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It’s a popular refrain: “I’m addicted to X food,” or “I can’t control myself around sugar.” The concept of food addiction has been readily accepted by the general public, and research suggests that most people believe that “obesity” can be caused by food addiction. In fact, up to half of people believe that they are addicted to food.
However, the idea that we can be addicted to food the way that we might become addicted to alcohol or cocaine is hotly debated in scientific circles.
Some scientists believe that we can be addicted to food as a substance. Others point out that there’s no solid evidence to support that idea, but it IS likely that some people experience “eating addiction.” (That would be a behavioral form of addiction, similar to being addicted to shopping or gambling.) I’ve written about this previously in my Seattle Times column.
But there’s another aspect of “food addiction” that is getting more traction in the scientific research. That’s how the idea of food addiction colors our perceptions of ourselves, or others. Let’s dig a little deeper.
Debating the nuances of food addiction
Earlier this year, a series of articles in The American Journal of Clinical Nutrition debated the concept of food addiction. Specifically in terms of whether it helps explain overeating and weight gain.
The researchers agreed that some people do eat in a way that is consistent with what looks like addiction. They also agreed that the attributes of the food being eaten, individual risk factors, and the behavioral eating patterns contribute to addictive-like eating. Finally, they agreed that the contributing factors to having a body mass index (BMI) in the “obese” range are multi-faceted, and that while addictive-like eating behavior is relevant for some people with higher body weights, addictive-like eating behaviors also occur in people of lower body weights.
There was disagreement about the addictive potential of highly processed foods. Specifically, one researcher said highly processed foods – containing rapidly absorbed carbs and fat along with salt and flavor additives – are more effective at triggering reward pathways in the brain and are more likely to be consumed in an addictive manner than minimally processed foods.
The other researcher said there’s little-to-no evidence that specific food ingredients are what triggers addictive-like eating behavior. First, highly processed foods are not comparable to drugs, which act via specific and direct biochemical mechanisms in the brain and body. Also, consider that most people consume highly processed foods daily without experiencing drug-related effects.
“Food addiction” and internalized fatphobia
Debates about food addiction aside, there may be unexpected harms from labelling ourselves, or others, as being “food addicts.” Fat phobia is common in our society (shocking, I know), and fatphobia can be amplified by certain beliefs about what causes weight gain.
Basically, when we make judgements about the causes of a health condition (not that being in a larger body is a health condition, but in our society it is painted that way), these judgements tend to influence our attitudes about the people themselves.
A study published in August in the journal Obesity randomized 447 adults to read one of four informational passages. Three explained what causes “obesity” – one passage focused on food addiction, one on eating addiction, and one on calorie imbalance – and the fourth was a “control” reading passage that had nothing to do with weight. The passages were designed to have a neutral tone, and did not use works like “choice,” “willpower” or “self-control.”
Participants then completed assessments designed to measure weight stigma (another term for fatphobia) directed at themselves (internalized) or others (externalized). Participants who read the passage that described food addiction as a cause of reported higher internalized weight stigma compared with those in the control condition. This was the opposite of what the researchers expected.
What’s really interesting is that people in the group assigned to read the food addiction passage had higher levels of internalized weight stigma regardless of how much they weighed or whether they self-identified as struggling with food addiction.
The authors said it’s possible that reading an argument for the role of addictive foods in weight gain – but not other foods – may have increased participants’ self-blame for choosing so-called “addictive” highly processed foods or caused them to feel hopeless about whether they could stop eating these foods. This in turn may have increased participants’ weight-related feelings of anxiety and depression, along with their desire to lose weight.
“Food addiction” and fatphobia directed at others
A 2019 research paper specifically asked if the “food addiction” label was feeding weight stigma. In two separate online studies, a total of 962 participants were asked to read a passage about a woman who was described as “very overweight.” But not all the passages were exactly the same.
Based on random assignment, some participants read a passage in which the woman had been diagnosed with food addiction by her doctor (the “medical condition”). In another, the woman believed that she was addicted to food (the “self-diagnosed” conditions). In the third, there was no mention of food addiction (the “control” condition).
Participants who read the “medical” and “self-diagnosed” passages expressed more stigma towards the woman than those who read the “control” vignette. This was true even for participants who indicated that they believed addiction was a disease rather than something within our personal control.
So the idea is that if someone is addicted to food, even if it’s not their fault, there’s something wrong with them and they are worthy of contempt. This isn’t dissimilar from how many people view alcohol or drug addiction.
Moving beyond semantics
I’ve said it before and I’ll say it again: whether food addiction is actually a real thing or not, if you feel like you’re addicted to food, your feelings are real.
It’s worth pointing out that if you took a group of people who all experienced the same sense of “out of controllness” when eating the same food, different people in the group would call the experience by different names:
- Food addiction
- Binge eating
- Emotional eating
- Overeating
Of these, only one (binge eating disorder) has actual diagnostic criteria, but what’s truly important isn’t the name, it’s that if something about your eating is causing you distress, you deserve help and support.
I will suggest that abstinence isn’t the answer. One thing that causes feelings of being out of control when we eat is restriction. That’s true when we’re restricting calories and the body’s not getting enough fuel. It’s also true when we’re restricting specific foods. This is the “forbidden fruit” syndrome. And what is abstinence but total restriction?
Trying to wrestle what may or may not be food addiction into submission is a recipe for rebound eating. Getting to the bottom of what’s going on really takes time and attention and an exploration of food and eating history. This includes early childhood experiences. It factors in things like food insecurity and trauma. It’s important healing work that doesn’t have a quick-and-easy path to resolution.
A few resources
I regularly recommend this episode of the Food Psych podcast: “The Truth About ‘Food Addiction’ with Marci Evans.” (#80 if you already subscribe to Food Psych in your podcast platform of choice.)
I interviewed Marci for The Seattle Times last year, and talked about food addiction in this Facebook video around the same time.
Carrie Dennett is a Pacific Northwest-based registered dietitian nutritionist, freelance writer, intuitive eating counselor, author, and speaker. Her superpowers include busting nutrition myths and empowering women to feel better in their bodies and make food choices that support pleasure, nutrition and health.
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