It turns out that there are similarities in the brain scans of cocaine addicts and the clinically obese (here’s the whole article on one page). That means it can be hard for the obese to control their food cravings and lose weight — but not impossible! It also means that some of the treatments and strategies for dealing with addiction may have a place in helping the obese.

These new treatments actually go back to a paper from 2004 that began by observing “Overeating in obese individuals shares similarities with the loss of control and compulsive drug taking behavior observed in drug-addicted subjects.” They found that obese people had less of a certain kind of dopamine receptor — without which we can’t properly use dopamine, a neurotransmitter which strongly impacts mood, memory, and cognition. There is ongoing research into the roles of dopamine and dopamine receptors in mood disorders, which may yet illuminate the issues here more fully. What is known now is that cocaine alters the flow of dopamine and other neurotransmitters. Specifically, cocaine prevents dopamine reuptake — keeps it from binding to the dopamine receptor — so there ends up being more dopamine in the system, so “more dopamine remains to stimulate neurons, which causes a prolonged feelings of pleasure and excitement.”

So, like the cocaine addict, the clinically obese food addict has a shortage of dopamine receptors and too much dopamine in the system, giving them a food high. Not shockingly, these patients have reduced impulse control, decreased memory, and decreased executive functioning. This theory also helps explain how many dieters end up with extremely dysfunctional relationships with dieting, engaging in such ultimately destructive behaviors as starvation diets, or diets that obsessively focus on one food item/group that allegedly has super-magic weight loss properties; they merely substitute one obsessive food behavior with another.

There is good news, however, even without the cutting edge treatments that this research may someday provide. It may be difficult for cocaine addicts to control their cravings without medication, but it is not impossible. By extension, that would tend to indicate that obese food addicts can learn to control their cravings as well.

Nobody said it was easy, but knowing is half the battle.