While the term Food Addiction has gained popular-usage within the scientific community and among the general public, the term ‘Eating Addiction’ better describes addictive-like eating behaviors. Although the research is still in its early stages, there is little available evidence to substantiate a substance-based addiction. There is, however, existing data to support the existence of addictive eating behavior. This supports the stance that eating addiction, commonly referred to as food addiction, is a process addiction rather than a substance addiction.
Where Did the Term ‘Food Addiction’ Originate?
The term ‘food addiction’ may be recently popularized, but it is not a new concept. Over 60 years ago T.G. Randolph first defined ‘food addiction’ as “[. . .] a specific adaptation to one or more regularly consumed foods to which a person is highly sensitive, produces a common pattern of symptoms descriptively similar to those of other addictive processes.” As obesity rates have risen worldwide, a search for answers has led both researchers and the general public to the idea of ‘food addiction’ as a potential cause for weight gain. The concept of food addiction places heavy responsibility on the substances food addicted people eat; highly palatable, energy-dense foods with high amounts of sugar, salt, and/or fat. This idea has led to a perception that the food industry, as a whole, has played a strong role in promoting poor nutritional policies and obesity trends (Davis, 2013). ‘Food addiction’, therefore, places the blame on the food industry and calls for more stringent nutritional policy as a means of influencing eating behavior- ‘if the addictive foods are not available, the addiction will also go away.’ An example of this occurred in New York City as the Sugary Drinks Portion Cap Rule sought to prohibit sugary drinks (above sixteen ounces). This suggests that certain food or drinks are either good or evil. We tend to blame the food, not the behavior.
Why is ‘Food Addiction’ No Longer Accurate?
Prior to the DSM-V, the fifth-edition of the Diagnostic and Statistical Manual of Mental Disorders, the only recognized addictions were substance-abuse addictions (e.g. drugs and alcohol). However, the current version of the ‘Psychologist's Bible’ includes a section titled Non-Substance-Related Disorders within the newly titled category ‘Substance-Related and Addictive Disorders’. This represents a major shift in what processes can now be classified as an addiction. Unfortunately, only Gambling Disorder is currently included under Non-Substance-Related Disorders.
Obesity is not currently included in DSM-5, despite the importance of behavior and the involvement of the same central pathways and reward systems that are involved in substance use disorders (Volkow and O’Brien, 2007). However, with the addition of Gambling Disorder, the door has been opened to consider including other process addictions such as internet gaming, sex, and shopping. This also allows researchers to focus more on addictive eating behaviors as an addiction rather than the foods being consumed, in order to be included in the DSM.
Then What is ‘Eating Addiction’?
Eating and food are interwoven into almost all cultures across the world. When we stop to think about it, food is a major part of almost any social gathering or celebration in America: Thanksgiving dinner, birthday cake, 4th of July BBQ’s, Halloween candy. Yet, many people can enjoy these food-centered celebrations, most of which is highly palatable, and not become addicted. Additionally, not everyone that consumes french fries, soft drinks, or donuts develops an addiction to these foods. So where does an eating addiction come into play and how does one become an eating addict?
Eating is a naturally rewarding and reinforcing behavior, and research has shown that food-consumption activates the reward system in the brain, but that does not necessarily mean that specific nutrients (i.e., sugar, salt, fat) are able to trigger a substance addiction. Instead, the activation of the reward system as the initial step of the process ending in addiction is dependent on eating palatable foods regardless of their specific ingredients (J. Hebebrand et al. 2014). Labeling a food or nutrient as ‘addictive’ implies that it has the inherent properties or ingredients necessary to make susceptible individuals addicted to it, similar to drugs or alcohol. However, "there is currently insufficient scientific evidence to label any common food, ingredient, micronutrient, standard food additive or combination of ingredients as addictive." (J. Hebebrand et al. 2014).
While it is common to hear people call themselves ‘chocoholics’, or claim to be ‘addicted’ to one particular food, eating addiction is far different. An eating addict becomes addicted to the process of overeating rather than a specific food itself. A classic finding in substance addiction indicates that substance misuse leads to changes in the brain’s reward system and how it processes dopamine, endorphins, etc. (Feng et. al. 2012). However, these changes can also be associated with non-substance based addictive behavior. Additionally, the link between appetite, hunger, and satiation with the reward system can be seen as a basis for the development of addictive eating behaviors. “Psychological cues such as boredom, perceived stress or a negative mood potentially may trigger overeating in the absence of hunger that would lead to neurobiological alterations in complex central regulatory systems related to addictive behaviors (J. Hebebrand et al. 2014).” Over time, these psychological cues become the catalyst for engaging in the addictive behavior of overeating.
Eating Addiction Classification and Diagnosis
Currently, eating addiction is diagnosed using the Yale Food Addiction Scale (YFAS), the first questionnaire developed to assess addictive eating behaviors. The naming of this questionnaire has fueled the debate of ‘food addiction’ vs. ‘eating addiction’. However, the questionnaire focuses on addictive eating behaviors rather than a substance/food based addiction. Eating addiction is not currently listed in the DSM-V due to a definitive lack of evidence on either side of the debate of whether food/eating addiction is a substance-based or behavioral addiction.
Eating Addiction (Food Addiction) Treatment
The good news is that the increased attention on food addiction has inspired more and more treatment programs for food addicts. However, any treatment protocol should begin with the understanding that food addiction is really a process addiction to the behavior of overeating. Treatment approaches that only try to address the food (e.g., diet plans that cut out all sugar or starch) are not likely to create lasting recovery.
At Lifestyle Transformation, we recognize that one does not become addicted to the process of overeating overnight. A successful treatment program will identify the underlying issues, in order to break the addiction cycle. Lifestyle Transformation is a leading national program that combines psychoeducation about the neuroscience of food addiction, with group psychotherapy, to help members understand their eating patterns and take the steps necessary to live a life free from addiction.
To find out if you have a food addiction, you can take the Lifestyle Transformation Quiz today and see if Lifestyle Transformation is the right treatment program for you.