By Autumn G. Hullings, PhD student in Nutrition
Content Warning: This article contains references to addiction, disordered eating, and weight stigma.
What is food addiction and can it be characterized as addictive in the same way as gambling, tobacco, alcohol, and other drugs? In a recent Great Debates in Nutrition published by the American Journal of Clinical Nutrition, scientists on both sides of the (food) aisle argued the concept of food addiction and whether it helps inform our understanding of overeating and obesity.
The concept of food addiction is highly controversial and requires dusting off your Psychology 101 knowledge to fully understand. Characteristics such as brain reward dysfunction, impaired control, fatigue, irritability, and withdrawal are typically used to classify drugs and other substances as “addictive.” Ultra-processed foods have been implicated as drivers of food addiction because they contain high amounts of the ingredients that our bodies crave, including refined carbohydrates, fats, and sodium. In the most recent definition, ultra-processed foods have 5 or more ingredients that include substances not commonly found in nature or culinary practices such as modified starches, hydrolyzed oils, and additives. Unlike most minimally processed foods, highly processed foods can cause rapid spikes in blood sugar levels, stimulate the vagus nerve, and increase dopamine release. Dopamine is known as the “happy hormone” and is a primary driver of reward-seeking behavior which can lead to addiction. The Yale Food Addiction Scale (YFAS) is one measure used to classify the degree of addictive-like foods and eating behaviors. This scale uses the Diagnostic and Statistical Manual of Mental Disorder to score individuals based on criteria such as diminished control over consumption, repeated attempts to quit, and withdrawal. While the YFAS is a validated psychometric tool, the concept of classifying foods as addictive remains controversial.
In the US food supply, ultra-processed foods contribute nearly 60% of total energy intake and have been associated with higher risk of dyslipidemia, coronary artery disease, and various cancers, and obesity. Several policy solutions have been proposed to help decrease the consumption of ultra-processed foods including adding an addiction label to these foods. However, this approach could lead to serious drawbacks such as increasing obesity-stigma and excessive restrictive eating patterns. While there is a consensus that addictive-like eating behavior exists, obesity is a multifaceted condition influenced by a variety of factors, such as the food environment and genetics. Scientists argued that applying an addiction label to highly processed foods could distract from more effective solutions including banning or taxing highly-processed foods.
While nutrition scientists do not fully agree on all points, this Great Debate offered a roadmap for future research priorities. On both sides, scientists agreed that more research is needed to investigate how different foods influence the brain, to examine the degree to which addictive-like eating predicts obesity and disordered eating, and to assess the impact of labeling highly-processed foods on weight stigma.
If you liked this topic, look out for the next Great Debate in Nutrition: ‘Does the Concept ‘Ultra-Processed Foods’ Help Inform Dietary Guidelines, Beyond Conventional Classification Systems?’
Peer-reviewed by: Sara Bernate, BSPH