Expert answer

Dear Eve: As someone who struggles with the same issue, I feel your pain. Increasingly, scientific studies suggest that eating activates the same brain areas that are the primary targets of drugs of abuse, and foods high in sugar, fat and certain carbohydrates are especially likely to stimulate our brain in ways that can become addictive. It is not for nothing that the modern Western diet --which is higher in sugar than any diet in history -- has taken the world by storm. Across the long years of human evolution sweet things were hard to find so we have all evolved a keen appreciation for these items that tends to betray us in the modern world.

Your question is too brief for me to get a clear sense of how deep your problem goes, but if you are seriously thinking of some type of rehab environment I am going to assume that you are struggling with a worst-case scenario in which you binge on, and consume, very large amounts of sweet items. I'm thinking, for example, of a patient I treated for years, who would eat an entire angel food cake whenever something stressful or upsetting happened in her life.

There is no doubt that this kind of eating arises from an emotional component. In addition to stimulating brain reward centers, sweet food markedly affects stress hormones in ways likely to provide a sense of temporary reprieve from anxiety. Of course, in addition to all the health problems linked to binge eating, the eater is likely to end up in a worse spot, much as the alcoholic who drinks to forget that he has an drinking problem. As the tone of your question attests, out-of-control eating can be a profound source of shame and frustration and can therefore contribute psychologically to the development of depression.

But the problem goes deeper. While processed sugars may produce a brief emotional high, several lines of evidence indicate that they affect our biology in ways that promote depression. For example, rates of depression in a country rise in lockstep with per capita sugar consumption. Sugars -- which are found in all sorts of processed foods we don't typically think of as sweet -- promote obesity, and obesity is a very powerful risk factor for the later development of depression.

So I don't need to tell you the problem is a bad one. The question -- your question -- is what to do about it. Actually we all know what to do about it: eat less sugary foods. The question is how to find the willpower to do this when sugar is everywhere and the emotional strains of life push us so consistently into its orbit.

Much experience over the years has taught me that nature abhors a vacuum. If you are going to take sugar out of your diet, it will need to be replaced with something else. This law of human nature often makes it the case that it is easier to do big things than to do little things. For example, it is easier for an alcoholic to stop drinking completely than to just drink a little. I want to suggest that the same approach might benefit your attempts to break the sugar addiction.

Assuming that you binge on huge amounts of sweets, I want to suggest that changing your entire dietary pattern might be easier than just stopping this one maladaptive behavior. I say this for two reasons. First, if you are going to give up sugar you are going to have to replace it with something very active and positive. And second, it is increasingly clear that even people who don't binge on sweet foods suffer significant health problems just from eating the standard American diet that most of us consume every day.

I want to suggest that you attempt to rid as many processed and packaged foods from your diet as possible, and replace them with a diet replete with natural foods. By natural foods, I mean food that humans evolved to benefit from: fruits, vegetables, some whole grains and meat from animals that are fed grass (not grains and antibiotics). To eat this way requires making a commitment to shop smart and to cook smart. These are both challenging and exciting activities that might help you organize an emotionally satisfying life beyond the grasp of your sugar addiction.

This column is far too short for me to describe how to go about doing this, but fortunately excellent sources of information on this topic are already in print. Let me recommend two books to you by Michael Pollan. "Omnivore's Dilemma" is an eye-opening expose of how we came, as a society, to eat so much sugar in everything, and "In Defense of Food" spells out how to go about extricating ourselves from the unhealthy Western diet to which most of us adhere.