Food Addiction: A Valid and Serious Health and Wellness Concern

Suggested Citation: Garko, MG. Food addiction and craving: Causes, biological and biochemical mechanisms. Let’s Talk Nutrition Bulletin. 2019; 18(1): 1-2.

Food Addiction: A Valid and Serious Health and Wellness Concern

   

Dr. Michael Garko, Ph.D.

Host & Producer of Nationally Syndicated and

Globally Streamed Let’s Talk Nutrition

Introduction

The issue of food addiction (FA) is the focus of both scientific research as well that of the media. There is considerable debate as to 1.whether FA is a valid concept, 2. how it should be defined, 3. its biological and biochemical mechanisms and 4.its connection to the obesity epidemic. This issue of Let’s Talk Nutrition Bulletin briefly examines these aspects of FA.

 

Definition of Food Addiction

The literature is replete with definitions of food addiction (FA). Imperatori et al. offer a useful and cogent definition: “FA refers to specific food related behaviors characterized by excessive and dysregulated consumption of high calorie food (i.e., foods with high sugar and/or fat.”1(p61) According to Imperatori et al., the most widely used approach in defining FA involves applying the DSM-IV-TR criteria for drug addiction.1 The criteria include the following: 1. substance taken in larger amount and for longer period than intended, 2. persistent desire or repeated unsuccessful attempts to quit, 3. a large amount of time/activity necessary to obtain, to use or to recover, 4. important social, occupational, or recreational activities dismissed or reduced, 5. continuative use despite knowledge of adverse consequences, 6) tolerance and 7.withdrawal symptoms.1

 

Although there is no agreement in viewing FA as an independent eating disorder (ED) or even a valid and useful concept,  Imperatori et al. make the argument that FA is valid and useful and that there is an overlap between FA and eating disorders (ED). For example, they contend that FA seems to have significant psychopathological overlaps with other EDs, especially with Binge Eating Disorder (BED) and Bulimia Nervosa (BN).1 For them, reduced control over eating, continued use despite negative consequences, elevated levels of impulsivity and psychopathology are some of the overlaps between FA and both BED and BN, notwithstanding differences between FA and BED and AN.1 My view is that FA has the hallmarks of ED. Thus, I tend to agree with Imperatori et al.’s view that FA is an ED and is connected to other eating disorders.

 

Cause of Food Addiction

In terms of the causes of FA, there seems to be “a neurobiological basis for food addiction” that implicates the mesolimbic reward system.2 Lennerz and Lennerz contend that just as the mesolimbic reward system is involved with drug abuse and addiction so too is it involved in FA in that similar to drugs of abuse addictive foods or foods of abuse hijack brain pathways for natural reward and aversion reactions.2 The mesolimbic reward system evolved to guide humans and other organisms toward seeking favorable, “potentially life- or kindred-sustaining stimuli” such as high caloric foods during times of sparse food supply, sweet foods and other natural rewards such as water.

 

Biological and Biochemical Mechanisms

Consequently, just as with drug addiction there is a “neurobiology of food addiction” that drives and is the underlying causal mechanism of action for FA. Lennerz and Lennerz explain that the neurobiology of consuming a problem food increases dopamine concentration in the mesolimbic system and, thus, increases salience and food motivation. Over time, dopamine signaling would perpetuate craving and food seeking. Consumption becomes habitual and compulsive. As dopamine receptors down regulate, food consumption becomes driven by the need to avoid withdrawal symptoms rather than by pleasure and homeostatic needs. Similar to what has been found in the research on chronic drug use, dopamine receptor levels represent a “vulnerability marker” and/or central dopamine and receptor concentrations become modified by excessive consumption of the addictive food over time.2

 

Food Addiction and Obesity

If it is as Lennerz and Lennerz explain and contend, it is not difficult to conclude that FA is intimately connected to obesity. In fact, Lennerz and Lennerz link food addition to obesity and argue that there is an epidemiological overlap between FA and obesity and a neurobiological overlap between addiction and obesity.2Such a view calls for a public health policy that recognizes obesity as biological and psychological disorder if not a disease. This recognition would shift the way obesity is conceptualized and treated. It would involve not only dietary and lifestyle behavioral changes but also psychologically-based interventions such as counseling and cognitive-behavioral therapy. Obesity is not just a matter of eating obesogenic foods and weight-loss is not simply replacing eating obesogenic foods with healthy foods. Rather, obesity is a multifactorial disease with a strong FA component.

Conclusion

FA is a real and concerning issue. It can be clearly defined. It possesses an underlying neurobiological basis, with specific biological and biochemical mechanisms. Further, FA is heavily implicated in the obesity epidemic. Taken together, all of these issues make FA a valid health and wellness concern deserving of scientific research and media focus.

References

 

  1. Imperatori, C, Fabbricatore, M, Vumbaca, V, Innamorati, M, Contardi, A, Farina, B. Food addiction: definition, measurement and prevalence in healthy subjects and in patients with eating disorders Riv Psichiatr, 2016; 51(2): 60-65.
  2. Lennerz, B, Lennerz, JK. Food addiction, high-glycemic-index carbohydrates, and obesity Clinical Chemistry, 2018; 64:1-8.

Suggested Citation: Garko, MG. Food addiction and craving: Causes, biological and biochemical mechanisms. Let’s Talk Nutrition Bulletin. 2019; 18(1): 1-2.