Sugar is addictive. That is not a metaphor. It is literally an addictive drug, a gateway drug. Sugar is the first drug that most humans ever experience.
For many Americans, the addictive nature of it begins shaping the brain in infancy, as sweeteners are put into formula. And if you didn’t get formula, I bet you didn’t make it past toddlerhood without getting regularly dosed with sugar: sweet baby food, candy, cake, etc.
Addiction is trained into us during the most key years of physiological development. What we eat in the first few years, as research shows, determines what tastes good to us for the rest of our lives. We are hooked.
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WHAT IS FOOD ADDICTION?
By H. Theresa Wright, MS, RD, LDN and Joan Ifland, PhD
The addictive properties of sugar are perhaps the most studied. Rats will choose sugar, high fructose corn syrup, and saccharine over cocaine and heroin. Rats have shown a withdrawal syndrome similar to that of morphine . Sugar activates the dopamine pathway.  Food addiction recovery groups often recommend abstinence from sugar and sweeteners. 
German Lopez: Walk me through the argument for treating sugar like a controlled substance.
Robert Lustig: The definition of addicted is that you know it’s bad for you and you can’t stop anyway, like heroin, cocaine, alcohol, and nicotine. You know it’s bad for you. You know it will kill you. But you can’t stop anyway, because the biochemical drive to consume is greater than any cognitive ability to restrain oneself.
There are two phenomena attached to addiction: one’s called tolerance, the other is withdrawal. It turns out sugar does both of those as well.
If a substance is abused and addictive and it contributes to societal problems, that’s criteria for regulation.
GL: Is that really grounds for considering it a controlled substance, though?
RL: There are four things that have to be met in order to consider a substance worthy of regulation. Number one: ubiquity — you can’t get rid of it, it’s everywhere. Number two: toxicity — it has to hurt you. Number three: abuse. Number four: externalities, which means it has a negative impact on society.
Sugar meets all four criteria, hands down. One, it’s ubiquitous — it’s everywhere, and it’s cheap. Two, as I mentioned, we have a dose threshold, and we are above it. Three, if it’s addictive, it’s abused. Four, how does your sugar consumption hurt me? Well, my employer has to pay $2,750 per employee for obesity management and medicine, whether I’m obese or not.
GL: The thing that led me to look into your paper is that I wrote an article a couple weeks back about how the three most dangerous drugs in the country are legal: tobacco, alcohol, and prescription painkillers. And a few people mentioned that I forgot sugar. That idea really interested me.
RL: Yeah, that’s right. The Wall Street Journal asked Americans what are the most dangerous of four substances in America: tobacco, 49 percent; alcohol, 24 percent; sugar, 15 percent; and then marijuana, 8 percent. Sugar was doubly worrisome to Americans than marijuana was. How about that?
GL: One potential hurdle is that controlled substances are typically seen as drugs. Do you consider sugar a drug?
RL: Of course it’s a drug. It’s very simple: a drug is a substance that has effects on the body, and the effects have to be exclusive of calories.
So in order to qualify it as a drug, the negative effects of sugar have to be exclusive of its calories. Is 100 calories of sugar different from, say, 100 calories in broccoli? The answer is absolutely.
Can you name another substance of abuse for which the effect of the substance is more dangerous than the calories it harbors? Alcohol. Its calories are dangerous not because they’re calories; they’re dangerous because they’re part of alcohol. Sugar is the same.
Sugar is the alcohol of a child. You would never let a child drink a can of Budweiser, but you would never think twice about a can of Coke. Yet what it does to the liver, what it does to the arteries, what it does to the heart is all the same. And that’s why we have adolescents with type 2 diabetes.
There are some studies of rats that are completely addicted to cocaine. So they have this drip, cocaine just comes out, and so they’re consuming it all the time. This is the crazy part. As soon as they taste sugar, they don’t care about the cocaine anymore and all they care about is a sugar. That is how addictive sugar is. It’s so addictive that rats that are addicted to cocaine, which we all know is an addictive substance, they would prefer the sugar over cocaine.
There is another study where rats are pulling a cord and every time they pull the cord a little bit a little drip of sugar water comes out. So they’re confined into this space and that is all they get. So then they learn to pull the cord so that they can get their drip of sugar. And over time the researchers open the door so that they have access to the outside. They even have access to family and they have access to all these other foods.
And guess what these rats do. They don’t care about anything else, but they just wait and wait and obsessively pull the cord to try to get sugar. This is how scary and addictive sugar is.
So the question is, is fast food addictive? What do you think? Yes? No? Okay, so we actually looked at that question.
So everybody familiar with this book? Michael Moss put this out, “Salt, sugar, fat, how the giants hooked us”, right? This is wrong, this is a mistake. Because there is one thing not on the list. What’s missing? Caffeine.
Now we’ve got fast food! Okay, salt, sugar, fat and caffeine, right? So the question is, of these four which are addictive?
Let’s talk about salt. Is salt addictive? No, it’s not addictive. In humans the threshold is physiologically fixed, higher levels are attributable to preference but you can alter that preference, lots of people do especially when they have to go low salt for some reason. And we know because we take care of a disease in endocrinology called salt-losing congenital adrenal hyperplasia where their kidneys are losing salt non stop. But when we give them the salt retaining hormone that works in the kidney called aldosterone, their salt intake goes way down. And if they were addicted that wouldn’t happen.
So when we fix their physiology, their preference gets a lot better. So salt? Not addictive.
Now let’s take fat. Is fat addictive? What do you think? Nope, rodents binge but show no signs of dependence, and humans they always binge on high fat high carb or high sugar items, like pizza and ice cream, you don’t binge on high fat per se, otherwise the Atkins diet would have everybody addicted and they’ll tell you, you know they are losing weight, how could they lose weight if they are all addicted?
Energy density actually has a stronger association with obesity and metabolic syndrome than fat does.
So, fat? Not addictive.
So we are left with these two. Caffeine? Oh man, caffeine is addictive and if you take my Starbucks away from me I’ll kill you. Model drug of dependence, gateway drug in fact, dependence show in children, adolescence, adults, 30% who consume it meet the DSM criteria for dependence and physiological addiction is well established with the headache, and the test performance, and everything else. Mega addictive.
But do you see anybody going out and regulating Starbucks or Pizza or anything like that? Why? Because it’s not toxic. It’s addictive, but not toxic, unless you mix it with alcohol and then you got something called four loco and that we are banning, everybody got it?
So when it’s toxic and addictive we ban it or we regulate it. And so, caffeine and alcohol together that’s a bad deal. But caffeine alone? Keep your hands of my Starbucks.
So caffeine? Yes, addictive.
Okay, that leaves this one. Sugar, is sugar addictive? What do you think? You know, we’ve known this for a long time, because, anybody know what this is? It’s called sweeties. This is a super concentrated sucrose, sugar solution, that you dip the pacifier in and you put in the newborn baby boy’s mouth before you do the circumcision, because it releases opioids and deadens the pain. And this has been known forever. Then you mix it with a little wine and then you got a really good cocktail, eh?
So is there really such a thing as sugar addiction, we have to look for similarities to other drugs of dependence like nicotine, morphine, amphetamine, cocaine. The one I think is most appropriate is alcohol, because after all alcohol and sugar are basically metabolized the same way, because after all where do you get alcohol from? Fermentation of sugar, it’s called wine, right? We do it every day, up in Sonoma. The big difference between alcohol and sugar is that for alcohol the yeast does the first step of metabolism called glycolysis; for sugar we do our own first step, but after that when the mitochondria see it, it doesn’t matter where it came from. And that’s the point, and that’s why they both cause the same diseases. And they do the same thing to the brain.
So for the criteria for addiction in animals are bingeing, withdrawal, craving, and then there is one down here called cross-sensitization with other drugs of abuse, that means that if you expose an animal to one drug of abuse, like cocaine for 3 weeks and addict them, and then you expose them to a second drug they’ve never seen before, like say amphetamine, they’re addicted to the amphetamine even though they’d never seen it before, because the dopamine receptors are already down-regulated because they are the same dopamine receptors, everybody got it?
Okay, and so, does sugar do this? Absolutely. Q.E.D. slammed on, sugar is addictive in animals.
What about humans? Who saw this movie? Right? Did you like it? More or less?
I’ve a big problem with this movie, because if you watch the movie his doctor, Morgan’s doctor keeps saying: “You gotta get off this high fat diet, high fat diet, high fat diet, high fat diet, high fat diet” Not the high fat diet, it’s the high sugar diet, high sugar diet, that’s what caused all the problems.
So, can sugar be addictive? Watch.
“I was feeling bad” “In the car, feeling like…I was feeling really, really sick and unhappy…started eating, feel great…feel really good now… I feel so good as crazy… Ain’t that right baby? Yeah you’re right darling”
This was on day 18, of his 30 day sojourn from McDonald’s. He just described withdrawal, that’s withdrawal, and he needed another hit in order to feel good again. He just described withdrawal, he was a vegan, right? Because his girlfriend was a vegan chef and in 18 days he’s a sugar addict.
So, you tell me. So this is what we are dealing with. We are dealing with an industry that wants us to consume its product, well gee, every industry wants us to consume their product in some fashion or another, the question is what if it hurts you? What if it hurts you?