"My name is Kris and I am a food addict." I've written a number of articles on food addiction before.
The feedback has been amazing... many people have commented and e-mailed me, sharing their struggles with food.
From talking to people, I have gotten the vibe that food addiction is a pretty common problem.
The cravings, obsessive thoughts about food, failure to cut back despite physical harm...
These symptoms are common, and they happen to be typical symptoms of addiction.
This has a well defined biological basis, because new studies have shown that junk foods activate the same areas in the brain as drugs of abuse (, ).
For this reason, people who are susceptible to becoming addicted can become addicted to foods, in the same way as drug addicts become addicted to drugs.
I personally know this to be true... I am a recovering drug addict, alcoholic and former smoker, and a few years after I became sober I developed an addiction to unhealthy foods.
The cravings, the thought processes, the complete lack of self control. It was exactly the same as my addiction to drugs, only a different substance and the social consequences weren't as severe.
Although I'm sure food addiction has been around for a long time, it is a relatively "new" term and isn't fully recognized as a real disorder yet.
Fortunately, times are changing. The number of papers on food addiction in the scientific literature has been increasing rapidly in the past few years.
Several studies have been conducted attempting to assess how common food addiction is, as well as how it affects peoples' weight and risk of chronic disease.
The results are pretty shocking and should serve as a wake up call for health professionals and public health authorities... many of which are currently clueless about the existence of this massive health problem.
As with most other addictions, there is no blood test to diagnose food addiction.
It is based on behavioral symptoms and is usually diagnosed with a questionnaire.
The DSM (Diagnostic and Statistical Manual of Mental Disorders) contains the official criteria used by health professionals to diagnose mental disorders.
Unfortunately, food addiction is not yet recognized in the DSM.
However, a scale called the Yale Food Addiction Scale has been developed in order to diagnose food addiction (, ).
It is a set of 27 questions that assess a person's eating and how it relates to the DSM's official criteria for addiction.
You can find the questions and the instructions on how to interpret them .
Someone who is a food addict according to this scale has the same brain responses and behavioral symptoms as a drug addict, it is just a different substance ().
Bottom Line: The Yale Food Addiction Scale is used to diagnose food addiction. It is a set of 27 questions that relate to the official criteria used by health professionals to diagnose addiction.
The largest study on the prevalence (percentage of people who have it) of food addiction was published in March, 2014.
This study included 134,175 women participating in the , a major observational study in the U.S. ().
Overall, 5.8% of the women met the criteria for food addiction and the numbers varied greatly with age:
- 45-64 years: 8.4%.
- 62-88 years: 2.7%.
- Food addiction was rare in the oldest women (80-88), around 1%.
This study did not include men or women under 45 years of age.
Not surprisingly, food addiction was strongly associated with overweight and obesity.
When the researchers looked at extreme obesity (BMI over 35), these women were 16-18 times more likely to be food addicts compared to those who were underweight.
Of the younger women (45-64), 14.6% of those with obesity were food addicts. This number rose to 24.7% for women with extreme obesity.
Food addiction was also linked to reduced physical activity and elevated cholesterol. Women who were depressed were twice as likely to be food addicts.
Bottom Line: In the largest study to date, 5.8% of U.S. nurses met the criteria for food addiction. This number was higher in the younger women and those who weighed the most.
Another study in 652 adults (both men and women) was conducted in Newfoundland, Canada ().
The researchers had the participants fill out the Yale Food Addiction Scale, then measured markers like weight, BMI, waist circumference and body fat percentage.
In this study, 5.4% of the individuals met the criteria for food addiction. If they looked at obese individuals only, 7.7% of them had food addiction.
Women were more than twice as likely as men to be diagnosed with food addiction, 6.7% in women compared to 3.0% in men.
Food addicts were, on average, 11.7 kg (26 pounds) heavier, measured 4.6 points higher on the BMI scale, had 8.2% greater body fat and 8.5% more abdominal fat.
Interestingly, not all food addicts were overweight or obese. 11.4% were either underweight or normal weight, although these people will be at a high risk of weight gain in the future.
Another important finding from this study was that people who didn't meet the full criteria, but still identified with some of the symptoms, were much more likely to be overweight.
In fact, there was a strong, positive correlation between symptom count and all markers of obesity.
This suggests that addiction-like behavior, even in the absence of downright addiction, was a major driver of overeating and weight gain.
In other words, the addictive nature of junk foods may be one of the main reasons that people overeat and get fat.
Bottom Line: One study showed that 5.4% of individuals in Newfoundland were food addicts. Symptoms of food addiction were strongly associated with all markers of obesity, even in people who didn't meet the full criteria.
Several smaller studies have assessed food addiction in different subgroups.
Not surprisingly, people who are obese are much more likely to be food addicts.
In one study, 15% of overweight/obese individuals seeking weight loss treatment were classified as food addicts ().
In a study of patients with Binge Eating Disorder, the prevalence of food addiction was 57%. In another study using a different criteria, 92% of binge eaters were diagnosed with food addiction (, ).
This is not surprising, because these two disorders share many of the same symptoms.
There are also studies showing that addiction-like symptoms are common in overweight children, suggesting that these problems can start at a young age (, ).
Bottom Line: Food addiction is even more common in obese individuals seeking weight loss treatment, as well as patients with binge eating disorder. Overweight children have addiction-like symptoms as well.
There are a few important takeaways from these studies:
- Around 5-6% of the general population has food addiction.
- This number goes up to 15% for those with obesity, and 25% for those with extreme obesity (at least in women).
- Women are twice as likely to be food addicts as men.
- Over 50% of patients with Binge Eating Disorder are food addicts.
- Overweight children have many signs of food addiction.
- Having addiction-like symptoms, without meeting the full criteria for food addiction, may also be an important driver of overeating and weight gain.
Overall, it seems very clear that food addiction is real and fairly common, especially among those who are overweight or obese.
In discussions about weight gain, it is often assumed that it is one and the same thing... that there is one single cause that applies to everyone who is overweight.
However, I think that obesity can have many different causes, biological, psychological and environmental, all of which lead to fat accumulation and positive calorie balance.
Food addiction may be considered a "subtype" of obesity. It is likely the main driver of overeating in many individuals, who may need a different type of treatment than non-addicts ().
Well... the only treatment that reliably works against addiction of any sort is complete abstinence. This is true of all addictions... smoking, alcoholism, drug addiction and food addiction.
In my opinion, telling a food addict to eat junk food in moderation is like telling an alcoholic to drink beer in moderation. It simply does not work, period.
Of course, we all need to eat, otherwise we end up starving to death. But no one needs to eat processed junk foods, there is absolutely no physiological need for them.
We need health professionals and public health authorities to open their eyes to the reality of this issue, so that we can actually help people with food addiction.
It is a serious disorder that greatly reduces quality of life, increases the risk of chronic disease and can lead to premature death.
Dealing with food addiction is difficult enough as it is. Not being acknowledged by doctors, nutritionists and public health authorities just makes it even harder.