Food addiction is thought to be similar to substance use disorders and may share many of the same symptoms and underlying causes. The understanding of food addiction is increasing with expanding research and literature, helping the development of effective treatment approaches.
Understanding food addiction
Food addiction (FA) is a complex and multifaceted condition involving a loss of control over eating habits and addictive behaviors that overlap with other substance and behavioral addictions.[1]
Currently, food addiction is not a recognized condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, growing research and literature recognize food addiction as a disorder separate from, albeit similar to, eating disorders and addictions.[2]Â
For example, binge-eating disorder (BED), an eating disorder listed in the DSM-5, includes symptoms such as overeating, a lack of control over eating habits, and physical or emotional distress due to eating habits. These symptoms are similar to those seen in FA, and many with BED meet the proposed criteria for FA, although the conditions are separate.[3]
How food addiction and substance use disorders are related
Food addiction (FA) and substance use disorders (SUDs) share many similarities in how they affect the brain, behavior, and overall health. Understanding the connection between the two can help shed light on why food addiction is increasingly being viewed through the same clinical lens as substance-related disorders. Dr Michelle Beaupre, Clinical Director at Villa Oasis, San Diego, had this to say:
Medical advisor
MSW, PhD, LCSW
Below are several key areas where FA and SUD overlap.
Symptom criteria
FA can be recognized with the use of the Yale Food Addiction Scale (YFAS), which has been found to demonstrate reliability and validity. The YFAS includes criteria that overlap with those of substance use disorders (SUDs).[4]
For example, both lists include behaviors such as:[4][5]
- Eating/using substances more than intended
- Physical and emotional issues due to eating/using substances
- Neglecting or avoiding responsibilities or hobbies to eat/use substances
- Failed attempts to reduce or stop
- Withdrawal symptoms when reducing or stopping
Neurobiology
Both FA and SUD can be linked to dopamine signaling, associated with the pleasure response. Food and drug cues are found to create elevated activity in the reward circuit, contributing to addictive behavior and an inability to inhibit intake.[5][6]
Medical advisor
MSW, PhD, LCSW
Risk factors
Potential risk factors for the development of FA and SUD include:[2][7][9]
- Childhood trauma
- Emotion dysregulation
- Genetic factors
- Environmental exposure
Treatment needs
Both substance and food addiction can require professional intervention to reduce or stop addictive behaviors, such as behavioral therapies.[3][8]
Co-occurring mental health issues
It is common for people with substance or food addictions to experience mental health symptoms such as depression, anxiety, or post-traumatic stress disorder (PTSD) that precede, emerge, or worsen with addictive behaviors.[7][8]
Consequential health issues
Like substance addiction, food addiction can lead to severe health consequences with long-term use, including obesity, diabetes, and heart disease.
Pattern of use
People with food addiction might engage in binges, overconsuming in one sitting, or steady use, continuously eating small amounts throughout the day. These patterns of use are also seen in substance addiction.[9]
Does food addiction lead to drug addiction (or vice versa)?
When compared with people who don’t have these conditions, those with FA might be more likely to develop SUD and vice versa. This is due to shared risk factors in the development of each condition.
For example, people who experience trauma, abuse, or mistreatment in childhood are often more likely to engage in substance use and disordered eating.[2][8]
Additionally, people reducing one addictive behavior are often likely to replace this behavior with an alternate one. As such, someone in SUD recovery might replace substance use with eating, which could lead to FA.[2]
How processed foods mimic addictive substances
Highly processed foods, including those high in sugars and fats, are found to have more addiction potential than healthier foods. These foods are significantly altered from their natural state to encourage overconsumption by producing a pleasure response. [1]
Repeatedly overconsuming these foods is, therefore, likely to lead to addiction, as people begin to crave the feeling. These cravings and desires for pleasure from consumption mimic the processes of substance addiction.[10]
Managing food cravings in recovery
In addiction recovery, individuals are encouraged to recognize and avoid temptations and refrain from using substances. However, unlike other addictions, people attempting to overcome food addiction cannot avoid food altogether, as it is necessary for survival and impossible to avoid exposure to food-related cues.
Medical advisor
MSW, PhD, LCSW
Because of this, it can be difficult to avoid cravings and urges to overeat or engage in food addiction behaviors. However, in most cases, these cravings are linked to highly processed foods or foods that are very high in sugar. As such, creating a healthy diet and forming positive eating habits can help reduce cravings.[1]
Integrated treatment approaches: Treating food addiction and SUD together
Currently, treatment approaches for FA are not evidence-based, as the condition has not been clarified. However, research suggests that behavioral therapies, particularly cognitive behavioral therapy (CBT), are likely to be an effective approach to FA treatment.
SUD treatment also often includes CBT, which aims to help individuals recognize and adapt harmful behaviors while managing associated emotional distress. As such, behavioral interventions may be the most effective integrated treatment for FA and SUD.[6][8]
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