Food Addiction: When the Craving Consumes You

by RUCHI DESAI

It’s not uncommon to hear people talking about how they are addicted to cheese, are chocoholics, or just can't get enough of bread. While we may throw around the term “addiction” loosely when we discuss our favorite foods, food addiction is actually a highly contested term, and many scientists and doctors still debate over whether or not this is a real concept. The closest disorder that has been accepted by the medical community is binge-eating disorder. Binge-eating disorder is a disease in which an individual consumes a large amount of food and has difficulty stopping eating. [1] While this disorder focuses more generally on overeating, the term food addiction seems to suggest that certain types of foods are not only overeaten, but are also addictive in nature. Read on to learn about what a food addiction is, how it works, and what the science has to say!

background

While scientific use of the term “addiction” in regard to food can be traced back to the 19th century, the term “food addiction” only became more popular in the last few years. Its rise in popularity can be traced back to the beginning of the 21st century when people began worrying about processed foods. [2] Because the term food addiction is relatively new, many researchers have attempted to draw parallels between it and substance abuse.

Oftentimes, when individuals think of food addiction, they associate obesity and weight issues with the disease. However, there is currently no consensus on whether or not a person of normal body weight can be a food addict or if food addiction is a disease restricted to individuals that are overweight or obese.

Definitions 

food addiction

Addiction, in terms of drug addiction, has been defined as an extreme psychological state in which an individual has lost control over drug use. The individual may suffer from physical consequences when attempting to stop drug use. [3] In a broader sense, addiction is defined as failure to stop doing a certain kind of activity despite attempting to do so. The word addiction generally has a negative connotation, and many clinical criteria focus on the negative effects of addiction on one’s body.

food dependence

This is another term that has to be defined in terms of drugs. Drug dependence is a phenomenon in which an individual needs a drug to function normally and, when refraining from using the drug, suffers from withdrawal. [3] Theoretically, food dependence would constitute a similar phenomenon.

food craving

A food craving is an intense desire to eat a certain kind of food. Individuals with a food craving are able to recognize that they have one. [3]

understanding addictions

When we think about addictions we usually think about substance abuse in terms of drugs, alcohol, and chemicals. As such, it’s not surprising that the majority of research on food addiction has focused on the similarities between food cravings and drug addiction. In fact, the Food Addiction Institute considers food addiction to be a form of chemical dependency. [5]

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), in order for a person to be considered addicted to or dependent on a substance, 3 of the following 7 symptoms must be present:

• tolerance: increasing amounts of the substance are needed to achieve the same amount of pleasure each time

• withdrawal: physical and emotional symptoms that arise when an individual stops using a particular substance

• using large amounts of the substance

• having a feeling of intense desire for the substance and being unable to control its use

• spending a lot of time using the substance, looking for the substance, or recovering from its effects

• using the substance despite it interfering with other aspects of the individual’s life

• using the substance despite prior knowledge about its ill effects [6]

In order to determine the existence of food addictions, researchers have used the DSM-V criteria for substance addictions and have attempted to draw parallels between food addiction and drug addiction. More specifically, researchers have looked into the neurochemistry and neuroimaging similarities between these two concepts.

so what does the research say?

neurochemistry

Dopamine, a neuromodulator in the brain, is considered to reinforce the effects of food, drug abuse, and pleasure. A 2003 study in NeuroImage found that consuming food causes the brain to release dopamine and that the amount of dopamine released is positively correlated with the degree of pleasure experienced. [7]

A 2009 review in the Journal of Nutrition analyzed a number of studies which demonstrated that consuming excess amounts of sugar can produce endogenous opioid dependency, a condition in which a food addict's brain produces its own opium-like chemicals and becomes dependent on them. Release of endogenous opioids leads to higher levels of dopamine, which trigger pleasure or a rewarding effect. In layman's terms this means that food addicts produce chemical signals in their brains that are very similar to those produced in the brains of opiate drug addicts. [4]

neuroimaging

A 2004 study in NeuroImage  conducted brain imaging scans to study food cravings. The researchers used functional magnetic resonance imaging (fMRI), which detects changes in blood flow in order to measure brain activity. They found that craving-related changes in the fMRI images occurred in the hippocampus, insula, and caudate nucleus, three areas of the brain that are also involved in drug craving. This study provides evidence for the idea that a common component in food and drugs causes cravings. [8]

A 2013 study in the American Journal of Clinical Nutrition found that after consuming a high glycemic meal, men experienced an initial spike in blood sugar followed by a sharp crash a few hours later. fMRI scans showed that the crash in blood sugar activated a part of the brain that is known to be involved in addictive behaviors—the nucleus accumbens. It is important to note that the study focused solely on men that were overweight and obese and that the sample may not have been representative of the population. [9]

specific foods that may be addictive

Foods that are high in fat or sugar are usually the ones that are considered “addictive.” In fact, foods that are high in fats, carbohydrates, and salts have a high glycemic load. This means that they are absorbed much faster by the body and give rise to an intense spike in blood sugar. This spike in blood sugar is often what is considered problematic and may be what gives rise to the development of food cravings and addictions. [10] However, when it comes to specific types of food, things get a bit trickier. The two food items that seem to be discussed most often are chocolate and cheese.

chocolate

“Chocoholics” are individuals that have an intense desire and love for chocolate. However, is this desire actually an addiction? According to a 2000 study in Pharmacology, Biochemistry, and Behavior, the answer would be no. The authors argue that much of the so-called addictive properties of chocolate are actually byproducts of social and cultural perceptions about appropriate intake and uses of chocolate. Food items like chocolate, desserts, and sweets are often considered nice but unhealthy and as such are consumed in addition to our normal meals as treats or rewards. As a result, many of us try to restrict our intake of these items. However, dietary restriction only seems to make chocolate more desirable, leading to the phenomenon that we label as a food craving instead of hunger because we have been conditioned to think of chocolate as an indulgence rather than a necessity. [3]

cheese

Cheese contains casein, a protein found in most dairy products. When casein is broken down, it forms small protein fragments called casomorphins, which can bind to the receptors for opioid molecules in the brain. As explained earlier, the release of opioids in the brain has been connected to feelings of pleasure and may be associated with drug addiction as well. [10]

In the 2009 scientific report by the European Food Safety Authority, researchers found that even though casomorphins can reduce pain in mice, they do not have the same effect as morphine, which is an opioid. [11] This is significant, because it demonstrates that while cheese may have some properties that intensify pleasure, it does not intensify pleasure on the same level as drugs. So all of those “cheese is as addictive as crack” headlines that you may have read were really quite misleading.

bottom line

Scientists and doctors are still divided on whether or not food addictions exist. While there seems to be some evidence that foods that have high levels of fat, sugar, and carbohydrates have the potential to be more addictive, there does not seem to be as much evidence that certain kinds of foods like chocolate and cheese are specifically addictive.

References ▾

1. “Binge-eating disorder.” mayoclinic.org. 2016.
2. “Back by Popular Demand: a Narrative View on the history of Food addiction Research.” Yale J Biol and Med. 2015.
3. “Food Craving and Food “Addiction”: A Critical Review of the Evidence From a Biopsychosocial Perspective.”Pharmacol Biochem Be. 2000.
4. “Food addiction in Humans.”J Nutr. 2009.
5. “What is Food Addiction?”http://foodaddictioninstitute.org/.2016.
6. “Symposium Overview- Food Addiction: Fact or Fiction?” J Nutr. 2009 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714380/
7. “Feeding-induced dopamine release in dorsal striatum correlates with meal pleasantness ratings in healthy human volunteers.” NeuroImage. 2003
8. “Images of Desire: Food Craving activation during fMRI.” NeuroImage. 2004
9. “Effects of dietary glycemic index on brain regions related to reward and craving in men.” Am J Clin Nutr. 2013.
10. “No Cheese is not just like Crack.” sciencenews.org. 2015
11. “Review of the potential health impact of β-casomorphins and related peptides.”European Food Safety Authority. 2009.

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