Food Addiction: Helpful, Hurtful, or Just Off the Mark?
The popular interest in food addiction is impossible to miss. A search for scholarly articles on the subject yields thousands of references in 2016 alone. A check for news items produces hundreds of thousands. Amazon will serve you more than seven thousand books on the subject.
So Nicole Avena and Nina Crowley met with an eager audience at YWM2016 yesterday when they debated the merits of food addiction as a cause for obesity.
Avena presented the argument for food addiction as a helpful explanation for one pathway to obesity. At the top of her list for the most addictive foods was pizza, chocolate, chips, cookies, and ice cream. Cucumbers, carrots, beans, apples, and brown rice were at the bottom.
To her credit, Avena conceded the limitations of this idea. Supporting data is mostly from animals. It adds stigma, perhaps as much or more than it adds understanding. And food and drugs play very different roles in the human experience. But she concluded with an emphasis on the addictive properties of sugar and highly processed foods.
The countering argument from Crowley was that addiction could not fully explain the complexity of obesity and the many factors that contribute. People without obesity may have symptoms of food addiction. And many people with obesity have no symptoms of food addiction.
However helpful models of food addiction might be, they also bring further stigma to a diagnosis that is already stigmatized. But perhaps the most serious limitation is that food addiction is a misleading model for the complex, chronic disease of obesity.
At best, it’s a just a small part of a much bigger picture.
Click here for their presentations and here for an excellent review of what is and isn’t known about food addiction.
Grass Addiction, photograph © Michael Davis-Burchat / flickr
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August 27, 2016
August 27, 2016 at 2:46 pm, Amy Endrizal said:
Looks like the consensus on food addiction is that there is no consensus. I was just looking at another review of the literature that reached a similar conclusion. http://www.ncbi.nlm.nih.gov/pubmed/27372453 But as long as the public thinks of addiction in the vernacular sense of craving for something pleasurable and not its scientific meaning, it will be hard not to jump to conclusions about the relationship among food, satiety, and weight. Always appreciate your insights and clarifications of the tangle of assumptions and ideas regarding obesity policy and treatment.
August 27, 2016 at 5:08 pm, Ted said:
Thanks, Amy!
September 02, 2016 at 11:29 am, Stephan Guyenet said:
I think if we start from the principle that obesity has multiple causes, the food addiction model makes some sense. I don’t think there is much support for the idea that food addiction, or any other single factor, completely explains obesity. But I think it’s likely to play a role in some people. Our food today is far more rewarding than what our brains evolved to expect, and in susceptible people it seems to lead to the destructive prioritization of reward-seeking behavior we call addiction. Or at least, something that resembles it closely.
But food addiction is part of a larger concept that has a lot more explanatory power for obesity, and that concept is food reward. Whether or not we’re addicted, when we have a greater “hedonic drive” to eat (not the most accurate term but commonly used), we’ll tend to eat more than is homeostatically necessary. Addiction is just an extreme version of this same reward drive phenomenon that affects all of us. Who hasn’t had the experience of eating too much of a food that’s highly rewarding, like cookies, pizza, ice cream, potato chips, or chocolate? It’s not hard to see how this would contribute to positive energy balance– whether or not you’ve crossed the threshold we call addiction– in a world where these types of foods surround us.