This content originally appeared on On a regular basis Health. Republished with permission.

By Laura Williams

Medically Reviewed by Allison Young, MD of American College of Lifestyle Medicine

Can the word “addiction” — typically related to drugs, alcohol, gambling, or other behaviors that done in excess can seriously damage someone’s health and well-being — apply to food or certain foods?

In keeping with an article within the American Journal of Psychiatry, food addiction isn’t considered a clinical substance use disorder (alcohol use disorder and opioid use disorder are subtypes) within the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic guide utilized by mental health professionals.

But some psychologists and nutrition and behavioral health researchers who study the subject say perhaps it must be.

“While it hasn’t been universally acknowledged as an official diagnosis, the term is used to explain eating behaviors that lack restraint and are [not stopped] despite adversarial physical, emotional, or social effects,” explains John Dolores, PhD, a clinical psychologist and the COO of Bespoke Treatment, a mental health practice based in Los Angeles.

There’s growing evidence to back up not only these claims, but in addition showing that specific foods do end in physiological processes within the brain that occur in other kinds of addictive behavior.

What Is Food Addiction?

In keeping with the Yale Journal of Biology and Medicine, the word “addiction” was first utilized in the context of food (in a reference to chocolate) in 1890. In 1956, the researcher Theron Randolph, MD, used the term “food addiction” within the Quarterly Journal of Studies on Alcohol to explain “a particular adaptation to 1 or more usually consumed foods to which an individual is very sensitive [which] produces a typical pattern of symptoms descriptively much like those of other addictive processes.”

More recently the term “food addiction” has grow to be related to addictive symptoms in response to highly rewarding foods (think candy, ice cream, potato chips, and pizza), says Ashley Gearhardt, PhD, a researcher and an assistant professor of psychology on the food and addiction science and treatment lab on the University of Michigan in Ann Arbor.

She and her colleagues developed the Yale Food Addiction Scale (YFAS) in 2009 to measure signs of addictive-like eating behavior. Its 25 questions are designed to find out whether certain highly processed foods (chocolate, ice cream, potato chips, and pizza, amongst others) trigger addictive behaviors in certain people — behaviors that map to the DSM-5’s diagnostic criteria for other kinds of substance dependence. It’s been shown to be effective in peer-reviewed research, and the newest version was published within the journal Psychology of Addictive Behavior.

Should you usually experience a lack of control while you eat, intense cravings, or feelings of sadness while you attempt to stop that behavior, or should you find it difficult to stop eating while you feel full (even when there are negative consequences), you’re more more likely to meet the YFAS criteria for food addiction.

One study from Dr. Gearhardt’s group with a sample of 500 adults found that greater than 14 percent met the standards for addiction to highly rewarding foods. A meta-analysis of 272 studies within the March 2022 European Eating Disorders Review found that the general prevalence of food addiction might be as high as 20 percent.

People predisposed to addiction, in addition to those that struggle with weight or weight-related problems, are inclined to be more more likely to behave in ways in which align with this definition of food addiction, as do individuals with low self-esteem, anxiety, and depression, explains Dr. Dolores. Research published in Frontiers in Psychiatry in 2021 backs this up.

But that definitely doesn’t mean that everybody in those groups has those behaviors, Dolores says. And it doesn’t mean that others outside those groups won’t have those behaviors, too. “Food addiction can impact anyone, no matter age, sex, or financial status,” he says.

The Science of Food-Related Addictive Behavior

Here it’s price declaring that evidence, published in Archives of General Psychiatry, did show that highly rewarding foods (ones with large amounts of sugar, fat, and salt) trigger the brain’s reward circuitry (namely dopamine neurotransmitters) in ways much like other addictive substances, like drugs and alcohol.

“When the reward system is activated, the brain experiences a dopamine rush, pushing people to devour more, creating an unhealthy cycle,” Dolores explains.

This dopamine reward system isn’t activated with the consumption of all foods, nonetheless. Gearhardt (who was a coauthor on the Archives research) adds that like addictive drugs — that are man-made and specifically designed to stimulate dopamine release — foods that end in addictive responses are also highly processed. They have an inclination to be man-made and chemically designed to taste as delicious as possible (which, in turn, prompts the dopamine reward system).

Other research checked out brain scans after participants ate various foods and located that the mix of fat and carbohydrates in food led to greater activation of the brain reward circuitry than foods with either fat or carbohydrates alone.

“It really is very processed foods that deliver unnaturally high levels of refined carbohydrates (like sugar) and/or fat that trigger addictive patterns of intake,” Gearhardt says.

She coauthored a paper published in November 2022 making the case that highly processed foods meet the standards to be labeled as addictive substances using the standards historically used to deem tobacco products addictive.

It’s price declaring that in the case of food addiction, Gearhardt and others concentrate on these highly processed foods. Naturally occurring and minimally processed foods (like fruits, vegetables, fish, or eggs) are highly unlikely to trigger addictive behaviors.

Should Food Addiction Be a Clinical Disorder?

Gearhardt says yes, the previously mentioned paper lays out the evidence that certain foods meet the identical criteria that classify tobacco as an addictive substance: It causes compulsive use, has mood altering effects on the brain, and reinforces certain behavior.

“There’s a gaggle of us currently working on an application for it to be regarded as a provisional diagnosis within the DSM because we imagine the research has now reached a degree to support it,” Gearhardt says.

Not all health professionals agree.

The evaluation published in Frontiers in Psychiatry in 2021 mentioned above acknowledges the work of Gearhardt and others, but argues there’s still not enough research and evidence to define parameters of food addiction, not to say clinical guidelines on find out how to diagnose it, treat it, and forestall it. While the YFAS is a well-validated instrument for identifying symptom severity, there are still no clinically validated diagnostic criteria which might be well-defined and universally accepted, based on the paper.

There’s also significant overlap between symptoms of eating addiction, obesity, and eating disorders like binge eating disorder — and in cases where eating patterns are problematic, one in every of these other existing diagnoses might apply and is likely to be more appropriate.

The underside line from those arguing against making food addiction a clinical diagnosis is that more research on find out how to properly diagnose it, treat it, and forestall it is required first. And until more studies are done to define the condition and treatment options, food addiction is left in a gray area where clinicians are aware of the potential diagnosis and are working with clients with the newest information available.

Can You Be Hooked on the Act of Eating?

Some researchers prefer the term “eating addiction,” arguing that the addictive symptoms are related to the act of eating or the behavior, relatively than specific foods.

Gearhardt disagrees. “In our lab, it’s overwhelmingly unnaturally highly rewarding foods which might be being consumed addictively,” she says. “We don’t see people losing control of their intake of bananas, beans, or chicken breasts.”

The history of food addiction also doesn’t align with the thought of an eating addiction, because the negative effects of food overconsumption have really only grow to be widely prevalent in essentially the most recent generations. Gearhardt cowrote a review of the evidence for this, published within the journal Psychotherapy and Psychosomatics in 2022.

“We have now needed to eat for the whole thing of human existence. Why did we only just begin to see these huge uptakes in excessive overeating, obesity, and diet-related disease? I’d argue it’s because that’s when low cost, ultra-processed foods began to dominate the food environment, thus triggering widespread addictive patterns of eating,” Gearhardt says.

Overlap With Binge Eating Disorder

Here it’s relevant to think about binge eating disorder (BED), a mental health disorder through which you usually have episodes of eating unusually large amounts of food in a single sitting and feeling like you may’t stop — or as in case your eating is controlling you.

Research shows that individuals with binge eating disorder usually tend to also meet criteria for food addiction than individuals with other eating disorders.

Food addiction (as defined by Gearhardt’s work) is marked by a lack of control when eating specific foods, feelings of guilt and shame, intense cravings, and an inability to stop the behavior despite negative consequences. And indeed, research suggests that the mechanisms of food overconsumption overlap in areas like reward dysfunction or impulsivity.

The difference, nonetheless, is that a binge episode involves a high volume of food, but not necessarily a particular food or an amazing drive to devour highly addictive foods. Someone with food addiction, alternatively, is more likely to experience a binge episode triggered by a craving for specific foods or kinds of foods, just like the highly addictive foods identified by Gearhardt and her team.

Food addiction aligns with an addiction framework, whereas BED aligns with an eating disorder model that’s tied to weight or size concern and dietary restraint.

So, yes, there are differences, but some experts say there’s also a number of potential overlap between these two phenomena.

“There’s an concept that it’s not the food that individuals are hooked on, but that they’re in a restrict-binge cycle,” explains Aisling Crosson, a licensed skilled clinical counselor and Health at Every Size therapist in private practice in Boulder, Colorado.

Effects on Weight Stigma

A clinical diagnosis of food addiction might increase the shame and stigma that exist around obesity and the fear of fat, which could further contribute to the event of restrict-binge cycles and BED, particularly in populations that could be more susceptible, Crosson says. It’s a reason she says food addiction shouldn’t be a separate clinical diagnosis.

A study published in Obesity in October 2021 involved experiments to find out if the usage of either obesity-framing or addiction-framing models contributed to weight stigma amongst adults. The information showed that telling someone they’ve a food addiction may not actually serve to scale back feelings of stigma or guilt around weight, but could increase those feelings.

You Think You May Be Hooked on Food: Now What?

Should you’re concerned chances are you’ll be scuffling with food addiction, Gearhardt encourages you to first talk over with a health care provider to find out if there are other underlying medical issues that might be playing a job, like a thyroid issue.

If there isn’t a underlying medical issue, but you’re concerned about your eating habits or eating patterns in the case of specific foods or scenarios, consider talking to a dietitian or therapist. All mental health care professionals licensed to diagnose clinical disorders should give you the option to discover and diagnose an eating disorder, but someone who makes a speciality of eating disorder treatment might need more experience developing a treatment approach around your specific concerns, Dolores says.

Treatment for eating disorders can include cognitive behavioral therapy for eating disorders (CBT-E), other kinds of talk therapy (or psychotherapy), nutrition counseling, medications, and a few integrative therapy approaches (like yoga, meditation, and acupuncture).

There are not any formal treatment guidelines for eating addiction, because it just isn’t currently a clinical disorder, but researchers have posited that similar psychotherapeutic approaches, in addition to nonsurgical brain stimulation techniques, corresponding to transcranial magnetic stimulation (TMS) — during which magnetic fields are used to stimulate nerve cells within the brain — could help.