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Food Addiction: Fact or Fiction?

“I am definitely a chocoholic”. Most of us have either heard – or spoken – these words.  Many people report feeling out of control with food: cravings that won’t be tamed, the “just a few”  Maltesers than turn into an entire packet, eating ANYTHING that is available regardless of taste or actual hunger, and feeling powerless in the presence of delicious food. So, is food addiction for real or is it just another excuse to tuck into a Family Block?

The concept of “food addiction” has been controversial among researchers; however there is now considerable evidence to suggest that food addiction does exist. Non-substance addiction, behavioural addictions, or impulse-control disorders (e.g. disordered eating, gambling, internet, computer games, shopping, and sex) are receiving increasingly more research attention.

Researchers have compared some eating behaviours to the current clinical definition of “substance dependence” and have made the following comparisons 1:

 

Dependence Criteria Typical Eating Behaviours
Tolerance (needing more of a substance to achieve desired effect) Starting with one biscuit, increasing to several or  a whole packet
Withdrawal symptoms, including taking the substance to relieve or avoid withdrawal symptoms Habitually eating to relieve depression, anxiety or other emotions; unpleasant physical sensations when trying to cut back
Taking in larger amounts or for a longer duration Intending to eat just one plate of ice-cream but finishing the whole tub; binges extending over hours
Attempts to “cut back” Frequent efforts to eat “properly” or healthily (avoiding overeating or eating certain foods, e.g. chocolate) that can only be maintained for a short period of time
Excessive time spent pursuing, using or recovering from use Being preoccupied with thoughts about food, planning intake, preparing, &/or resting or sleeping after eating a large volume
Reduction/discontinuation of important activities because of use Eating instead of spending time with friends; feeling too sick after overeating to do anything
Continued use despite negative consequences Overeating in spite of gaining weight or being overweight, physical illness, &/or distress about overeating

Based on these criteria, many people could meet the Dependence criteria with food.

What is the evidence?

Research into food addiction has developed considerably in the past decade. A brief snapshot of available research shows many similarities between food and substance addiction:

  • Brain studies have shown that food can trigger similar biological and neurological processes to illicit drugs. 1
  • Alcohol and high-fat sweets trigger the release of opioids. Blocking the release of these opioids reduces the reward associated with alcohol in alcoholics and high-fat sweets in binge eaters. 2
  •  Fructose and alcohol also share similar physiological properties: ethanol is the fermented by-product of fructose. 3
  • Rats fed randomly with sucrose tripled their daily sugar consumption 4, which is consistent with the increased tolerance that is seen in addiction.
  • When sugar was removed from animals on a high-sugar diet, they displayed changes commonly associate with substance withdrawal, such as drop in body temperature, anxiety & agitation. 5
  • Food cravings activate the same part of the brain as drug cravings. 6

Are some types of foods more addictive?

The main food culprits seem to be carbohydrates, fat, sugar and caffeine. I am not aware of any research implicating lettuce or broccoli. Processed foods are especially problematic, as some types of sugar such as high fructose corn syrup may be labelled as “food enhancers” rather than sugar.

It may not just be the food: some people, for genetic or biological reasons, may be particularly hypersensitive to sugar or carbs, while other research suggests it is the way food is eaten, such as cycles of restriction and overeating (i.e. yo-yo dieting) that creates addiction. 7 Personality traits, impulsivity and reward driven are also implicated.

OMG I think I might be a food addict! Am I a lost cause?

Just because you struggle with the brie or can virtually inhale a family block does not mean you have a food addiction. Not all overweight people or those with diagnosed Binge Eating Disorder (BED) have a food addiction either.  Researchers are still working to clarify the differences, however preliminary research shows that people with BED plus a food addiction are likely to have a history of trauma, have greater difficulty with their emotions, lower self-esteem and are more likely to have a mood disorder than those without food addiction. 8

Is it possible to recover from food addiction?

Yes it is, just as it is possible to recover from alcohol and drug addiction. Is it easy? Of course not. One of the tricky aspects of food addiction is that abstinence is not an option – food is necessary for survival. Food addiction needs to be diagnosed by an appropriately trained and qualified professional. This process would include a comprehensive diagnostic interview, a functional analysis of eating behaviours, and assessment tools such as the Yale Food Addiction Scale. 9

Treatment components focus on mindfulness, emotion regulation, behavioural and environmental strategies and reducing impulsivity. Negative emotional states can trigger binges or relapses, so it is important to manage these emotions without using food. Mindfulness strategies can reduce impulsivity; allowing cravings to pass without acting on them. It is important to modify the restraint/overeating cycle, and address underlying trauma or low self-esteem.

References

  1. Gearhardt, A.N., Corbin, W. R., & Brownell, K. D. (2009). Food addiction: An examination of the diagnostic criteria for dependence. Journal of Addictive Medicine, 3 (1), 1–7.
  2. Drewnowski, A., Krahn, D.D., Demitrack, M., et al. (1995). Naltrexone, an opiate blocker, reduces the consumption of sweet, high-fat foods in obese and lean female binge eaters. American Journal of Clinical Nutrition, 61, 1206-1212
  3. Davis, C., Curtis, C., Levitan, R et al (2011). Evidence that food addiction is a valid phenotype of obesity. Appetite, 57, (711-717).
  4. Rada, P., Avena, N. M., Hoebel, B. G. (2005). Daily bingeing on sugar repeatedly releases dopamine in the accumbens shell. Neuroscience, 134, 737-744.
  5. Colantuoni, P.,Rada, P., McCarthy, C et al. (2005). Evidence that intermittent, excessive sugar intake causes endogenous opioid dependence. Obesity Research, 10, 478-488
  6. Pelchat, M. (2009). Food addiction in humans. Journal of Nutrition, 139, 620–622.
  7. Corsica, J., & Pelchat,M (2010). Food Addiction: True or False? Current Opinion in Gastroenterology, 26, 165-169.
  8. Gearhardt, A. N., White, M., Masheb, R. et at. (2012).An examination of the food addiction construct in obese patients with binge eating disorder. International Journal of Eating Disorders, 45, 657-663.
  9. Gearhardt, A. N., Corbin, W.R.,, Brownell, K. B. (2008). Preliminary validation of the Yale Food Addiction Questionnaire. Appetite, 52, 430–436.
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