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PREFACE TO THE SECOND EDITION Since I wrote the first edition of Food Junkies in 2014, much has changed — and little has changed. This new edition includes the most promising current research and details the latest advances in clinical practices and treatments, including my own. We may still have a long way to go, but giant steps have been taken in some areas. And many of the people I interviewed earlier have successfully navigated the minefields of food sobriety. I also bring their stories up to date. First, the hopeful news: In the last four years, our awareness of how specific foods (such as sugar) ensnare both the hormonal appetite regulators and the reward circuitry of the brain has grown exponentially. Studies highlighting how sugar can be addictive are cited continually in the media. Growing numbers of consumer groups are aghast at how the food industry is manipulating our appetites for its own profit. Calls to regulate the food industry and legislate healthy eating are multiplying. There are Internet chat groups, summits, cookbooks, and public lectures offering to help people quit sugar and other addictive foods. The tipping point of awareness that we need to stem the tide of addictive foods is approaching. While we agree that some foods, such as sugar, are addictive, the bad news is that we are loath to recognize the dynamic of addiction that other foods ignite. Even clinicians scoff at this biological imperative, unwilling to identify the withdrawal and lack of choice that eating some foods engender. This unwillingness means that diagnosis, research, and funding of treatment of food addiction continues to flounder. When it comes to acknowledging the syndrome of food addiction, we remain in the dark ages. I am unable to be objective about food addiction. I have struggled with this disease for decades, so, although my purpose in this book is to present a fact-based examination of food addiction, I can hardly be neutral. Many of us have struggled to control our addiction through diet pills, diet doctors, and even diet candy. We have spent thousands of dollars on Weight Watchers and Jenny Craig, therapists and psychiatrists, weight-loss vitamins and herbs. We have ingested diuretics, laxatives, and other substances to purge ourselves of extra food. We have exercised hours each day, so obsessively that we eliminated the rest and relaxation most people enjoy on weekends and vacations. Our eating has been out of control; we’ve often ingested enough calories in an hour to fuel a two-hundred-pound male for days. We have repeatedly tried, and failed, to tame our appetites. We have enlisted people — friends, family, even professionals — to help us by shaming, blaming, bribing, nagging, cajoling, ignoring, encouraging, comforting, and punishing. A food addict myself, I am on a passionate mission to present vital information to the many individuals who struggle with unwanted eating behaviours. I want to give readers a better understanding of the continuum that begins with food compulsions and ends with full-blown addiction. For years, food addicts of all types — including myself — tried to talk about this phenomenon, but all too often our disclosures were met with light-hearted dismissals (Oh, everyone eats a little too much sometimes) or blunt skepticism (It’s not a disease, you know; you just eat too much). Now that obesity, one of the hallmark symptoms of food addiction, has grown to epidemic proportions, scientists and medical professionals are no longer laughing. Instead, they are taking a closer look at what is really going on in the bodies and brains of those of us who struggle with our food intake. In Food Junkies, I present this information about the addictive nature of food in a format that can be understood by patients, clinicians, and, most importantly, the general public. And I introduce you to people who are struggling with this disease and tell their stories — their tragedies and victories — which have been for so long silenced, scoffed, scorned. I don’t want the book to be drily academic, the sort written by experts dispensing prescriptive advice. Though you will find helpful information here, much of it drawn from authoritative studies, the book also contains very personal stories — moving accounts full of feeling and struggle. Given my history as both a food addict and a clinician in the addiction field, I am well situated to present this information in an authentic, accessible way. As yet, there have been no books like mine, written by an author who has both experienced food addiction and its recovery and who is also equipped to speak from the authoritative stance of a medical clinician in the field. In this book you will meet men and women suffering from food compulsions and addictions as well as those who have recovered. You will also meet people who are not addicted to food, but who have a tendency to overeat. Although their names have been changed, they are all real people whom I have met in my practice. You will meet Mary, who made the decision to lose weight when her scale indicated that she weighed more than two hundred pounds. She has managed to keep her weight off for many years. And you’ll meet Janet, who insists that her lack of willpower is her real problem; she has lost weight and kept it off, but she is only able to do so as long as she sticks to her diet. And you’ll also meet Ellen, who, despite great willpower, simply cannot control her bingeing at night. She worries that she might be a food addict. You will be introduced to Laura, who is addicted to alcohol as well as food. While she no longer drinks, she simply cannot stop eating. As badly as she wants to stop, her cravings for food are even stronger than her cravings for alcohol. You’ll learn about Lawrence, a morbidly obese food addict, whose death marks the inevitable conclusion of this disease when left untreated. And you’ll meet Ruthann, whose primary addiction is undereating. Yes, I believe that even anorexics suffer from a kind of food addiction. Ruthann learns to control her anorexia by applying the same approaches I present for food addicts who overeat to her undereating patterns.