We’ve been told that sugar is a drug and that having a “food addiction” is responsible for the struggles that so many individuals face when it comes to overeating, obesity, and a poor relationship with food. Many experts feel strongly that food can be addictive, while others say that it simply feels like an addiction.
So today we are diving into both sides of the argument so we can better understand: Is it really possible to be addicted to food?
Defining Addiction
Many researchers are pushing to have food addiction recognized in an upcoming version of the DSM. In an attempt to do this and make the argument for food addiction being a diagnosis, the Yale Food Addiction Scale (YFAS) has been utilized a lot to form an argument.
The Yale Food Addiction Scale was developed as a tool to measure food addiction by assessing DSM-5 criteria for substance use disorder but assessing the criteria in the context of food intake instead.
But before we discuss if someone can be addicted to food or act like “a drug”, we need to get clear on what we really mean when we say “addiction.”
This is honestly probably the biggest reason there are many polarizing opinions about food addiction in the scientific community: are we talking about a drug-like addiction, or just eating in high quantities?
So let’s discuss addiction in its most familiar and understood context: drugs. Drug addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. It involves functional changes in the brain circuits related to stress, the reward system, and self-control. In a true addiction, changes may last long after a person has stopped taking drugs.
Food Addiction vs Drug Addiction
When we consider this definition, we can see some crossover between food “addiction” and drug addiction.
For example, binge eating disorder involves a loss of control over the eating episode and is happening at least once a week for 3 months. This is not dissimilar to drug addicts who have a chronic, relapsing compulsion to take the drugs. In the case of binge eating disorder, there’s a chronic, relapsing compulsion to eat the food, and that compulsion is strong enough to make that individual feel out of control.
Psychological dependence on food is also possible, thanks to some’s reliance on it for mood enhancement or as a coping mechanism for stress or negative emotions. There is a connection between eating and how we deal with stress, our reward systems in our brain, and our ability to self-regulate i.e. have self-control.
For example, this systematic review of 32 studies looked at neuroimaging in bulimia nervosa and binge eating disorder and found that there are reductions in the overall size of the brain, as well as diminished activity in the frontostriatal circuits – which is a region associated with self-regulation.
Furthermore, there is possibly some dysregulation in the reward center of the brain and even impulse control issues.
But is overeating and even binge-eating food on the same caliber as an addiction?
Differences Between Drug Addiction and Food Addiction
In a 2018 paper published in Neuropsychopharmacology, the two authors debated the concept of food addiction and whether there was true merit in using that phrase or not.
In an argument against food addiction, one of the authors, Paul Fletcher, notes, “[Food addiction] carries the claim that this resemblance occurs because certain foods have effects on the brain comparable to those of addictive drugs.” He goes on to say that “the assertion that foods have pharmacological effects on the brain demands strong and convincing evidence, which has not been found.”
Put simply, the idea that sugar is essentially a drug and that people can be literally addicted to it? Probably not accurate.
In his argument, Fletcher points out the fact that there has been no one specific substance found to be addictive in food. We know, for example, that nicotine is the addictive substance in tobacco products, but what is the addictive substance in foods?
If it were sugar, then why are we also finding ourselves addicted to potato chips which have no added sugar? Wouldn’t we also be seeing people walk into a supermarket to crack open a bag of table sugar and down it right in the middle of the aisle? If it were salt, then why are we finding ourselves addicted to foods like candy, cookies, and ice cream which have very little salt added?
The Yale Food Addiction Scale helps shed some light on these questions.
Is Food Addictive?
According to the Yale Food Addiction Scale, when people wonder if they’re addicted to food, the concern isn’t an addiction to one particular substance. Instead, what we seem to be addicted to broadly speaking is ultra-processed foods that have been engineered to taste really freaking good.
Those foods are generally high in both refined carbohydrates and fat. This is not something we see naturally occurring in nature, which makes those foods extra special…and extra tasty with the addition of flavors, salt, and other additives. We’re also seeing a rise in the availability of these foods, making this “food addiction” problem seemingly worse.
These foods are often low in fiber, easy to eat quickly, and calorie-dense. This means it’s easier to consume more calories in a shorter amount of time, which could be a part of why they’ve developed an “addictive” reputation – because more calories are being consumed more quickly.
If you’ve ever accidentally eaten an entire bag of chips in one sitting, then you know just how easy it can be to eat these types of ultra-processed foods. Still, this doesn’t mean that food addiction is worthy of being its own mental health diagnosis.
Food Addiction vs Binge Eating
Fletcher also argues that there is too much overlap between binge eating disorder and food addiction to justify food addiction being its own diagnosis. He states there needs to be more validity and reliability of other characteristics for food addiction to be its own condition, suggesting more consideration on the topics of tolerance and withdrawal.
When it comes to food, there just simply isn’t the same physiological withdrawal and physical dependence issues that there are with drug and alcohol addiction.
He argues against all the rat studies done on food addiction and makes the valid point of how we cannot directly correlate those in humans. Our food environment, emotions, and decision-making abilities are just so vastly different from rats, and we (for the most part) have regular access to food rather than constrained access, such as in the context of a science experiment done on rats.
And then when we look at human studies, there’s also not enough compelling evidence in humans to justify food addiction as being a real condition either.
There is definitely an argument for there being similar dopaminergic pathways for reward in the brain as a result of these addictive-like foods, and the author Paul Kenny discusses this at length in the paper, but we have to keep in mind that this nowhere near the magnitude of euphoria/buzz/high that somebody gets off of a drug or from excessive alcohol use. Overall they share similar neurological pathways, but the highs/lows are vastly different.
So is it really that justified to say we can be addicted to food if the responses in the brain, though similar in pathways, are vastly different in the degree of severity?
Perhaps you can see now why this is such a hotly debated topic.
The Verdict: Is It Possible to Be Addicted to Food?
The last thing I’ll mention on this topic is that having a tumultuous relationship with food marked by “good” and “bad” labels can often drive us towards those “bad” foods even more.
Not surprisingly, those foods thought to be bad are also the ultra-processed foods that people vilify and claim to be highly addictive, and that our research mentioned earlier is shown to be addictive-like. This can increase the feelings of being addicted to that food simply because you struggle with self control around them and there’s feelings of guilt, shame, and rebellion at play.
Remember that no 1 food is inherently good or bad for you, unless you’re a) allergic to it b) it’s expired/spoiled c) it has shards of glass in it (but let’s hope that last one was pretty obvious!).
In summary, when looking at the topic of food addiction we need to consider a few things:
- We need to be sure we are clear about what we mean when we say “addiction”, and specify if we mean truly addictive like a drug, or just addictive-like.
- There should be a clear substance in food that influences the sense of addiction, and at this point there is no 1 specific substance in food that we know of
- Rather, it’s a combination of factors that make a food highly palatable such as refined carbohydrates, fats, sugar, salt, and other food additives.
- Food “addiction” could be refuted simply by the fact that withdrawals and the euphoria from food is nowhere near to the caliber of substance abuse.
- We may feel more addicted to food simply because we decided that some foods are off-limits, which creates a complex psychological reaction to those foods, making us feel “addicted”.
- Psychological dependence may occur due to reliance on that food for mood enhancement or as a coping mechanism for stress or negative emotions.
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