Is Sugar Addictive? I Will Say What Harvard Will Not by Roxana Soetebeer, MPHC NNP MHP

Is Sugar Addictive? I Will Say What Harvard Will Not

I am a sugar addict in remission. I am not saying that to be controversial, but because it is the truth. If you recognize yourself in what follows, I want you to know two things. First, it's not your fault. You are trapped in an addiction cycle that is hard to see from the inside, especially when 'experts' tell you it's normal. Second, remission is possible. I live it.

A recent Harvard Gazette piece asked "Is sugar addictive?" and landed on a familiar, soft answer. Cravings are real, but let's not lump sugar with alcohol or nicotine. Translation: We see the behaviour, but we refuse the label. They refuse to commit, which keeps people sick while keeping the industry out of the spotlight.

Addiction is a chronic brain disease. Once that pathway is established, it is always there, even when you are not using the drug of choice, sugar and by extension, ultra-processed food products. This is why we talk about remission, not a cure. With sugar, the wiring is laid early. For some people one hit is all it takes to pave the path of reward. The brain does not care whether the trigger is sugar, sex, or screens. The pathway is always the same. Sugar lights it up, and so do other addictive behaviours. This also explains cross addiction: when users easily hop from one addiction to another.

Social users exist. Addicts exist. Both can be true.

Let’s use alcohol as an example. Some people are social users. They have a drink and enjoy it. The thought of when they can have the next drink doesn’t occupy their mind. Still, alcohol is recognized as a substance of abuse. Just because we have social users who never get addicted doesn’t stop alcohol from being addictive. The same logic applies to sugar. The fact that some people can have dessert on a birthday without spiraling out of control says nothing about the addictive potential for others.

Are you a sugar addict?

Here is a simple self-test I use with clients. Go 30 days without added sugar or hyperpalatable junk food that hides it. If you try and feel lousy, if you find excuses why this test is stupid, chances are you are addicted to sugar. If you try, struggle, and then gain control by week three, you are already working toward remission.

The DSM-5 criteria do not belong to alcohol and opiates alone.

Clinicians use DSM-5 to diagnose a substance use disorder. There are 11 criteria. Meet two in a 12-month period and you qualify as mild. Six or more is severe. The categories include impaired control, social consequences, risky use, tolerance, and withdrawal.

When Harvard implies that sugar cannot "really" be addictive because it is "normal food" or because withdrawal does not look like alcohol detox, that is a category mistake. Behavioural addictions like gambling meet DSM-style patterns without a molecule like ethanol. The question is not whether you drink vodka. The question is whether a stimulus hijacks your reward system, drives compulsive use, causes harm, and resists control. Sugar and ultra-processed food products check those boxes for a significant number of people.

Here are the DSM-5 criteria. Check for yourself if they apply.

You take more than you intended. You promised yourself one cookie. You ate the sleeve. You planned to skip dessert. You searched the pantry at 10 pm. That is impaired control.
You try to cut down and cannot. You quit on Monday, bargain on Tuesday, and "start next week" on Wednesday. If this pattern repeats, it means unsuccessful control.
You spend time planning, getting, using, and recovering. You route errands to pass the bakery. You keep "emergency" candy in the car. You feel foggy and irritable after a hit, then chase relief with another one.
You crave. Not "I would like a sweet." More like a pressure that builds until you give in.
You continue despite harm. You know your CGM spikes. You know your A1c is creeping. Or in my case, I broke off two teeth, still I kept going.
Tolerance builds. One sweet used to do it. Now, you need the family size, or you combine sweet, fat, and crunch to get the same relief.
Withdrawal shows up. Headache, irritability, dizziness, low mood, anxiety, fatigue. I am not saying this is delirium tremens. But it still impacts your day. Harvard calls this "withdrawal-like." That word "like" is doing a lot of heavy lifting.

If you are keeping score, many of you just hit the threshold for a mild to moderate disorder. I don't mean this as an insult. But there comes a point to face the facts. You can't get better until you acknowledge you have a problem.

"But sugar is natural" is not a defense.

Nicotine is natural. So are opiates in poppies. The "natural" argument is meaningless. The form, the dose, and the delivery system decide the effect. In modern food, sugar is rarely alone. It is formulated with refined fats, emulsifiers, and flavours designed to drive repeat bites. Products are designed in a lab to be hyperpalatable. There even is a name for it: The bliss point. Food products are engineered to promote overeating as part of the business model.

And neuroscience backs this up. Sugar intake activates dopamine and opioid pathways in animal and human studies. Repeated intake sensitizes those pathways in ways that mirror dependence. That's when it feels like, "I do not even want it, but I keep reaching for it."

We have validated tools, like the Yale Food Addiction Scale, which is a research instrument designed to identify addiction-like symptoms. So, this isn’t just theory. When researchers use it, they find significant rates of food addiction, double-digit percentages in adults and children, especially in those whose diets are dominated by ultra-processed foods.

We also have population data tying high ultra-processed intake to worse metabolic and brain outcomes. While this data cannot show causation, it is still hard to ignore.

Why the science messaging sounds careful or even useless.

Academic nutrition likes safe language. I get it. But calling sugar "not exactly addictive" while describing cravings, habitual use, and withdrawal is more than being cautious. They are avoiding taking a stance. It protects the food industry and everyone who benefits from their profits. The moment a major institution names sugar as addictive, policies need to be changed along with labels, marketing to children, and possibly even liability. But language stays soft. Imagine the same messaging on candy bars as on cigarette packs.

WARNING: Sugar is Addictive.
WARNING: Sugar contributes to Type 2 Diabetes.
WARNING: Sugar contributes to heart disease and obesity.
WARNING: Excess sugar during pregnancy can harm your baby.
WARNING: Cutting sugar now greatly reduces serious risks to your health.
WARNING: Sugar causes fatty liver disease.

In the literature, you can see reviews concluding that highly processed foods meet the scientific criteria for addiction. Press offices default to "addictive-like" because they refuse to use the real word.

I am not asking anyone to exaggerate. I am asking them to stop downplaying. People trapped in compulsive eating patterns deserve the truth, not soft descriptions. When you tell a sugar-dependent brain that it is just a preference, you extend the harm.

The Harvard article.

First, the piece was not a study. It was not even a review. It was a Gazette Q&A. An opinion piece where Dr. Frank Hu, an epidemiologist, offered his personal take. He did not use data, references, methodology, or evidence, but a few sentences that may sound reasonable until you realize there is nothing behind them.

That kind of academic sleight of hand gives the public the impression that Harvard "looked into it" and found sugar innocent. They did not. This is opinion journalism pretending to be science. It is not worth a second thought if you care about evidence.

And if we are going to lean on authority, we should ask what kind of authority. Dr. Hu is an epidemiologist, not a neuroscientist or addiction specialist. His work deals with dietary patterns, not reward pathways. He is outside his lane when he declares what counts as addiction.

So the conclusion that sugar "has addictive qualities but is not addictive" is not a scientific finding. It is his interpretation. One that conveniently keeps the industry-friendly definitions intact.

Point by point:

"Sugar is part of normal nutrition, so the drug analogy fails." This is a straw man. Addiction is about what repeated exposure does to behaviour and health, not whether the substance appears in nature.
"Symptoms are withdrawal-like, not true withdrawal." The body doesn't care what they call it. If headaches, anxiety, and fatigue drive a relapse, the effect is real. It behaves like withdrawal.
"Moderation is the answer." For social users, maybe. For addicts, moderation is the bait that keeps the cycle going. We do not tell gamblers to play only on weekends or alcoholics to limit drinking to once per week.
"Equating sugar with drugs is counterproductive." What is counterproductive is minimizing a problem because the fix would disrupt profits. We cannot fix a problem we refuse to acknowledge. The literature already argues that highly processed foods meet addiction criteria. Harvard is choosing to ignore that.

The metabolic tie-in

Addiction does not live only in the head. It lives in the whole person. Sugar spikes insulin. Chronically high insulin drives hunger, energy crashes, and fat storage. Reward and behaviour amplify each other. As insulin resistance worsens, the brain asks for fast reward and the body asks for frequent refills. They call it a preference. I call it addiction.

Remission is possible.

Addiction is chronic, but it can be put in remission. I did just that. My first step was to acknowledge the problem. I had to realize: One bite is too many, a thousand bites is not enough. Over time my cravings quieted, one day at a time. Now, I no longer obsess about my former drug of choice.

How to beat sugar addiction will be the topic for another blog.

Eat like it matters,
–Coach Roxana

References

Written by Roxana Soetebeer, MPHC, NNP, MHP, PFC
Published October 28th, 2025

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