Is Sugar Addiction Real?

If I had a dime for every time someone has mentioned their “sugar addiction” (or just the general concept) to me, I’d probably have enough capital to finally fund a nutrition science study that’s run correctly.

The concept of “sugar” addiction is a huge matter that deserves an equally huge, detailed response.

Maybe you came across this article because you’re wondering whether what you are suffering from is true sugar addiction.

Maybe you want to know if you’ll need to go on a “sugar detox” or eat a certain food in order to fix this problem.

Maybe you’ve just heard both sides of this debate and want a clear answer… Does sugar addiction exist?

Regardless of why you came here, I can promise you that this is going to be an extremely comprehensive look at sugar addiction: What it means, what the studies say, and what that means for you. Strap in and enjoy!

The “Sugar Addiction” Hypothesis

The book that arguably started it all.

The book that arguably started it all.

A decade ago, a book called The Sugar Addict’s Total Recovery Program (followed by an unnecessarily long subtitle) came out and was an instant hit.  The author, Kathleen DesMaisons, argued that sugar is an addictive substance, much like an opiate, and that the solution to escaping its grips is to eliminate it entirely, as per her program.  From here, the term “sugar addiction”, which had prior been thrown around sporadically, gained traction and grew into the beast it is now.

In my work as a nutrition coach, I can say without exaggerating that almost 75% of the clients I see come to me first reporting a strong case of “sugar addiction”.  Many of them feel like if they start letting themselves eat sugary foods, they’ll quickly fall back down the rabbit hole of unstoppable sugar consumption.

This presents a unique problem, and question, for us.  Can something like the neurobiological existence of an addiction to sugar explain the modern overeating tendencies so rampant throughout the world? Could this lead to obesity? Is it the cause of obesity? Importantly for our purposes, what role does it play in binge eating tendencies? Hell, is it even real in the first place?

A Comprehensive Analysis

After much internal debate about how helpful this would actually be, I decided to bite the bullet, hunker down, and crank out a super comprehensive treatment of this question.  What follows is a response to all relevant arguments and concepts in this discussion.

This is not going to be a legitimate literature review.  As such, it’ll be simple to understand regardless of whether you’re scientifically literate or not.  This can be a really confusing matter for anyone without a background in health sciences, and so this post serves to clear that confusion up and give you an easy answer to this all.

However, a simple “Yes” or “No” will not suffice, even if it’s followed by one of the typical sound bites people love to include.  

“Yeah, it’s real alright; studies show Oreos are basically cocaine.”

“No, man, there’s no such thing as sugar addiction. How can you be addicted to a nutrient? Like, duh, no.”

So that means we’ll have to go through this step-by-step, so we can come up with a basic answer you’ll fully understand how we arrived at. Let’s begin.

What IS Sugar?

Discussions about sugar addiction are almost always prefaced with a definition of “addiction”.  That’s great, and we’ll be doing that shortly, but what they miss is an even more basic operational definition.  What even is sugar?

Sugar is a loose term for of a number of carbohydrates that are quickly absorbed.  Carbohydrates include monosaccharides, disaccharides, oligosaccharides, and polysaccharides.  

Credit: Wikipedia

Credit: Wikipedia

When we say “sugar”, we’re largely talking about monosaccharides and disaccharides. These are known to be highly sweet and palatable, which is one reason sugar was so easily implicated in this discussion.

  • Monosaccharides have one sugar unit (glucose, fructose, galactose).

  • Disaccharides have two sugar units (lactose is glucose and galactose; maltose is two units of glucose; and sucrose is glucose and fructose).  

  • Oligosaccharides have anywhere from three to ten sugar units (fructooligosaccharides, galacto-oligosaccharides).

  • Polysaccharides usually have over ten sugar units (starch, glycogen, cellulose).

When we talk about sugar addiction, which it should be noted is not an official term or one of much substantial scientific backing, we’re broadly talking about these simple, sweet-tasting sugars.  “Sugar” can also refer specifically to sucrose, or table sugar, which is a combination of glucose and fructose.  This combination emphasizes the ultra-sweet quality we seek out in desserts and candy.  

This has been emulated with the production of high-fructose corn syrup (HFCS), which also combines these two monosaccharides, albeit in slightly different proportions.  Contrary to popular belief, there is virtually no difference between HFCS and sucrose, in terms of human digestion or absorption. The former is just cheaper and more ubiquitous.

Okay, let’s talk addiction.

What IS Addiction?

I’ll skip the corny reiteration and analysis of the technical definition and instead just lay out the two necessary elements of addiction: physical dependence and psychological craving.  

Physical dependence

The physical dependence side of the addiction equation itself has two elements: tolerance and withdrawal.  Tolerance refers to a progressive desensitizing to the stimulus. Basically, we get used to how a certain dose feels and now require a larger dose to elicit the same response. With habitual substance abuse, this poses the risk of the user resorting to greater and greater doses to continually “chase the dragon”, until they overdose.

Withdrawal means that when the user is off of the substance for some extended length of time, physiological cravings surface in the form of physical pain and/or discomfort.  Withdrawal symptoms include, depending on the substance in question: nausea, vomiting, headaches, itching, appetite fluctuations, difficulty sleeping, and more.  This tells us that the substance has tapped into neural circuitry that promotes reward-seeking behavior, to the extent that the body senses a survival threat when the stimulus is revoked.  

Credit:  Find Rehab Centers

Credit: Find Rehab Centers

In other words, when a cocaine user in recovery finds himself itching and uncomfortable, it’s the body’s way of trying to alert him to the lack of cocaine. Withdrawal can also be explained by tolerance, insofar as - for example - when we’re used to dopamine flux X+10, dropping down to X all of a sudden feels like severe depression.

Psychological craving

When it comes to the psychological aspect of addiction, we’re dealing with a different monster.  This is isolated to the neural implications of substance abuse and the mental side effects therein.  When the user no longer has access to the substance, reward-seeking motivation is way upped. In other words, you’ll do anything to get your next fix.

This also has to do with “bingeing”, a concept referenced not only in the ED world but also when discussing substance abuse.  Bingeing behavior with any addictive substance shows the same pattern of: deprivation - access - excessive consumption (disproportionate to what the body actually thinks it’s “in need” of) - physical side effects.

Why Is This Important?

So, regardless of what we discover in this investigation, let’s ask ourselves why this is even important.  If you feel like you can’t stop eating sugar once you’ve started; if you feel like you can’t “be trusted” around sugary foods because you’ll binge; if you feel physically worse when you overeat sugary foods, why does it matter what we call it? Addiction or not, it’s a problem you want to fix.

There are two primary reasons it is still important for us to harp on the semantics of this debate:

  1. Things generally live up to their names.

  2. The diet industry generally uses fear to suck people in.

First, going through life believing you “oftentimes feel very down and hopeless” is a markedly different experience than going through life holding “high-grade, drug-resistant major depressive disorder” close to your identity.  In much the same way, having the belief that “certain foods trigger me to binge” is different than resigning yourself to being a “sugar addict”.

If after our investigation we determine sugar addiction is a valid concept, then we’ll reason that it’s an appropriate diagnosis to go off of.  This would ensure you aren’t underplaying the severity of the condition.

In other words, if this concept is real and someone is really going through it, they’d be doing themselves a great disservice to dismiss it as “a weird eating quirk I have”.  On the flip side, if we determine this is not a valid concept, then we can help remove that disproportionately heavy-handed term from your identity.  

Credit: Flickr user  marmar gee

Credit: Flickr user marmar gee

Second, most importantly, the whole “sugar addiction” phenomenon has worked out mighty well for the multibillion-dollar a year diet industry. With the cloudy evidence we actually have on the existence or validity of sugar addiction, it’s all too easy for diet gurus and coaches to draw you in with fear-mongering.  When they have you see yourself as not just someone with problematic eating behaviors but an addict, it’s much easier to get you to sign up for their useless programs.

No matter what our result, getting a scientifically grounded answer should help chip away at this.  Even if we determine sugar addiction is a valid concept, you’ll come away from this with the scientific understanding of how this works and what to do.  

You won’t have to believe the only answer is some 30-day “sugar detox” advertised on Instagram.  And if we determine it’s not a valid concept, then we’ll sidestep this entire problem.

Now that we’ve cleared all of that up, let’s get into what the evidence actually says.

Rats vs. Humans

Rat (or mice) studies are incredibly common in health science-related trials.  This is because these little rodents share a similar physiology with humans, and they’re dirt cheap to raise and house.  Plus, genetic modification of rats is a simple enough strategy to render them genetically identical (removing that potential confounder) and be able to turn genes off and on at will.  

However, there’s a reason that rat models (and animal models in general) and human models are separated where research is considered.

Even if rats have a similar physiological makeup, they fundamentally are not humans.  They have different enzymes, rates of metabolism, and even behavioral quirks.  And that’s where we run into problems.

First, sugar addiction has all but never been shown in humans.  Since “proving addiction” requires crossing a lot of ethical boundaries, and because it’s a murky concept as is, we just don’t have controlled trials using human subjects.  

The only studies that exist look at surface-level signs and fMRI readings in response to sugar consumption. But that is a laughable way to “test for addiction”.

Credit: Flickr user  Rick Eh?

Credit: Flickr user Rick Eh?

Compare that to how sugar addiction is found in rats (which, even then, is not abundant in the literature).  Since lab rats can be taken through very specific feeding protocols and have all sorts of confounding elements controlled for, it’s much easier to elicit addictive-like symptoms (1).

Humans, on the other hand, eat in a much less controlled manner.  And until science can come up with cloned or “blank slate” humans to keep in metabolic chambers for years on end, this one might be tough to crack.  

For example, rats are often chosen based on sucrose preference.  Scientists want to ensure the rats they’re using are going to eat the hell out of the sugar they’re provided, so they genetically select for (either through specific inbreeding practices or literally just buying a set of rats online) a taste preference for sweetness.

Even with rats this can be difficult.  Increasingly, the standard in addiction studies is using what are called drug-naive rats.  These rats have never been exposed to the variable drug before the trial, so they are essentially clean slates.  But, as you can imagine, it’s a lot harder to single out rats that have never eaten sucrose in their lives (2).  

Is It Sugar Addiction or Sugar Compensation?

Remember how we earlier identified tolerance and withdrawal as the two pieces of the physical dependence side of the equation? Yeah, neither of these actually occur with sugar intake (3).  And, in fact, any “addictive” traits seen in response to sugar almost exclusively arise after deprivation.  

In other words, rats can become sugar-dependent but only when they’re first starved of sugar (4).  In ad libitum feeding studies (where rats get as much sugar as they’d like, on a consistent basis), addictive behaviors simply don’t occur (5).

If we look at most people’s anecdotal experiences with sugar, we see a similar storyline.  Maybe you believe, or you know someone who believes, you just can’t be “trusted around sugar”.  You worry that unless you go on a “sugar detox” and stay totally away from it, you’ll indulge too much and get all those negative side effects you notice (maybe it’s acne, lethargy, GI issues, etc.).  

Well, let’s think about that logically. It’s a bit of a self-fulfilling prophecy, isn’t it?

When you totally restrict sugar for, say, 30 days, you might “feel better” (both in terms of an absence of excessive sugar intake-related symptoms and the psychosomatic element of feeling good about sticking to a habit), but then one day a coworker brings in donuts and you “go off the deep end”.  

What’s really happening here is that you induced a state of sugar starvation-prompted “sugar bingeing”. You restricted it so long that when you finally came in contact with it, you went all out.  Calling that an addiction would be like calling someone who just returned from being stranded on a desert without water “water-addicted”.

Credit: Flickr user  Ars Electronica

Credit: Flickr user Ars Electronica

The “Sugar = Heroin” Story

We still have to reconcile the fMRI studies that find sugar intake - even in humans, and even in moderate amounts - lights up similar neural circuits to opioids like heroin.  Surely that must mean it’s not good for us and is, for all intents and purposes, a drug… right?

Again, the story is not this clear, and anyone other than pop science bloggers would have a hard time proving anything substantial from this.

What it boils down to is this: The fact that similar neural circuits light up when human subjects are exposed to sugar or heroin is necessary but not sufficient as evidence towards sugar’s addictive qualities.  That is to say, that relationship needs to be true to prove that sugar is addictive, but that alone is not enough to prove that.  

How so? Well, consider what other things light up those neural circuits.  Corn oil (6), music (7), winning money (8), to name a few (sounds like my kind of a weekend).  Clearly, seeing activation of these circuits is not sufficient for proving the presence of an addiction.  

This is where the fear-mongering “authorities” excel at playing off our emotions.  Logically, if someone were to tell us, “Paper is white and cocaine is white. Therefore, paper is basically cocaine,” we would laugh them off.  We know that it’s not the color of cocaine that is responsible for its mind-altering effects.

But when “color” is replaced with something science-y and legit-sounding like “neural circuits”, all of a sudden we pay attention.  It’s understandable; knowledge of addictive pathways is not very common and has a huge learning curve for anyone interested. So we resort to the most compelling argument.

An Unnatural Dopamine Response

Okay, so far we’ve reasoned that rat studies kind of suck, “sugar addiction” symptoms only exist when one has first been deprived of it for a long time, and fMRI probably stands for “Fear-Mongering Reshapes the Imagination” (look, I tried, okay?).  

But certainly, we were not meant to have access to this much sugar in one sitting, and definitely not without anti-nutrient factors like fiber to balance it out, right? And anything that causes that great of a dopamine response certainly can’t be healthy, can it?

These might be some of the most compelling arguments.  It’s true that, considering the course of human history, access to quick hits of sugar like we have now is unprecedented.  Even just a century ago, the food industry had not begun pumping out these sugary snacks and cereals. We’re essentially all the guinea pigs for this type of a diet.  

I actually totally agree that this is not good, but I reject the idea that an appropriate response to this is total elimination of sugar. You see, our ancient ancestors didn’t have access to Lucky Charms and Ho-Hos.  If they did, you can bet your bottom dollar they’d be eating that stuff up. Hell, we don’t even have to guess on that one, since we’re essentially the ancient ancestors who’ve been given access to those foods, and look where we are now!

Here’s a simple yet comprehensive illustration of the difference between the food- and drug-induced dopamine response (credit to NIH).

Here’s a simple yet comprehensive illustration of the difference between the food- and drug-induced dopamine response (credit to NIH).

That brings us to the true answer, which I’ll expand on at the end: Sugary foods are perfectly fine, but appropriately consuming them necessitates a conscious awareness of one’s hunger/satiety cues and eating motivations.  

For what it’s worth, it’s not even a given that we all respond the same way to refined sugars. In fact, there is a large degree of interpersonal variability when it comes to postprandial glucose responses to different sources of sugar.  Some people respond more appropriately to the sugars from, say, brownies than apples, even (9).  

Even when studies take obese subjects and study them to see if they’ve become “sugar addicts”, there’s no story.  Most overweight and obese individuals show a behavioral/neurobiological profile that does not resemble one of a substance addict (10).  And what about dopamine?

Yes, dopamine spikes pretty “unnaturally” in response to excessive sugar intake (it also spikes after an intense workout, an exhilarating concert, or a mind-blowing orgasm).  But even still, it doesn’t act like it does with opioids.

You see, dopamine release in response to drugs persists across multiple administrations, whereas dopamine release in response to high-sugar foods ceases when the food loses novelty or the subject is no longer hungry (4).  Basically, dopamine levels return to baseline after sucrose administration, whereas they are elevated further with drug administration (11).

So… Is Sugar Addiction Real?

If you’re just skipping to this paragraph now to get the cut-and-dry answer, I highly recommend you at least skim through the evidence we first worked through.  Next time someone confronts you about sugar addiction, or starts talking about how wonderfully their 30-day sugar detox has gone, you’ll be academically armed to put their dogma to the test.  

Plus, you’ll have a more profound understanding of this and won’t have to just take my word on it.

Credit: Flickr user  Dave See

Credit: Flickr user Dave See

With that said, here’s our conclusion: No, sugar addiction does not exist.  You cannot be addicted to sugar. With that said, symptoms of sugar deprivation and compensation totally do.  And there’s more factors at play when it comes to human consumption of sugar, since us humans are a bit more complex than rats, or even other humans who just sit in a lab and take an oral glucose test.  

You see, we don’t usually eat sugar in isolation. That means there’s a whole array of other ingredients and nutrients that could have roles in this story. And, we also have something called “taste preferences” that pretty drastically alter our food seeking behaviors (12).

Here’s the takeaway I’d like to leave you with.  Our dietary focus should always be on a primarily whole foods diet - one that satisfies hunger cravings; provides dietary variety; is high in proteins, fruits, vegetables; and is not restrictive.  “Fun foods” have a place in your diet, but they should ideally be incorporated into big meals, or eaten after (as a dessert).

Essentially, allow yourself sugary foods without restriction, but first and foremost ensure you are eating whole foods-dominant, high-protein meals.  Don’t fall for the self-fulfilling prophecy trap of the “sugar detox - sugar addiction” cycle.

If you have any questions at all, don’t hesitate to reach out to me and let me know.  I hope this has been a useful and insightful resource for you!

References

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  2. Westwater ML, Fletcher PC, Ziauddeen H. Sugar addiction: the state of the science. Eur J Nutr 55: 55–69, 2016.

  3. Hebebrand J, Albayrak Ö, Adan R, Antel J, Dieguez C, de Jong J, Leng G, Menzies J, Mercer JG, Murphy M, van der Plasse G, Dickson SL. “Eating addiction”, rather than “food addiction”, better captures addictive-like eating behavior. Neuroscience & Biobehavioral Reviews 47: 295–306, 2014.

  4. Avena NM, Rada P, Hoebel BG. Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Biobehav Rev 32: 20–39, 2008.

  5. Colantuoni C, Schwenker J, McCarthy J, Rada P, Ladenheim B, Cadet JL, Schwartz GJ, Moran TH, Hoebel BG. Excessive sugar intake alters binding to dopamine and mu-opioid receptors in the brain. Neuroreport 12: 3549–3552, 2001.

  6. Liang N-C, Hajnal A, Norgren R. Sham feeding corn oil increases accumbens dopamine in the rat. Am J Physiol Regul Integr Comp Physiol 291: R1236-1239, 2006.

  7. Blood AJ, Zatorre RJ. Intensely pleasurable responses to music correlate with activity in brain regions implicated in reward and emotion. Proceedings of the National Academy of Sciences 98: 11818–11823, 2001.

  8. Breiter HC, Aharon I, Kahneman D, Dale A, Shizgal P. Functional Imaging of Neural Responses to Expectancy and Experience of Monetary Gains and Losses. Neuron 30: 619–639, 2001.

  9. Zeevi D, Korem T, Zmora N, Israeli D, Rothschild D, Weinberger A, Ben-Yacov O, Lador D, Avnit-Sagi T, Lotan-Pompan M, Suez J, Mahdi JA, Matot E, Malka G, Kosower N, Rein M, Zilberman-Schapira G, Dohnalová L, Pevsner-Fischer M, Bikovsky R, Halpern Z, Elinav E, Segal E. Personalized Nutrition by Prediction of Glycemic Responses. Cell 163: 1079–1094, 2015.

  10. Ziauddeen H, Farooqi S, C Fletcher P. Obesity and the brain: How convincing is the addiction model? Nature reviews Neuroscience 13: 279–86, 2012.

  11. Roitman MF, Stuber GD, Phillips PEM, Wightman RM, Carelli RM. Dopamine operates as a subsecond modulator of food seeking. J Neurosci 24: 1265–1271, 2004.

  12. Benton D. The plausibility of sugar addiction and its role in obesity and eating disorders. Clin Nutr 29: 288–303, 2010.