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Can people even be addicted to food? This question is still an ongoing debate. Many current articles and studies dictate that there is evidence of food addiction. Yet, there are a lot of questions around the validity of food addiction as being comparable to a substance use disorder. If it is addictive, what is the recognizable addictive element in food? Also, there are a lot of questions around whether the concept of food addiction is just a reiteration of eating disordered behavior. Are people addicted to food, or is it the act of eating that is yielding the “addicted” feeling? Over the course of this article, you will be able to decide where you stand in the debate of whether food addiction is real or not.
The concept of food addiction goes back to the 1950s, when food was fractionally processed compared to how processed it is today. Food addiction is exactly as it sounds. Avena et al (2008)’s study defined food addiction by the drive to partake in food and then the feeling of withdrawal followed by higher sensitivity to addictive foods. Simply put, food addiction is the inability to resist consuming foods to a point of negatively affecting one’s life. There has been some psychological and biological proof of “food addiction” that is comparable to already medically recognized addictions, like alcohol addiction and drug addiction. Yet, food is a substance that we all need to survive, and not all foods elicit an addictive response. So, can someone really be addicted to food (4,6,12)?
Ruddock et al. (2015) did a questionnaire determining the similar elements between people that self-diagnosed as “food addicted.” The similarities included a psychological drive to eat, a loss of control around food or certain foods, a constant rumination around food, consistent food cravings, a physiological effect from consuming an unhealthy portion of food, or weight gain. 59 out of the 210 people reported experiencing these symptoms. However, are these symptoms similar to an established addiction’s symptoms, or are these people experiencing a form of disordered eating (10,12)?
A lot of articles focus their studies of food addiction through the lens of binge-eating disorder, a pre-established disorder in the DSM-5. Binge-eating disorder is characterized by a person eating large quantities of food in one sitting on consistent occasions. This behavior, from the outside perspective, does seem like it could possess an addictive element. However, no specific substances in food have been scientifically established to identify food as having the potential to form a substance use disorder, but we’ll discuss more on that later (3,6,12).
Adrian Meule (2011) made the insightful point that “food addiction” could be a language when speaking about eating disorders. Eating disorders have had successful treatments that do not rely on food addiction for explanations. However, Meule also theorized that “food addiction” might provide useful understanding in binge-eating disorder treatment, but otherwise, “food addiction” seems like redundant, possibly harmful, terminology. When you frame eating disorders through “food addiction,” typically the answer to addiction is abstinence. People who are addicted to alcohol and drugs are told not to use those substances, but we cannot abstain from eating. There is not enough research pertaining to partial abstinence-based treatment for certain eating disorders; it could potentially be beneficial, but inherently, it does not seem like a great idea. After all, eating disorders can produce unhealthy thought patterns around food; telling someone who is suffering from a binge-eating disorder to not eat all the time sounds patronizing and destructive (3,6,12).
Some scientists, like Adrian Meule (2019), claim that obesity might be evidence that there is food addiction. Meule also recognizes that there is evidence that people that are normal or under normal weight have symptoms of being “addicted” to food. Research on food addiction has largely been centered around people who are classified as obese, but this is simplifying the obesity epidemic and disregarding food rumination, and maybe even food addiction, in people with eating disorders like anorexia and bulimia, which are disorders that are often characterized by dangerously low weight. Adams et al. (2019) also discusses that food addiction is potentially an element within the obesity epidemic, but he recognizes this theory is not accounting for the numerous other factors that play into obesity. Additionally, it disregards other populations that could be experiencing food addiction (1,2,9).
Meule (2019) discusses his biggest concern that if there are people that can be classified as food addicts, but do not possess the criteria of an eating disorder, then people are falling through the cracks that need treatment. Meule discusses that there have been studies that have compared people with binge-eating disorder to the Yale Food Addiction Scale. There was a consistently high percentage of people with binge-eating disorder who also aligned with the Addiction Scale, seemingly rendering the food-addiction diagnosis purposeless. Yet, Valentina Ivezaj et al. (2016)’s study shows 19% of 51 people met the Addiction Scale criteria but did not meet the DSM-5 determinants for binge-eating disorder. This means that people can be classified as food addicted but not qualify as having an eating disorder, proving that eating disorders in the DSM-5 may not be meeting the full scope of food-related diagnoses (6,7,9,12).
Does food actually have an addictive element? Hebebrand et al. (2014) proposed the theory that, since the addictive element of food was difficult to pinpoint, an “eating addiction” might be more appropriate terminology than “food addiction.” This means that the actual act of eating is what is addictive, rather than the food itself (6).
Hebebrand et al. (2014) did not believe food was inertly addictive, however, that is a controversial stance considering what we now know about the way our body interacts with certain foods. It is universally recognized that foods high in sugar, carbohydrates, and fats are more likely to yield a desire to overindulge and to continually partake. Potatoes and breads were even recognized in the 1950s as being more desirable than other foods. Avena et al. (2008)’s study regarding consistent intake of sugar looked at the neurochemical effects on the brain of rats from sugar consumption. They found that the rats’ brains spiked reward system changes that were similar to brain reactions in people suffering from active addiction. This proves that food does have a potential addictive element, whether that is clinically recognized or not (4,8).
It is well known that food processing companies are capitalizing on the addictive ingredients in food in order to make some foods impossible to ignore on the grocery shelves. There is no one classified “addictive” substance found in food, as aforementioned, but it is well established that sugar elicits the same neural response in the brain as other addictive substances, like alcohol and drugs. Food scientists across the country are trying to figure out how to make the taste of foods more flavorful but also dissolve instantaneously. Not only is so much of our food being genetically engineered to be more tasteful and visually enticing, but a team of marketers, perfumiest, psychologists, etc. are creating task forces, in numerous food companies, to make food undeniable. It is well known that companies are fully cognizant of the actions they are undertaking in food development (11).
Food addiction is not recognized in the DSM-5. Gordon et al. (2018) and many others claim that food addiction is clinically relevant and should potentially be implemented in the DSM-5. The last argument for the existence of food addiction is that it might qualify to be a classified substance use disorder since it is similar to a recently added substance use disorder in the DSM-5, known as gambling addiction. Gambling addiction, similarly to food addiction, is not just substance-based but has a behavioral element to its nature, as well (5,12).
Our behavior, especially regarding eating, is so interesting. In this current climate in American culture, eating has become less and less of a meaningful experience and more of a shame-ridden task that must be crossed off the to-do list. Eating disorders and eating addictions are showcasing the importance our food has on our mind-body relationship. It seems people can have addictions related to food, or possibly the action of eating. The debate has shifted away from the validity of addiction regarding food toward whether food addiction should be added to the DSM-5 and whether that addition would provide helpful insight into helping people who suffer from a food related problem. This is an important decision that must be addressed in the future.
References:
1. Adams, R. C., Sedgmond, J., Malzey, L., Chambers, C. D., & Lawrence, N. S. (2019). Food Addiction: Implications for the Diagnosis and Treatment of Overeating. Nutrients.11(9), 2086. doi: 10.3390/nu11092086 https//doi.org/10.3390/nu11092056.
2. Adrian Meule (2019). A critical eximination of the practical implications derived from the food addiction concept. US National Library of Medicine National Institutes of Health. 8(1), 11-17. doi: 10.1007/s13679-019-0326-2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424934/#CR23.
3. Adrian Meule. (2011). How prevelant is “food addiction”? frontiers in Psychiatry. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyt.2011.00061/full.
4. Avena, N. M., Rada, P., Hoebel, B. G. (2008). Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. ScienceDirect. 32(1), 20-29. Published online 2018 Apr 12. doi: 10.3390/nu10040477
5. Gordon, E.L., Ariel-Dingas, A.H., Bauman, V., and Merio, L.J. (2018). What is the Evidence for “Food Addiction?” A Systemic Review. Nutrients, 10(4), 477. doi: 10.3390/nu10040477 https//doi.org/10.3390/nu10040477.
6. Healthline Media UK. (2021). Food Addiction: Symptoms management 2021. Medical News Today. https//www.medicalnewstoday.com/artciles/319670#definition.
7. Ivezaj, V., White, M. A., Grilo, C. M., Examining binge-eating disorder and food addiction in adults with overweight and obesity. PubMed. 24(10), 2064-2069. Doi: 10.1002/oby.21607. https://pubmed.ncbi.nlm.nih.gov/27558207/.
8. Johannes Hebebrand et al. (2014). “Eating addiction”, rather than “food addiction”, better captures addictive-like eating behavior. ScienceDirect. 47, 295-306. https://www.sciencedirect.com/science/article/pii/S0149763414002140.
9. Leonard, J. (2020). What to know about food addiction. Medical News Today. https://www.medicalnewstoday.com/articles/319670.
10. Ruddock, H. K., Dickson, J. M., Field, M., Hardman, C. A. Eating to live or living to eat? Exploring the casual attributions of self-perceived food addiction. PubMed. 95, 262-268. Doi: 10.1016/j.appet.2015.07.018 https://pubmed.ncbi.nlm.nih.gov/26206173/.
11. Shepard, D., Padman, M. (hosts). (2018-present). Armchair Expert [Audio Podcast]. Spotify. https://armchairexpertpod.com/pods/michael-moss.
12. Yvette Brazier. (2019). What’s to know about binge eating disorder? Medical News Today. https://www.medicalnewstoday.com/articles/173184.
Contributors:
Author: Katrina Peavy
Editors: Lauryn Agron and Anum Khan
Health scientist: Hira Mughal
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