Food addiction

DEFINITION: Food addiction is characterized by the uncontrolled desire for and preoccupation with food. People who are addicted to food are driven by obsessive-compulsive thoughts about food and eating despite knowing the negative effects of excess food intake, including obesity . Dependency on food, as with other dependent substances, occurs when destructive behavior persists despite the negative outcomes associated with repeated use.

ALSO KNOWN AS: Compulsive overeating

Causes

Cited causes of food addiction include depression, loneliness, stress, hostility, boredom, childhood sexual or emotional trauma, and low self-esteem. Some scientists believe there is a biological explanation for food addiction that involves dopamine, a neurotransmitter in the brain. Neuroscientists and nutrition researchers continue to investigate the precise mechanisms by which food can trigger addiction-like eating behavior. Some hypotheses include attractiveness of certain foods, different reactions to sucrose and fructose than glucose, low satiation from energy-dense foods, and genetic variation in expressing the hormone leptin, which cues satiation.

Eating is typically a pleasurable experience, but food addiction is caused by a loss of control over the agent of abuse: food. Persons addicted to food may not recognize their addiction or may feel incapable of breaking the cycle of overeating. They have an undeniable preoccupation with food and are compelled to eat large amounts of food. For those with a food addiction, this cycle eventually becomes the norm.

In an episode of binge eating, it is not uncommon to consume in excess of 10,000 calories. These calories lead to obesity if not expended, yet it is not accurate to assume that all obese persons are addicted to food. People experiencing food addiction continue to engage in compulsive overeating even when aware of its destructive effects. Those who eventually want to break the cycle often feel incapable of doing so, while others feel they can stop but continue to postpone doing so.

Eating habits are established during childhood. The development of poor eating habits, including binge eating, may result from ineffective coping mechanisms. Food serves as a barrier or substitute to dealing with emotionally difficult situations and relationships. Poor eating habits continue into adulthood and become ingrained in behavior.

Risk Factors

Binge eating disorder is the most common eating disorder in the United States. This and other forms of food addiction most commonly affect girls and women age fourteen to thirty-five years, perhaps because of society’s emphasis on appearance and thinness. Both women and men can be addicted to food, but women more often seek treatment. Food addiction affects persons of all body types and body weights.

Although food addiction most often results in obesity, not all obese persons are addicted to food. Persons with a family history of overeating and persons who lack adequate coping mechanisms for stress, disappointment, and anger may be more at risk for the disorder. Persons with a genetic predisposition for binge eating are enabled by family members, who often allow the cycle to continue through their own actions and expectations. Impulsivity may be another risk factor for food addiction (though not obesity), much as it increases vulnerability to other addictions.

Symptoms

Binge eaters differ from individuals with bulimia in that they do not attempt to rid themselves of the consumed food after a binge. Binge eaters and those addicted to food spend overwhelming amounts of time planning and fulfilling food “frenzies,” which occur publicly or privately. They may eat a reasonable portion in public yet overeat in private. They often eat when they are not hungry or when they are emotionally upset. Feelings of low self-worth and guilt often follow binges, yet these binges are followed by planning for the next episode of eating. Each encounter with food can perpetuate the cycle of destruction.

Though the majority of Americans eat more than what the US Department of Agriculture recommends, people experiencing food addiction far exceed these same recommendations. Those addicted to food often feel full but may appear ravished, out of control, or on a high, or they may always claim to be hungry.

The insatiable appetite for food is often a manifestation of other underlying problems. Food often becomes a substitute for other aspects of life that people experiencing addiction do not perceive as fulfilled, including personal goals, finances, and personal and professional relationships. Food has filled these voids and temporarily provides the comfort, completeness, or pleasure that the addicted person so desperately seeks. Often, the addicted person makes food the object of obsession in attempts to delay or avoid dealing with uncomfortable situations or emotions.

Foods high in sugar and fat are thought to act as triggers for obsessive, compulsive eating. Studies have shown that for some people, these highly palatable foods trigger a response in the same reward and pleasure centers of the brain affected by cocaine, heroin, and other addictive drugs. Therefore, withdrawal from these triggers is real and can cause cramps, tremors, and exaggerated feelings of depression and guilt.

Screening and Diagnosis

Screening tools in the form of questionnaires are available to determine if further evaluation may be necessary to aid in the diagnosis of a food addiction. However, these tools rely on self-reports. People who are addicted to food are typically ashamed or in denial, or they feel they are too out of control to modify their behavior. These facts alter self-assessment tools.

Researchers have developed the Yale Food Addiction Scale (YFAS), based on an addiction scale for alcohol dependence, to screen takers for dependence on high-sugar and high-fat foods. Critics have pointed out that the scale does not clearly delineate the boundary between normal eating and problematic eating, however. This undermines the usefulness of the YFAS in determining whether an individual is overeating and whether food addiction can be said to exist as its own separate condition.

Health care providers are in a unique position to help those who may experience food addiction. Obesity is often attributed to other medical problems, such as thyroid disorders. However, appropriate laboratory tests can determine if a causal relationship exists. Among other complications, binge eating may lead to depression, suicidal thoughts and tendencies, obesity, heart disease, hypertension, type 2 diabetes, high cholesterol, and joint problems.

Notably, binge eating disorder, but not “food addiction,” is a recognized diagnosis in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Binge eating is also a symptom of the well-known eating disorder bulimia, yet in bulimia, other dysfunctional behaviors such as vomiting or abusing laxatives are undertaken to mitigate negative feelings and to avoid weight gain. According to DSM-5 criteria, for a diagnosis of binge eating disorder to be made, the individual must have engaged in binge eating episodes a minimum of once a week for three months. The exclusion of food addiction as such from the DSM-5 reflects ongoing debate among scientists as to the nature of the problem—whether specific foods or behaviors are to blame, whether the label of addiction is helpful or harmful to individuals’ treatment, and so forth. Nevertheless, problematic eating is a recognized health issue in need of treatment

Treatment and Therapy

Other substances of abuse (such as cocaine and heroin) are harmful regardless of dose. Treatment and therapy for those addicted to a substance involves the elimination of the abused substance, which not only is detrimental to the body but also is completely unnecessary to sustain life.

Treatment and therapy for food addiction is unique because eating is required for human survival. The abused substance cannot be entirely removed from the person’s environment. Also noteworthy is that eating is a social behavior. Eating’s social aspects make it more challenging to control, given that humans are immersed in activities involving food and eating. Whether compulsive or not, overeating is more acceptable when others are also engaging in this behavior.

To sever their dependency on food, a person addicted to food must first realize and accept that they have a problem and must willingly receive treatment and support from trained professionals, such as physicians, dieticians, and mental health specialists. Those addicted to food must reclaim power and learn to control food instead of allowing it to control them.

Obesity that often accompanies binge eating and food addiction should also be addressed. Weight loss and psychological counseling may occur separately or simultaneously, but both are required to optimize the addict’s future.

Prevention

Unhealthy foods tend to be more accessible and often are more affordable than sound, nutritious foods. Considering the predominance of hectic lifestyles in developed nations, this limited availability of healthy foods creates the perfect opportunity to make poor food choices. Obesity, the second leading cause of preventable death in the United States, can lead to premature death or disability. The United States spent an estimated $173 billion (2019 dollars) on obesity-related health care in 2024; obesity rates, and thus medical spending, have continued to rise.

Behavioral changes are required to prevent and correct binge eating and obesity. Apart from eating healthy and exercising regularly, several other strategies are suggested. Education is necessary to increase awareness of the problem, and educational efforts should be provided worldwide. Ideally, healthier food choices will be made equally available and healthy eating habits will be taught and reinforced. Researchers continue to explore the underlying reasons behind unnecessary eating or overeating and potential use of medications.

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