The debate is serious, but does food addiction deserve medical recognition? (photo: Getty)
Sure, we all need food to survive. But guys aren’t getting into shoot-outs over cheeseburgers. They aren’t squandering their life savings on just a few more potato chips. So is food addiction legit? Is it a real disorder?
It’s too soon to say for sure, but yeah, probably—at least according to two doctors we spoke to.
“Drugs of abuse vary in potency and their effects on brain. A smoker has mild euphoria compared to someone who is a cocaine addict,” says Nicole M. Avena, Ph.D., research neuroscientist in the fields of nutrition and addiction at the Mount Sinai School of Medicine, and coauthor of Why Diets Fail. “Drawing food into the mix, I see it as sitting along the drug spectrum. The effects of food are more along the lines of addiction to alcohol and nicotine.” Still, those are pretty hard addictions to crack.
In the brain, food has the potential to act a lot like drugs. It spurs a release of feel-good dopamine in the brain, the nucleus accumbens, which regulates motivation and reward, lights up, and over time the brain’s neurons down-regulate so that you need more and more of the good stuff (be it pot or pizza) to feel better, explains Brad Lander, Ph.D., clinical director of addiction psychiatry at the Ohio State University Wexner Medical Center. “For some people, food is kind of a drug of choice. Thank goodness those people haven’t discovered cocaine,” Lander says. (He notes that when people get off of drugs, they often switch their addictions to food.)
Research published in the International Journal of Obesity shows that the ‘come-downs’ from high-sugar and fatty foods are chemically similar to those from drugs. “People who are addicted to food need to eat to feel better, but the more they eat, the worse they will feel,” Lander says. “It’s essentially what happens with drug addiction.”
These sugar- and fat-packed foods are often termed “hyperpalatables,” says fellow of the American College of Physicians Pam Peeke, M.D., M.P.H., senior science adviser for Elements Behavioral Health and author of The Hunger Fix. It’s those foods that appear to lead to food highs and lows. “No one is going to tell you they need an apple fix,” Peeke says. That’s because the brain is wired to handle whole, natural foods.
However, the brain wasn’t designed to handle eating fast-food meals and birthday cakes—and this is important—on a regular basis. A single slice of cake isn’t going to turn anyone into a junkie. “The brain goes into temporary overdrive and recovers,” she says. “The problem is that as time goes on, we exposed to more and more of these foods and, eventually, the reward center’s chemistry changes.”
Read more: 5 Foods That Are Making You Fat
However, not all experts agree that highly palatable foods meet the criteria of an addictive substance. For instance, the authors of a 2012 study in Nature Reviews concluded that although some foods do have addictive-like properties, they aren’t true addictive substances. “The vast majority of overweight individuals have not shown a convincing behavioral or neurobiological profile that resembles addiction,” they wrote.
True. But most drunk guys on a Saturday night don’t necessarily meet the criteria for being an alcoholic. If, in fact, food has to potential to be legitimately addictive, that doesn’t mean that everyone is addicted to it. “Everybody overeats once in a while and abuses food once in a while, but it doesn’t mean you are a food addict,” Avena says. Meanwhile, Peeke notes that some brains may be more vulnerable to food addictions than others.
Currently, the Diagnostic and Statistical Manual of Mental Disorders, the U.S.’s authority for psychiatric diagnoses, does not include food addiction. However, in 2013 year, the American Psychiatric Association added binge-eating disorder to the DSM-5, the manual’s most recent update. Binge-eating disorder is common in people with food addiction, according to Avena.
“It’s still too premature to have food addiction in the DSM. It’s not even been 15 years ago that scientists first started studying at food addiction in rats. Only in the past five to six years have we started to see clinical studies,” Avena says. “So far, results are consistent that food addiction does exist but, as with all science, need time to flush out details before we can call it a disorder. But just because we don’t call it a disorder doesn’t meant it’s not a disorder.”