Can you be addicted to food?

Sugar addiction. Carb addiction. Junk food addiction. It seems we’re in the middle of a food addiction epidemic. But everyone is addicted to food to some degree; just try not eating for a day or two and you’ll crave the stuff. So, here it is a case of contrasting the deep physiologic survival need we have to eat versus the desire for specific types of foods. But can we really elevate what someone may consider a food addiction to that of a drug or gambling addiction? In this podcast, I’ll explore if food addiction really is a thing.

Links referred to in the podcast

• Systematic review on the evidence for ‘food addiction’ https://www.mdpi.com/2072-6643/10/4/477
• Ranking of foods based on ‘addictive potential’ https://pubmed.ncbi.nlm.nih.gov/25692302

Episode transcript
To access the full episode transcript, go to the following link and select the individual podcast episode and then click on the ‘Transcript’ tab https://thinkingnutrition.buzzsprout.com

Connect with me
Instagram: doctimcrowe
Facebook: Thinking Nutrition
Twitter: CroweTim

Transcript

Sugar addiction. Junk food addiction. Carb addiction. It seems we’re in the middle of a food addiction epidemic. But everyone is addicted to food to some degree; just try not eating for a day or two and you’ll crave the stuff. So, here it is a case of contrasting the deep physiologic survival need we have to eat versus the desire for specific types of foods. But can we really elevate what someone may consider a food addiction to that of a drug or gambling addiction? In this podcast, I’ll explore if food addiction really is a thing. 

To set the scene in getting into the mindset to answer the question of if food addiction is a real thing, consider these examples: If you go without food for a day, you will be thinking and obsessing about it, craving it even. Are you addicted to food? Now, what about if you stop drinking all fluids and the weather is hot and you’re exercising and you are parched: are you addicted to water? What about if you hold your head underwater for a minute and your lungs are screaming: does that mean you’re addicted to oxygen? Of course not. None of these examples are remotely related to addiction. They represent deep-seated physiologic needs that our body will drive us to seek. Every. Single. Time.

Now, what about when it’s a nice warm spring day and you get outside for a relaxing walk and you look forward to more of these days? Does that mean you’re addicted to walking on warm spring days? What about having a glass of wine on the couch on a Friday night? Does that mean you’re addicted to alcohol? None of these examples of course are addictions: they’re just pleasant things we like to do.

So, you can see that addiction is a special situation. It is separate from essential needs and definitely is much more than just enjoying something. Food addiction, if it exists, likely sits somewhere between the two. Because everyone is 'addicted' to food to some degree.

The term ‘addiction’ gets thrown around way too loosely in the nutrition world despite the lack of consensus of on an established clinical definition. The fact that food addiction is not listed in the latest DSM-V handbook – that’s the bible of psychological and mental disorders – should tell you that food addiction is still a label in search of recognition.

But there are many things that we do acknowledge as addictions and which fall under the wider umbrella of substance use disorders.

A substance use disorder is a complex condition in which there is uncontrolled use of a substance despite harmful consequences. Think of things like alcohol, tobacco, or drugs that are used to the point where the person’s ability to function in day-to-day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe substance use disorders are sometimes called addictions.

Then there are other characteristics of substance use disorders that include withdrawal symptoms when the substance is not consumed, increased time and effort to obtain or use the substance or recover from its effects, and a reduction of social, occupational, or recreational activities because of substance use.

So, it would be a big stretch with that extended definition of an addiction to say that food addiction is a real thing that many people face. But it also would be fair to say that when someone describes themselves as having a food addiction of some sort, it may really be code for loss of control.

There is though considerable overlap in the behaviours ascribed to food addiction and binge eating disorders. That doesn’t mean they are the same, only what someone may describe as a ‘food addiction’ could be on the spectrum of being closer to a binge eating disorder.

A more useful term rather than ‘food addiction’ could still fall under the category of substance use disorder if you apply it to certain foods. And that was the conclusion of a 2018 systematic review that looked at the evidence for ‘food addiction’ and was one of the first studies to look at this topic from a broader view. And I’ll link to the review in the show notes. And indeed, there was evidence of some characteristics of addiction with some level of brain reward dysfunction and impaired control seen across many studies. But it was certain foods, particularly highly processed foods with added sweeteners and fats, that demonstrated the greatest addictive or should that be ‘substance abuse’ potential. https://www.mdpi.com/2072-6643/10/4/477

Researchers have identified behaviours associated with this concept. These include compulsive overeating, even in the absence of hunger, cravings for high fat and sugary foods, difficulty in controlling food intake, and binge eating and disordered eating patterns

High-calorie, sweet, and fatty foods can cause changes in the structure and circuitry of the brain. Studies show that many regions of the brain, including those involved in anticipation of and the satisfaction derived from rewards, are altered in similar ways by drug use and by consumption of certain high-sugar and high-fat foods—and especially combination foods that are rich in both carbohydrates and fats.

The media loves these types of studies as it allows them to run with headlines that carbs, or sugar, or junk foods are as ‘addictive as cocaine’. Great for clickbait, terrible for true reporting of the actual science as these types of studies are always done in rats. And those same reward and pleasure brain centres that respond to desirable foods can also be lit up in humans by pictures of puppies or receiving a hug, as well as by food.

But a combination of sugar, fat or salt in highly processed foods, can make a food hyper-palatable. One study that looked at brain regions involved in reward found that foods high in fat and carbohydrate were, calorie for calorie, more desirable than foods that contained only fat or carbohydrate and that this effect is associated with greater recruitment of brain reward circuits. https://pubmed.ncbi.nlm.nih.gov/29909968

And this hyper-palatability could be a major driver of weight gain. The ‘food addiction’ hypothesis puts the case forward that exposure to these foods alters the brain's reward circuitry, driving an addiction-like behaviour of compulsive overeating.

When people blame carbs or sugar for their addiction, they fail to mention that it is a combination of refined carbs PLUS dietary fat which is what can make something hyper-palatable. If people really had a ‘sugar addiction’ then pure white sugar would be what they desire, but it is the food matrix that contains sugar and other nutrients that is more appealing. And hyper-palatability can be created in the savoury realm too with no sugar or starch, as long as fat and salt are properly incorporated into the mix. Lots of levers to play with for companies wanting to get you to eat more of their products. So, when you hear addictive, think more hyper-palatable or desirable.

Research has attempted to rank the most addictive foods. And the Top 10 most ‘addictive foods’ are all highly palatable because of being calorie-dense and containing both fat and carbohydrates. The top 5 food in order were chocolate, ice cream, French fries, pizza and biscuits. Soft drink, which is really just sugar water, came in at number 14. At the bottom of the list were broccoli and beans. I’ll link to this study in the show notes. https://pubmed.ncbi.nlm.nih.gov/25692302

So, let’s wrap all this up. Eating behaviours can share some things in common with addictive behaviours involving other substances, like binging, strong cravings, relapse after trying to cut back, and continuing the behaviour despite negative consequences.

From an emotional standpoint: yes, it is possible to feel as if you are addicted to food because of the overwhelming lack of control you feel when you’re around it. But that doesn’t mean you’re actually addicted to food in the same way you might be addicted to something like drugs or alcohol

Labelling a food or nutrient as addictive can drive unwarranted fears that can increase the risk for various eating disorders. And while the types of foods that usually get labelled with the ‘addictive’ tag are ones we’d be best to not be eating too much of, they don’t need to cut out completely. Desiring energy-dense palatable foods that hit the ‘sweet spot’ of our brain is part of being human.

So that’s it for today’s show. You can find the show notes either in the app you’re listening to this podcast on if it supports it, or else head over to my webpage www.thinkingnutrition.com.au and click on the podcast section to find this episode to read the show notes.

If you find this podcast of value, then please consider sharing it with your friends and colleagues. Or maybe even leave a review. This all helps increase the ranking and reach of the podcast which means a big win for credible evidence-based nutrition messages while helping to dilute out the crazy and making the world a slightly less confusing place.

I’m Tim Crowe and you’ve been listening to Thinking Nutrition.