What is food addiction?

Read this for an overview of food addiction and the growing evidence base around it.

In our modern culture we often use expressions such as ‘chocaholic’, ‘sweet fix’, and ‘sugar addict’? We also talk about food ‘cravings’ and ‘withdrawal’. We also talk about wanting to 'quit sugar' and there are many quit sugar, stop sugar, eliminate sugar, and similar programs out there. All of these are words and phrases commonly used in relation to addiction. But if you went to your doctor and said you’re addicted to food you’d probably not be taken seriously. Food addiction is not formally recognised as an addiction in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the International Classification of Diseases (ICD-11). However, there is a growing evidence base that supports the existence of food addiction.

In the world of food addiction peer recovery groups and among a growing number of global food addiction professionals, we have known that food addiction exists in people's experience for a long time. And with all the modern ultra-processed foods out there, it’s incredibly common. In an Australian research study led by Dr Tracy Burrows from the University of Newcastle, over 20% of participants showed signs of food addiction! It has now been confirmed by various studies that the prevalence of food addiction globally is around 16% of the population, as outlined by Dr Claire Wilcox in her excellent textbook Food Addiction, Obesity, and Disorders of Overeating: An Evidence-Based Assessment and Clinical Guide (2021)

Ultra-processed foods are defined as 'industrially produced foods containing ingredients not available in home kitchens' by Gearhardt et al in their 2023 article Social, clinical, and policy implications of ultra-processed food addiction. They say that the most addictive types of foods are refined carbohydrates or fats that effect the brain's dopamine response similar to other addictive substances such as nicotine and alcohol.  They explain that 'while natural or minimally processed foods typically contain either carbohydrates or fat, they rarely contain both... By contrast, many ultra-processed foods contain much higher levels of both carbohydrates and fats in more equal proportions'. That makes them more bioavailable (more quickly being absorbed into the body) and causes the strong dopamine response. 

In her early and groundbreaking book Food Addiction – The Body Knows (1993) Kay Sheppard describes food addiction as repeated compulsive episodes of uncontrolled eating despite negative consequences. Even though this is an old book, it's still very relevant. She says food addiction is a metabolic, biochemical imbalance of the brain and body that creates craving for refined foods. The addictive eater is obsessed with food, preoccupied with weight and body image and progressively loses control over the amount of food they consume. Dr Vera Tarman, in her book Food Junkies – The Truth About Food Addiction (2019), describes food addiction as a condition where particularly highly processed foods can’t be consumed without developing strong physical cravings and mental obsessions about food. She says that you can be addicted not only to specific foods, but also to quantity. My experience is that we can be addicted to specific foods but also the activity of eating itself. So, food addiction is a substance and a process addiction, and could also be called an eating addiction for some people. 

It’s common for people to develop what is often referred to as eating disorders to try and control the underlying food addiction. The obsession with food means the person can’t stop eating and becomes concerned about weight gain. The person may begin using ‘disordered’ ways of dealing with the problem, such as fasting, purging through vomiting, using laxatives or over-exercising. In many cases, the addictive eater gives up any attempts to control their food, often leading to rapid obesity. Research now shows a high correlation between food addiction and eating disorders, and obesity. Every person is different, for some people the food addiction came first, and for some, eating disorders came first. This requires different treatment pathways.

Food addiction involves a great deal of shame which prevents a person from seeking help. Ashamed of not being able to control their food consumption, an addictive eater will often eat moderately in front of others and then binge in secret. After a binge they feel a sense of guilt, remorse and self-contempt, with a firm resolution to never binge again. Yet, the combination of the physical craving and the mental obsession always sets off a new cycle of binge eating leading to even greater despair, shame and isolation.

Internal Family Systems (IFS) says that addictions (and eating disorders) are made up of many conflicting teams of parts of us. For example, you might find that you have a part that really needs to binge and is very impulsive. After the binge, a strong inner critic shows up and scolds you for having done it again. This may be followed by a purger showing up, who makes you go to the gym and be bulimic. This leads to a great deal of inner turmoil and the more extreme one part gets the more extreme the others become.

According to Sheppard, sends the confronting message that food addiction is chronic, progressive and ultimately fatal. She says that it’s chronic because the condition never goes away, progressive because the symptoms always get worse over time and fatal because the addictive eater will die an early death, usually as a result of obesity related diseases such as heart disease, stroke and diabetes, or as a result of deteriorating mental health.

As the food addiction progresses, more time is needed to manage it. The addictive eater spends a huge amount of time food shopping, preparing food, hiding traces of binges, vomiting or using laxatives, exercising, or recovering from the physical discomfort of a binge. Compounding difficulties such as financial strain, not showing up for work, health issues, social and relationship challenges often accompany the addiction.

Researchers are beginning to recognise that food addiction may be a key contributor to our global obesity epidemic. If you ask me, in a country like Australia where over 60% of us are overweight or obese, it’s high time to take a closer look at food addiction as one of the increasingly common and socially accepted addictive behaviours, and to compassionately enquire why we do these behaviours, what positive intentions are behind them, and what may be biology, and the ultra-processed food environment we live in. 

My lived experience of food addiction is that it’s not always the same as an eating disorder. In my lived experience, food addiction came first. I may even have been born with it, or it shaped my brain very early on. Addiction to me is like a developmental brain adaptation. The brain formed to seek sources of comfort, security and love where those resources might have not been optimally available in very early life. In contrast, my disordered eating, the bingeing, starving and over-exercising, started much later, around age 11, as a result of other people’s and society’s judgment about my body weight and shape. My addiction needed me to overeat to make sure my nervous system could be soothed and regulated. The eating disorders only had one function: to control the unwanted weight gain caused by the addiction to protect from potential judgment and rejection by others. This is different for everyone though!

I consider my food addiction to be healed now. This does not mean that I can eat all foods in moderation. It appears that the biology of addiction remains intact in me, meaning that to keep my food addiction dormant, I need to practice abstinence from specific foods and ways of eating. I am at peace with that. To me, it is like a medical condition. As long as I take certain steps, I am not affected by it whatsoever.

This is not the case for everyone, and I have seen many people resolving their food addictions in other ways and return to moderate eating. My theory is that if addiction starts really early or may even have been transmitted genetically or epigenetically across several generations, it may be that the brain is permanently wired for addiction. If an addiction develops at a later age it may be fully reversed, meaning that people can eat all foods in moderation. I do not have scientific proof for that. It’s my lived experience and what I am learning from clients. My aspiration is to continue this path with a lot of curiosity, openness and compassion and learn from YOU!

Categories: Food Addiction

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