Inherency and Food Addiction — Some Thoughts

We have quoted before from a landmark 2014 paper with a dozen authors, titled “‘Eating addiction’, rather than ‘food addiction’, better captures addictive-like eating behavior.”

Humans who overeat usually do not restrict their diets to specific nutrients; instead the availability of a wider range of palatable foods appears to render prone subjects vulnerable to overeating…

It can be argued that access to a diversity of foods, especially a diverse range of palatable foods, may be a pre-requisite for the development of addictive-like eating behavior.

In other words, while it is pretty clear that manufacturers are at fault for messing around with the ingredients of processed foods, something else is going on too. Why might it be suspected that the problem is inherent in or intrinsic to the human being who eats too much and becomes too large? This is not a “blame the victim” move, but an acknowledgment that some of the causality might originate with the individual, whether they had any control over it or not.

Why would they not? Maybe because of their chromosomes. Maybe because of societal forces, whether blunt or casual. What makes a “prone subject”?

Psychology professor Bruce Alexander (of Rat Park fame) has noted the importance of the discovery that many medical patients who have been prescribed opiates for months at a time are able to quit very successfully — no muss, no fuss.

As writer Johann Hari phrased it,

The same drug, used for the same length of time, turns street-users into desperate addicts — and leaves medical patients unaffected… Professor Alexander argues this discovery is a profound challenge both to the right-wing view that addiction is a moral failing caused by too much hedonistic partying, and the liberal view that addiction is a disease taking place in a chemically hijacked brain.

On the social front, Dr. David Kessler has called food addiction “the most socially acceptable fix in our society,” which seems fair in the realm of substances, anyway. It is true that unlike alcohol abusers and hard drug addicts, people whose lives are dominated by food and eating never go to jail for it. The downside is, whether it is called food addiction or eating addiction, the concept is treated like a joke, which it most certainly is not, when a person is helplessly caught in its trap.

Political journalist George Monbiot went so far as to say,

When alcoholism and drug addiction are discussed, the tone tends to be sympathetic. When obesity is discussed, the conversation is dominated by mockery and blame, though the evidence suggests that it may be driven by similar forms of addiction.

There was a time, before all this complicated stuff was discovered, when people didn’t even know there was such a thing as drug dependence or addiction, and simply concluded that their obstreperous relatives were possessed by demons, or whatever. Could it be that our current suppositions will turn out to be equally fanciful?

What if, for instance, reincarnation were to be proven as the mechanism behind human life? What if some people cannot stop eating because in their last lifetime they were starved? Or conversely, because in a previous life they were a powerful, wealthy and enormous person in the HenryVIII mold, who feels entitled to consume every deer and partridge in the kingdom? While that may seem improbable, it is possible that while scientists argue the fine points, some new discovery could come out of the left field and render all previous theories moot.

Even as the various food addiction and eating addiction points are being made, empirically there does seem to be some benefit in treating compulsive overeating with the programs and protocols designed to help addicts. If treating it according to an addiction model is effective, it seems sensible to do that while still figuring out the big picture.

Your responses and feedback are welcome!

Source: “’Eating addiction’, rather than ‘food addiction’, better captures addictive-like eating behavior,” ScienceDirect.com, November 2014
Source: “The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think,” HuffiPost.com, 01/20/15
Source: “Alzheimer’s could be the most catastrophic impact of junk food,” Guardian.co.uk, 09/10/12
Image by Ann Longmore-Etheridge/Public Domain

Inherency and Food Addiction and Factors

Food Addiction (FA) causality will probably never be a settled matter because, in matters like this, various factors can change. It is difficult, in other words, to do any kind of deliberate study in the real world because we cannot set hard rules about what the conditions will be.

One part of the multi-faceted conversation says that all or some foods can contain substances that act like hard drugs in the human body. Here is an example of how controlled experiments are not compatible with life in the wild. Just when that issue was starting to be explored, the food processing corporations were seriously ramping up their efforts to prove that there is indeed such a thing as FA, and a whole industry eager to sell it to us.

More data, more problems

The multidisciplinary NeuroFAST program was designed to figure out whether FA exists, and in the course of about five years compiled a massive archive of findings. Not surprisingly, the more deeply researchers look into these issues, the more complicated everything becomes. One conclusion contains a lesson in the futility of making generalizations:

Our epidemiological studies have identified risk factors for the onset of substance use and eating disorders and have found these to differ widely depending on age, gender, sample and individual diagnoses.

The relationship between eating and addiction problems differs by age and gender.

As befits a multifactorial problem,

This multidisciplinary project explored the neurobiology of addiction and eating behaviour and the complex socio-psychological forces that can lead to its dysregulation.

And get this:

Food addiction-related overweight/obesity cannot be identified using anthropometric, metabolic, biochemical or adrenal hormonal parameters… These forces include dietary components (e.g. highly palatable foods and alcohol), some of which may have addictive properties, but also cultural and social pressures and cognitive-affective factors (perceived stress and stress regulation, anxiety and depression), and family-genetic influences on these.

Under the “Limits to Our Understanding” subhead, one of the limits is,

[W]e do not know the importance of ”food addiction” as an obesity factor in women, or what mechanisms underlie gender differences in eating behaviour…

While the hormones ghrelin and leptin have been intensely scrutinized because of their influence over the presence or absence of eating urges, little attention has been paid to what the female hormones can accomplish in this regard. An interesting discovery has been made about obese and overweight women. A cerebral positron emission tomography test can tell the difference between an addicted woman and a non-addicted one. And let us never forget,

In rodents, females are more vulnerable than males to weight gain in response to intermittent sweet treats.

Your responses and feedback are welcome!

Image by madaise/CC BY-ND 2.0

Inherency and Food Addiction — Oh No! More Wrinkles

Where is the handle to grab this problem known as Food Addiction (as distinct from Eating Addiction), which may or may not have consistent rules? Is it the particular kind of food, or something found in many foods? Is it not even caused by food at all? Where and what is the addictor? Or is the problem inside the person? Why do corporations take such outlandish measures in their effort to make food as addictive as the major drugs?

Obviously, the profit motive is involved in a big way. If a company can amass fortunes by selling its customers something that will diminish their quality of life and possibly even kill them, why should the manufacturers care, any more than the leaders of a drug cartel care if their heroin kills people? It’s just business.

Sound familiar?

But extra-paranoid people suspect that something else comes into play. They relate it to, for instance, Orson Scott Card’s science fiction novel, Xenocide.

The colonizers of a planet had introduced a genetic mutation that would cause some of their brilliant population to suffer from OCD, so distracting that it would prevent the individuals from being able to concentrate on seizing power, if the thought ever happened to enter their heads. Which it wouldn’t, because they were so wrapped up in counting and other obsessive-compulsive rituals.

Is there some powerful force or entity that wants Earth’s population anesthetized, immobilized, demotivated and hypnotized, collapsed in a limpid pile in front of an electronic entertainment device, too heavy to move very far and too preoccupied to know or care what goes on in society? If there were such a force or entity, it could thrive by employing this method.

To sum up so far: First, a very weak case for addictive substances in natural foods. Second, an increased possibility for an addiction-like reaction when processed food comes into the picture, which it mostly has for most people on the planet’s surface. There is another whole side to this matter. To what extent is the propensity to become food-addicted (or eating-addicted) inherent in the person?

More questions

There is a problematic difference between addiction to a substance, and addiction to eating; along with and despite the suggested possibility that some foods actually do contain chemically addictive substances. But then why doesn’t everyone who eats those foods become addicted? Dr. Pretlow says,

Only a subset of individuals who are exposed to substances with addictive potential develop addictive behaviors, just as not all people who are exposed to foods and diet patterns that pose difficulties with weight control become obese.

And yet, so many people find it impossible to shed their addictions, whether categorized as substance, behavioral, or other. Dr. Pretlow has written that addiction and obesity “both reflect the consequences of ingestive behavior gone awry,” and notes the core similarities between these conditions:

First, in terms of clinical diagnostic features, both addiction and obesity result from repetitive foraging and ingestion behaviors that intensify and persist despite negative and (at times) devastating health and other life consequences.

Likewise, despite often repeated attempts to reduce or quit using addictive substances, relapse is common in the addiction recovery process, just as those with obesity who attempt to regulate their food intake through dieting frequently relapse and return to their elevated body weight.

Your responses and feedback are welcome!

Image by dschmieding/CC BY 2.0

Inherency and Food Addiction — More Wrinkles

The subject is still the validity of food addiction as a concept, and now we’re talking about the intentionality of it. Dr. Pretlow once wrote,

Dr. Wang […] commented […], “We make our food very similar to cocaine now.” [CNN, 2010]. He added, “We purify our foods,” which concentrates the pleasurable ingredients, just as cocaine producers purify the coca leaves to make cocaine.

This attitude is capsulized in the famous potato chip commercial, “Bet you can’t eat one!” By which the manufacturers meant, “You can’t eat just only one; you won’t be able to stop.” And they were more right than they knew. Apparently, back in the 1950s, Lay’s was the first corporation to advertise snack food on TV! In those days, potato chips pretty much stood alone, because the lavish variety of chips had not been developed yet.

As chip after chip flooded the market in the ensuing years, they all followed the lucrative pattern of proving to customers that the darn things were so enticing, that to close the bag before it was empty would be a painful sacrifice.

Youse ain’t prove nuttin’

H. Ziauddeen and P. C. Fletcher wrote,

The hyperpalatable foods that are thought to be addictive are widely available and widely consumed. To consider that they may become addictive in some individuals will require the characterization of a specific feature (or several features) of these foods that acts in concert with certain individual vulnerabilities.

That was almost 10 years ago, and while universal agreement that people can become addicted to the natural substances in foods has not been arrived at, considerably more experts have made the case that a certain something can be, and is, built into many processed foods — a characteristic that very closely resembles addictiveness. As Dr. Pretlow has said, “The sensory aspects of food are engineered to encourage consumption.”

In the debate over whether food addiction is a valid and useful concept, this is a very considerable wrinkle indeed. Nowadays, we’re talking about overdoses of ingredients that may be fine in small amounts, like salt; plus a vast assortment of chemical additives; and who-knows-what other tricks of the trade.

Addiction specialist Dr. Vera Tarman, the co-author of Food Junkies: The Truth about Food Addiction, self-identifies as one of the many who have struggled with overeating in her own life. She draws the distinction between natural foodstuffs and “manipulated” products. There, she describes some of the measures that nature put in place to safeguard against overindulgence, the built-in boundaries that formerly kept a leash on the human craving for mouth pleasure:

While a non-addicted eater may be able to ‘relearn’ how to curb the use of their favorite foods, the food addict cannot. For those in the population who are more vulnerable to the ‘quick fix’ potency of processed foods – foods that act as if they are a drug – eating a favorite food, however small the portion, is a trigger, a tease. The food addict’s ‘stop’ switch has become battered. In the same way that a type 2 diabetic has developed insulin resistance, the food addict can be regarded as having developed a dopamine resistance. Relapse inevitably follows.

Your responses and feedback are welcome!

Source: “Is food addiction a valid and useful concept?,” NIH.gov, January 2013
Source: “Guest Post: Food Abstinence for Food Addicts: Deprivation or a New Freedom?,” DrSharma.ca, February 2015
Image by Marcu Ioachim/Public Domain

Inherency and Food Addiction, a Wrinkle

Recent posts have rehashed the points made by various authorities about whether food, or some components of food, or components of some foods, can be physically addicting in the same way as heroin, cocaine, alcohol, nicotine, etc. Or maybe, the situation is that people who are genetically or psychologically vulnerable can be physically addicted by these components, while others are untouched. All these questions took a back seat when the makers of food products accepted the challenge of proving that food can, indeed, be addictive, or at least something very close to it.

In a paper previously quoted here, one significant phrase sticks out like a sore thumb:

Humans who overeat usually do not restrict their diets to specific nutrients; instead the availability of a wider range of palatable foods appears to render prone subjects vulnerable to overeating.

Of course, “palatable” just means pleasant, acceptable, or satisfactory; and hopefully, most foods fulfill those qualifications. It seems apparent that what they meant is closer to “hyperpalatable,” a description that Childhood Obesity News has covered extensively.

The point being, while there may be little evidence for the presence of addictive substances in natural foods, the food industry has a few tricks up its sleeve. And that’s the wrinkle in this particular debate — namely, very powerful corporations work extremely hard to change natural foods into chimerical potions designed to hook people and keep them hooked.

Here are some words from an organization that has looked deeply into these matters:

[I]t appears that the reward value of food can overwhelm the body’s energy balance mechanisms that otherwise regulate feeding, leading to intake of calories beyond hunger and nutritional requirements. In our obesogenic environment, we are surrounded by inexpensive palatable foods that are high in sugar, fat and calories.

For years, this problem has been discussed from all angles. Senior reporter Anna Almendrala wrote for HuffPost.com,

Is food addiction real, and should food industries be held accountable for engineering hyper-palatable sugar-salt-fat bombs that override feelings of fullness? Or is it more accurate to describe overeating as an eating addiction — a disordered relationship to all foods that can and should be brought to heel by the individual?

In this area, one word makes an expensive difference. If engineered food is, in and of itself, potentially addictive, then manufacturers should be held liable. If the obese customer’s addiction is to eating, well sorry, it’s all on them. Almendrala quoted clinical psychologist Ashley Gearhardt:

Humans have been eating food since we’ve been in existence, but we haven’t seen this boom in eating-related problems, binge eating and obesity until very recently…

She cites the “vast amount” of interest and attention this matter has been receiving, concerning differential brain responses and the eating behaviors associated with engineered foodstuffs, saying,

[W]e need to keep evaluating […] our understanding of how our food environment is potentially negatively impacting us as a society — especially children.

Your responses and feedback are welcome!

Source: “’Eating addiction’, rather than ‘food addiction’, better captures addictive-like eating behavior,” ScienceDirect.com, November 2014
Source: “The Biology Behind ‘Food Addiction,” undated
Source: “Food Addiction vs. Eating Addiction: Why A Single Word Makes All The Difference,” HuffPost.com, 09/23/14
Image by dschmieding/CC BY 2.0

Inherency and Food Addiction, Some Interesting Points

In the previous posts on the debate over whether food can have inherent or intrinsic addictive properties, we mentioned the final report summary from NEUROFAST on “The Integrated Neurobiology of Food Intake, Addiction and Stress.” This document summed up the findings from five years of extensive and multidisciplinary studies.

For a comprehensive list of key findings, plus explication, see the report, but these are some interesting highlights:

1B: Different eating disorders have different patterns of association with substance
abuse disorders.

1C: [There is] evidence for pathways involved in the relationship between eating and substance
disorder onset.

3B: Reward consumption activates brain regions conventionally thought to be involved in homeostatic control of food intake.

Once again, the multifactorial nature of a problem is clear. There are a number of different recognized eating disorders (and maybe even one or two as yet unidentified.) The struggle that some individuals have with food and eating certainly resembles addiction in many respects.

Yet the basic contradictions, as previously described, still persist. If some foods are addictive, why isn’t everyone hooked on them? Is it the food itself, or the more subtle rewards of handling internal and external conflict with displacement behaviors? In the realm of treatment, how do we get past the irrefutable fact that nobody can quit eating?

Meanwhile, here are some of the chemically interesting facets of the integrated neurobiology of food intake, addiction, and stress:

6E: Sweet taste and postingestive effects of food both support motivation for food. The postingestive effects of carbohydrates increase the motivation for food through an incentive learning mechanism.

3A: Ghrelin, a metabolic signal, modulates the rewarding value of food.

3C: Central kappa opioid receptors are a suitable drug target for the treatment of obesity and some associated co-morbidities.

3F: Different neural circuitry is implicated in different aspects of addictive behaviour… [D]ifferent neuropeptides specifically modulate addiction-related behaviors.

6B: In rodents, the hypothalamic oxytocin system is promptly and robustly activated by intragastric delivery of high calorific food.

In the section labeled “Limits to Our Understanding,” an interesting question is posed. If it is shown that some foods are particularly addictive, could it be that other foods are protective against this reaction?

The authors will go so far as to acknowledge an evident link between eating disorders and other disorders based on reward-seeking, such as substance abuse. But when it comes to common susceptibility factors, they cite a “critical ‘missing link’ in human data.” Nor do we have a good understanding of the common neurobiological substrate from which the mechanisms common to food reward and chemical drug reward originate. Also incompletely understood is “the relationship between psychopathology, stress, body weight and stimulatory behaviors of the reward system.”

Your responses and feedback are welcome!

Source: “Final Report Summary — NEUROFAST (The Integrated Neurobiology of Food Intake, Addiction and Stress.),” Europa.eu, January 2016
Image by Andrew Malone/CC BY 2.0

Inherency and Food Addiction, Continued

The previous post mentioned some of the authorities who have a hard time justifying a scientific basis for the intrinsic addictiveness of foodstuffs. But always, there is just enough evidence to make the possibility tantalizingly attractive to many parties, for various reasons.

The title “The Biology Behind ‘Food Addiction‘” puts the loaded term in quotation marks, and discusses the activation of reward systems:

[T]he activity of the endogenous, natural, opioid system is influenced by ingestion of palatable diets, and […] changes in the activity of the system in turn affect behavior, feeding and, perhaps, diet preference.

Similarly, both dopamine release and dopamine receptor levels are affected by palatable diets. From this it is apparent that dysfunction of these systems has the potential to contribute to overeating and the pathophysiology of obesity.

The authors explain that brain reward systems evolve to reinforce natural behaviors that are advantageous to the individual. Addictive substances connect up with the same reward systems and subvert them, making their existence a liability rather than an asset. Still, this does not constitute convincing proof that foods or food components should be considered addictive in the same sense as, for instance, cocaine.

The same organization published in 2016 a multi-faceted report on their investigations into “clinical, basic, and epidemiological research exploring the neurobiological interface between food intake, reward and stress.” They found slender evidence to support the idea that food or isolated ingredients can cause addiction in the same sense as addictive drugs.

Sugar probably presents the strongest case for thinking of a food as addictive, but the notion of sugar addiction left this team unmoved for a number of reasons:

[W]e find little evidence to support “sugar addiction.” Indeed, in animal studies we found divergence regarding brain pathways involved in reward behavior for a sweet reward from those that specifically modulate addiction-related behaviors.

The authors went on to speak of the importance of interactions between the brain’s reward pathways and the regulatory circuitry in the body that pertains to feeding. They mention the poor understanding of the neural substrate that makes this all happen, or not happen, as the case may be. It is known that the hormones leptin and ghrelin signal for other things to occur, but lining up their actions with the origin and persistence of eating disorders was nowhere near complete enough to be positive about anything.

In summation,

There is a reasonable expectation that this interaction is key to the addictive properties of specific food components and the emergence of disordered eating. But it is poorly understood how food components affect the reward circuitry, and to what extent hormones provide the link between ingestion of food and reward, and we have a poor understanding of the addictive properties of individual food components.

Your responses and feedback are welcome!

Source: “The Biology Behind ‘Food Addiction'”, Cordis.europa.eu, undated
Source: “Final Report Summary — NEUROFAST (The Integrated Neurobiology of Food Intake, Addiction and Stress.),” Cordis.europa.eu, January 2016
Image by Robin Stickel on Unsplash 

Inherency and Food Addiction

Debate continues about whether some foods can be addictive in the same sense as, for instance, heroin. Is the addictiveness inherent in the food, or in the person? Or does it have to be both, two variables with the potential to cause damage, and when they meet up, the person is doomed to a lifetime of struggle?

A 2020 paper by Dr. Pretlow and three co-authors says,

There is increasing interest in whether overeating/obesity stems from an addictive process, although this notion is controversial… Food addiction (FA) connotes a substance dependence on ingredients in food, e.g., sugar, and is comparable to drug and alcohol dependence. The FA construct involves addictive eating of certain foods, which are craved, sought out, and eaten in excess.

At the same time, there is “a dearth of evidence supporting substance dependence on food ingredients.” For starters, all foods do not have the same power over people, which opens the way for facetious questions like, “Why there are so many chocolate addicts and so few broccoli addicts?” To complicate matters even further, legit substance dependencies like drug and alcohol addiction also have behavioral components. Even years ago, an important point was being made:

Labeling a food or nutrient as “addictive” implies that it contains ingredients and/or possesses an inherent property with the capacity to make susceptible individuals addicted to it, as is the case for chemical substances of abuse.

In practical terms, inherency means that no matter how expensive a substance may be, people will buy it. They will stick a hypodermic syringe between their toes to get it into their bloodstream, and risk imprisonment and disgrace. In food terms, they would eat it whether they were hungry or not, and even if the stuff tasted awful. If it meant going to jail, they would do it anyway. In all honesty, it would be difficult to name a food with those properties.

A 2014 paper encouraged professionals in the field to begin thinking in terms of “Eating Addiction.” Even though in practical terms, such foods as corn, wheat, coffee, milk, eggs, and potatoes do a very good job of making a case for addictiveness, there seems to have been difficulty in identifying any chemical or “substance-based” causative agent.

Officially, this was the state of affairs at the time:

The currently available evidence for a substance-based food addiction is poor… Humans who overeat usually do not restrict their diets to specific nutrients; instead the availability of a wider range of palatable foods appears to render prone subjects vulnerable to overeating.

The new DSM-5 (APA, 2013) currently does not allow the classification of an “Overeating Disorder” or an “Addictive Eating Disorder” within the diagnostic category Substance-Related and Addictive Disorders; indeed, the current knowledge of addictive eating behaviors does not warrant such a diagnosis.

[T]here is currently insufficient scientific evidence to label any common food, ingredient, micronutrient, standard food additive or combination of ingredients as addictive.

Your responses and feedback are welcome!

Source: “Treatment of the sensory and motor components of urges to eat (eating addiction?): a mobile-health pilot study for obesity in young people,” Springer.com, 01/14/20
Source: “’Eating addiction’, rather than ‘food addiction’, better captures addictive-like eating behavior,” ScienceDirect.com, November 2014
Image by whologwhyCC BY 2.0

Some Wrinkles in the Food Addiction Concept

Many aspects of the food addiction (FA) concept can be discussed extensively, including whether we are talking about a substance addiction or a behavioral addiction, or both, or neither; and even whether there are more than two main camps.

Discussing FA is tricky because a good argument can be made that it is a behavioral addiction to one or more of an assortment of displacement behaviors including biting, chewing, licking, sucking, crunching, swallowing, etc. Yet at the same time, it is undeniable that what these people eat is food. Sure, in a few exotic cases people cannot stop eating styrofoam or mattress stuffing. But for the vast majority, what they are eating is food (or at least it is marketed as such).

One belief is that what is called food addiction is actually a subset of drug addiction. While some edible substances apparently have a drug-like effect on the brain, this is by no means a blanket truth. The conditions characterized as sex addiction and love addiction also produce endogenous chemicals like oxytocin, but relating this to someone who scarfs down a pound of potato chips at one sitting is a stretch.

In “The View from Rat Park,” Bruce Alexander explained how rats who had morphine available consumed a lot more of it when they were isolated:

This fact definitely undermined the supposed proof that certain drugs irresistibly cause addiction. [T]he drug only becomes irresistible when the opportunity for normal social existence is destroyed.

Under such conditions, both rats and people consume too much of whatever drug is made easily accessible to them. [I]t is not too early to be sure that the old theory that addiction is a problem caused by addictive drugs is far too simple…

Moreover, it has become absolutely clear that drug and alcohol addiction is only a corner of a much larger addiction problem!

A basic difficulty in this type of study is that lab subjects and lab conditions are very different from real life. Of course, lab conditions must be strictly controlled, and much discipline must be observed. Some argue that there is no way to know what rats are feeling, which is a good point. We can only presume from the way they act. Rat Park showed that the closer the conditions are to real life — i.e., replete with variables — the more difficult it becomes to tease out meaningful differences in response to any single stimulus.

When trying to measure or observe something, a slew of variables will definitely complicate matters. Rat Park showed what happens when variables are introduced. A creature with the potential to become a junkie is presented with the opportunity to take another path. There are toys, frisky playmates, and intriguing corners to hide in. When the environment contains things other than a morphine dispenser, the world is a different place, and you get a different kind of rat.

Some researchers have invested a great deal of credence in the idea that there is an orderly and inevitable progression from trying a substance for the first time to becoming a bona fide addict. As H. Ziauddeen and P. C. Fletcher put it,

Seminal models of drug dependence have characterized a set of core processes involved in the transition from drug taking to drug dependence. There is little consistent data across these various studies and the findings thus far do not support an addiction model or indeed any one model of altered brain function in obesity.

In “Is food addiction a valid and useful concept?” the authors concluded that evidence for its existence in humans is actually rather scarce, and it is “clear that an addiction model has a limited, if any, place in understanding obesity.”

Your responses and feedback are welcome!

Source: “Addiction: The View from Rat Park,” BruceKAlexander.com,
Source: “Is food addiction a valid and useful concept?,” NIH.gov, January 2013
Image by Matt/CC BY-SA 2.0

Different Schools of Thought

Late in 2014, a lengthy contribution was added to the conversation about terminology. ” ‘Eating addiction’, rather than ‘food addiction,’, better captures addictive-like eating behavior” is the title of a report published by Neuroscience & Biobehavioral Reviews. The authors (13 in number) note that some people believe their relationship with problem foods constitutes an addiction, and if they seek help, they look to the addiction sector of therapeutic possibilities.

They also mention that food addiction means different things to different people, who are talking about either substance addiction or behavioral addiction, or both, and this ambiguity causes confusion. They prefer “eating addiction,” and proceed to explain why.

Observations

First, they say there is no evidence that it is a substance use disorder. Sure, there have been indications that the brain equally welcomes a rush from cocaine and an ecstatic experience from the chocolate sauce. But by and large, it has been difficult to pinpoint addictive substances in the food itself, although, of course, some results have been quite clear. But no one has tried to make the case that drug-like substances are in every type of food that obese people eat.

While they scoff at the idea that the substance use disorder category of the DSM-5 will ever recognize “Glucose/Sucrose/Fructose Use Disorder” as a diagnosis, they also concede that both rodent and human data are consistent with the existence of addictive eating behavior. Landing somewhere in the middle, they agree with contemporary experts who say it is “premature to conclude validity of the food addiction phenotype in humans from the current behavioral and neurobiological evidence gained in rodent models.”

Let’s roll with it

But for the time being, and because it works adequately for educational purposes, they will go with “eating addiction” because it highlights the behavioral component. The point of this paper is to discuss, from the behavioral, clinical, and neurobiological angles, how addiction and overeating are both the same and different.

And again, the terminology becomes the subject. Where is the line between occasional overeating and binge eating? In what ways does an eating addiction resemble binge eating (or not)? How do we make sense of addictive disorders that are not even substance-related?

Like so many other problems, overeating is multifactorial. The pros have to look at the severity, the degree of compulsiveness, and the “clinically significant level of personal impairment.” These authors regret that Binge Eating Disorder has become conflated with food addiction, for this reason:

The impaired control over eating behavior in “eating addiction” does not necessarily require that the affected individual experiences a sense of lack of control over eating during a single episode of overeating.

Your responses and feedback are welcome!

Source: “‘Eating addiction’, rather than ‘food addiction’, better captures addictive-like eating behavior,” ScienceDirect.com, November 2014
Images by Jesse Case and CC Runs via Twitter

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources