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Sugar can become an addiction, and it's terrible for oral health.

Sugar: Food or addictive substance?

Dec. 12, 2023
Not only is sugar bad for the teeth, it can become a health-altering addiction. Here's how to help patients who are struggling.

Have you ever wondered if sugar was addictive? Does it fall into the category of a substance or a food? I began to struggle with an addiction to sugar during my teen years. Sugar addiction was still an unknown in the ’80s, and it was decades before sugar’s harmful effects were recognized.

Sugar as a coping mechanism

When I was growing up, my grandmother always baked fresh cookies. My family philosophy was there was never a bad time for sweets. Breakfast was for donuts, lunch was for cookies, and dinner, of course, was for cobbler. Dessert always followed dinner, and we were reminded not to fill up on the main meal.

Does this sound familiar? My association with sugar and sweet foods became associated with happiness, positivity, and love. It was a coping mechanism used in my family, and it became a crutch for me. It took me a long time to realize that I used sugar to relieve stress, pain, and anxiety. It became an addiction that I struggled with daily. Even after years of yo-yo diets, visits with nutritionists, learning healthy eating habits, and learning that my suspicions about sugar being dangerous and addictive were correct, I still consumed it.

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What is addiction?

Addiction is classified as a substance use disorder (SUD) and is a “complex condition, a brain disease manifested by compulsive substance use despite harmful consequences.“ The evolution of food and drugs and the emersion of refined sugars, processed foods, and high fats have presented a similar drug-like effect.1 Our bodies are not biologically prepared to withstand the unnatural responses and effects that have evolved.  

Sugar, like drugs that are abused, changes our brain activity. There’s stimulation that takes place via the brain cells. This stimulation occurs cellularly in the sweet-taste cells in the mouth and follows in the gut. Post-absorptive stimulation is the secondary process that occurs via a brain mechanism involving glucose signaling. It is similar to a drug-like psychoactive mood-altering effect. However, these psychoactive effects from sugar are less severe than from drugs. Even foods extremely high in sugar are incapable of producing a mind-altering effect.2

Humans experience a reward sensation when they consume sugar. The reward sensations help cope with stress, pain, fatigue, boredom, and intense cravings. Studies suggest that sugar cravings are less profound than cravings for drugs; many drug addicts elicit a cross-addiction to sugar. Sugar cravings are similar to the intensity of food and sex, but most like caffeine and nicotine.2

History of addiction

The first addiction epidemics were in the 17th, 19th, and 20th centuries.2 Distilled spirits such as whiskey and gin were introduced in the 17th century. Injectable synthetic drugs came in the 19th century. The 20th century brought industrialization and highly palatable foods. These industrialized foods were high in both sugars and fats.1,2

In the 1960s and 1970s, pit was suggested that fats were what caused cardiovascular disease (CVD), diabetes, and high cholesterol. The introduction of the low-fat diet led to an increase in sugar intake. The results were a rise in obesity rates due to high sugar consumption, not fat consumption.3

Added sugar and glucose

The body can produce its own energy source (glucose). Since added sugar is not an essential nutrient as it’s not necessary for our bodies to function. Our livers break down carbohydrates and proteins making the body’s needed fuel—glucose.4 Sugar does not have a recommended daily allowance (RDA) but a daily dietary guideline. The World Health Organization (WHO) recommends that the daily dietary intake of sugar should be less than 10% of total calories, with additional health benefits gained by lowering it to 5%.5

Sugar elimination

A study to eliminate sugar for 28 days was only 41% successful. Participants, who were dental hygienists, stated they felt sugar was addictive and was closely related to a drug more than a food. High danger potential and low nutritive benefits were the reasons they stated for this opinion. Diseases of concern were tooth decay, diabetes, heart disease, cancer, and obesity.

The participants voiced concerns that sugars were hidden in foods and found in what they considered to be healthy processed foods. Vegetarian and gluten-free options contain a large amount of sugar. Ultra-processed foods—foods that typically have ingredients such preservatives, emulsifiers, artificial colors, artificial flavors, and sugar—appear to be the link to the high and hidden sugar addiction problem.3

Battling my addiction, I attempted a sugar-free diet. My husband joined the sugar-free lifestyle with me. Our primary goal was to improve our health. Some of the results we experienced were weight loss, overall feeling better, more energy, clear-mindedness, reduced anxiety, and reduction in body aches. A sugar-free lifestyle becomes easier but takes time and extensive planning. We consume most of our meals at home, whereas before the sugar-free lifestyle we ate out regularly. Most social events focus on food and alcohol. This reduces our control of food choices. Consuming sugar can happen at any time, but routines and environment play an enormous role in success.

Addiction is a hugely concerning public health problem in the United States.1 I’ve found that sugar is an addictive substance and less food-like. Its highly addictive properties and brain-altering activity place it in the category of SUDs. 

How can you learn if you’re addicted?

I suggest you try to stop consuming sugar for 28 days and see how far you can get. This is a good starting point on a journey of discovery regarding your relationship with this highly addictive substance.


1. Wess D, Avena N, Rada P. Sugar addiction: from evolution to revolution. Front Psychiatry. 2018;9(11). doi:10.3389/fpsyt.2018.00545

2. Ahmed S, Guillem K, Vandaele Y. Sugar addiction: pushing the drug-sugar analogy to the limit. Curr Opin Nutr Metab Care. 2013;16(7):434-439. doi:10.1097/MCO.0b013e328361c8b8

3. Ives T. An investigation into what dental hygienists and dental therapists would discover if they stopped consuming added sugar for 28 days. Ann Clin J Dent Health. 2021;10(3):11-15. 
4. Nordalie R, Foster J. Regulation of glucose production by the liver. Ann Rev Nutr. 1999;19(7):379-406. doi.10.1146/annrev.nutr.19.1.379

5. WHO calls on countries to reduce sugar intake among adults and children. WHO. 2017. https://www.who.int/news/item/04-03-2015-who-calls-on-countries-to-reduce-sugars-intake-among-adults-and-children

Tracy L. Boyan, BS, RDH, RDHAP, PG Cert, has been in the dental field for more than 30 years. She has practiced clinically as an RDH in private practice and public health for more than 24 years, and in dental-related marketing, research, and consulting. She had the opportunity to volunteer for her state and local associations. Tracy loves learning and is passionate about her career in dental hygiene.