Speaking of Psychology - Can you be addicted to food? With Ashley Gearhardt, PhD

Episode Date: August 17, 2022

We live in a nation awash with cheap, easy-to-get calories, mostly from highly processed convenience foods. Now, some researchers argue that these foods may actually be addictive – just like cigarettes or alcohol. Ashley Gearhardt, PhD, of the University of Michigan, talks about why highly processed foods may trigger addiction, the difference between addiction and simply liking to indulge in treats, who is most at risk for food addiction, and more. Links Ashley Gearhardt, PhD Speaking of Psychology Home Page Learn more about your ad choices. Visit megaphone.fm/adchoices

Have you ever said, I'm addicted to chocolate? Or, I just can't stop eating these chips? You might have meant it jokingly, but what if there's more than a kernel of truth to the idea that food can be addictive? We live in a nation awash with cheap, easy to get calories, mostly from highly processed convenience foods. One recent study found that two-thirds of the calories that kids and teens in the U.S. consume now come from all. ultra-processed foods like industrial breads and cereals, frozen meals, and packaged snacks. In recent years, some researchers have begun to argue that these foods are more than just tempting and tasty. In fact, they argue some types of food may actually be addictive, hijacking the reward pathways in our brain in a way similar to alcohol or cigarettes.

So what's the scientific evidence that food addiction is real? And how can some foods trigger addiction? How does food addiction compare with other addictions, such as to cigarettes and alcohol? Are some people more likely to struggle with food addiction? And if so, what are the risk factors? Welcome to Speaking of Psychology, the flagship podcast of the American Psychological Association that examines the links between psychological science and everyday life. I'm Kim Mills.

My guest today is Dr. Ashley Gearhart, an associate professional. professor of psychology at the University of Michigan, where she runs the food and addiction science and treatment lab. Dr. Gerhardt studies the similarities between addictive and eating behaviors and how some foods may trigger addiction. She also investigates how food advertising drives eating behavior and the development of food preferences in infants. She has more than 100 academic publications and her research has been featured in media outlets including the Washington Post, The New York Times, NPR, and the Today Show. Thank you for joining us today, Dr. Gearhart.

I'm thrilled to be here. Thank you for inviting me. Not all researchers agree that food can be addictive, but you and others argue that ultra-processed food in particular can be. So first of all, what is ultra-processed food, and what's the evidence that this type of food can be addictive? Ultra-processed foods is something we've really just started to understand and investigate recently. We're really thinking about these ultra-processed foods as these industrial creations that when you look at the back of the ingredient list, it looks more like a chemical science experiment than it does a food. You don't really recognize most of what goes into it. And what we're realizing is that the food industry has gotten really good at creating products that trigger our bliss points that make us want more and more and more. And they don't hit our satiety signals the way real food, fruits, vegetables,

legumes, the sort of food we've been consuming for all of human history, these foods are so wildly different than those foods that some people have suggested that food is a wrong term for it, and we should instead call them chemical substances. So what's the difference between being addicted to food and just liking to indulge in treats more than you should? How can you tell if someone meets the threshold for addiction? I think that's such a great question, and it really gets at a little bit of a myth around addiction. I think people think you're either addicted or you're not. And in general, we really see that it looks like more of a dimension.

Some people will drink alcohol and not have any issues and can completely moderate it. Some people have a tendency to sometimes binge drink or consume past what's good for their health, but they're not necessarily consuming in such a compulsive, out-of-control way that it's starting to really impair or distress them. When I started to do this work, I really thought, well, how do we tell whether somebody, you know, just kind of eating a bag of chips at the end of the day and it's just a stress reliever, like having a glass of wine or whether they really are showing an addictive profile. And so I took our diagnostic criteria that we have in the DSM to try and dissociate between social drinkers and somebody who's actually addicted to alcohol.

And I've applied that to the intake of these really highly processed foods with unnatural levels of refined carbohydrates and fats. And so, you know, the hallmarks of addiction that I'm looking at, for are a loss of control over intake. You're continuing to use in the same way, even though it's causing you emotional problems or physical problems. You're having these intense cravings where it's just kind of occupying your mind. And it's starting to really impair or distress you in a way that other important things in your life, like your social engagements or your health or your ability to focus at work, are being negatively impacted. How widespread do you think food addiction is? Are there really

research-based estimates of what percentage of people meet the criteria for it? Yes. So in 2009, we developed the Yale Food Addiction Scale when I was in my PhD program with my advisors, Will Corbin and Kelly Brownell. And we just took those diagnostic criteria for what was called substance dependence at the time and applied it to the intake of highly processed foods. And from that scale, we can kind of estimate a similar diagnostic profile for what would look like a clinical level of addictive pull to these foods. Recently, there's been a meta-analysis that kind of combines across, you know, a range of the studies that have been done to provide us with an estimate of how many people might be really

showing this kind of full-blown addictive pull. And the estimate's about 14% of adults. And that's shockingly similar to what we see with alcohol, another legal, easily accessible substance. About 90% of people drink, but probably about 12 to 14% of people actually show a sign of an addiction to it. One of the things that's really striking to me is that we also have a version of this scale for children. And a meta-analysis that came out in children in adolescence found that about 12% of children were showing signs of this clinical level of food addiction. That is, of course, way past what we would see with something like alcohol or cigarettes or cannabis because kids are

not really getting exposed to those products until typically adolescence early adulthood. In contrast, as you mentioned, it starts to become a majority of the diet for kids, at least in the United States and in other westernized countries. You know, there was a study that came out, I think just last week that talked about how nobody should start drinking alcohol until the age of 40. And I'm just wondering, should we be doing something similar with processed foods? No processed foods until you're 40. Yeah, you know, we certainly know that the brain is vulnerable.

The younger you are when you're exposed to an addictive substance, the more likely you are to have problems. And to me, it's one of the big questions and concerns about this sort of research is that, you know, kids are being exposed to this and aggressively marketed to, especially children of color. are particularly being aggressively marketed to by the food industry. And so it's setting them up where this is one of the major sources of reward, sources of ways to cope. It's not just really about the calories. It starts to be about the hedonics, the pleasure, the emotion regulation from a very, very young age.

And, you know, we do see that children who are showing these signs of addiction and they're eating, they have higher body mass index, higher emotional overeating, they're less sensitive to their satiety signals. they have greater body fat percentages. So it would suggest that this is a group of children who are at risk. Now, I'm a mother of two young children, and I have to tell you, it's hard.

I know all of this, but we have an environment that is set up to make my job as a parent as hard as humanly possible when it comes to navigating what my child eat and what we eat as a family. And so I'm focused on how do we set up an food environment that encourages health over profits. So are people who are at risk for other addictions also at higher risk for food addiction? And for example, if you have a family history of alcohol or other substance use, might you be a candidate for food addiction? Yeah. So we actually just have a study recently coming out in this in the APA Journal, Psychology of Addicted Behaviors. And there we found that a family history of problematic alcohol intake was associated with a much more heightened risk.

of food addiction. Actually, even it was a better predictor of food addiction and even having personal alcohol problems. So it would really suggest that if you have a family history of addiction, you look back and you can see even if it wasn't food, you had family members who were struggling with things like alcohol, that this might tell you that you might be at heightened risk when it comes to responding to our food environment in a way that's problematic. In this study, we found that the people who are showing this kind of compulsive, addictive pattern of intake with these highly processed foods were also at heightened risk for their own personal alcohol problems and smoking and vaping. So it would suggest that kind of there could be this cluster of, you know, addictive risk that's

expressing itself across multiple substances. So I have to ask you a question about a particular food. I know you've talked about how processed foods can be addictive and that people don't tend to get addicted to carrots or peas or things like that. I mean, you can control how much of that you eat. But there's one thing that I think is delicious, which is homemade bread, like the best bread ever in the world. And I mean, I could eat that like every meal, two loaves. What's happening with something like that, which is not a processed food? You know, Kim, it actually is, I would consider a highly processed food. So right now the field is really struggling with what are the best terms. And ultra-processed has really

been focusing on the kind of industrial concoctions of these sorts of foods that we are already kind of designed and programmed to find, you know, that frozen pizza tasty and that, you know, cookie you pick up on your impulse buy at the gas station to be yummy. But I and my lab have really been focusing on highly processed foods. And how we define that is the inclusion of refined carbohydrates and or added fats. And so even though it's homemade, it's homemade from a processed ingredient, which is refined flour, refined carbohydrate. And when you combine that often with things like, you know, salts and there's often

fats and those breads as well, what you're doing is you're creating a product that delivers really reinforcing refined carbohydrates and fats and salts. to your body in a way where you can just devour it really rapidly. And often we add butter, right? So we're adding, you know, or some olive oil that we dip into it. And so we're amplifying it even further. And so when we compare that to something like, let's say, a bean or, you know, even a banana, the level of refined carbohydrates in that is a higher dose.

And the speed in which we can eat it, and the speed in which it impacts, our gastrointestinal systems and gets into our blood systems is much more rapid. And when I think about how we've created addictive substances, it's really similar. Like, for example, there's nicotine in eggplants. There's nicotine and cauliflower. But nobody's getting addicted to eggplants and cauliflower to get their nicotine, right? It's about the kind of processed cigarettes, the processed tobacco leaves that you get that provides a dose of artificially high levels of nicotine at a really rapid dose.

And then when you get the industrialized ultra-processed version of the tobacco cigarette, it also has a bunch of additives in there, like sugar and cocoa and menthol and things that even further amplify it. And that's what I see with these foods, that it's really about our brain getting kind of hooked on really powerful, impactful, rewarding substances that can set you up to lose control. So if, in fact, food is addictive, I mean, let's say that somebody has a food addiction, if they're taken off of highly processed foods, is there a period of withdrawal? Are there symptoms similar to the withdrawal that you might feel from stopping cigarettes or

alcohol or a drug, another drug? Yeah, so my lab has actually found some evidence that this does occur. It's preliminary early evidence. I'd say we need some more experimental work. But when we've asked people who in the last year have given up highly processed foods have tried to cut down on it and ask them about their experiences, they've reported that they experience many of the classic signs of withdrawal that we see in other addictive drugs. Again, I think we hit on a little bit of a myth here that people often think of withdrawal from addictive drugs as really physical where you're vomiting and you're shaking and you're sweating. Well, if we think about withdrawal from cigarettes, it really doesn't look like that. It's more about

irritability and agitation and cravings and you feel edgy. And that's really aversive and plays a role in people returning back to cigarette use. When we look at those same exact criteria when it comes to people trying to cut down on highly processed foods, they report those same things that they feel edgy, irritable, anxious. They have cravings that are challenging where they can't focus on other things. They feel down. They have kind of anhydonia. And they report that that's one of the biggest factors that lead them to go back to their highly processed foods.

And one of the things that was striking to me when we did this research is we asked people to kind of identify what was the period after you cut down where it was the most intense. Those symptoms were hardest to deal with. And people said it was about three to five days after cutting down on the highly processed foods. They really felt like it was really challenging to manage. when we look at withdrawal from other addictive substances, it actually follows that same time course of about three to five days is when it really peaks. And then if you can stick with it, it starts to get

better over time. And after about six weeks, you start to feel a lot better. I think one of the things, again, that's striking about it in the context of food is that we also looked at this and talked to parents about when they tried to cut down on their children's highly processed food intake. And the parent said, oh yes, my kids were more irritable. They were anxious. They would try and sneak food. They were acting out. They were so much harder to parent. And it was the worst about three to five days after we tried to cut back. And so to me, this suggests that this might be a really important factor that's contributing to our really high failure rates and being able to sustain dietary change that we're completely missing right now and we're not addressing. Are there treatments then that help people get over that hump? What would you say to somebody who's really trying to kick the habit? Yeah, so this is an area where we definitely need more scientific study. I feel like we're so in the spot right now where we're still really arguing about whether this is a real thing, that we've only started to pivot into what are the best ways to treat this. But there is some emerging evidence. So when we look at the behavioral side of things, we see that a lot of the intervention targets that we traditionally use and our addictive treatments also are really key with trying to get control of your food intake. And that's about, you know, being able to identify your emotions and developing healthier ways of regulating your emotions that doesn't rely on the

substance, whether that's alcohol or food or tobacco, helping people really identify what are their cues and triggers ahead of time. And that might be seeing an advertisement on TV or a certain time of day where you usually snack or a certain person, but you know, either makes you mad or is the person you usually go get your three o'clock coffee break donut with. Having more of a sense of your cues and your reactions can start to give you some of your power back. We're also seeing that some of the medications that we see are effective in treating substance use disorders like naltrexone and buproprin are also showing some evidence of being

effective in the context of binge eating and addictive eating, that these are factors that medications that might help support people in their recovery. But one thing I think that is kind of interesting in the opposite side is that we're really starting to think about in the realm of traditional addictive substances about the food that you're eating and how that might set you up to be successful or not in your recovery. And so we're starting to really understand that when you're really hungry, you're actually calorically deprived. Those gut hormones that tell you you need calories, have a direct message system up to the reward centers of the brain. And they say, hey, you know, pay attention. We need some reward. We need some food. We need some

calories. We need some cues. So we're actually seeing that if you're really hungry, it might not just make you more vulnerable and sensitive to highly processed food cues, but also make you more vulnerable to traditionally addictive substances like alcohol, cigarettes, and cocaine. And that having people really focus on eating regularly, three meals, one or two snacks of high-quality foods, getting enough protein, stabilizing that blood sugar, that might be not only really key in recovering in the context of your relationship with these highly processed foods, but also may be an underlooked intervention that we could use and the recovery from other addictive substances. Is there any relationship between food addiction and anorexia or bulimia?

Yeah. So we've done work on that. And we're definitely seeing in the context of bulimia nervosa really high endorsement rates of food addiction. So some studies have estimated that up to 80 to 90% of people who have bulimia nervosa report experiencing an addiction and addictive-like profile in their relationship with food. In some ways, that's really not surprising, right? They're both hallmarked by a loss of control. With binge eating disorder, we see a, it's maybe more about 50% of people with binge eating disorder meet for the food addiction, phenotype, and 50% dope. The 50% that do are more likely to endorse addictive mechanisms like intense cravings,

emotion dysregulation, heightened impulsivity, those kind of core factors that we think of as playing a big role in substance use disorders. Anorexia nervose has been more of a perplexing one. It should be the complete opposite. it. But we see particularly individuals who have anorexia and nervosa binge purge subtype, where even though they're not eating large amounts of food, they subjectively experience it as a loss of control binge. That group of people will also endorse addictive eating. And I'm really curious that in the same way we see that some people have objective binge eating where they're

objectively binging on lots of food, but some people aren't having a lot of food but experience it as a binge, whether we're also seeing that with food addiction, where some people, you know, all they eat is like a turkey sandwich and, you know, a bag of chips and they say, oh, man, that was really an addictive eating episode. So in the context of anorexia, we really need to understand it more. We do see that that endorsement of food addiction and anorexia is associated with a more severe clinical presentation and potentially a worse clinical prognosis. But just to pivot a little bit, I think one thing I want to make really clear is that a lot of people have asked me, well, isn't this already covered in our diagnoses? You know, we have binge eating

disorder. We have bulimia. You know, is food addiction? It's just that. And I would say that that really isn't the case. You know, I think when we look at those estimates of prevalence, we see that about, you know, as I mentioned, about 14% of adults are endorsing this food addiction phenotype, whereas only about 2% of people endorse binge eating disorder, about 1% have bulimia and herbosa. And that means we have tons of people who are endorsing a clinically relevant phenotype of problematic eating that's in line with addiction that we're not addressing and we're not treating.

And those individuals are more likely to have lower qualities of life, to have higher psychopathology across the board, to be less likely to respond to. to our traditional treatments for weight loss and for disordered eating. And so I think we really need to kind of attend to them and help them, even if they're not presenting in a way that's captured by our more traditional eating disorder diagnoses. One thing that we've talked about on this podcast before is the problem of weight stigma. Do you worry that talking about food and eating as an addictive behavior might increase the stigma around weight and obesity?

Absolutely. So the institute where I got trained was the Red Center for Food Policy and Obesity at Yale. And there was a really big group there, Rebecca Pohl as one of the leaders, really focusing on weight stigma. So it was front and center for me and my training. And so actually, Rebecca Pohl, myself and others have done work where we've actually experimentally investigated this concern that we had, that, you know, if we talk about these highly processed foods as addictive, are we doubly stigorous? and already stigmatized group. And actually, our research has found that it's either neutral and doesn't increase stigma or if anything, it might reduce stigma towards individuals with higher weight.

Because right now, we're at kind of where I see we've been with a lot of addictions in the past, which is that it's just a focus on, you know, willpower. You just have to try a little harder calories and calories out. And what it's ignoring is that there's a true. billion dollar industry that is using its research and development budget to specifically design these highly processed foods to trigger a naturally intense levels of reward in your brain and a way that makes it hard to manage. And that if this is triggering this addictive, compulsive pull, it's not just an adult choice, but really the result of a toxic

environment, really pushing a risky food substance. that we're not well-informed about. And so that seems to actually be somewhat helpful in reducing stigma and reducing the belief that people just aren't trying hard enough. And it's just a matter of willpower. Do you have any advice for parents who are trying to figure out how to feed their young children? I mean, you alluded to the fact that you are struggling as a parent yourself. Is it better to avoid these prepackaged ultra-process foods altogether?

or if you forbid kids to eat them at home, are they going to be more tempted to go out and get them, maybe at a neighbor's house, or when they're older, they'll just overcompensate for the fact that my mom never let me eat this stuff? I'd say this is an area where we need more longitudinal research. Almost all of our research in this area is really cross-sectional. And so for a long time, there's really been for parents this idea of, you know, if you restrain or restrict your child from having highly processed foods, that you're going to cause them to then develop a restrictive eating disorder. They'll binge in other places where they can get it. But one of the caveats to that sort of work, and I've been somebody who's treated eating disorders

before, is that parents will come into me and they will say from the moment this child was born, they have had such a strong reward pull and drive towards these highly processed foods that they'll eat them to the point where they'll throw up, you know. And so if I don't step in and try and, you know, help moderate that or prevent that, they will get sick. They will have such problems with these foods. And so we also see that kids who are maybe prone to this intense reward drive with these foods, it's eliciting parents to try and step in and restrict more. Now, in general, I think either extreme is probably not going to be where we land. I think saying, you know, it's full, there's no moderation. It's, you know, eat these highly processed foods

whenever and however you want with your kids. There's no kind of guidelines in your house is not great. On the other end, if it becomes an obsession in the family and you never, ever, ever eat these highly processed foods, it's, you know, the forbidden fruit, I think that's probably not great either. The hard part is it's probably one of those complex topics where it's a middle ground. and that for each family, it's probably going to be a somewhat unique answer. And so in my own family, I try and make it the default where the majority of what we're eating is real food, you know, actual food. But we'll absolutely, you know, have times where we eat popsicles or we'll have a Friday

pizza night. But I try and make it kind of, you know, more of, you know, less of the status quo. Now, that's what works for my family. But I don't think that there is one perfect answer for anyone. And honestly, I think we need to be a lot kinder to parents, that as scientist, we don't have the answer and that they need to kind of figure out what is healthiest for their family and with their children. So you've written that this is an issue that can't be solved at the level of individual choices, which is kind of what we were just talking about. And that instead, we need broader societal changes and regulations around, food and food advertising to really make a difference. What are the changes that you think are needed?

Yes, I think when we look at the history of addiction, this is so clear to us that, you know, when we look at tobacco, which diet-related disease related to excessive intake of these highly processed foods, is on par with killing the amount of people that tobacco products do. This is as big of a public health crisis. And we really saw that with tobacco, it wasn't that, you know, we developed better treatments to help people realize that tobacco was addictive or unhealthy. It was that we really focused on the environment and policies and things like restricting advertising to children, getting vending machines out of places where, you know, you could just go get it and there wasn't like an ID check. Taxation to really set it up where there's economic factors that

nudge people away from this substance are all factors that have been considered in the context of changing our highly processed food environment. And there are countries that have been really frontrunners on this. Chile has made really huge changes about restricting advertising and packaging of these foods that are really targeting children, restricting, you know, increasing taxation and really doing public efforts to change our attitude and relationship to these foods. The UK has a lot of new policies coming on board soon. America's really at the back end of this. We've really not been the leaders in this. Well, we're kind of the pioneers of ultra-processed food, aren't we? Absolutely. And it's just like how we were with tobacco. We were the biggest creators and

exporters of tobacco products. And, you know, it's really not surprising that we're the leaders with these ultra-processed foods because, you know, the biggest producers and creators of ultra-processed foods from 1980 to 2007 was Philip Morris and RJ Reynolds, Big Tobacco. They used the same playbook to market these foods, often create some of these foods like Kool-Aid, you know, that was a creation from Big Tobacco, and target children, target racial ethnic minorities, and then, you really try and deflect and focus solely on personal responsibility as the answer to the negative public health consequences associated with their substances. And, the funding of scientists and politicians to really be in their court rather than thinking about

what's best for society. I mentioned earlier that not all researchers agree that food can be addictive. And in fact, you recently wrote a journal article in the form of a back and forth discussion with another scientist debating the point. What are the main areas of disagreement among researchers right now? And what research do you think needs to be done to fill the gaps in our knowledge? Oh, that's such an excellent question. And, you know, this is science where we need more attention and we need kind of more of a focus on it. It's definitely not an open and shut case. But I would say that, you know, there's starting to be more and more of a general consensus around whether people can show signs of addiction and they're eating. I mean, it's really clear when we think of what are the hallmarks of an addiction, that loss of control, those intense cravings, you know, continued use despite. negative consequences. If we think of tobacco, one of the biggest pieces of evidence was that,

you know, someone will be told you're going to die. You have emphysema. You have lung cancer. You have to stop smoking. And many people couldn't. We see that for a lot of people, they'll get a type 2 diabetes diagnosis. They'll have a heart attack. They'll have gastric bypass surgery to try and deal with health conditions and severe obesity. And arguably the majority of people are unable to kind of make sustainable changes and their intake of these highly processed foods. For many people, the craving, the pull, the desire for these highly processed foods is too great. And even though they know it's actually literally killing them, they are unable to change their behavioral patterns.

So I think they're starting to be an understanding that, okay, those indicators of addiction and people's behavior seem to be there. But now the debate is really about what is the real. role of the food. And some people have said, you know, it's really not about the food. It's just about the act of eating, you know, kind of regardless of the food that you're consuming, because we can't identify a single kind of chemical agent that is addictive. And so I actually think that personally, that these highly processed foods are an essential ingredient in being able to trigger this addictive response. You know, when we look at scientifically, what are the foods that people consume in a

compulsive, addictive loss of control manner? It's about 100% highly processed foods. You know, if people could binge on kale and bananas or strawberries and watermelon and get the same fix, they would, right? These are people that are desperate to change and they're unable to. Now I think it turns to what do we use as our benchmarks for a value? evaluating what foods may be addictive and how do we know. And I've been really focusing on, you know, what are the benchmarks we use with tobacco? Tobacco products are incredibly complex substances. They have thousands of chemicals in them. And we were able to say, you know, these tobacco products are addictive and nicotine is the addictive agent because of the benchmarks that

they were able to trigger compulsive use. They're highly reinforcing, meaning we'll work hard to get them. They change our mood. They impact our brain. And when we look at these highly processed foods, you know, they tick all those boxes. They actually trigger sugars and fats and highly processed foods trigger the same amount of dopamine release, which is kind of, you know, the most key neurotransmitter in addiction. They trigger the same amount of dopamine release in the brain as nicotine, as alcohol. And so when we think about whether they are as powerful, I would argue that they are. And so I think more research really needs to be focused on, you know, even in this podcast, we've said food addiction so many times. And that's what I called it. You know, we first started doing the research. It's clearly not all foods. It's clearly this subset of highly processed foods that are unnatural, highly refined, highly rewarding products. And that's what people get hooked on. We can't get people to eat enough fruits and vegetables and legumes and lean meats. Even when we spend, you know, millions of dollars. on public health campaigns to encourage them, whereas, you know, people are really struggling to get

a handle on their relationship with these foods, even in the face of really stark consequences. So are you saying the argument on the other side, the researchers who don't believe this is an addiction, is because you can't identify this one substance like nicotine? That's the main argument. And that eating is just so complex that it's so hard to tell. However, you know, people are dying. You know, this is now number two, maybe even number one, cause a preventable death in the United States is our relationship with these highly processed foods. And when I think about this, I also find that that idea that we've never, we did not identify tobacco as addictive because we were able to tell something about the chemical signature of nicotine.

As I mentioned, you know, nicotine exists in eggplants and cauliflower. Nicotine and, you know, a nicotine patch is not very addictive. If anything, it's a treatment. It's not just about whether it has the chemical in it, but about what is the dose in which it's delivered, how rapidly is it delivered to the system, and is it further amplified by additives? You know, we see with nicotine that the flavor additives, the taste, the sugar, the cocoa, the menthol starts to play a huge role in amplified.

flying that nicotine. Right now we're considering taking menthol out of cigarettes and that's thought to save millions of lives not due to any change in nicotine content, but because the menthol, that flavor, that cue becomes so potent and powerful in driving the addictive response. And so when I look at these foods, you know, I don't think carbohydrates in any form are addictive. I don't think fat in any form is addictive. But when I look at how it's delivered in these highly processed foods where it's refined made to be exceptionally potent, if you think of natural foods, fruits have sugar, nuts and meats have fat, and natural foods, carbs and fat don't come packaged together. You know, they don't, breast milk is probably our best example of, you know, carbohydrates and fat being delivered together

because they're both really potent reward activators. When we think of our processed foods, the majority of them have fat and carbohydrates that are refined and then at levels that far surpass what we see and naturally occurring foods. I don't think our brain knows what to do with that. And I think if you have risk factors like a family history of addiction or trauma is a big one we're seeing or struggle with emotion regulation, then you are at heightened risk for being vulnerable to these foods. Well, Dr. Gerhardt, this has been fascinating. I really thank you for joining me today. My pleasure. Thank you so much for inviting me on. I really enjoyed it.

You can find previous episodes of Speaking of Psychology on our website at www. speakingof psychology.org or on Apple, Stitcher, or wherever you get your podcasts. If you have comments or ideas for future podcasts, you can email us at speaking of psychology at APA.org. Speaking of Psychology is produced by Lee Wynerman. Our sound editor is Chris Condyenne. Thank you for listening. For the American Psychological Association, I'm Kim Mills.