craving, and, once that happens, we are swept away in a flood of neural responses that leave us unable to self-regulate. Or as we gluttons say, one bite is too many and a thousand bites are never enough.
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While the addict label has been used to describe chocolate cravings since the first processed desserts came off the assembly line, many question the legitimacy of the concept, often making the case that we need to eat to live.
And it’s true, the theory of natural selection posits that genetic traits will emerge and endure if they support survival. Over millennia, our bodies learned to protect against starvation by developing mechanisms for identifying calorically dense foods, specifically carbohydrates. Here’s the hitch: technology and capitalism have conferred to alter food faster than biology can keep pace. Ultra-processed foods have stripped away naturally occurring deterrents of over consumption such as fiber. The quantity and potency of what we consume today, experts say, has thrown the whole mechanism out of whack.
Food dependency, with its sweet lullaby, is the Trojan horse: its victims don’t know they’re under attack until it’s too late.
Evidence emerging over the last two decades suggests that refined sugar, flour, fat and salt—or, better yet, the combination of all four—hijack the brain in the same way that other addictive substances do. “The data is so overwhelming the field has to accept it,” Dr. Nora Volkow, director of the National Institute on Drug Abuse, told reporters back in 2011. “We are finding a tremendous overlap between drugs in the brain and food in the brain.” The more recent work of Anna Lembke, chief of Stanford University’s Addiction Medicine Dual Diagnosis Clinic and author of Dopamine Nation: Finding Balance in the Age of Indulgence, has shown that when we eat hyper-palatable snacks the brain releases dopamine, which regulates our experiences of pleasure. Human neurology, though, is wired to strive for homeostasis. So after a spike in pleasure, the brain downregulates to restore balance, which we know as a comedown. This state is usually temporary; however, when we continue to flood the neural receptors, the brain’s baseline eventually shifts, so that we aren’t eating to feel good anymore but just to feel OK. One study found that rats with access to a sugar solution will significantly up their intake over time, which is accompanied by neurochemical changes that mimic those in rats given cocaine. When that drug disappears, the sugar-hooked brain experiences symptoms of withdrawal.
“The [food addiction] theory directly implicates the food industry,” write the researchers behind Sugar Addiction: From Evolution to Revolution, a recent academic analysis considering whether there is empirical evidence of sugar addiction. Their conclusion: yes.
When I suffered a stress fracture to my fibula from overuse, it was easy to make sense of. I upped my mileage too quickly. I was hitting too much vert. Pushing too hard. And I was prescribed a straight forward regimen to recover: hobble around in a boot until the bone mends, then slowly rebuild strength and stamina. I knew with time and patience my body would heal, which it did.
With compulsive eating, there is no such assurance. “By the time I see people, they’ve tried everything—and none of it worked,” says Tarman. Intuitive eating isn’t going to work for me; my biological start and stop signals are clearly not functioning properly. At the same time, some abstinence advocates say that cutting out sugar and flour isn’t enough; I need to eliminate all grains. As a plant-based endurance athlete, that’s not a realistic option either.
And that grazes another issue: overeating and undereating often compliment one another. Underweight folks are more likely to suffer from food addiction than those with healthy body weights. Running is an essential recovery tool, but it can easily be wielded as a weapon (see overuse injury above). So I must walk the line between abstinence and restriction, which often gets blurry.
Runners are doers. We set goals and we do the day-in, day-out work until we achieve them. My first ultra started with a spreadsheet and methodical progression. For decades, I thought I could “do” my way through addiction. There must be a winning combination: If I do A, B and C, then I will achieve abstinence. It hasn’t worked out that way. I’m 36 years old, and I’ve tried a lot: meditation; literature; 12-step; inpatient treatment; outpatient treatment; dietitians; prayer; a buffet of therapeutic modalities—cognitive behavioral therapy, EMDR therapy, hypnotherapy, psychedelic therapy. All of it worked, and none of it worked. My disposition has surely been reconfigured along this journey and my binges are fewer and farther in between, but I’m not entirely free.
Yet, over thousands of enduring miles, some run in peak physical condition and others with the softness of a few extra pounds, something unexpected has happened: I’ve begun to see that my sobriety—or occasionally lack thereof—is not a reflection of my performance. It’s simply my reality. Meanwhile, when my running aspirations—the times, the standings, the distances—rely on the belief that only once I reach my destination will I be and have enough, they too can become a desperate grasping not unlike addiction. Each runner begins from a different starting line. We each lug the weight of varied difficulties. What matters is only that we keep moving forward and that instead of lamenting how much farther we have to go, we embrace exactly where we are. Because as anyone who has run far knows, there is no greater pain than the pain of resistance.
Ultra running is the closest I’ve come to experiencing freedom. On the trail, I’m able to break away from the compulsions, corporate oppression, personal history, and insecurities. It all sits stationary on the periphery, receding into the background the further I go. No matter what, I keep putting one foot in front of the next and letting go of the outcome. I accept, but I don’t surrender.
