Food addiction is the controversial contention that compulsive eating is an addiction analogousto alcohol, tobacco, and drug addictions.
Some experts believe that food addiction only applies to specific foods—refined carbohydrates and possibly fats; others argue that it is a behavioral disorder rather than a true chemical dependency. Furthermore, distinctions between food addictions and eating disorders such as binge eating and bulimia nervosa are not always clear. In any case, food addiction differs from other addictions in that it cannot be treated by total abstinence. Nevertheless, uncontrollable cravings for food can contribute to obesity and cause physical, emotional, and social problems. Self-identified food addicts describe their addiction as a chronic, progressive, and ultimately fatal disease, because it leads to life-threatening complications such as obesity, type 2 diabetes, and heart disease.
There have been few large, controlled studies examining food addiction in humans. Much of the evidence for food addiction comes from animal studies that may not be applicable to humans. Nora Volkow (1956–), director of the National Institute on Drug Abuse, has advocated categorizing food addiction as a diagnosis, and some experts, as well as self-described recovering food addicts, agree.
Two 2015 studies reported preliminary evidence that addictive-like eating behavior was associated with highly processed, high-sugar, and high-fat foods, such as chocolate, cookies, pizza, chips, and French fries. These foods may have addictive properties similar to those of heroin and cocaine, including rapid absorption by the body and the need for higher and higher doses. Pediatric endocrinologist Robert H. Lustig, who has branded sugar a poison, argues that there are three levels of motivation—liking, wanting, and needing— and that progressing from wanting to needing is a sign of addiction. Lustig believes that sugar and flour are addictive because they raise blood sugar levels rapidly and dramatically and override physiological mechanisms that signal satiety. According to Lustig, the more refined and processed a food, the higher its addictive potential, with increasing amounts required to satisfy cravings and avoid withdrawal symptoms, as with other addictive substances.
In contrast, a 2014 literature review found little evidence for food as an addictive substance or for brain responses to food that were similar to responses to addictive drugs. The authors did find support from both animal and human studies for food as a behavioral addiction, similar to gambling, and hypothesized that pleasant brain sensations associated with eating might drive addictive behaviors in some people under certain circumstances. Although the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not include food addiction, the review recommended that it be labeled eating addiction under the DSM-5 umbrella term non-substance-related disorders in the substance-related and addictive disorders category. Not surprisingly, the food industry has vehemently opposed the concept of food as an addictive substance.
Some experts argue that food addiction is a contributor to the obesity epidemic in the United States and around the world and that food addiction should be a focus of obesity-prevention strategies. More than one-third of adult Americans and 17% of children and teens are considered obese, and two-thirds of adults are overweight. Obesity causes or contributes to an estimated 400,000 deaths in the United States each year, making it the second most common cause of preventable death after smoking. However, food addicts are not necessarily obese, and obese people are not necessarily food addicts: according to some estimates, 50% of obese people, 30% of overweight people, and 20% of healthy weight people are addicted to a specific food or foods or sometimes to total amounts of food.
Other suggested causes of food addiction or cravings are:
Although food addiction is not necessarily associated with obesity, repetitive overeating that leads to weight gain may be a food-addiction symptom. For example, consuming a box of chocolates at one sitting might be a symptom of binge-eating disorder, whereas eating the box over several sittings could be a food addiction. Twelve-step food addiction programs identify the signs and symptoms as similar to those of other substance addictions:
Other signs and symptoms may include:
Yale University's Rudd Center for Food Science & Policy developed a questionnaire for identifying addictions to specific foods:
Overeating and obesity have historically been diagnosed as eating disorders caused by emotional problems that can be treated with counseling or psychotherapy. Although therapy can help people who use food to deal with emotions or stress, it may not be sufficient for a true food addict with a physiological craving for specific foods. Therefore, food addiction treatments are usually similar to treatments for other types of addiction. Although complete abstinence from food is not possible, complete abstinence from addictive foods is often recommended. There are several 12-step self-help programs for food addiction, as well as residential detoxification and treatment programs, halfway houses, and food-addiction recovery homes and groups. Food Addicts Anonymous combines a 12-step program with a strict diet that avoids sugar, refined flour, and wheat.
Most recommended food-addiction treatments are successful for at least some people. After a period of abstinence, food addicts often find that their cravings disappear, and they may not even want the addictive food(s).
See also Anorexia ; Bulimia nervosa.
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