Cupcakes or Cocaine – Relapse Rates

11 Jun

One of the ideas that has been popping around my head lately is the idea of relapse rates in dieting. We have all heard that a high percentage of people who go on diets end up failing – especially in the long term. Hell if this wasn’t the case why would we be blogging right here right now. But why does this happen?

People who have never dieted tend to believe it is a lack of willpower. To a certain degree I guess they are right. But perhaps the high failure rate is not because of willpower but more because its an addiction. So I thought why not do a little bit of background work and look at the statistics for relapse rates for different addictions. Below is a list of relapse rates ranked from highest to lowest with the number representing the percentage of people who try to give up that addiction and then fail. I consider a diet an attempt to break food addiction.

Food: 95%

Cocaine: 90%

Alcohol: 90%

Smoking – 90%

Heroin – 82%

Im not trying to start  a war of ‘my addiction is worse than yours’ here. There are obviously a lot of factors at play here. But what I want to highlight is the fact that relapse rates are similar for all addictions including dieting. I don’t think this is a coincidence! Is it that surprising that so many dieters fail when you look at it in the light of addiction?

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18 Responses to “Cupcakes or Cocaine – Relapse Rates”

  1. Michael June 11, 2010 at 11:04 pm #

    Hey Dr. Dan,
    I am sure you have thought of this, but I think with food addiction it is a little different than drugs or alcohol, and on certain levels it is much harder to get the addiction manageable. With drugs or alcohol, one may also have relapses, but they have to stop doing all drugs or all alcohol completely. With food, one still has to eat food. With alcoholics I heard the expression “One drink is too many, and 100 are never enough”, or something like that. I have battled moderation all my life. In other words, I am very prone to go to extremes in my passions or in filling the emptyness inside with something. That something has sometimes been a positive thing like exercise, but just as often it has been negative things, like food, alcohol or other things.

    • Dan June 11, 2010 at 11:18 pm #

      Yes I do think we can completely abstain. Because we never crave vegetables. Its usually fat, carbs or salt. Predominantly carbs. So if we eat a fairly strict paleo diet, which unfortunately includes nothing exciting culinary wise, I think you can abstain.

    • David I June 17, 2010 at 1:51 pm #

      Hmm. Interesting post.

      I note that in Europe, the AA approach to alcoholism is not the most popular or successful tactic. Instead, the European focus is usually on teaching people to manage thier alcohol intake, rather than total abstention. I think this makes for a better analogy with food.

      I lost about 60 pounds by going low-carb, and am approaching 2 years of keeping it off. But for me, the issue was metabolic–I’ve never had the kind of urgent attraction to food, irrespective of legitimate hunger, that some people describe.

      I think that some overweight people do indeed have something that fits the model of an addiction, while others have simply gained weight because of poor dietary choices (ie, those the authorities recommend).

      Therefore, I think the statistics about dieting may be skewed, since I don’t think that everyone who becomes overweight is necessarily “addicted.” The stats may even be worse for food addiction than your numbers would suggest.

      • Dan June 17, 2010 at 2:07 pm #

        Really interesting idea. Its a little bit like that in New Zealand too. They teach moderation and if that doesn’t work then they tell you to abstain. So I guess for now Im learning to abstain. Just to let my cravings die down. After a few months (at least) I will then divulge. I know ex alcoholics who have done this with beer and had no problems.

  2. Carla June 12, 2010 at 12:52 am #

    I want to be one of the 5% of people who succeed.

    • Dan June 12, 2010 at 12:58 am #

      I think you already have! I want to be as well. But theres always this deep part of me that just doesn’t believe Im going to lose weight. Its kind of annoying.

  3. Tracy June 12, 2010 at 8:46 am #

    Hi Dr. Dan! This is my first ever post on a blog, and since you agreed with me, I wanted to give you a great big thank you!!!!!

    I’m Michaels wife, Tracy. I have a theory about addiction I thought you might have come across research on. In my experience with addictions, watching Michael and others in my family through the years, I have never seen addiction “cured.” I have seen the pendulum sway from one addiction to another, but never the quest to find pleasure go away. It all starts harmless, is fun, and feels good. But it eventually takes a toll. Back in the 70’s it was pot, 80’s cocaine, and alcohol. Once alcohol was removed, food took it’s place. Cigarettes wandered in and out the whole time, to help ease the transfer of addictions. And in between these pendulum swings, there is a brief period of centeredness, but I do mean brief! The new pleasure becomes the next addiction. Now it’s paleo and kettlebells for Michael. We went to our son’s pizza party, ant not a thing would he eat! The will power is admirable to me, but I call it the “anti-addiction.” None, nada, nothing. It has done wonders for his diabetes and other health issues, but I wonder about it’s sustainablility.

    I look at myself and I don’t see the addiction to these types of things (putting things in my body to change it’s chemistry to feel pleasure?), but I am excessive about some things. I work A LOT, (70 plus/week), cant’ shut down my mind at the end of the day without a glass of wine, and I constantly analyze things in my head.

    So, my question is this…can you ever cure addiction? You can shift them to something less destructive, although most things in their extreme state become destructive.

    Thank you for being so real and exposed out here. It does encourage others (like me) to try to explore areas of their own lives that they struggle with!

    • Dan June 12, 2010 at 12:37 pm #

      Hmmmm. Well I can only speak for myself here. I think your right in some respects. I have always thought how ironic it is that I am writing about food addiction, but in some ways I am obsessed with blogging about it. I also spend most of my time thinking about it. But the other option is a much worse scenario. If I DONT think about my food as an addiction, and constantly monitor what I am eating, I will fall off the wagon. I need those strict controls in place to prevent myself from relapsing. So far this blog has helped immensely in me not bingeing. Simply because I know that if I didn’t post for a few days that would be a tell tale sign.

      So I understand what he is doing. Not only that I agree with what he is doing. Moderation just doesn’t work for addicted types. YOu probably have a normal relationship with food and so you don’t ‘get’ how this can be the case for us. But I imagine that if he begun to allow himself some non paleo foods (ie trigger foods) every now and then he would eventually break and relapse. It would be similar to an ex-smoker having a sneaky cigarette. It eventually leads you to smoking again.

      Does this help?

      • Tracy June 12, 2010 at 9:35 pm #

        Hi Dr. Dan,

        Thank you, the explanation does make sense to me. I just have to accept that moderation is not in the cards.

  4. Methuselah - Pay Now Live Later June 12, 2010 at 11:09 am #

    To me it makes perfect sense that addiction to bad food has a higher relapse rate than drugs – for two reasons. First, because I find that decisions on whether to have something are usually based on reward vs. cost. Since the cost of eating cake is pretty low but the rewards quite high, motivation to avoid needs to be especially firm. Sure, I’ll hate myself, but it won’t profoundly affect where I am in my life. With hard drugs, the consequences are more profound. Second, because with drugs it’s not as hard to remove oneself from the environment in which others approve. Okay, I am sure that for many it is pretty hard because all their friends are doing drugs. But, it pales into insignificance compared to the fact that the full weight of the media and retailers appears to be approving of the bad foods, not to mention most of our friends, relatives and work colleagues around us…

    • Dan June 12, 2010 at 12:40 pm #

      Thats a really really good point, and one I completely agree with. It is about cost/benefit and one has less to lose (short term) by inhaling a cupcake. But then this is the insidious side of food addiction. Its so normalised, and so easy to relapse, that no one can ever break it, and I do believe it significantly effects peoples lives. You have to approach it with full abstinence.

  5. Bearfriend June 13, 2010 at 11:45 am #

    Hi Dan. I was away from blogland for a couple of weeks and seem to have missed a lot of the action!

    I think the path of greater understanding and insight into your food addiction that you’re currently on is going to be interesting and helpful to many many people.

    This post is illuminating. But what would be more interesting would be to know the percentage of people who actually suceed over a lifetime because for example, many alcoholics have several relapses but may still manage to stay sober the majority of say 40 years. Same with smoking.

    Your figures only show rates of relapse – not rates of longer term success. And in fact relapse is a natural and normal stage within the breaking of an addiction.

    Google “stages of change” to see this theory of breaking addiction.

    Bearfriend xx

    • Dan June 13, 2010 at 7:55 pm #

      This is true. Also good link. The point I was trying to make was that relapse rates are similar between diets and addictions. Lending weight to the idea that food is addictive.

  6. Bearfriend June 13, 2010 at 6:10 pm #

    Hi Dan. Just awarded you the Mindblowing blog award BTW as I think you’re truly deserving of it!

    Bearfriend xx

    • Dan June 13, 2010 at 7:47 pm #

      Thank you!!!!

Trackbacks/Pingbacks

  1. Cupcakes or Cocaine « At Darwin’s Table - June 11, 2010

    […] or Cocaine June 12, 2010 Posted by Dan in Uncategorized. trackback A new post at Pavlovs Ape comparing relapse rates of dieters with people trying to break other addictions such as smokers or […]

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