For some years now, there has been research into the possibility that we can become addicted to certain foods, especially those whose taste we really like.
You have probably heard that, for example, sugar is addictive.
But what does science say about all this?
Hooked on food that tastes better
Addiction can be focused on substances (such as alcohol or cannabis) or on behaviors (such as gambling).
Focusing on the first type, the American Psychiatric Association establishes the criteria for diagnosing it in its Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR).
These include social deterioration and lack of control over consumption.
Food addiction has been established based on similarities to substance addiction. For example, the loss of control or the compelling need to eat food, a drive that is activated by highly palatable foods.
This is how we define those that we like much more than others, such as those that include high levels of sodium or saturated fats.
At the brain level, they could act in a similar way to drugs of abuse.
A problematic diagnosis
However, the concept of food addiction raises a number of difficulties. One of them is that eating is physiological, so establishing what is appropriate and what is not can be complex.
On the other hand, it is not possible (as in the case of drugs) that the goal of treatment is to eliminate consumption: we need to eat to survive.
Furthermore, food addiction is often confused with other problems such as obesity, binge eating disorder or bulimia. Clinically, separating these disorders is difficult.
If we consider that a person can develop a food addiction, it seems logical to think that it is possible to diagnose it.
Remember that we mentioned the DSM-V-TR manual above? Well, food addiction is not considered a disorder here. There are no specific diagnostic criteria for this behavior, beyond those that exist for addiction in general.
Neither the American Psychiatric Association nor the World Health Organization consider it a disorder.
So how can we diagnose it? The main tool for this is a psychometric test developed a few years ago by Yale University, called YFAS.
Since then, it has become the most widely used tool for detecting and investigating food addiction.
Arguments in favor
Some of the characteristics of addiction in general seem to be present in the case of food intake.
For example, there are overweight people who are unable to control the amount of food they eat, even though they know that this has caused them serious health problems. It is very similar to what happens to drug addicts.
Neuroimaging techniques have been able to observe changes in the brain in food addiction. For example, alterations have been identified in brain areas that are also modified in drug addiction.
In particular, the mesolimbic dopaminergic system would be altered in both cases.
Fluctuations in levels of the neurotransmitter dopamine in these regions may mediate our sensitivity to reinforcing stimuli such as food or substances of abuse.
Counterarguments
Much of the research on food addiction has been conducted in animal models, such as rats or mice.
In these studies, the subjects’ availability to one type of food or another is quite limited. This is something that does not happen in real life: in prosperous societies, human beings can access any type of food at any time.
Second, the overlap of food addiction with other disorders (especially binge eating disorder) makes it very difficult to isolate it as a stand-alone disorder. For example, patients with binge eating disorder and people with food addiction have scored similarly on the YFAS.
Finally, there is no agreement on whether the problem is a specific food or the act of eating itself, which further complicates the conceptualization of the disorder.
What about sugar addiction?
You have probably heard more than once that we are addicted to sugar. In this sense, it can be considered a subtype of food addiction.
It would consist of excessive consumption of ultra-processed foods with a high sugar content, addictive due to its reinforcing properties. However, it is not clear that it can function as a drug of abuse at the brain level, at least in humans.
In line with the case of sugar, some studies have even explored the possible existence of addiction to chocolate or fast food (which, in addition, is often consumed with drinks with a high sugar content). But there is still much to be investigated in this regard.
In conclusion
Although it seems obvious that something is happening with food, the concept of addiction applied to food intake still has many shades of gray that need to be clarified through research. Today it is an ambiguous term, at least at a clinical level.
The preference for some foods over others is something that all human beings share and that, in general terms, we have learned.
What we need to know is why the consumption of certain foods can become very problematic for certain people. Only then can we prevent these problems and help those who suffer from them.
*Elisa Rodríguez Ortega is a PhD Associate Professor, UNIR – International University of La Rioja, Spain
*This article was first published on The Conversation and is reproduced here under a creative commons license. Click here if you want to read the original version.
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