Do You Have a Food Addiction?

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

If you do, it’s usually to food that is satisfying to your senses but not good for your weight and health. Take a quick addiction self-assessment and learn more about this common problem.

Food Addiction – Are You an Addict?

During years in medical practice I learned that many patients habitually succumbed to food cravings and overate even though they had serious health issues, were overweight, and might even get sick as a result of overeating. Such habits run rife in our consumer- and pleasure-oriented society, and typically involve food high in calories or taste satisfaction widely believed to contribute to diabetes and weight problems. Examples are sugar, starch, fat, and salty foods.

The degree to which there is food addiction within the population is controversial. Through a 2014 study (Flint et. al) from Harvard published in the American Journal of Clinical Nutrition, researchers examined the food habits of nearly 135,000 middle-aged and older women enrolled in the Nurses’ Health Study and found that 8 percent of women (aged 45 to 64) and nearly 3 percent of older women met the criteria of food addiction.

In their study, the researchers used a food addiction scale to assess the women’s answers to 27 different questions about their eating habits over the past year. The questions included:

  • “I find that when I start eating certain foods, I end up eating much more than planned.”
  • “I find myself continuing to consume certain foods even though I am no longer hungry.” 

Through another 2013 study (Pedram et. al) from Canada, researchers found that “food addicts” were 11.7 (kg) heavier and had 8.2 percent more body fat than “non-addicts.” The researchers concluded that addiction contributes to severity of obesity and body composition measurements in the general population and that there was a higher rate in women as compared to men.

The target of a middle-of-the-night food foray is not likely to be kale or leftover steamed vegetables, low in calories and tastiness, but rather something like cookies or ice cream or chocolate. Foods like that deliver satisfaction to the palate and the brain.

The issue of food addiction is not just a matter of lack of willpower. Craving and overeating can have many stimuli, including appetite, psychological, emotional, and sensory factors. Age may also be a factor, with younger people more involved with addiction issues. Unmarried women are more likely affected than married women. And some ex-smokers have replaced their nicotine habit with a food addiction, a practice known as addiction transference.

So-called “pleasure eating” certainly plays a role. A 2012 study (Monteleone, et. al) in the Journal of Clinical Endocrinology concluded that when eating is motivated by pleasure, rather than to restore the body’s energy needs, chemical signals are activated that can lead to overeating. This phenomenon ultimately affects body mass and may be a factor in the rising incidence of obesity. The authors of the study used the term “hedonistic hunger” to describe eating for the sake of enjoyment of taste. An example is desiring and having a piece of cake even after a filling meal. That’s pleasure-driven consumption.

I often encountered patients who admitted that they headed for the sweets when they were stressed. For them, and for many others like them, highly palatable food serves as almost a pacifier, a quasi-antidote to the stress. However, it is a maladaptive antidote, and if done regularly, has consequences.

Patients also told me they craved bread. The 2011 bestselling book Wheat Belly, written by William Davis, M.D., a cardiologist in Milwaukee, focuses on how wheat, and even whole grains, raises blood sugar and causes weight gain. More than common sugar, he asserts. His answer is to eliminate grains from the diet. That’s quite a challenge for most people because wheat and grains are so ubiquitous, the primary element in bread and pasta as well as ingredients in many processed foods. My recommendation, and something I am doing myself, is to try to minimize consumption, especially if you have a weight or blood sugar problem.

Another question mark in all of this is the proliferation of genetically modified foods. It is not unreasonable to suspect that unnatural elements being introduced into these foods could possibly generate a craving effect. Who knows?

The bottom line is that food addiction is an addiction. I often found it difficult to help patients whose eating habits had a negative effect on their health unless they participated in some form of psychotherapy to address the problem.

Food Addiction Checklist

What exactly is food addiction?  Are you addicted?

Experts say the problem involves three particular characteristics:

  • an intense craving
  • a loss of control over the food craved
  • and a continual eating of the craved food despite bad consequences.

Do you have any of those characteristics? Some people can exhibit all three in their relationships with food.

References and Resources:

  • Flint AJ, Gearhardt AN, et. al. Food addiction scale measurement in 2 cohorts of middle-aged and older women. Am J Clin Nutr, March 2014. [Abstract.]
  • Pedram P, Wadden D, et. al. Food Addiction: Its Prevalence and Significant Association with Obesity in the General Population. PLoS One. 2013; 8(9): e74832.[Full article.]
  • Monteleone P, Piscitelli F, et. al. Hedonic eating is associated with increased peripheral levels of ghrelin and the endocannabinoid 2-arachidonoyl-glycerol in healthy humans: a pilot study. J Clin Endocrinol Metab. 2012 Jun;97(6):E917-24. doi: 10.1210/jc.2011-3018. [Abstract / Press release.]
  • Davis, W. Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health (Rodale, Inc. 2011). [ page.]

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