Scientists hope that recognition of obesity as a form of food addiction may improve obesity treatment and foster greater public acceptance of health policies. Results of this study show a need for further investigation to explain the inconsistency between support for food addiction and a strong emphasis on weight being a personal choice.
Full Answer
Is obesity an addiction to food?
The Neurobiology of "Food Addiction" and Its Implications for Obesity Treatment and Policy There is a growing view that certain foods, particularly those high in refined sugars and fats, are addictive and that some forms of obesity can usefully be treated as a food addiction.
Can CBT be used to treat obesity and addiction?
CBT interventions have been effective in the treatment of substance addictions [451] and have also demonstrated their potential in the treatment of obesity [452,453] and BED [453,454,455,456]. However, it has been argued that the success of treating overeating and BED with CBT refutes the food addiction model [30].
Is there an addiction model of overeating?
Although there are important differences between overeating and other addictive behaviors, an addiction model of overeating may effectively inform prevention and treatment of obesity. Keywords: Obesity, overeating, addictions, substance use disorders
What is the best treatment for obesity and addiction?
Behavioral Treatments Some behavioral treatments for addictions can also help obese individuals control food intake. Examples of treatments that may be effective for both obesity and substance use disorders include cognitive behavioral therapy, 12-step programs, and contingency management. a.
How does food addiction cause obesity?
Overeating, sometimes called 'hedonic' feeding because foods consumed are usually palatable and high in sugars and fats, is the leading cause of overweight and obesity in the US.
What are the effects of food addiction?
This can lead to several physical, emotional, and social consequences, such as digestive issues, heart disease, obesity, low-self esteem, depression, and isolation. A food addict will often re-engage in these destructive behaviors, even amidst undesired consequences, due to the need for induced feelings of pleasure.
Is obesity caused by addiction?
Although the cause of obesity is multifaceted, it is clear that chronic overconsumption plays a fundamental role. When this type of overeating becomes compulsive and out of control, it is often classified as a “food addiction,” a label that has caused much clinical and scientific controversy.
Can food be addictive public health and policy implications?
Data suggest that hyperpalatable foods may be capable of triggering an addictive process. Although the addictive potential of foods continues to be debated, important lessons learned in reducing the health and economic consequences of drug addiction may be especially useful in combating food-related problems.
Who does food addiction affect?
Food addiction occurs in almost 7% in women and 3% in men. Food addiction occurs in 2% of under/normal weight people and 8% of overweight/obese people. Women between 45-64 years old have an 8.4% prevalence rate, while those between 62-88 years old have a 2.7% prevalence rate.
What is a food addiction?
People with food addictions lose control over their eating behavior and find themselves spending excessive amounts of time involved with food and overeating, or anticipating the emotional effects of compulsive overeating.
How many obese people have food addiction?
Addicted to food The Yale Food Addiction Scale, based on these criteria, was designed to assess food addiction in people. According to Klein, evidence of food addiction type of behavior can be found in as many as one-third of people with obesity.
What is the relationship between overeating and obesity?
Binge Eating and Obesity Binge eating is considerably more common among adults with obesity than in the general population, and individuals who binge eat are more likely to become obese than individuals without disordered eating (Hudson et al., 2007).
How common is food addiction?
Up to 20% of people may have a food addiction or exhibit addictive-like eating behavior ( 1 ). This number is even higher among people with obesity. Food addiction involves being addicted to food in the same way as someone with a substance use disorder demonstrates addiction to a particular substance ( 2 , 3 ).
Do you think it's possible to be addicted to a specific food or to food in general?
The human body needs food to provide energy and nutrition. However, people can feel addicted to food when they become dependent on certain types of foods. Any food can make a person feel addictive tendencies.
Can we become addicted to food?
Up to 20% of people may have a food addiction or exhibit addictive-like eating behavior ( 1 ). This number is even higher among people with obesity. Food addiction involves being addicted to food in the same way as someone with a substance use disorder demonstrates addiction to a particular substance ( 2 , 3 ).
Are there foods that are addictive?
The most addictive foodsChocolate.Ice cream.French fries.Pizza.Cookies.Chips.Cake.Cheeseburgers.
How many participants agreed that Sarah was responsible for losing weight?
Three quarters (76%) of participants agreed that Sarah was responsible for losing weight and half agreed that she was responsible for becoming obese. Participants were strongly divided as to whether Sarah exhibited control over her weight (see Table 2 ).
Is food addiction a neurobiological explanation?
According to their advocates, neurobiological explanations of overeating, or “food addiction”, have the potential to impact public understanding and treatment of obesity. In this study, we examine the public’s acceptance of the concept of food addiction as an explanation of overeating and assess its effects upon their attitudes toward obese persons and the treatment of obesity.
How does Overeaters Anonymous help with obesity?
Therapeutic interventions such as Overeaters Anonymous and cognitive behavioural therapy have taken a more holistic approach to the treatment of obesity. Overeaters Anonymous (OA) is based directly on the 12-step programme developed by Alcoholics Anonymous. The OA organisation promotes the central belief that obesity is a symptom of ‘compulsive overeating’, which is an addictive-like illness with physical, emotional and spiritual components [ 450 ]. Individuals are required to acknowledge that compulsive overeating is beyond their willpower to overcome and, therefore, they must attempt to control their intake by avoiding certain foods and surrendering to a ‘higher power’. Just like Alcoholics Anonymous, OA involves group meetings for individuals to share their feelings and experiences. Although the way in which this programme influences outcomes is unclear [ 53 ], the group meetings may act to alleviate feelings of isolation and instead foster a sense of community. As discussed earlier, due to the feelings of shame and guilt and the weight teasing experienced, overweight and obesity are associated with a preference for isolative activities [ 159 ]. This social isolation can subsequently exacerbate overeating, creating a vicious cycle [ 42, 160 ]. It is possible, therefore, that OA acts to break this cycle by providing a supportive and encouraging social environment. However, due to the anonymous nature of OA, there has been little research conducted on its efficacy and it is not understood exactly how OA affects overeating and the extent to which it may do so.
What is food craving?
The term ‘food craving’ typically refers to an intense desire to consume a specific food [ 114, 115 ]. Food cravings appear to be very common with reports of 100% of young women and 70% of young men experiencing a craving for at least one food in the past year [ 116, 117 ]. The most commonly reported craved food is chocolate, although cravings for carbohydrates and salty snacks are also common [ 118, 119, 120, 121, 122 ]. The prevalence of food cravings has prompted the development of several standardised questionnaires that measure food cravings with a good degree of internal consistency and construct validity [ 123, 124, 125, 126, 127 ], including a specific questionnaire just for chocolate (Attitudes to Chocolate Questionnaire) [ 128 ]. Recurrent food cravings are of interest in relation to food addiction as they have been associated with binge eating, increased food intake and increased BMI [ 124, 127, 129, 130, 131, 132 ]. Increased reports of food craving have also been demonstrated in individuals who score highly on measures of self-reported food addiction [ 133, 134, 135] and those with BED and BN [ 136, 137, 138 ]. Furthermore, just as drug craving is associated with an increased likelihood of relapse [ 139, 140, 141 ], food craving has been linked to poor dieting success [ 142, 143, 144 ].
How does tolerance to sugar work?
Tolerance to a substance occurs when the same amount of the substance has an increasingly diminished effect with repeated use. This effect usually results in escalated use as the individual increases their dosage in order to recreate the original experience. There is some evidence of food tolerance in animal models of sugar addiction. Rats given intermittent and excessive access to sugar solution increase their intake significantly over time, and this is accompanied by neurochemical changes that are similar to those seen in drug abuse [ 180, 181 ]. In humans, there is some indication that tolerance to sugar may occur in the first few years of life. The effectiveness of sucrose as an analgesic in young infants is reported to diminish after 18 months of age as sugar consumption increases [ 182, 183, 184, 185 ]. The possibility of such early tolerance to palatable foods and the methodological difficulties of diet restriction in humans makes finding empirical evidence of tolerance in adults difficult and unlikely. However, statistics indicating increased consumption and portion sizes for these foods provide indirect evidence of tolerance to high-fat/high-sugar foods at a population level [ 52, 186 ], and also at an individual level based on anecdotal reports. For example, Pretlow [ 42] found that 77% of overweight poll respondents reported eating more now than when they originally became overweight. Furthermore, in response to a follow-up question asking why they believed that they ate more, 15% indicated that they were less satisfied by food. Hetherington et al. [ 109] also found that when participants were provided with chocolate for three weeks, they increased their intake over time while simultaneously reporting a reduction in food liking.
What is the definition of food addiction?
Addiction was not originally a scientific or a medical term, with a traditional meaning, derived from the Latin addicere, “the state or condition of being dedicated or devoted to a thing , [especially] an activity or occupation” (Ref. 33 ). However, the term addiction is now in common use as a casual label for any excessive habitual behaviour 34. The original definition of addiction is neutral in that the target behaviours do not necessarily harm the individual and some of these behaviours could even be beneficial (for example, devotion to a project, to a charity or to one's family). Therefore, this definition is also indiscriminately broad, as the list of objects to which the addiction label could be applied is unlimited (including, television, social media, shoes and dancing), and scientifically redundant. The use of addiction in its medical sense has only emerged in the past century (the term was not formally included in the main Oxford English Dictionary until 1989) and, unlike the original definition, its meaning is unambiguously categorical (narrowing down the concept to designated classes of drugs) and explicitly negative (capable of causing significant harm or impairment to the individual or society). The rise of the medical concept of addiction has closely corresponded to public and political opinion of drug use in general 35.
What is the Yale Food Addiction Scale?
Over the past 7 years, much of the scientific literature proclaiming support for food addiction has circumvented the issue of having no defined syndrome or symptoms by adopting a proxy definition that is derived from the generic behavioural criteria for substance-use disorders as specified in the DSM. This diagnostic approach has mostly been directed by the development of a questionnaire-based self-report screening tool named the Yale Food Addiction Scale (Refs 37, 38 ). The well-publicized name of the questionnaire is regrettably value-laden considering the emotive and hypothetical status of food addiction 30 and might bias the interpretation of patterns of otherwise normal eating behaviour in studies using the tool. In the latest revision of the scale, 35 items that fall under the 11 generic diagnostic criteria for substance-related disorders in the DSM-V have been adapted so that the class of substance relates broadly to “certain foods” with which people sometimes “have difficulty controlling how much they eat” or “any other foods you have had difficulty with in the past year” (Ref. 38 ). In addition to this conflation of certain or any foods under one substance category, the scale provides 23 examples of potential certain foods listed under five categories (sweets, starches, salty foods, fatty foods and sugary drinks). Therefore, the identification of the specific foods, food categories or biochemical properties that are the reason for a given patient's responses is impossible using this scale. However, researchers can refer to the foods listed in the scale to speculate that any one food, food category or property might account for scores and diagnoses using the Yale Food Addiction Scale.
What are the two classification systems for addiction?
The two leading classification systems for determining medically accepted forms of addiction are the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) published by the American Psychiatric Association 21 and the International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10) from the WHO 64. Both systems recognize ten separate substance-use disorders, and the DSM-V also includes gambling disorder as the only non-substance use addictive disorder. These conditions are generally conferred the status of discrete disease entities and are intended for widespread clinical use as a result of their convincing empirical evidence base or clinical utility. The DSM-V further proposes caffeine use and Internet gaming as conditions for further study. These potential conditions require more research before their inclusion or exclusion as additional distinct disorders can be judged. In the DSM, diagnostic criteria are provided for pica (eating items with no nutritional value), rumination disorder, avoidant or restrictive food intake disorder, anorexia nervosa, bulimia nervosa and binge eating disorder. The term addiction is omitted from the DSM-V diagnostic terminology owing to its ambiguous definition and potential to stigmatize those diagnosed with the condition. Food addiction, whether framed as a substance-related or as a non-substance addictive disorder, has not been approved as a diagnosable entity in the DSM or the ICD. The classification of disorders by their common symptoms does not contribute to understanding of their underlying aetiology or mechanism, and the DSM has been criticized for its lack of validity and for promoting a short-hand approach to diagnosis, bypassing the comprehensive clinical assessment that is necessary to find out more about the course and stability of illness, familial predisposition, biomarkers and response to treatment 65, 66. This criticism should serve as a caution that considerable doubt currently exists about the authenticity of food addiction as a clinical condition.
Is food addiction a clinical disorder?
Controversy over the concept of 'food addiction' and its viability as a distinct clinical disorder is being fuelled by misconceptions on both sides of the debate 1, 2. Much of the confusion has stemmed from academic commentary debating the status of food addiction in the context of obesity 3, 4, 5. Importantly, food addiction is not currently a validated concept; it has not been approved by either of the two leading classification systems for diagnosing mental diseases, which include all medically recognized subtypes of substance-use disorders and eating disorders. No clear scientific proof exists in humans that certain biochemical properties in foods are addictive. Agreement is also lacking on the symptoms of food addiction that a patient might present with in the clinic that would distinguish these symptoms from the defined clinical symptoms of recognized aberrant forms of eating (that is, binge eating disorder, bulimia nervosa and anorexia nervosa). Several major critical reviews have given detailed criticisms examining neurobiological 4, 6, phenomenological or phenotypic 7, 8, 9, and psychometric or diagnostic 10, deficiencies that are damaging to the concept of food addiction. Some researchers have expressed concern that the concept invites the medicalization of natural motivational needs 11, 12. Indeed, no strong evidence exists to substantiate the existence of food addiction that cannot be adequately explained through normal (biopsychological) adaptations to unhealthy lifestyles that are shaped by powerful socio-cultural pressures from the modern (obesogenic) environment. However, the food addiction concept persists. If one conducts an Internet search of the term 'food addiction', more than 12 million results will be found on self-diagnosis, treatment and support for this unfounded condition and over one-third of these results make explicit reference to obesity. In the scientific literature, ardent advocates assert the existence of food addiction in reviews and commentaries, which are often uncritically accepted as evidence. Several conflicting accounts now exist to describe numerous potential aetiological pathways and a range of clinical manifestations attributed to food addiction. A clear clinical definition and test of the validity of food addiction is badly needed. In the meantime, some of the misconceptions that persist around food addiction need to be dispelled, and these misconceptions should be replaced with reasoned biopsychological argument drawing on evidence for the role of appetite and the hedonic (or reward) system in natural homeostatic eating patterns when pushed to extremes.