I’ve spent some time in work and graduate school thinking about why certain people have a greater tendency to develop obesity and diabetes than others. I’ve come to agree with the most prevalent explanation (at least, in the world of obesity research): the tendency to develop fatness has been clearly associated with major individual and reproductive advantages. In the presence of adequate nutrition and the absence of major infectious disease, fatness on the part of a given individual may be in large part the result of a historically superior genetic predisposition rather than an inferior capacity for self control.
That idea is an interesting solution to the problem, because it is clear that food intake is under voluntary control. It is also true that people very rarely starve themselves with sufficient stringency and duration to effect permanent body weight reduction. In the face of an obesity epidemic and a medical establishment that insists that body weight can be controlled through conscientious effort, should the overweight be considered mentally imbalanced? I don’t think so, but that is essentially the argument of those who maintain that the obese should simply starve and exercise themselves thin.
Not to diminish the importance of moderation, prevention, exercise and proper diet. However, doctors have studied morbidly obese individuals who maintain excessive fat stores on a diet of only 800 calories a day, while a marathon runner in training may need only a few hundred extra calories than the average. The amount of food restriction that is necessary for a given individual to effect and maintain change is not always modest. How much starvation is it possible to choose? Is it even mentally normal for an individual to be able to restrict their own intake to such a degree? How much voluntary control do we really have over biologically essential behaviors such as eating?
Now, I’ve become interested in the neuroscience of reward and addiction. I’ve wondered why it is even possible for a person to become an addict. Most addictive drugs, with the glaring exception of alcohol, are relatively recent developments. Often, a drug will work in the body at a receptor, where it causes a chain reaction of events inside cells of the brain, ultimately leading to changes in brain function. The receptors that drugs work through are made by the body - but they have not evolved over millions of years in order to respond to a drug first created in the last 100. It is a coincidence that the drug is able to act in this way, a chance match of the particular molecular shape or charge of the drug that happens to interact with the particular shape and charge of the target. Much like the coincident abundance and health of western culture has resulted in disease states such as polio and obesity.
The most prevalent explanation for addiction is that it occurs when drugs activate a neural circuit that was really meant for another purpose. The reward system is meant to mediate things such as the pleasure of food, of social interaction, of learning, of sex. When drugs act on this system, they activate it directly and massively, and this is thought to lead to addiction, whereas natural rewards (food, etc.) might only lead to a pleasant association. But I’m not sure this is entirely correct.
Let me ask you about something that could happen to you. I’ll explain it to you, and you can decide whether it sounds like something you’d like to try. This something is unlike anything you’ve ever seen before. Nothing shocking, just a little different. You are going to like this thing. Right now you are free to go about your life as you have been. Your interests, hobbies, where you live, your job, your priorities, etc. they are a certain way, and they are important to you. But after this thing enters your life, none of that matters as much as it did. This thing becomes the most important thing in your life, by far. You would die for this thing. You live for this thing. This thing might interfere with things you like, or make it impossible for you to do other things you always thought you’d do. It may make you miserable at times when it is not available, or when it disagrees with you. Also, you won’t be able to change your mind later. While you might not become so attached to this thing immediately, it has been known to happen on the first exposure. The way you feel about this thing will never really go away. If you try to get rid of it, you might be successful, but it will hurt. Alot.
First of all, does this sound like a good deal to you? Would you agree to this arrangement? I’m not sure many people would willingly give up so much personal freedom. Unless, of course, this thing is really, really good stuff.
OK. What is this thing? If it is a drug, you are an addict. If it is a person, you are in love. The similarity of these experiences suggest that perhaps the biological bases for love are part of the biological processes of addiction.
If so, why are certain people more likely to become addicts? Some biological explanation may be possible, as there are clear genetic links to “addictive personality”. Some people are likely to become obese on a western diet because they carry genetic traits that gave them an advantage in a less abundant past. Is it possible that people with addictive personalities likewise carry genetic traits that, in the absence of drugs, are actually adaptive? In the past, would these people be more likely to care for and protect their children or their social group? Are these individuals more likely to fall in love? Although addiction usually destroys relationships, there is no reason to believe that addicts love others any less. On the contrary (e.g., Lester). It is the nature of addictive disease to restrict voluntary choice. It is possible to choose whether or not to care for your children, but it is the rare (and usually malignant) person who chooses not to, despite considerable sacrifice involved. Although this is perhaps the most horrible aspect of addictive disease, the biological limitation of choice may be the very reason that love is such a miracle.
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