FooD Addiction

Is food addiction real?

Yes, it is. Food addiction is often referred to as ultra-processed food addiction (UPFA), carbohydrate addiction, sugar addiction or even eating addiction. Read my blog What is food addiction.

Food addiction is not recognised in the Diagnostic and Statistical Manual (DSM), or the International Classification of Diseases (ICD), the two manuals that is used to diagnose conditions. But it can be assessed through questionnaires such as the Yale Food Addiction Scale (YFAS). Mounting research shows that food addiction is an experience that many people identify with. There is a really great text book by Claire E. Wilcox MD published in 2021 'Food Addiction, Obesity, and Disorders of Overeating An Evidence Based Assessment and Clinical Guide'. Dr Vera Tarman's book 'Food Junkies' (2019) and the 'Food Junkies podcast' are also excellent resources that will keep you up to date with what researchers and clinicians have to say about the topic.

In May 2024, the first International Food Addiction Consensus Conference took place in London to bring together professionals to discuss the next steps to ensure ultra processed food addiction (UPFA) is included  in the ICD and an evidence base for treatment is established. Even though professionals agree that a person can also engage in addictive eating behaviours with non ultra-processed foods, it was decided the UPFA label is the most convincing description for food addiction to obtain formal recognition because the detrimental health impact of ultra-processed food is now widely understood and accepted.  

Below are the YFAS questions to help you understand if you may identify with the concept of food addiction.  

Do these food addiction symptoms resonate with you?

In the last year...
• I ate to the point where I felt physically ill.
• I spent a lot of time feeling sluggish or tired from overeating.
• I avoided work, school or social activities because I was afraid I would overeat there.
• If I had emotional problems because I hadn’t eaten certain foods, I would eat those foods to feel better.
• My eating behaviour caused me a lot of distress.
• I had significant problems in my life because of food and eating. These may have been problems with my daily routine, work, school, friends, family, or health.
• My overeating got in the way of me taking care of my family or doing household chores.
• I kept eating in the same way even though my eating caused emotional problems.
• Eating the same amount of food did not give me as much enjoyment as it used to.
• I had such strong urges to eat certain foods that I couldn’t think of anything else.
• I tried and failed to cut down on or stop eating certain foods.
• I was so distracted by eating that I could have been injured (e.g., when driving a car, crossing the street, operating machinery).
• My friends or family are/were worried about how much I (over)eat.

Eating Disorders

In my experience, many people who have food addiction will identify as also struggling with some forms of disordered eating or eating disorders such as binge eating disorder, bulimia nervosa, anorexia nervosa or other eating disorders. Obesity is also often present when somebody presents with a food addiction.

Research now confirms that there is a clear overlap between food addiction, eating disorders and obesity, which requires further research. There is an especially high correlation between people who have ultra-processed food addiction and binge eating disorder. (Claire E. Wilcox, 2021, Food Addiction, Obesity, and Disorders of Overeating An Evidence-Based Assessment and Clinical Guide). 

Do you identify with having an eating disorder?

Here are just a few questions from the EDE-Q questionnaire which is one of the tools used by clinicians to assess for the presence of an eating disorder. This may help you to identify a possible eating disorder, such as binge eating disorder, bulimia nervosa or anorexia nervosa. Please note this is NOT the full questionnaire. There is also a great amount of resources on eating disorders on the Butterfly Foundation's website.

• Have you been deliberately trying to limit the amount of food you eat to influence your shape or weight (whether or not you have succeeded)?
• Have you gone for long periods of time (8 waking hours or more) without eating anything at all in order to influence your shape or weight?
• Has thinking about food, eating or calories made it very difficult to concentrate on things you are interested in (for example, working, following a conversation, or reading)?
• Has thinking about shape or weight made it very difficult to concentrate on things you are interested in (for example, working, following a conversation, or reading)?
• Over the past 28 days, how many times have you made yourself sick (vomit) as a means of controlling your shape or weight?
• Over the past 28 days, how many times have you taken laxatives as a means of controlling your shape or weight?