Junk-food junkies?

No, the Oreo study doesn’t prove much. But understanding why is worth the effort: much of the “scientific” support for the “brain disease” theory of addiction comes from similar methods. Anything that demystifies habitual behavior – anything that gets people to treat eating disorders and drug addictions as similar phenomena – is a social gain.

I have to agree with Keith’s post below: the Connecticut College study does not show that “Oreos are as addictive as cocaine.” The college should not have put out a press release making that claim, and respectable news outlets (plus Fox and HuffPo) should not have published that claim uncritically.

But I wouldn’t just put this in the “junk science” folder next to vaccines-and-autism or supply-side economics.  Understanding what the study found, and what those findings mean and don’t mean, seems to me worth some effort. Eoin O’Carroll’s careful reporting in the Christian Science Monitor is both a rebuke to the shoddy journalism – mostly based on that story – that Keith justly derides and a valuable contribution to public understanding of the phenomenon of habituating behaviors.

The study was straightforward: maze-running rats were offered pairs of alternative outcomes: cocaine v. saline, Oreos v. rice cakes.

1. In each case, they overwhelmingly chose the more rewarding alternative over the less rewarding alternative.

(No sh*t, Sherlock!)

2. The preference for Oreos over ricecakes, measured in terms of the fraction of the time rats chose one rather than the other, was quantitatively greater than the preference for cocaine over saline.

(So what? The relevant measure would have been a choice between cocaine and Oreos, and that choice wasn’t offered. Or, as Edythe London points out, experimenters could have measured how much work the rats would do for each type of reward. Those would have been valid quantitative measures of reward intensity, with the caveat that the results would probably have been strongly dose-dependent, and there’s no obvious equivalence between milligrams of cocaine and grams of Oreo.  The actual measurement doesn’t seem to measure anything interesting.)

So far, then there’s less here than meets the eye. It’s a cute science-fair project, but not much more than that.

However, Schroeder and his students then took another step. They killed the rats and measured c-Fos in the nucleus accumbens. The brains of the junk-food junkie rats produced even more of it than the brains of the cocaine-junkie rats.

Of course London is right: all that provies is that Oreos produce pleasure, which we already knew. But once you’ve said that, much of the NIDA brain-centric theory of addiction starts to fall apart.

In some ways, the more illuminating finding about food and addiction came from the Johnson and Kenney study (published in Nature Neuroscience three years ago) showing that rats habituated to a high-fat diet, but not other rats, would pursue fatty food even in the fact of electric shocks. Now that’s starting to sound like “addiction” rather than mere “reward-seeking.”

Of course none of that means that Oreos are as dangerous as cocaine. But surely the life-years lost to junk-food eating habits must exceed the life-years lost to illicit drug abuse, even counting the violence in illicit markets.  And eating disorders are much more chronic, and much harder to cure, than drug dependency. In a natural population, two-thirds of the people with diagnosable substance abuse disorders recove within three years, almost all of them without treatment, while most people who try to lose weight on their own can’t keep it off, and even aggressive interventions produce only a few pounds’ worth of sustained improvement.   (Whoever wrote the Washington Post headline implying that people habituated to sweets don’t go through withdrawal has obviously never been on a diet.) Food, like alcohol, is a familiar problem, while “drugs” is an exotic problem.  That fact has been used both to mystify “drug abuse” or “addiction” and to make  those categories in to bogey-men, while minimizing the extent of the more familiar risks.

Bad habits and unwise decisions are integral to the human condition, and they exist on a continuum between fully self-aware, self-controlled, and rational actions on the one hand and intractable habitual behaviors on the other, not in neat boxes labeled “normal behavior” and “addiction.”  And that means – contrary to the mantras of the brain-scan fetishists – that addictive behaviors respond to contingencies, and that therefore categories of moral responsibility apply. Having impaired volitional control is not the same as acting involuntarily; a meth addict is not a zombie. And it’s quite possible to be a little bit addicted, or to be dependent at one time and a controlled user at a later time.

Note also that the Connecticut College study, though it hasn’t been through the peer-review mill yet, isn’t just “press-release science.”  Apparently the paper has been accepted for presentation at the forthcoming Society for Neuroscience meetings, though I’m not sure how high a bar the Society for Neuroscience sets.  Perhaps Keith and I differ on this point, but it seems to me that once a paper has been presented at a scientific meeting – even as a poster – it’s fair game for reporting, though a careful journalist should note whether the study has or has not been peer-reviewed and published.

 

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

41 thoughts on “Junk-food junkies?”

    1. Here Keith and I part company. Smith’s scientific training didn’t keep her from both making a basic logical error and introducing a major conceptual confusion. She reasons, falsely, from “This claim is not supported by these data” to “This claim is false.” And she confuses addiction with physical withdrawal. Granted, no one dies of Oreo withdrawal. But on that dimension Oreos are like cocaine, though unlike alcohol or the benzos. Lots of people keep eating sweets well past the point where the negative consequences are overwhelmingly huge and obvious; ask any physician who treats diabetes or heart disease.

    2. I didn’t realize Oreos were *this* declasse before. Ninety percent of the comments to that article are testimonials about how awful and revolting Oreos are and how wonderful it is to not have an American palate. Are they very salient in British food politics for some reason?

  1. I think the more interesting issue is WHY Keith is so mad that someone would compare oreos to cocaine. Drug prohibition looks like a much worse idea when you can’t separate the things the hated hippies and stoners and urban black males do from the risks the white middle class respectable public takes.

    The drug war has never been about substances that are particularly dangerous, or risks that one shouldn’t run. It’s about people, such as blacks and hippies and kids having fun, whom other people are prejudiced against.

    1. Dilan, please read before commenting. We’re all familiar with your prejudices, which do not constitute facts. Keith’s objection, as he makes clear, is to press-release science, not to any specific finding.

      1. Mark, I read his post. Basically, I have not seen one post by Keith here on drugs that I consider honest.

        What do I mean by honest? I mean the following:

        He never tells us how he feels about the morality of people who use drugs. Yet his posts are full of assumptions that drug users MUST be doing something bad.

        The Oreo-drug comparison is quite sound. Indeed, it is obviously sound. It is not “press release science”. Keith’s post is awful, hackish, and unintelligent. So why would Keith go off on it? For the same reason as every other post he makes here on the War on Drugs.

        He needs to tell us EXACTLY how he feels about stoner culture. What his biases are. What he thinks about the morality of drugs. He is hiding behind hackish arguments and not admitting he just hates certain classes of people.

        Your blog deserves better posters, Mark. This guy is a really awful person who wants the police to enforce his prejudices at the barrel of a gun, and isn’t honest enough to admit it.

        1. To add one thing:

          To be clear, my problem with Keith isn’t that he’s a drug warrior. It’s that he is a drug warrior who hides behind dishonest arguments that purport to be about “science”.

          At bottom, all arguments in favor of continued criminalization of at least the less harmful substances are basically about morality. So I have a lot more respect to people who actually come out and say they don’t want the public to do immoral things than people who lie about the science. Not admitting one’s moral priors on this issue is basically cowardice.

        2. The Oreo-drug comparison is quite sound. Indeed, it is obviously sound. It is not “press release science”.

          The fact that you consider this study* to be a priori correct says a lot about you. And none of it good.

          (* If it indeed deserves to be called that, I haven’t read it myself.)

  2. Mark:

    Great post! You often provide insightful solutions to public policy drug issues. What policies do you support for fighting nutrition public policy problems?

    A fat, sugar, and salt tax? Limits on food marketing? Licenses for bad food?

    I have been wondering your thoughts on “food addiction” for awhile now….

    Frank

    1. Me, too. No really good ideas.

      Marketing restrictions seem to be obviously justified, along with taxes on unhealthy foods and subsidies for healthy foods.

      How to make that happen politically, how to avoid its capture by the health-food nuts and racketeers, and whether it would make a noticeable difference are harder questions.

      I am (if you’ll pardon me) an expert on drugs and drug policy. Food habits in some ways resemble drug habits. That does not make me an expert on nutrition.

      1. Not to be reductionist, I would think high prices may be the most effective strategy…

        I think if you look at the rest of the OECD countries, high food prices are strongly correlated to low obesity rates
        especially in Northern Europe and Japan/South Korea…

        Frank

        1. Our food subsidies are all screwed up. It’s crazy for lettuce to be expensive and corn to be cheap.

          And changing them could save thousands of lives. Indeed, it would take Keith 50 years of his beloved drug war to save as many lives as a couple of years of good food policy might.

  3. I’ve never been to the SfN, but I have friends who have. It’s inconceivably huge (tens of thousands in attendance, lasts up to ten days, and had perhaps 20,000 poster presentations in 2012), and “accepted for presentation” is far from enlightening. My impression (my recollection of when friends went) was that it’s fairly typical for a large meeting in the biological sciences: essentially all applicants are welcome (though registration is moderately expensive), and registrants submit along with their registration a title and abstract (perhaps 150-250 words) describing their current research. On the basis of that abstract (essentially, the perceived magnitude and importance of the work, as asserted, and without reference to the data or the experimental designs), the submitting author may be invited to give a brief talk at one of many parallel sessions (typically 10-15 minutes including a couple for questions); more commonly, they will be invited to present a poster, one of dozens or hundreds on display during their session (over 700 poster sessions in 2012, it seems!). Being invited to present a poster is essentially a default circumstance (I suppose a registrant who was an obvious crank might be excluded), and being invited to present a talk is an honor but doesn’t constitute peer review – the committee making the selection has assessed the importance of the claims as made and made some basic credibility judgment about the writing and the authors, but likely has seen no details whatsoever.

    1. That is an exact description of the situation for annual meeting of SfN, ASCB, ASBMB et al. Posters and talks at large international meetings are good for a line on the CV, but that is all. I have about 50 of them. So what? In years past the program for ASCB was a supplement to a real journal, which implied peer review to the uninformed since the title made it into PubMed and the Web of Science database; probably Google Scholar, too. That has ended for most such “contributions,” which is a good thing.

  4. This is a very good post, and it is churlish to be cranky about a trivial point. But right now, I am feeling like a churlish crank. “S–t” is a fine English word, and “No s–t, Sherlock” is a fine American idiom. Mark used the idiom righteously, but had some spelling problems. “Sh*t” is not an English word, although Mrs. Bowdler may think so.

    1. I share your views. Alas, the nanny programs installed by law in many libraries don’t, and we’re trying to keep the RBC accessible to The Children. So I’m replacing the middle two letters of the word in question with dashes in your comment. Sorry!

  5. I don’t think it’s necessarily junk science, either. c-Fos in the nucleus accumbens is about as good a biological measure of pleasure as we have. The relative latency before ingestion is a solid, objective measure of desire/drive for the reward.

    One (seemingly unavoidable) problem is that cocaine is not usually eaten, and eating is a very slow delivery system for the drug. Slower delivery systems are, of course, less addicting. So I don’t buy into the results reflecting anything about actual cocaine use by human addicts (usually snorting or smoking).

  6. The Oreo experiment IS nonsense. But it is nonsense because the whole prevailing discourse of addiction is nonsense, not because cocaine may actually be more pleasurable to consume than Oreos.

    This issue arises because most drug prohibitionists believe two things:

    1. Drugs exist in nature*

    2. Pharmacological determinism – the idea that certain substances possess unique addictive or “enslaving” powers.

    You will often, for instance, hear them say things like: “Heroin is so addictive don’t even try it once!” It is as though they believe the properties of the chemical itself can cause addiction. It cannot:

    “It is self-evident that a drug alone does not cause addiction because the great majority of those who experience its effects do not become addicted, even if the drug is one that is regarded as ‘highly addictive’, such as heroin or cocaine.” http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2009.02739.x/abstract

    An extension of these two false beliefs (that some substances can be labelled ‘drugs’ and ‘drugs cause addiction’) is that subset of these substances called ‘drugs’ have ‘abuse pontential’. Because prohibitionists have yet to coherently articulate a list of ‘foods of abuse’ (and they’re damn well trying!) these kinds of studies tend to cause consternation among believers (like Humphreys).

    *They don’t exist:

    “there are no drugs in “nature.”…As with addiction, the concept of drugs supposes an instituted and an institutional definition: a history is required, and a culture, conventions, evaluations, norms, an entire network of intertwining discourses, a rhetoric, whether explicit or elliptical… The concept of drugs is not a scientific concept, but is rather instituted on the basis of moral or political evaluations: it carries in itself both norm and prohibition, allowing no possibility of description or certification – it is a decree, a buzzword. Usually the decree is of a prohibitive nature.” – Derrida, J. (1993). The rhetoric of drugs. An interview. Differences: A Journal of Feminist Cultural Studies, 5(1): 1-25.

    “The truth is that no single uniform feature is found in all the substances called drugs that differentiates them from all the substances called nondrugs, except that all drugs have been called drugs by somebody.” http://knowledge.sagepub.com/view/the-relativity-of-deviance-2e/n9.xml

    1. Derrida on the science of drugs, huh? He would argue alcohol isn’t a drug, because it occurs in nature? Never mind that after its ingestion it acts directly on the GABA-A receptor, causing the relaxation response that people are looking for when they drink it. Forget that people develop a tolerance for it with usage– one must make a “moral or political evaluation” of it to decide whether it is an addictive drug.

      This is where sticking to a neuroscience perspective adds clarity: the only addictive drugs are psychoactive drugs. The only psychoactive drugs are those that stimulate or suppress neurotransmitter systems in a way that could be pleasurable.* People don’t get addicted to antibiotics because they aren’t an analogue to a neurotransmitter; nicotine is, and they do. People don’t get addicted to Metrazol because it blocks GABA, which is unpleasant; they do get addicted to cocaine, which stimulates dopamine, which is usually found to be pleasant.

      Derrida’s perspective doesn’t actually allow any room for neuroscience, and that is why it fails.

      * developing a tolerance is usually fait accompli when you have regular or large increases in neurotransmitter function.

      1. Some substances have psychoactive properties – nutmeg for instance. Others (like antibiotics), none.

        My mother puts nutmeg in her pumpkin soup. Does that make me a ‘drug’ user? Why hasn’t nutmeg been labelled a ‘drug of abuse’?

        The fact that some people develop a physical tolerance to a substance does not render a substance addictive. Most people who take opioids [daily] for pain relief form some degree of physical dependence (their body will adapt to the presence of this chemical, as it is designed to do) but very few will form an addiction (and keep taking it despite clear harm).

        1. “My mother puts nutmeg in her pumpkin soup. Does that make me a ‘drug’ user?”

          Here you go: http://www.thefreedictionary.com/quantity
          And here: http://abcnews.go.com/Health/large-doses-nutmeg-hallucinogenic-high/story?id=12347815

          “Most people who take opioids [daily] for pain relief form some degree of physical dependence (their body will adapt to the presence of this chemical, as it is designed to do) but very few will form an addiction (and keep taking it despite clear harm).”

          Yeah, people almost never get addicted to heroin, morphine, Vicodin, or OxyContin. On your planet.

          1. No, most people who take it for pain relief will not end up addicted. For instance, during my chemo I was given a prescription for Vicodin, because part of the treatment was known to be painful. I ended up dropping the Vicodin for an over the counter pain reliever, and after the chemo was over, dropped off the remains of my first bottle with the local pharmacy.

            I wasn’t likely to be addicted, because I wasn’t self-selected for taking it. Has it occurred to you that people who go out of their way to try opiates for fun might be a bit different in their tendency to get addicted, than people who get them prescribed because of pain?

          2. (1) I admire your restraint in the use of painkillers, but frankly, the pain of chemotherapy is both mild and short-lived compared to, say, the pain of stomach or pancreatic cancer. Or other chronic conditions where nerves are impinged upon.

            (2) Prolonged pain often causes sensitization to painful stimuli, which leads to a need for a higher painkiller dose to neutralize it. This is why patients are usually advised to take enough meds to keep any pain from occurring, which means they are very likely to overshoot their mark. And that gets you drug tolerance.

            (3) I have no doubt there is some degree of self-selection, but people in treatment for chronic pain get a lot of drugs, often for no marginal cost, delivered round-the-clock, and are often hospitalized or bed-ridden at home (i.e. not having to work). These conditions make addiction far more likely than otherwise.

          3. Truth is, it doesn’t require much restraint for me; I’m one of those people with a paradoxical response to opiates. If I take any opiate I’ll be hyper until it wears off, but too muzzy to get anything done. Not a pleasant combination at all.

    2. “1. Drugs exist in nature*

      *They don’t exist”

      Um, tell that to the bears. And to the moose.

      There seems to be something to this idea of the existence of (psychoactive) drugs over and innate desire to consume them over and above marketing efforts or esoteric discourses on political evaluations. The question regarding nutmeg is a non-sequitur for the reasons others have elucidated.

      As it is, the fact that sorts of proclamations you made so fly in the face of the reality that very nearly all adults have experienced is such to immediately discount the remainder of your comments. And I write this as one who thinks the ‘War on Drugs’ is as misguided and quixotic a quest as one is likely to find in human endeavors.

      1. “proclamations you made so fly in the face of the reality”

        To be fair, it was probably just the non-drugs talking.

  7. Strikes me that you’ve missed a very key distinction between obesity and ‘addiction’: Generally speaking, obesity creeps up on a person very, very gradually, over a period of years, even decades. You can shed weight through self-denial. But if you stop, you tend to rapidly return to the SAME weight, and resume that slow climb.

    The precision balance between energy use and calorie intake during this slow climb is incredible. If you gain 50 lbs of fat by your 50’s, that’s a pound a year, 10 calories a day. How do you maintain such a precision balance, just grabbing food, and doing what you feel like? It’s not like you’re measuring your food on a precision lab scale, and living in a calorimeter.

    This is so not what you’d expect if people were simply exhibiting a lack of control in their eating.

    What appears to be going on is that people have a weight set point, which they instinctively and accurately hold, and that set point has a tendency to drift as they age, and if it does, it tends to drift upwards. But it is under control by autonomic mechanisms the whole while.

    Further, there’s the mystery of obese lab animals. It isn’t as though THEY have access to Oreos on their own initiative.

    Obesity IS problematic, and eating can be pleasurable, but it does not appear that obesity is generally the result of an addiction to food. Unless maybe you want to call breathing an addiction to oxygen, too.

    1. Interesting. Libertarians would hold everyone personally responsible for how they find themselves situated in life. For example– if you are poor it is because you are lazy. This is apparently true for all life’s circumstances except for fatness. In which case, libertarians blame genetic mechanisms. I’d say this is another example of shameful self-serving libertarianism, but the very nature of libertarianism is that it is self-serving: Thus libertarians want their cake and to eat it shamelessly too.

      So yes son, you are fat not because you can’t control the most basic human trait (what you put in your mouth) but because of your genes. Your libertarian self isn’t to blame. As for those nasty poor lazy people, well, that’s a different story…

    2. The reason people often gain weight again after weight loss is because willpower is a depletable resource and diet requires eternal vigilance; a vigilance that is undermined by being constantly bombarded with messages to eat, eat, eat, “grab a quick bite” and always prioritize “doing what you feel like”. We have been gulled into thinking that this is freedom when in actual fact our beliefs about food & drink are being carefully manipulated by the food/beverage/advertising industry at all times. The predictable outcome is overconsumption (that results in obesity).

      People who are under additional stress (from poverty, mental illness, discrimination, alienation etc) are more susceptible to obesity precisely because willpower is exhausted more rapidly under these conditions.

      The obesity crisis won’t be solved by a better understand of genetic or new medical treatments but interventions that limit the power of the food/advertising industry and address poverty, discrimination and other structural inequalities.

      1. As to the power of the food/advertising industry: Yes!

        Ditto the power of the alcohol/advertising industry and the nicotine/advertising industry.
        Ditto also the power of the emerging cannabis/advertising industry and the power of similar industries that would emerge if the commercial sale of cocaine, opioids, and amphetamines were made legal.

        It is not necessary to attribute demonic powers to “drugs” to recognize that some commodities tend to form bad habits in large minorities of their consumers, and that leaving those commodities in the hands of the market means creating incentives for vendors to create and sustain addictions.

        1. Mark, MANY things cause addiction, too many to regulate, and unless you want to eliminate capitalism, most of them are going to be marketed, even if marijuana is not.

          You have to come up with ways to stop people from being self-destructive without curbing marketing, because that’s impossible in a capitalist system. And you also need to respect people’s RIGHT to be self-destructive if they want to be, even if the marketers induce it. I am not a fan of tobacco (or pot, for that matter), but the fact that tobacco is heavily marketed doesn’t mean that smokers don’t find it fun to smoke.

          1. Mark, MANY things cause addiction, too many to regulate, and unless you want to eliminate capitalism, most of them are going to be marketed, even if marijuana is not.

            Ah, the old “we can’t do everything so let’s do nothing” argument. A close cousin to “it’s not perfect so we shouldn’t do it”.

            Great foundations for public policy, surely.

          2. Ah, the old “we can’t do everything so let’s do nothing” argument. A close cousin to “it’s not perfect so we shouldn’t do it”.

            Let’s not forget the “slippery slope” argument too…
            If a school district makes a ‘nudge rule’ that fruit must appear on cafeteria shelfs in front of brownies…Why…
            Next week they will surely be banning twinkies and carbonated hummingbird food (i.e. soda pop).
            And the next thing we know… you will be trying to take away my guns too.

        2. In a perfect world we could rationalize the whole mess, and we’d end up with a variety of nudges that served to push down overconsumption of sugar, booze, MJ & other currently-illegal drugs, etc, without attempting full-on prohibition or allowing industries selling harmful things to run riot. Some taxation, some regulation, some public health messaging. When we get there, be sure to include my magic pony (properly regulated, of course, particularly if it can fly). 😉

        3. But why should we use the power of public policy to influence these areas (marketing of so-called “habit-forming substances”) when other risky, self-reinforcing behaviors can be freely advertised?

          Examples that leap to mind include mountaineering expeditions (terribly deadly!), chainsaws (they are used in logging, one of our most deadly economic activities), and ATVs (notoriously dangerous, a couple boys in my area were just killed by them last week).

          Is there something about drugs that makes them an important target for intervention, and also excludes these commodities/activities from the purview of the nanny state (beyond policing fraud and basic quality control / labelling)?

          1. That’s a good question. My answer is that we should definitely look at these things through a cost/benefit (cost should include “annoyance of people”) analysis. If the harm is small – either great harm to a very few or minimal harm to many – it doesn’t justify much of a response. Widespread significant harm justifies a stronger response.

  8. “The relevant measure would have been a choice between cocaine and Oreos, and that choice wasn’t offered.” The correct protocol is to have dispensers of Oreos and cocaine outside the rat cage, with levers to allow the rats to offer either to their undergraduate carers. The undergraduates then have a lever to dispense Rice Krispies to the rats. The happier the undergraduates, the more they will reward the rats.

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