This content material initially appeared on Everyday Health. Republished with permission.
By Laura Williams
Medically Reviewed by Allison Young, MD of American College of Lifestyle Medicine
Can the phrase “addiction” — usually related to medicine, alcohol, playing, or different behaviors that performed in extra can significantly harm somebody’s well being and well-being — apply to meals or sure meals?
According to an article within the American Journal of Psychiatry, meals habit isn’t thought-about a medical substance use dysfunction (alcohol use dysfunction and opioid use dysfunction are subtypes) within the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic information utilized by psychological well being professionals.
But some psychologists and diet and behavioral well being researchers who research the subject say possibly it must be.
“While it hasn’t been universally acknowledged as an official diagnosis, the term is used to describe eating behaviors that lack restraint and are [not stopped] despite adverse physical, emotional, or social effects,” explains John Dolores, PhD, a medical psychologist and the COO of Bespoke Treatment, a psychological well being observe based mostly in Los Angeles.
There’s rising proof to again up not solely these claims, but in addition displaying that particular meals do lead to physiological processes within the mind that happen in different forms of addictive habits.
What Is Food Addiction?
According to the Yale Journal of Biology and Medicine, the phrase “addiction” was first used within the context of meals (in a reference to chocolate) in 1890. In 1956, the researcher Theron Randolph, MD, used the time period “food addiction” within the Quarterly Journal of Studies on Alcohol to explain “a specific adaptation to one or more regularly consumed foods to which a person is highly sensitive [which] produces a common pattern of symptoms descriptively similar to those of other addictive processes.”
More just lately the time period “food addiction” has change into related to addictive signs in response to extremely rewarding meals (suppose sweet, ice cream, potato chips, and pizza), says Ashley Gearhardt, PhD, a researcher and an assistant professor of psychology on the meals and habit science and therapy lab on the University of Michigan in Ann Arbor.
She and her colleagues developed the Yale Food Addiction Scale (YFAS) in 2009 to measure indicators of addictive-like consuming habits. Its 25 questions are designed to find out whether or not sure extremely processed meals (chocolate, ice cream, potato chips, and pizza, amongst others) set off addictive behaviors in sure individuals — behaviors that map to the DSM-5’s diagnostic standards for different forms of substance dependence. It’s been proven to be efficient in peer-reviewed analysis, and the most recent model was printed within the journal Psychology of Addictive Behavior.
If you usually expertise a lack of management if you eat, intense cravings, or emotions of unhappiness if you attempt to cease that habits, or for those who discover it troublesome to cease consuming if you really feel full (even when there are destructive penalties), you’re extra prone to meet the YFAS standards for meals habit.
One research from Dr. Gearhardt’s group with a pattern of 500 adults discovered that greater than 14 p.c met the standards for habit to extremely rewarding meals. A meta-analysis of 272 research within the March 2022 European Eating Disorders Review discovered that the general prevalence of meals habit may very well be as excessive as 20 p.c.
People predisposed to habit, in addition to those that wrestle with weight or weight-related issues, are usually extra prone to behave in ways in which align with this definition of meals habit, as do individuals with low vanity, nervousness, and melancholy, explains Dr. Dolores. Research printed in Frontiers in Psychiatry in 2021 backs this up.
But that definitely doesn’t imply that everybody in these teams has these behaviors, Dolores says. And it doesn’t imply that others exterior these teams gained’t have these behaviors, too. “Food addiction can impact anyone, regardless of age, sex, or financial status,” he says.
The Science of Food-Related Addictive Behavior
Here it’s price mentioning that proof, printed in Archives of General Psychiatry, did present that extremely rewarding meals (ones with massive quantities of sugar, fats, and salt) set off the mind’s reward circuitry (particularly dopamine neurotransmitters) in methods much like different addictive substances, like medicine and alcohol.
“When the reward system is activated, the brain experiences a dopamine rush, pushing people to consume more, creating an unhealthy cycle,” Dolores explains.
This dopamine reward system isn’t activated with the consumption of all meals, nonetheless. Gearhardt (who was a coauthor on the Archives analysis) provides that like addictive medicine — that are man-made and particularly designed to stimulate dopamine launch — meals that lead to addictive responses are additionally extremely processed. They are usually man-made and chemically designed to style as scrumptious as potential (which, in flip, prompts the dopamine reward system).
Other analysis checked out mind scans after members ate numerous meals and located that the mix of fats and carbohydrates in meals led to higher activation of the mind reward circuitry than meals with both fats or carbohydrates alone.
“It really is highly processed foods that deliver unnaturally high levels of refined carbohydrates (like sugar) and/or fat that trigger addictive patterns of intake,” Gearhardt says.
She coauthored a paper printed in November 2022 making the case that extremely processed meals meet the standards to be labeled as addictive substances utilizing the requirements traditionally used to deem tobacco merchandise addictive.
It’s price mentioning that in the case of meals habit, Gearhardt and others deal with these extremely processed meals. Naturally occurring and minimally processed meals (like fruits, greens, fish, or eggs) are extremely unlikely to set off addictive behaviors.
Should Food Addiction Be a Clinical Disorder?
Gearhardt says sure, the beforehand talked about paper lays out the proof that sure meals meet the identical standards that classify tobacco as an addictive substance: It causes compulsive use, has temper altering results on the mind, and reinforces sure habits.
“There is a group of us currently working on an application for it to be considered as a provisional diagnosis in the DSM because we believe the research has now reached a point to support it,” Gearhardt says.
Not all well being professionals agree.
The evaluation printed in Frontiers in Psychiatry in 2021 talked about above acknowledges the work of Gearhardt and others, however argues there’s nonetheless not sufficient analysis and proof to outline parameters of meals habit, to not point out medical pointers on how one can diagnose it, deal with it, and stop it. While the YFAS is a well-validated instrument for figuring out symptom severity, there are nonetheless no clinically validated diagnostic standards which might be well-defined and universally accepted, in keeping with the paper.
There’s additionally important overlap between signs of consuming habit, weight problems, and consuming problems like binge consuming dysfunction — and in circumstances the place consuming patterns are problematic, one among these different current diagnoses would possibly apply and is perhaps extra applicable.
The backside line from these arguing in opposition to making meals habit a medical prognosis is that extra analysis on how one can correctly diagnose it, deal with it, and stop it’s wanted first. And till extra research are performed to outline the situation and therapy choices, meals habit is left in a grey space the place clinicians are conscious of the potential prognosis and are working with purchasers with the most recent info out there.
Can You Be Addicted to the Act of Eating?
Some researchers choose the time period “eating addiction,” arguing that the addictive signs are associated to the act of consuming or the habits, reasonably than particular meals.
Gearhardt disagrees. “In our lab, it is overwhelmingly unnaturally highly rewarding foods that are being consumed addictively,” she says. “We don’t see people losing control of their intake of bananas, beans, or chicken breasts.”
The historical past of meals habit additionally doesn’t align with the thought of an consuming habit, because the destructive results of meals overconsumption have actually solely change into extensively prevalent in the newest generations. Gearhardt cowrote a assessment of the proof for this, printed within the journal Psychotherapy and Psychosomatics in 2022.
“We have had to eat for the entirety of human existence. Why did we only just start to see these huge uptakes in excessive overeating, obesity, and diet-related disease? I would argue it is because that’s when cheap, ultra-processed foods started to dominate the food environment, thus triggering widespread addictive patterns of eating,” Gearhardt says.
Overlap With Binge Eating Disorder
Here it’s related to contemplate binge consuming dysfunction (BED), a psychological well being dysfunction wherein you usually have episodes of consuming unusually massive quantities of meals in a single sitting and feeling like you possibly can’t cease — or as in case your consuming is controlling you.
Research exhibits that individuals with binge consuming dysfunction usually tend to additionally meet standards for meals habit than individuals with different consuming problems.
Food habit (as outlined by Gearhardt’s work) is marked by a lack of management when consuming particular meals, emotions of guilt and disgrace, intense cravings, and an incapacity to cease the habits regardless of destructive penalties. And certainly, analysis means that the mechanisms of meals overconsumption overlap in areas like reward dysfunction or impulsivity.
The distinction, nonetheless, is binge episode includes a excessive quantity of meals, however not essentially a particular meals or an awesome drive to eat extremely addictive meals. Someone with meals habit, then again, is prone to expertise a binge episode triggered by a longing for particular meals or forms of meals, just like the extremely addictive meals recognized by Gearhardt and her workforce.
Food habit aligns with an habit framework, whereas BED aligns with an consuming dysfunction mannequin that’s tied to weight or dimension concern and dietary restraint.
So, sure, there are variations, however some consultants say there’s additionally quite a lot of potential overlap between these two phenomena.
“There is an idea that it’s not the food that people are addicted to, but that they are in a restrict-binge cycle,” explains Aisling Crosson, a licensed skilled medical counselor and Health at Every Size therapist in personal observe in Boulder, Colorado.
Effects on Weight Stigma
A medical prognosis of meals habit would possibly enhance the disgrace and stigma that exist round weight problems and the concern of fats, which may additional contribute to the event of restrict-binge cycles and BED, significantly in populations that could be extra prone, Crosson says. It’s a motive she says meals habit shouldn’t be a separate medical prognosis.
A research printed in Obesity in October 2021 concerned experiments to find out if using both obesity-framing or addiction-framing fashions contributed to weight stigma amongst adults. The knowledge confirmed that telling somebody they’ve a meals habit might not truly serve to scale back emotions of stigma or guilt round weight, however may enhance these emotions.
You Think You May Be Addicted to Food: Now What?
If you’re involved you could be combating meals habit, Gearhardt encourages you to first discuss to a health care provider to find out if there are different underlying medical points that may very well be taking part in a job, like a thyroid subject.
If there isn’t any underlying medical subject, however you’re involved about your consuming habits or consuming patterns in the case of particular meals or eventualities, take into account speaking to a dietitian or therapist. All psychological well being care professionals licensed to diagnose medical problems ought to be capable to establish and diagnose an consuming dysfunction, however somebody who makes a speciality of consuming dysfunction therapy might need extra expertise growing a therapy strategy round your particular issues, Dolores says.
Treatment for consuming problems can embrace cognitive behavioral remedy for consuming problems (CBT-E), different forms of discuss remedy (or psychotherapy), diet counseling, medicines, and a few integrative remedy approaches (like yoga, meditation, and acupuncture).
There are not any formal therapy pointers for consuming habit, as it’s not at present a medical dysfunction, however researchers have posited that comparable psychotherapeutic approaches, in addition to nonsurgical mind stimulation methods, resembling transcranial magnetic stimulation (TMS) — throughout which magnetic fields are used to stimulate nerve cells within the mind — may assist.
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