03/30/2026
š§µFood Addiction: What is it? How do you know if you have it? What test can you do to determine if this is a problem for you?
I didnāt realize I was battling addiction myself until I gave a CAGE questionnaire to one of my patients to determine if they were struggling with alcohol abuse. My personal addiction wasnāt alcohol. As a 350lb physician who desperately wanted to lose weight but couldnāt, my addiction was food. As I went through the questions, āHave you ever felt the need to cut down on your substance use? Have people annoyed you by criticizing it? Do you feel guilty about it? Have you ever used a substance first thing in the morning as an eye-opener?ā I started to see myself in every one of them. By the time I finished, I realized I was four for four. The acronym stands for Cut, Annoyed, Guilty, and Eye-opener, and I fit every category. That was the moment it hit me. My addiction was food.
Our modern food environment feels like a casino. Itās designed to keep us hooked. People have lost their sense of how to eat, and even doctors, dietitians, and trainers are often confused. This confusion feeds into a system where there are clear winners and losers. The winners? Processed food companies, pharmaceutical giants, and the healthcare industry. The losers? People like me and the patients I see every day. I saw my family lose from a young age, watching obesity, diabetes, and heart disease ravage them. I got tired of watching people lose. I saw myself losing. That frustration is what drives me forward.
At my practice, I focus on providing real, meaningful support to help patients break free from the traps of modern eating. We have a wellness coach who works closely with patients to uncover their eating patterns and pinpoint their vulnerabilities. Education is at the core of what we do. We teach patients not just about hunger and appetite, but also about food addiction and how it impacts their lives. Weāve also embraced technology to keep a close eye on our patientsā health. With tools like continuous glucose monitors, smart scales, and blood pressure cuffs linked directly to our office, we can track their progress in real-time and make adjustments as they go.
Iāve come full circle with the CAGE questionnaire, now using it to understand where my patients fall on the spectrum of food dependency. The acronym stands for Cut, Annoyed, Guilty, and Eye-opener, and it was originally designed to assess alcohol addiction. Iāve adapted it to food addiction by asking similar questions: āHave you ever felt the need to cut down on certain foods? Do you get annoyed when people comment on your eating habits? Do you feel guilty about your relationship with food? Do you ever feel like you are eating large amounts of ājunk foodā at odd hours, late at night? Do you find yourself hiding or sneaking food? Or maybe eating well all day in front of others, then eating too much alone or in private?ā
Each question reveals something critical. If a patient says they want to cut down, it tells me they recognize the harm and want to change. However, that alone doesnāt mean theyāre addicted.
Itās this next question that begins to reveal the story: āDo you get annoyed when people comment on your eating habits?ā This is where emotions come into play. That annoyance isnāt just frustration. Itās a sign of a deeper emotional conflict, one that separates the personās actions from their goals.
When I was 350lb and desperately wanted to lose weight, I would get angry when people suggested I eat less or something different. I chalked it up to being stubborn or not wanting to be told what to do. That was a lie. The food was manipulating my emotions, making me angry and resistant. So when patients tell me they get angry too, it reveals something deeperāa huge emotional disconnect. They should feel delighted that someone cares enough to help them on their health journey, but they donāt. This emotional disconnection is critical to understand because food addiction twists their emotions, preventing them from aligning with their goals.
And then thereās guilt. This one hits hardest. When a person feels extensive shame and guilt, it typically means their underlying emotional disconnect from their goals is so strong, and their captivity by the substance so pervasive, that even their desire to change isnāt enough to overcome it. This creates profound psychological and even spiritual distress. They feel trapped, unable to break free from behaviors that go against their deepest intentions. This is why so many report intense feelings of guilt and shame. Itās not just about overeating. Itās about the crushing weight of being out of alignment with their own goals, stuck in a cycle of frustration and despair.
Then thereās the āeye-openerā question. For food, this isnāt about steadying your nerves like it might be with alcohol. Itās about compulsive behaviors like late-night binges or sneaking food when no one is watching. Itās about hiding what youāre eating because you know itās too much or the wrong thing.
When the emotional and psychological disconnects are so strong, the person begins to modify their behavior to accommodate the substance. They eat in secret to avoid psychological distress. They sneak or hide food for the same reasons. Instead of eliminating the substance, which is their ultimate goal, they adjust their behavior to allow its continued use. Over time, their psyche finds ways to justify or minimize the shame and guilt, leading to larger and larger quantities of the substance. The food has literally taken over. This is full-blown addiction.
My personal struggle with food addiction and the realization of how deeply it had taken over my life became a turning point. It wasnāt just for me, but for how I practice medicine. The lessons Iāve learned from my own experience, combined with the use of tools like the adapted CAGE questionnaire, have transformed how I approach food addiction in my patients. This simple yet powerful framework has helped me uncover the emotional disconnects and behaviors that keep people trapped in a cycle of addiction, shame, and disease.
But my journey isnāt just about me. The tragedy of my own struggle, along with my clinical experience, offers a roadmap for others. Doctors, dietitians, and healthcare professionalsāand yes, even your friends and family membersācan better recognize food addiction and address it head-on. By understanding the emotional and psychological barriers that drive these behaviors, we can provide the tools and support patients need to break free.
Food addiction isnāt just a personal battle. Itās at the heart of the chronic disease epidemic we face today. If we, as healthcare professionals, can use tools like CAGE to identify food dependency and address it with compassion and evidence-based strategies, we have the potential to reverse this epidemic and restore health and dignity to countless lives. The fight against food addiction isnāt just critical. Itās urgent. Together, we can make a difference.
If you are looking for help please DM me and my staff will reach out to you to get started with our FREE app or if you are looking for an amazing medical team, we can get you into our comprehensive weight management program.
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