Is Food Addiction Real?

Over the years, I’ve counseled several clients that have described certain foods as “crack.” They insist that eating one cookie or scoop of ice cream will set off a cascade of binge eating for days. The notion that food is addictive, particularly high-sugar, high-calorie, overly-palatable foods, has become more popular over the past few years, often being compared to substance abuse. In reality, the term "food addiction" dates back to the 19th century when chocolate was considered addictive (1,2). Overeating itself may suggest addictive behavior. But unlike drugs and alcohol, people cannot simply give up eating.The interest in food addiction is reflected in increased media exposure on the topic as well as scientific studies. In 2012, a handbook on food addiction was also published. The impression that food addiction is new and related to the availability of highly-palatable, processed foods (and is the cause of obesity) is misguided. The term "food addiction" was first introduced in 1956 by Theron Randolph. He described it as “a specific adaptation to one or more regularly consumed foods to which a person is highly sensitive [which] produces a common pattern of symptoms descriptively similar to those of other addictive processes.” Ironically, his list of foods considered addictive were corn, eggs, wheat, coffee, potatoes, milk, and other frequently-eaten foods, which are not processed foods like chips, cookies or other snacks that we commonly consider addictive today (3). The availability of calorie-dense, highly-palatable, inexpensive food is often seen as a cause of obesity today. However, normal weight individuals may also overeat certain foods as well.The reason food may be considered an addictive substance comes from the effect it may have on the brain, which can be similar to chemical addiction. Animal studies have shown that processed foods high in white sugar and fat may trigger overeating as they set off dopamine, a neurochemical associated with pleasure in the brain. The more of these foods we eat, the more we may crave them (5). University of Michigan researchers found that foods such as pizza and ice cream have addictive properties while “boring/healthy” foods like salmon or broccoli do not trigger the same effect in the brain (6).A test developed by Ashley N. Gearhardt, William R. Corbin, and Kelly D. Brownell called the Yale Addiction Food Scale was created to identify individuals who are showing signs of substance abuse behavior with the intake of high-sugar/high-fat foods. The self-reporting measure includes a 25 item set of mixed response categories. Food addiction symptoms such as tolerance, withdrawal, loss of control, etc can be identified and are very much like the criteria used for substance dependence according to the DSM-IV-TR (American Psychiatric Association, 2000). In addition, two items evaluate clinically-significant impairment or discomfort from eating. When three symptoms and clinically-significant impairment or distress are present, food addiction can be diagnosed.A few sample questions include:

• Do you eat when you are full?
• Do you go out of your way to enjoy certain foods when they aren’t readily available in your home?
• Do you find yourself finishing off a bag of chips or package of cookies when you intended to only eat a few?
• Do you have intense cravings? (7)

Similar to foods being addictive, caffeine is considered an addictive substance according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and is considered the most commonly-used psychotropic drug in the world. In low to moderate doses, it increases alertness and attention. While too much caffeine is rarely life-threatening, excessive intake may impart negative effects such as increased anxiety, insomnia, increased heart rate, and restlessness. The regular, habit-forming use of caffeine causes physical dependence and withdrawal symptoms that impact normal functioning. The World Health Organization (WHO) also recognizes caffeine dependence as a clinical disorder (8).Thankfully, there is treatment for those who consider their eating habits to be addictive in nature or out of control. Discuss your concerns with your doctor or dietitian who can refer you to a mental health professional.By Lisa Andrews, MEd, RD, LDReferences:

1. Weiner B, White W. The Journal of Inebriety (1876-1914): history, topical analysis, and photographic images. Addiction. 2007;102:15–23.
2. Back by Popular Demand: A Narrative Review on the History of Food Addiction Research, Yale J Biol Med. 2015 Sep; 88(3): 295–302. Adrian Meule
3. Brownell KD, Gold MS. Food and addiction - a comprehensive handbook. New York: Oxford University Press; 2012. p. xxii.
4. Randolph TG. The descriptive features of food addiction: Addictive eating and drinking. Q J Stud Alcohol. 1956;17:198–224.
5. EMBO Rep. 2012 Sep; 13(9): 785–790.Published online 2012 Aug 17. doi: 10.1038/embor.2012.115The neurobiology of overeating. Treating overweight individuals should make use of neuroscience research, but not at the expense of population approaches to diet and lifestyle Natalia M Lee,1 Adrian Carter,1 Neville Owen,2 and Wayne D Hall3
6. Schulte, E. Avena, N, Gearhardt, A. Which Foods May Be Addictive? The Roles of Processing, Fat Content, and Glycemic Load. Published: February 18, 2015. https://doi.org/10.1371/journal.pone.0117959
7. https://www.forbes.com/sites/quora/2016/10/13/studies-show-that-some-foods-may-be-as-addictive-as-heroin-and-cocaine/#737a80155611
8. Md. Sahab Uddin, Mohammad Abu Sufian, Md. Farhad Hossain, Md. Tanvir Kabir, Md. Tanjir Islam, Md. Mosiqur Rahman, and Md. Rajdoula Rafe. Neuropsychological Effects of Caffeine: Is Caffeine Addictive? Psychol Psychother 7:295. doi:10.4172/2161-0487.1000295.