Food Addiction: Adding to Obesity Stigma?

The concept of food addiction holds strong sway in popular culture. You can find tips for overcoming it. WebMD will tell you how to diagnose and treat it. Psychiatrist Anna Lembke has a book to sell you. In Dopamine Nation, she describes the source of addictive behaviors linked to food, phones, and sex. It was an instant bestseller this year. But a big question remains. Does food addiction accurately explain eating behaviors or does it do more to heap stigma on people with obesity?

An Effect on Self-Stigma

Newly published in Obesity, a study by Lindsey Parnarouskis and colleagues tells us that food addiction explanations for obesity may fuel self-stigma. This was an RCT that assigned people randomly to four different groups. One received an explanation of obesity tied to food addiction. For a second group, the explanation was eating addiction. Another read a passage that explained obesity as a problem of calorie balance. Finally, a control group read something about memory which had nothing to do with obesity.

None of the obesity frames had an effect on stigma directed toward others with obesity. But the food addiction frame resulted in more internalized stigma. The calorie balance frame did not. Nor did the eating addiction frame.

Now, this is a small study – 447 persons in total – with important limitations. So this is hardly the last word. But other studies have found stigma coming from the use of food addiction labels.

Words are powerful tools for for promoting stigma.

Controversy Beyond the Stigma

Of course, it’s also worth remembering that the concept of food addiction is not something embraced by all the scientists who have studied it. In AJCN earlier this year, Ashley Gearhardt and Johannes Hebebrand summarized points of agreement and disagreement. It’s clear enough that some eating behaviors resemble addictive behavior. Some of the mechanisms that fuel this behavior overlap with addiction. The food industry may contribute to this problem.

But scientists still disagree about the strength of evidence to say ultra-processed foods are addictive.

This presumption is common among food policy advocates and pundits who pretend to have all the answers for obesity. But we’ve learned the hard way that presumptions about obesity have a way of tripping us up.

It’s possible that the label of food addiction will do more to create stigma than to explain or overcome obesity.

Click here for the study by Parnarouskis et al, here and here for additional studies of food addiction and stigma. For further perspective, click here, here, and here.

Poppies, painting by Katsushika Hokusai / WikiArt

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September 20, 2021