In this blog I’ll be publishing excerpts from my dissertation on food addiction and research that supports using a whole-food plant-based diet to conquer food addiction for good.
Food addiction is more common than most people think.
While the concept of food addiction is, at this moment, still a very highly debated one, the evidence that food addiction is a real problem keeps accumulating. Health and addiction professionals as well as addiction researchers have questioned whether food or eating behaviors can be addictive, while others have confused the concept of food addiction with the prevalence of obesity or binge eating disorder (BED). But looking at literature reviews on the subject we can see that the evidence supporting the validity of the concept of food addiction significantly outweighs evidence against it.1
Food addiction is still not officially recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a substance use disorder such as tobacco or cocaine use or a behavioral addiction such as gambling disorder. However, the latest version of the DSM (DSM-5) has expanded the criteria for substance use disorder (SUD), and the expanded criteria have been applied by addiction specialists to the problem of food addiction1.
Despite the lack of official recognition in the DSM, the concept of the addiction potential of certain foods and the addictive behavior displayed by many individuals suffering from obesity, binge eating and other eating disorders, has been discussed for decades. Nonetheless, it was not until approximately the year 2000 that the term food addiction started to be utilized in a more systematic way1. The increase in interest in the concept of food addiction can be at least partly attributed to the development of neuroimaging techniques that have allowed researchers to draw parallels in the stimulation of the reward path of the brains of drug addicts and of obese individuals. Several animal-based studies with rodents have confirmed the drug-like behavior and neurological changes produced by administering foods high in sugar and/or fat to laboratory animals. Also, the American Society of Addiction Medicine (ASAM) has included “food addiction” in its list of possible addictive disorders2. Therefore, we can see that the legitimacy of the concept of food addiction has grown considerably in the last few years.
Food addiction is similar to drug addiction in the sense that addictive foods, that is, “highly palatable” foods usually high in sugar and/or fat, stimulate intense good feelings mediated by the release of dopamine in the brain, which overstimulate the pleasure mechanisms (reward pathways) in the brain. As the normal neurochemistry of the reward mechanisms of the brain are disrupted, the brain eventually compensates for the overstimulation, and develops a diminished reward response caused by downregulation of dopamine 2 receptors (D2R) in the brain. The neurotransmitter dopamine is also involved in several survival mechanisms, such as hunger, thirst and sexual behavior, and provides the motivation for humans to engage in them. Therefore, dopamine is involved in both drug rewards and natural rewards. However, similar to drugs of abuse, highly palatable food overstimulates and can eventually cause downregulation of the dopaminergic pathways, which can cause reward deficits, affective dysregulation and negative reinforcement.
The overall incidence of food addiction has been estimated to be has high as 19.9% of the general population,3 however the prevalence rate varies according to the characteristics of the sample. For instance, in obese individuals seeking bariatric surgery, food addiction rates of 14-58% have been observed,4 while among individuals with bulimia nervosa, prevalence rates as high as 81% to 100% have been noted.5,6
Therefore, yes, food addiction is real, and it is much more common than most people think. Unfortunately, the treatment for food addiction many times is not evidenced-based due to the fact that so little research has been done on what types of treatments are most effective. Most food addiction food plans limit carbohydrates and may also severely limit calories. This approach can be counterproductive in the long term and lead to high relapse rates. I’ll be sharing why in this blog, based on research I did for my doctoral dissertation. Stay tuned.
- Meule, A., & Gearhardt, A. (2014). Food Addiction in the Light of DSM-5. Nutrients, 6(9), 3653–3671. doi:10.3390/nu6093653
- Gordon, E., Ariel-Donges, A., Bauman, V., & Merlo, L. (2018). What Is the Evidence for “Food Addiction?” A Systematic Review. Nutrients, 10(4), 477. doi:10.3390/nu10040477
- Pursey, K., Stanwell, P., Gearhardt, A., Collins, C., & Burrows, T. (2014). The Prevalence of Food Addiction as Assessed by the Yale Food Addiction Scale: A Systematic Review. Nutrients, 6(10), 4552–4590. doi:10.3390/nu6104552
- Ivezaj, V., Wiedemann, A. A., & Grilo, C. M. (2017). Food addiction and bariatric surgery: a systematic review of the literature. Obesity Reviews, 18(12), 1386–1397. doi:10.1111/obr.12600
- Granero, R., Hilker, I., Agüera, Z., Jiménez-Murcia, S., Sauchelli, S., Islam, M. A., … Fernández-Aranda, F. (2014). Food Addiction in a Spanish Sample of Eating Disorders: DSM-5 Diagnostic Subtype Differentiation and Validation Data. European Eating Disorders Review, 22(6), 389–396. doi:10.1002/erv.2311
- Meule, A., von Rezori, V., & Blechert, J. (2014). Food Addiction and Bulimia Nervosa. European Eating Disorders Review, 22(5), 331–337. doi:10.1002/erv.2306