Is Sugar Addictive?

I have wondered about this topic for quite some time.

Over the years I have had a number of patients report to me that they are not able to eat any sugar because they believe that they cannot control the quantity that they eat once they start eating it. Having specialized in addictions, there appears to be common ground between the relationship that some people have with sugar and those that are addicted to substances or behaviors.

Here’s the American Society of Addiction Medicine (ASAM) definition of addiction: 

Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addictions use substances or engage in behaviors that become compulsive and often continue despite harmful consequences. 

As a medical provider, I am also acutely aware of the impact that a high sugar diet is having on people’s health.

12% of adults in the U.S. have diabetes and these numbers continue to trend upward. Most people are aware that sugar intake is harmful to their health yet often they continue to eat large quantities.

Researchers investigated to find out if eating sugar met the four main criteria for addiction in a study using rats as subjects. 

These criteria were:

  1. Impaired control

  2. Social impairment

  3. Continued use despite risk

  4. Tolerance and withdrawal

The conclusion was that, yes, sugar use in rats seems to meet the criteria with the exception of social impairment because that would be too difficult to assess in rodent studies.  Otherwise, rats exhibit craving behaviors for sugar. They will use sugar despite the application of aversive interventions. 


There was increased tolerance to sugar, the rats would eat more and more of it. Most interesting was that the rats had demonstrated symptoms of withdrawal when treated with Naloxone. This is Narcan, the rescue drug given to people who overdose on opioids. It’s thought that sugar stimulates the body’s own production of natural opioids. 

There are changes that occur in the brain from eating sugar

These changes are similar to the changes seen in addiction. These include an increase in activity related to reward-seeking and the anticipation of the reward and the decrease in motivation and in the rational (executive) functioning of the brain. 

There is also evidence that there can be cross-addiction between substances and sugar. There is research evidence for this and it’s common for people in recovery from drugs or alcohol will report that they now struggle with a sugar addiction.

I do recommend a diet of minimally processed sugar for all of my patients

However, for those that report sugar as being an addiction, it is probably best to avoid it entirely. Especially if they have a history of addiction. This recommendation is not unlike abstinence from alcohol for the person in alcohol recovery as even a small amount will likely stimulate the brain’s pathways related to addiction. 


References:

National Diabetes Statistics Report

Westwater, M. L., Fletcher, P. C., & Ziauddeen, H. (2016). Sugar addiction: The state of the science. European Journal of Nutrition, 55(Suppl 2), 55–69.

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