At nearly 42% of the adult population, the rate of obesity in the United States is at an all-time high. In addition to the stigma related to the physical appearance of carrying excess body fat, obesity is a driver of a variety of chronic medical conditions like heart disease and type 2 diabetes. While there are numerous factors that play a role in obesity, one that may be central for many people is food addiction. Yet not everyone who is obese has a food addiction, and not everyone who has a food addiction is obese. 

What Is Food Addiction?        

The term “food addiction” is a relatively new and somewhat controversial concept in the context of mental health care. Overeating has long been accepted as the primary cause of overweight and obesity, but the idea of an addiction to food being the main driver of compulsive overeating is a more recent idea that has come from ongoing psychiatry research. Food addiction can be defined as an eating behavior that involves the consumption of highly palatable foods that activate the rewards system of the brain in a way that is similar to other kinds of behavioral addiction.  

Food addiction is usually distinguished from eating disorders like bulimia nervosa or binge eating disorder, even though they share similar and overlapping symptoms. With binge eating disorder, for instance, a person will engage in bouts of binge eating as an expression of a deeper psychological problem; eating a large amount of food essentially becomes a coping mechanism and a source of validation. With food addiction, the person experiences a loss of control when confronted with a specific food craving. As with drug addiction, satisfying the craving feels necessary just to feel “normal.” 

The factor that sets food addiction apart from eating disorders is the biological and psychological dependence on a specific set of foods that are typically high fat or high sugar (or both). And like with other substance abuse problems, there can be withdrawal symptoms if the person’s food intake isn’t high enough. Where with binge eating or bulimia the issue is the emotional deficit filled by food, food addiction is about substance dependence and the specific biochemical response of the body to a food. 

How Does Food Addiction Work? 

The basic cause of food addiction appears to be related to the biochemical reactions certain “trigger foods” have on the brain. Certain types of foods (like ice cream, fast food, donuts, etc.) that are high in carbohydrates, fat, sugar, salt, or artificial sweeteners cause the release of neurotransmitters in the brain; these neurotransmitters, like dopamine and serotonin, are associated with the pleasure center of the brain. This is the same area of the brain that addictive drugs (including opioids), alcohol, and other addictive behaviors act upon as well.  

Consuming junk food and other highly palatable foods too often, the pathways to the dopamine receptors in our brain may override other signals that would normally signal satiety and a sense of fullness. Over time, the brain begins to expect elevated dopamine levels, and that drives behavior to eat more of the trigger foods. Regular food cravings develop around just returning the brain to a new “normal” level of dopamine, and then eating becomes less about an emotional need and more about keeping brain chemistry in balance.  

Diagnosing Food Addiction

As food addiction has begun to be considered in the same realm as other addictive behaviors, psychologists have looked for ways to further understand and define the condition. In 2009, psychologists at the Rudd Center for Food Policy and Obesity used principles from the DSM-V (Diagnostic and Statistical Manual of Mental Disorders) related to substance use disorders to develop a method for assessing food addiction in an individual. The result, the Yale Food Addiction Scale (YFAS), is a 25-point questionnaire that looks at seven criteria for addiction: 

1. Substance taken in larger amount and for longer period than intended
2. Persistent desire or repeated unsuccessful attempt to quit
3. Much time/activity to obtain, use, recover
4. Important social, occupational, or recreation activities given up or reduced
5. Use continues despite knowledge of adverse consequences (e.g., failure to fulfill role obligation, use when physically hazardous)
6. Tolerance (marked increase in amount; marked decrease in effect)
7. Characteristic withdrawal symptoms; substance taken to relieve withdrawal

What Are Some Signs and Symptoms of Food Addiction? 

Food addiction is considered present in the above questionnaire when a person meets at least three of the seven criteria. However, not everyone will have access to this questionnaire nor necessarily immediate access to a psychologist or psychiatrist to help them interpret the results. Below are some other signs and symptoms of a food addiction: 

• Persistent cravings: One of the clearest symptoms is the presence of cravings even after you’re already full. A person with food addiction could even eat a filling and nutritious meal and then still feel an overwhelming urge for a trigger food. The craving isn’t about still being hungry, but instead it’s the brain seeking dopamine. 
• Binge eating: Not all binge eating is a sign of food addiction, but it usually plays a role. A person may start without intending to eat so much, but one cookie turns into 10, and 10 cookies turn into the whole container. 
• Guilt: Guilt plays a significant role in any kind of overeating, but with food addiction it will likely have no bearing on whether you’ll overeat again. 
• Unable to set rules: When people recognize that they are eating too much, they may attempt to set up rules like “only one slice of cake” or “one cheat meal per week.” These rules are typically ignored, though, and the person will find themselves making excuses and finding reasons to abandon the rule. 
• Hiding the problem: Both the eating itself and the repeated breaking of rules can naturally lead to deep feelings of shame. From shame comes a desire to hide the problem from others at all costs. 
• Can’t quit even when problems emerge: A lack of control is one of the key aspects of food addiction, and a major sign is when that lack of control continues even when negative consequences become apparent. Such consequences can include shorter term problems like weight gain, bad breath, fatigue, or acne, but it can also include longer term issues like heart problems and diabetes.  

Treatment for Food Addiction 

As noted above, food addiction is still a relatively new concept, and there are stigmas related to overeating that treat it as a character flaw. The impact on brain chemistry, however, makes it clear that food addiction is similar to other kinds of substance abuse. And that’s why some of the same treatment methods are also applicable:

• Talk therapy: cognitive behavioral therapy is a form of psychotherapy that is often recommended for people with addictions because it allows you to connect with the negative thoughts and feelings that become associated with overeating. 
• Support group: 12-step programs or support groups like Overeaters Anonymous and Food Addicts in Recovery Anonymous utilize the well-known tenets of Alcoholics Anonymous to provide a supportive environment as a person tries to get out of their addiction.  
• Psychiatry: In some cases, people with food addiction may need additional help to move beyond the addiction. This can include psychiatric assistance and potentially medication that can have an impact on the brain chemistry aspect.    

Long Term Weight Loss 

Treatment for food addiction is a separate concern from weight loss, but the two are often linked. Even if you don’t have a food addiction, long term weight loss is a challenging goal that most people struggle to achieve. If, like many other people, you’ve attempted to lose weight without much success, it may be time to consider a new approach. At True You Weight Loss, we are dedicated to providing alternative solutions that can be the difference between more of the same and the freedom you’ve been looking for. To learn more about our non-surgical weight loss procedures, please contact us today to request a consultation.