The obesity epidemic is one of the top health problems in the U.S., but one disorder affecting the epidemic has been largely misunderstood or ignored. A new report sheds light on food addiction and its similarity to drug addiction.
The symptoms, cravings and causes of food addiction are remarkably similar to those experienced by drug addicts, according to a new report from the National Center on Addiction and Substance Abuse (CASA).
“From what we know about substance use and addiction, we feel that many of the measures that have proven to be effective in policy, prevention and clinical practice might fruitfully be employed to reduce the risk and consequences of food addiction,” said Dr. Linda Richter, the lead author of the report, in a press release.
Experts at CASA released the report on food addiction on Feb. 1 in order to help public health professionals in their fight against the obesity epidemic. It provides a summary of research and recommendations for policymakers and health care providers.
“This paper employs lessons learned from years of research on the addictive substances to improve our understanding and approach to an issue of utmost importance to our nation’s public health: unhealthy or disordered eating behavior and the role this plays in the medical disease of obesity.”
Food addiction is not recognized by the latest version of the Diagnostic and Statistical Manual of Mental Disorders, but the manual’s chapter on feeding and eating disorders compares the cravings and patterns of compulsive behavior experienced by people with eating disorders to those with substance use disorders, according to the report.
The CASA report cites support for food addiction as a disorder from numerous peer-reviewed studies. Studies using a scale developed by researchers at Yale indicate between seven and 15 percent of obese individuals in the general population suffer from food addiction, meaning the majority of obese individuals do not suffer the disease.
“There are probably as many reasons why people overeat as there are causes of obesity,” the authors wrote in the CASA report. “Not all overweight persons eat in ways that resemble an addictive or eating disorder, and not all people who score on a measure of food addiction are obese.”
However, samples of clinical populations — such as people seeking weight-loss surgery — indicate between 42 and 57 percent of obese individuals meet the criteria for food addiction. Obesity is a nation-wide epidemic in the U.S., affecting about one-third of all adults and one-fifth of all American children and adolescents, according to the report.
“Given the extent to which obesity and unhealthy eating contribute to sickness and skyrocketing health care costs, it is well worth our time to marshal all available resources to better understand food addiction and the strategies that may help to improve how people eat and the quality of the food supply,” Richter said.
Similarities Between Food Addiction and Drug Addiction
The symptoms, risks and treatments for food addiction and drug addiction are remarkably similar. Like people suffering from other forms of addiction, food addicts are likely to suffer from co-occurring mental health disorders like depression, attention-deficit/hyperactivity disorder and binge eating. They’re also more likely to make impulsive or emotional decisions, according to the report.
According to CASA, similarities between drug addiction and food addiction include:
- Consuming a substance in an unhealthy or excessive manner
- An inability to control consumption of a substance
- Continuing harmful behavior despite its consequences
- Obsessive thoughts
- Emotional reactions
- Feeling distressed, regretful or depressed
- A tendency to relapse
Drug abuse and compulsive eating also affect the body in similar ways. Experts believe certain ingredients in food — like sugar, fat and salt — are responsible for food addiction.
Like drugs, they can:
- Stimulate the reward and motivation regions of the brain
- Create cravings
- Cause the development of tolerance
- Cause withdrawal symptoms
Experts believe the most addictive foods are highly-processed foods or foods consumed in large quantities. Both cause the reward system in the brain to respond positively and crave the foods in the future. Addictive drugs affect the brain in a similar way.
Recommendations for Combatting Food Addiction
CASA’s recommendations to prevent and treat food addiction are similar to efforts that should be used to reduce the rate of obesity and binge eating because the conditions are very similar. Like drug addiction, the best way to prevent and treat food addiction is to implement a comprehensive treatment plan that addresses all of the underlying causes of the disease. The CASA report offers recommendations to treat food addiction on a national level.
Reduce Accessibility of Addictive Ingredients
Policymakers and public health professionals should work to limit the amount of addictive ingredients found in food. The CASA report compares the food industry to the tobacco industry, claiming it “has a vested interest in maintaining and enlarging its customer base by recruiting new consumers of its products and ensuring the continued loyalty of existing consumers.”
In order to offset the industry’s power, CASA recommends policymakers:
- Develop subsidies that encourage food manufacturers to produce health food.
- Decrease incentives that encourage the agricultural industry to produce unhealthy foods like corn starch, cheese and fructose.
- Implement humane farming practices that increase the cost of farm products and limit the amount of processed foods on the market.
- Develop zoning restrictions that limit the amount of unhealthy food venues (e.g., fast food) in one area.
- Heavily tax sugary beverages, high-processed foods and foods that are low in nutritional value.
- Prohibit direct-to-consumer marketing of unhealthy food to children.
Improve Public Awareness
Public health officials should improve public awareness of risk factors for food addiction through informational campaigns and supplemental policies. Policymakers should support educational efforts by implementing policies that force food labels to use less-confusing terms and force food menus to provide calorie and salt counts.
Implement Screening and Intervention Procedures
Health professionals should regularly screen and identify individuals at a high risk for food addiction. Evidence-based food addiction models are available to help health professionals identify food addiction in adults and children.
Although research is limited, medical interventions should be developed to treat food addiction. Some treatments that work for drug addiction seem to be viable options for food addiction. Certain medications seem to be able to reduce impulsive behavior and help people lose weight. Additionally, cognitive behavioral therapy effectively treats binge eating and may treat food addiction as well.
Continue Research on Food Addiction
Overall, academic and medical research on food addiction is limited.
Experts at CASA are calling for more research in the following areas related to food addiction:
- Diagnostic criteria
- High-risk populations
- Common co-occurring illnesses
- Risk factors
- Protective factors
- Prevention and intervention approaches
Food addiction, like drug addiction, has been viewed as a choice for decades, according to the report. Experts are learning more about the way food addiction affects the brain and a person’s behavior, and are recommending new prevention and treatment methods as a result.