In a sense, we are all addicted to food. Think about what it feels like when you aren’t able to eat. You start to crave food, and become more physically and emotionally uncomfortable the longer the cravings go on for, until eating becomes the most important thing for you to do. This is the experience of all addicts.
Food is essential to survival, and unlike other addictive behaviors, it is normal to eat repeatedly every day, and to look forward to eating for pleasure. But several characteristics separate normal or occasional binge eating from a food addiction.
Firstly, food addiction is maladaptive, so instead of enhancing the person’s life, it is detrimental. Food addiction can threaten health, causing obesity, malnutrition, and other problems.
Secondly, it is persistent, so a food addict eats too much food -- often the wrong kinds of food -- too much of the time. We all overeat on occasion, but food addicts overeat every day, and as the individual’s principle way of coping with stress, they experience anxiety if they are unable to do so.
The Controversy of Food Addiction
Like other behavioral addictions, food addiction is a controversial idea. Many experts balk at the idea that over-eating can constitute an addiction, believing that there has to be a psychoactive substance which produces symptoms such as physical tolerance and withdrawal for an activity to be a true addiction. Although this has been demonstrated in research with sugar and fat (the two most common obesity-causing constituents of food), and other studies show that food produces opiates in the body, these are often not considered comparable to other substance addictions.
However, the growing epidemic of obesity over the past 20 years has raised public health concern. In almost all US states, one in five adults is obese. Childhood obesity was ranked as the top health concern for children in 2008, higher than either drug abuse, rated second, or smoking rated third, both of which were ahead of obesity in 2007.
This concern, along with effective treatments for addictions, which are being successfully applied to more and more problematic behaviors, is contributing to a movement towards understanding over-eating, and the consequences of obesity and related health problems, in terms of addiction.
Food addiction is not currently included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), although a working group of professionals recently suggested diagnostic criteria. Excessive eating is a characteristic of several eating disorders outlined in the DSM, including Bulimia Nervosa, and sometimes Eating Disorder NOS (specifically Binge-Eating Disorder). At present, it is unclear whether eating disorders are addictions.
How Is Food Addiction Like Other Addictions?
There are several similarities between food addiction and drug addiction, including effects on mood, external cues to eat or use drugs, expectancies, restraint, ambivalence, and attribution.
Neurotransmitters and the brain's reward system have been implicated in food and other addictions. In animal studies, for example, dopamine has been found to play an important role in overall reward systems, and binging on sugar has been shown to influence dopamine activity.
Food, drugs and other addictive substances and behaviors are all associated with pleasure, hedonism, and social, cultural or sub-cultural desirability. When advertising or the people around us tell us that a food, drug or activity will feel good, it sets up a self-fulfilling prophecy. We are more likely to seek it out, and we are more likely to experience pleasure when we indulge.
A Unified Theory of Addiction and Mental Health?
Similarities between food addiction and other addictions suggest a universal process underlying food and other addictions. Some experts go further, theorizing that overlaps, similarities, and co-occurrences of mental health problems, including addictions, depression, obsessive-compulsive disorder and eating disorders, and the phenomenon of a new addiction or mental health problem developing when an old addiction is treated, indicate that they are expressions of related underlying pathologies. It has been argued that viewing these conditions separately hinders the development of a comprehensive view of addictions.
More evidence is needed to support these proposed ideas, and at present, professionals differ in the extent to which they see these problems as related.
Sources
Centers for Disease Control and Prevention. U.S. Obesity Trends 1985–2007. 8 Jan 2009.
C.S. Mott Children’s Hospital, the University of Michigan Department of Pediatrics and Communicable Diseases, and the University of Michigan Child Health Evaluation and Research (CHEAR) Unit. National Poll on Children’s Health. 8 Jan 2009.
Food & Addiction Conference on Eating and Dependence New Haven, Connecticut. July 2007.
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