As a doctoral student at the University of Würzburg in Germany, Adrian Meule
was influenced by Dr. Pretlow’s “Addiction to Highly Pleasurable Food as a Cause of the Childhood Obesity Epidemic: A Qualitative Internet Study” in Eating Disorders: The Journal of Treatment & Prevention.
Meule advocated using the Yale Food Addiction Scale (YFAS) as a standardized measuring device, so researchers could better understand the phenomenon. He came across even then as an original thinker fascinated by orphaned facts and strange coincidences. He pointed out, for instance, that bulimia nervosa patients and binge-eating disorder patients are also drawn to addictive drugs, while patients with anorexia nervosa apparently are not. It is the type of puzzle that can inspire a career.
Even though Meule believed in food addiction, he did not give it credit for causing the entire obesity epidemic. He wrote to Dr. Pretlow at the time, about this and other ideas and mysteries. For instance:
In the studies of Gearhardt et al. (2011) and Davis et al. (2011), many obese individuals had at least 3 food addiction symptoms, but did not receive a “diagnosis” because they did not meet the clinically significant impairment criteria. So, the construction of the YFAS might lead to an underestimation. However, when I administered the YFAS to obese individuals seeking bariatric surgery, I experienced that – although some 40% received a diagnosis – many persons told me that all those questions did not apply to them at all.
Having earned his doctorate, Meule is now at the Hospital for Child and Adolescent Psychiatry in Hamm, Germany. In the past few years he has published articles on emotional eating, bariatric surgery, impulsivity, food-cue affected motor response inhibition, and many more topics.
Recently, along with Vittoria von Rezori and Jens Blechert, Meule returned to the tantalizing similarity between obese patients with binge eating disorder (BED) and patients with bulimia nervosa (BN). In BED patients, they find that:
…eating patterns can show addictive qualities, with similarities to substance use disorders on behavioral and neurobiological levels.
BN patients also show binge eating symptoms, although this has not been much attended to.
Neither the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) nor the previous edition recognized food addiction as an entity, but the Yale Food Addiction Scale was created using the DSM symptom checklist for substance use disorders. Interestingly, there are people of normal weight who fulfill the food addiction criteria – and they are women with active BN.
Meanwhile, among women whose bulimia is in remission, only a fraction as many qualified for a food addiction diagnosis according to the YFAS, and none of the normal control group. Because of these findings, the researchers tend to see bulimia nervosa as an “addiction-like eating behavior.”
Your responses and feedback are welcome!
Source: “Food Addiction and Bulimia Nervosa
Image by thepeachpeddler