The awareness that food can be addictive is relatively new. That’s not so surprising when you consider that binge eating disorder (BED) made it into the official list of mental disorders for the first time in 2013 in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Many physicians and treatment centers consider BED simply disordered eating, without recognizing its addictive component.
Research shows fats and sugars affect certain neural pathways in the same as abusive drugs. They all stimulate the release of dopamine and promote changes in the brain’s opioid system. In highly processed foods, the concentrated dose and rapid rate of absorption accelerate dopamine release, which occurs with other addictive substances.1 , 2
Animal models demonstrate bingeing, withdrawal symptoms and craving associated with sugar. Animals will also binge on fat and fat-sugar combinations. Studies also show cross-sensitization between sugar and known drugs of abuse, meaning animals that develop what appears to be a sugar addiction are more likely to develop dependency on alcohol and drugs, such as amphetamines.3 , 4
Neuroimaging also reveals greater activity in the reward-related regions of the brain in response to food cues.
Based on research, it appears certain foods have addictive qualities that may lead to behaviors commonly observed in substance use disorder patients, such as over consumption, use despite negative consequences and an inability to reduce consumption independently.
Processed foods high in fat, sugar and salt most commonly stimulate binge eating. Binge episodes often revolve around easy-to-eat, calorie-dense foods, such as pasta, bread, sweets, chips and other salty snacks. In a recent study that ranked problematic foods, chocolate, ice cream, French fries, pizza, cookies and chips took the top spots.5
To meet the criteria for BED, an individual must repeatedly experience episodes in which he or she eats a larger-than-normal amount of food in a short period of time and also meets three of the following six criteria:
- Eating until uncomfortably full
- Eating large amounts of food when not physically hungry
- Eating much more quickly than normal
- Eating alone out of embarrassment because of the quantity consumed
- Feeling disgusted, depressed or guilty about overeating
- Marked distress or anxiety regarding binge eating
Not everyone who has BED also has a food addiction. Two studies found that more than half of obese individuals with BED meet the criteria for food addiction.6 Treatment for BED must address the addiction issues of this population.
For a heroin addict, the first step in treatment is containment: Stop using heroin. Stay away from friends who use. An alcoholic takes similar steps. They stop drinking, stay out of bars, dispose of liquor at home and avoid places where they will feel pressured to have a drink.
Food addicts cannot stop eating. They cannot easily avoid trigger foods. They see food signs everywhere. These signals activate the brain reward system, which reminds them of achieving a high during their prior bingeing experience and triggers a desire to binge again.
Avoiding cues without living in a bubble is nearly impossible. Food addicts must develop other protective strategies. They may choose to attend social gatherings that don’t feature eating as the central activity, such as baseball games rather than cookouts or movie nights rather than dinner at an all-you-can-eat buffet. Some individuals find distraction techniques invaluable for weathering a bingeing urge. These techniques might include snapping a hair tie on the wrist or counting to 100.
Because the study of food addiction is still in its infancy, we do not yet know what other therapies may work. Pharmacotherapies developed for other addictions may help food addicts. Increased awareness may also lead to broader social changes, particularly in combination with concern about rising obesity rates. Those might include portion control, a reduction in processed foods consumption and more opportunities for non-food-related social interactions.
- Avena NM, Rada P, Hoebel BG. Sugar and Fat Bingeing Have Notable Differences in Addictive-like Behavior. J Nutr. 2009 Mar;139(3):623-628. ↩
- Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent excessive sugar intake. Neurosci Biobehav Rev. 2008;32(1):20-39. ↩
- Avena NM, Carrillo CA, Needham L, Leibowitz SF, Hoebel BG. Sugar-dependent rats show enhanced intake of unsweetened ethanol. Alcohol. 2004;34:203–209. ↩
- Avena NM, Hoebel BG. A diet promoting sugar dependency causes behavioral cross-sensitization to a low dose of amphetamine. Neuroscience. 2003b;122:17–20. ↩
- Schulte EM, Avena NM, Gerhardt AN. Which Foods May Be Addictive? The Roles of Processing, Fat Content, and Glycemic Load. PLOS One. 2015;10(2):e0117959. ↩
- Gearhardt AN, White MA, Masheb RM, Morgan PT, Crosby RD, Grilo CM. An examination of the food addiction construct in obese patients with binge eating disorder. Int. J. Eat. Disord. 2012 Jul;45(5):657-63. ↩