Food addiction: The symptoms and how it affects your health
There's some debate as to whether food addiction is real, but mental health pros see it often.
"Just one piece" sometimes ends up like this. But does that always mean you're addicted to food?
Just one piece of chocolate, you think, after a long day at work. You have good intentions but before you know it, wrappers lie all around and you're left with a tummy ache -- and probably a wave of guilt or self-shame.
Food -- especially palatable food -- has a way of making people temporarily toss their healthy resolutions for the instant gratification of satisfied taste buds. While the occasional chocolate indulgence is no problem, if you often find yourself unable to stop eating certain foods even when you're full, it may indicate a problem.
Food addiction, while not defined in the Diagnostic and Statistical Manual (DSM) of Mental Disorders as a psychiatric condition, resembles drug and alcohol addiction in many ways, and many mental health professionals agree that food addiction is a real condition.
Like other addictions, addiction to food can interfere with relationships and obligations, as well as impact your health -- learn what kinds of foods are addictive, how food addiction develops, and how to get help if you're struggling with food addiction.
Is food addiction real?
The topic of food addiction is debated among medical experts, mental health care workers, scientists and dietitians.
Whether or not food addiction truly exists is controversial among health professionals, Ashley Hopkins, RD, LDN, director of wellness program success at Wellable tells CNET. Though it's highly debated, she says, the concept of food addiction was examined in a systematic review of studies in 2018, to determine if certain addiction characteristics -- such as preoccupation and impaired control -- can be associated with food.
The findings did, in fact, support the idea that food addiction is possible. Additionally, some scientists argue that ignoring the potential addictiveness of foods can lead to public health issues just like other addictions.
Susan Masterson, a health psychologist, tells CNET that much of the debate about food addiction arises because food doesn't pack the chemical "punch" that alcohol and drugs do, but the effect can still be emotionally powerful.
"Contrary to what most people think, it's not the actual substance people become addicted to, it's the chemical [and] emotional response within us that hooks us,"Masterson says. "The temporary pleasure and emotional relief stems from the release of neurotransmitters in combination with other cognitive factors such as our expectations of our experience being met."
What kinds of foods are addictive?
Foods you would call "junk food" -- cookies, candy, potato chips, cheese puffs, and the like -- are very palatable, which gives them their addictive qualities.
Typically, high-fat, high-sugar and high-calorie foods are the most addictive, Hopkins says.
"Highly processed foods with added fats and sugars tend to have the greatest addictive potential," she says. "It's thought that the brain develops a stronger preference for calorie-dense foods, and prepackaged snacks fit the bill."
One important thing to call out is that these kinds of snacks also tend to contain higher amounts of refined grains and lower levels of satiating fiber, Hopkins says, which results in food moving more quickly through the digestive system.
"Combine this with starch, sugar, salt and fat and you have yourself a food that can be addictive and also likely to leave you feeling hungry not long after eating it," she explains. This is one of the reasons why even people without food addiction may find it difficult to to eat certain foods in moderation, and the reason why these foods are not usually fresh fruits and vegetables.
Studies have found that eating processed foods, especially those with high fat content and a high glycemic index (a measure of how a food affects your blood sugar), results in the most addictive behaviors. There's limited evidence of whether or not fast food is addictive, though most fast food meals meet the criteria for what's generally considered an addictive food: high-fat, high-sugar and high-calorie foods are all potentially addictive.
How does food addiction happen?
True food addiction works just like addictions to drugs or alcohol: by hijacking the reward pathways in your brain.
Food addiction develops just like drug and alcohol addiction, by affecting the way your brain works. Research shows that certain types of foods can influence neurological patterns in your brain, and some patterns overlap in people with obesity and drug addiction.
While no one can say for sure if there's any one underlying psychological issue to point to, Masterson notes that the general theory is that "people who tend to become dependent on a substance have a deficiency in the reward mechanism in the brain."
Ingestion of palatable foods can fill that gap, she says, which is what makes the food so satisfying. As for what causes the reward mechanism deficiency, Masterson says that any number of factors in your history or genetic or biological makeup could be the culprit.
Effects of food addiction
People with food addiction may find themselves inexplicably eating past the point of fullness, eating in secrecy, or avoiding social gatherings to eat alone instead.
Masterson puts it poignantly: "Well, for the most part, someone with a food addiction isn't exactly going to be hooked on broccoli."
People usually become addicted to something nutritionally deficient, high in fat or sugar and high in calories, she says. Two effects of this are weight gain and an ongoing fight with weight management, which can add additional struggles on top of the issues that led to the addiction in the first place. The cycle of dependence can also exacerbate underlying emotional difficulties, Masterson says.
Hopkins says that food addiction can impact your relationships and responsibilities, too. People with food addiction may find themselves avoiding social gatherings, eating alone or in secrecy and being preoccupied with food. Preoccupation with food may mean spending excessive amounts of time planning meals and snacks, buying food and the actual act of eating, which can become a problem if these activities cut into work, school or family time.
As with other addictions, there's a spectrum of severity depending on how many symptoms are present -- for example, tolerance in terms of food addiction can apply to consumption of salty, sugary or fatty foods, Dr. Stacy Cohen, double-board certified addiction and general psychiatrist and founder of The Moment, tells CNET.
"People can have multiple unsuccessful efforts to cut back intake of these foods with no avail," Cohen says, "and people will eat these foods until they are ill and will go to great lengths to obtain them, despite them not being immediately available, like late-night runs to the store or ordering delivery multiple times."
These are just a few of the examples that overlap with both substance and behavioral addictions, she says, noting that the more criteria present from the DSM, the more severe the addiction.
Food addiction and eating disorders
Food addiction may be related to eating disorders in some cases, Cohen says.
This may be the case because most food-related disorders are rooted in the binge-restrict cycle: Restriction, such as excessive fasting, inadequate calorie intake or removal of entire food groups, sends the body to believe it is in famine, and ends in episodes of overeating or bingeing.
People make jokes about eating disorders and binge eating, like in the Instagram post above, but it can become a serious problem if the cycle persists.
Cohen emphasizes that it's completely natural to use food as a comfort in times of stress and to soothe yourself in moderation. It becomes a problem "when overeating is not connected to an emotional moment but rather is a frequent occurrence, happening time and time again."
A key sign of a problem that may point to an eating disorder: thoughts of guilt and shame that accompany overeating, especially after the fact.
An eating disorder specialist may say you can't be addicted to food, Cohen says, explaining that "you can be fooled into thinking you are addicted to food, but that typically comes from a place of restriction and your body's desire to be fueled."
A person who thinks they are addicted to food may be chronically under-fueling themselves (not eating enough) or stuck in a binge-restrict cycle where they overeat and then try to compensate by fasting, dieting or compulsively exercising. Eventually, Cohen says, the body's biological system takes over and induces overeating, which becomes a cycle.
How food addiction is treated
There isn't one standard or widespread food addiction treatment method as of yet, Masterson says, and "finding a treatment center dedicated to this type is going to be hard to find."
For the most part, she says, a mental health specialist can help you address food addiction by identifying any underlying thoughts, beliefs and behavior patterns that fuel the addiction, and then finding ways to replace those thoughts and patterns.
Cohen says there are two "radically different" approaches to treating food addiction. Eating disorder specialists do it one way and addiction specialists do it another way.
"Eating disorder experts will say that removing foods will only trigger a greater biological subconscious desire to eventually eat these foods, and usually overeat to abundance," she says. "The guilt that then surrounds the eating episodes ('I ate too many cookies') then triggers a restriction cycle ('I am never buying those cookies again') and the pattern continues."
In that sense, in order to heal your relationship with food, eating trigger foods (and eating enough in general) can reverse the idea you're addicted to food, Cohen says.
On the flip side, addiction experts may create strict rules around food and use a 12-step program similar to Alcoholics Anonymous -- in this case, it's Overeaters Anonymous (OA). In an OA program, abstinence from trigger foods is key, Cohen says.
It's common for dieticians, like in the Instagram post above, to say food addiction occurs as an effect of food restriction -- this is a valid train of thought, but some people need a different approach, Cohen says.
How to tell if you're struggling with food addiction
Food addiction will play out differently in everyone, but there are some common symptoms to look out for.
Behavioral symptoms of food addiction, according to Cohen, Hopkins and Masterson, as well as the 2018 systematic review on food addiction, can include:
- Intense and persistent food cravings
- Eating past the point of fullness, and even past the point of physical discomfort
- Eating in isolation or secrecy, especially because of feelings of shame
- Finding it very difficult to say "no" to fatty, sugary, processed foods
- Feeling guilty after overeating
- Attempting to avoid certain foods because they trigger you to overeat
- Excessively using food as a coping mechanism
- Engaging in a binge-restrict cycle
- Making late-night food runs
- Spending excessive amounts of money on foods, specifically for bingeing
- Avoiding social interactions to avoid trigger foods, or to eat in isolation instead
- Making food rules for yourself and breaking them over and over
Food addiction also brings about emotional symptoms, such as low self-esteem and feelings of hopelessness, as well as physical symptoms, such as fatigue and digestive issues.
As for when to seek help, Masterson says to look at how food is affecting your life. "If something you're doing causes you impairment in an aspect of your life, such as your health, relationships or job, it's worth addressing," she says. "If you suspect it's a problem, it probably is. Often we don't recognize a pattern as problematic until it's pretty well-established and hard to ignore."