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Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications

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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 July 2019) | Viewed by 90759

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Special Issue Editors

Assoc. Prof. Dr. Adrian Carter

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Guest Editor

School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton Victoria 3800, Australia
Interests: addiction; ethics; public policy; neuroscience; mental health; stigma; discrimination; self-effiacy

Dr. Tracy Burrows

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Guest Editor

School of Health Sciences, Faculty of Health, University of Newcastle, Newcastle, NSW 2308, Australia
Interests: dietary assessment; biomarkers; obesity; addictive eating
Special Issues, Collections and Topics in MDPI journals

Dr. Charlotte Hardman

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Guest Editor

Department of Psychological Sciences, University of Liverpool, UK
Interests: psychology; eating behaviour; appetite control; obesity; addiction-like eating

Special Issue Information

Dear Colleagues,

There is a growing view that certain foods, particularly those high in refined sugars and fats, may be addictive and that some forms of obesity can usefully be treated as a food addiction. This perspective is supported by an expanding body of evidence from animal studies, human cognitive neuroscience, and brain imaging. Obese and overweight individuals also display patterns of eating behavior that resemble the ways in which addicted individuals consume drugs. Scientific and clinical questions remain: Is addiction a valid explanation of excess weight? Is food addiction a behavioural (i.e., eating) or substance (i.e., sugar) addiction, or a complex interaction of both? Should obesity be treated as a food addiction? Should we distinguish food addiction from other forms of disordered eating like Binge Eating Disorder? It is also unclear what impact food addiction explanations might have on the way in which we think about or treat people who are overweight: what impact will a food addiction diagnosis have on individuals’ internalised weight-bias, stigma, self-blame, and belief in their ability to lose weight? Should some foods be regulated like other addictive commodities (i.e., alcohol and tobacco), whose advertising and sale is restricted, or like certain foods, which are taxed? This Special Issue will cover a range of scientific, clinical, social, and policy questions raised by the concept of food addiction.

Assoc. Prof. Dr. Adrian Carter
Assoc. Prof. Dr. Tracy Burrows
Dr. Charlotte Hardman
Guest Editors

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Keywords

Food addiction
Eating addiction
Public policy
Stigma
Treatment
Weight bias
Obesity

Published Papers (11 papers)

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Editorial

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4 pages, 191 KiB

Open AccessEditorial

Food Addiction and Eating Addiction: Scientific Advances and Their Clinical, Social and Policy Implications

by Adrian Carter, Charlotte A. Hardman and Tracy Burrows

Nutrients 2020, 12(5), 1485; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12051485 - 20 May 2020

Cited by 5 | Viewed by 7333

Abstract

There is a growing understanding within the literature that certain foods, particularly those high in refined sugars and fats, may have addictive potential for some individuals [...] Full article

(This article belongs to the Special Issue Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications)

Research

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10 pages, 249 KiB

Open AccessArticle

The Effect of a Food Addiction Explanation Model for Weight Control and Obesity on Weight Stigma

by Kerry S. O’Brien, Rebecca M. Puhl, Janet D. Latner, Dermot Lynott, Jessica D. Reid, Zarina Vakhitova, John A. Hunter, Damian Scarf, Ruth Jeanes, Ayoub Bouguettaya and Adrian Carter

Nutrients 2020, 12(2), 294; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12020294 - 22 Jan 2020

Cited by 17 | Viewed by 5708

Abstract

There is increasing scientific and public support for the notion that some foods may be addictive, and that poor weight control and obesity may, for some people, stem from having a food addiction. However, it remains unclear how a food addiction model (FAM) explanation for obesity and weight control will affect weight stigma. In two experiments (N = 530 and N = 690), we tested the effect of a food addiction explanation for obesity and weight control on weight stigma. In Experiment 1, participants who received a FAM explanation for weight control and obesity reported lower weight stigma scores (e.g., less dislike of ‘fat people’, and lower personal willpower blame) than those receiving an explanation emphasizing diet and exercise (F_(4,525) = 7.675, p = 0.006; and F_(4,525) = 5.393, p = 0.021, respectively). In Experiment 2, there was a significant group difference for the dislike of ‘fat people’ stigma measure (F_(5,684) = 5.157, p = 0.006), but not for personal willpower weight stigma (F_(5,684) = 0.217, p = 0.81). Participants receiving the diet and exercise explanation had greater dislike of ‘fat people’ than those in the FAM explanation and control group (p values < 0.05), with no difference between the FAM and control groups (p > 0.05). The FAM explanation for weight control and obesity did not increase weight stigma and resulted in lower stigma than the diet and exercise explanation that attributes obesity to personal control. The results highlight the importance of health messaging about the causes of obesity and the need for communications that do not exacerbate weight stigma. Full article

(This article belongs to the Special Issue Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications)

16 pages, 840 KiB

Open AccessArticle

Food Addiction in Eating Disorders and Obesity: Analysis of Clusters and Implications for Treatment

by Susana Jiménez-Murcia, Zaida Agüera, Georgios Paslakis, Lucero Munguia, Roser Granero, Jéssica Sánchez-González, Isabel Sánchez, Nadine Riesco, Ashley N Gearhardt, Carlos Dieguez, Gilda Fazia, Cristina Segura-García, Isabel Baenas, José M Menchón and Fernando Fernández-Aranda

Nutrients 2019, 11(11), 2633; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11112633 - 03 Nov 2019

Cited by 52 | Viewed by 8317

Abstract

Food addiction (FA) has been associated with greater psychopathology in individuals with eating disorders (ED) and obesity (OBE). The current study aims to provide a better phenotypic characterization of the FA construct by conducting a clustering analysis of FA in both conditions (ED and OBE). The total sample was comprised of 234 participants that scored positive on the Yale Food Addiction Scale 2.0. (YFAS-2) (119 bulimia nervosa (BN), 50 binge eating disorder (BED), 49 other specified feeding or eating disorder (OSFED) and 16 OBE). All participants completed a comprehensive battery of questionnaires. Three clusters of FA participants were identified. Cluster 1 (dysfunctional) was characterized by the highest prevalence of OSFED and BN, the highest ED severity and psychopathology, and more dysfunctional personality traits. Cluster 2 (moderate) showed a high prevalence of BN and BED and moderate levels of ED psychopathology. Finally, cluster 3 (adaptive) was characterized by a high prevalence of OBE and BED, low levels of ED psychopathology, and more functional personality traits. In conclusion, this study identified three distinct clusters of ED-OBE patients with FA and provides some insight into a better phenotypic characterization of the FA construct when considering psychopathology, personality and ED pathology. Future studies should address whether these three food addiction categories are indicative of therapy outcome. Full article

(This article belongs to the Special Issue Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications)

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17 pages, 664 KiB

Open AccessArticle

Obesity Stigma: Is the ‘Food Addiction’ Label Feeding the Problem?

by Helen K. Ruddock, Michael Orwin, Emma J. Boyland, Elizabeth H. Evans and Charlotte A. Hardman

Nutrients 2019, 11(9), 2100; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11092100 - 04 Sep 2019

Cited by 10 | Viewed by 6891

Abstract

Obesity is often attributed to an addiction to high-calorie foods. However, the effect of “food addiction” explanations on weight-related stigma remains unclear. In two online studies, participants (n = 439, n = 523, respectively, recruited from separate samples) read a vignette about a target female who was described as ‘very overweight’. Participants were randomly allocated to one of three conditions which differed in the information provided in the vignette: (1) in the “medical condition”, the target had been diagnosed with food addiction by her doctor; (2) in the “self-diagnosed condition”, the target believed herself to be a food addict; (3) in the control condition, there was no reference to food addiction. Participants then completed questionnaires measuring target-specific stigma (i.e., stigma towards the female described in the vignette), general stigma towards obesity (both studies), addiction-like eating behavior and causal beliefs about addiction (Study 2 only). In Study 1, participants in the medical and self-diagnosed food addiction conditions demonstrated greater target-specific stigma relative to the control condition. In Study 2, participants in the medical condition had greater target-specific stigma than the control condition but only those with low levels of addiction-like eating behavior. There was no effect of condition on general weight-based stigma in either study. These findings suggest that the food addiction label may increase stigmatizing attitudes towards a person with obesity, particularly within individuals with low levels of addiction-like eating behavior. Full article

(This article belongs to the Special Issue Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications)

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13 pages, 1466 KiB

Open AccessArticle

Food Addiction Is Associated with Irrational Beliefs via Trait Anxiety and Emotional Eating

by Laurence J. Nolan and Steve M. Jenkins

Nutrients 2019, 11(8), 1711; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11081711 - 25 Jul 2019

Cited by 25 | Viewed by 8516

Abstract

Irrational beliefs (IB) are believed, in cognitive behavioral therapies, to be a prime cause of psychopathologies including anxiety, depression, problem eating, and alcohol misuse. “Food addiction” (FA), which has been modeled on diagnostic criteria for substance use disorder, and emotional eating (EE) have both been implicated in the rise in overweight and obesity. Both FA and EE are associated with anxiety. Thus, in the present study, the hypothesis that IB is associated with FA and with EE was tested. Furthermore, possible mediation of these relationships by trait anxiety and depression (and EE for IB and FA) was examined. The responses of 239 adult participants to questionnaires measuring FA, IB, EE, depression, trait anxiety, and anthropometrics were recorded. The results revealed that IB was significantly positively correlated with FA and EE (and depression and trait anxiety). Furthermore, only EE mediated the effect of IB on FA and this was not moderated by BMI. Finally, trait anxiety (but not depression) mediated the effect of IB on EE. Exploratory analysis revealed a significant serial mediation such that IB predicted higher FA via elevated trait anxiety and emotional eating in that order. The results of this study suggest that IB may be a source of the anxiety that is associated with EE and FA and suggest that clinicians may find IB a target for treatment of those persons who report experiences of EE and FA. IB may play a role in food misuse that leads to elevated BMI. Full article

(This article belongs to the Special Issue Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications)

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10 pages, 1161 KiB

Open AccessArticle

Food Addiction Symptoms and Amygdala Response in Fasted and Fed States

by Kirrilly M. Pursey, Oren Contreras-Rodriguez, Clare E. Collins, Peter Stanwell and Tracy L. Burrows

Nutrients 2019, 11(6), 1285; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11061285 - 06 Jun 2019

Cited by 20 | Viewed by 4890

Abstract

Few studies have investigated the underlying neural substrates of food addiction (FA) in humans using a recognised assessment tool. In addition, no studies have investigated subregions of the amygdala (basolateral (BLA) and central amygdala), which have been linked to reward-seeking behaviours, susceptibility to weight gain, and promoting appetitive behaviours, in the context of FA. This pilot study aimed to explore the association between FA symptoms and activation in the BLA and central amygdala via functional magnetic resonance imaging (fMRI), in response to visual food cues in fasted and fed states. Females (n = 12) aged 18–35 years completed two fMRI scans (fasted and fed) while viewing high-calorie food images and low-calorie food images. Food addiction symptoms were assessed using the Yale Food Addiction Scale. Associations between FA symptoms and activation of the BLA and central amygdala were tested using bilateral masks and small-volume correction procedures in multiple regression models, controlling for BMI. Participants were 24.1 ± 2.6 years, with mean BMI of 27.4 ± 5.0 kg/m² and FA symptom score of 4.1 ± 2.2. A significant positive association was identified between FA symptoms and higher activation of the left BLA to high-calorie versus low-calorie foods in the fasted session, but not the fed session. There were no significant associations with the central amygdala in either session. This exploratory study provides pilot data to inform future studies investigating the neural mechanisms underlying FA. Full article

(This article belongs to the Special Issue Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications)

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13 pages, 262 KiB

Open AccessArticle

Validation of the Japanese Version of the Yale Food Addiction Scale 2.0 (J-YFAS 2.0)

by May Thet Khine, Atsuhiko Ota, Ashley N. Gearhardt, Akiko Fujisawa, Mamiko Morita, Atsuko Minagawa, Yuanying Li, Hisao Naito and Hiroshi Yatsuya

Nutrients 2019, 11(3), 687; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11030687 - 22 Mar 2019

Cited by 31 | Viewed by 5654

Abstract

The Yale Food Addiction Scale 2.0 (YFAS 2.0) is used for assessing food addiction (FA). Our study aimed at validating its Japanese version (J-YFAS 2.0). The subjects included 731 undergraduate students. Confirmatory factor analysis indicated the root-mean-square error of approximation, comparative fit index, Tucker–Lewis index, and standardized root-mean-square residual were 0.065, 0.904, 0.880, and 0.048, respectively, for a one-factor structure model. Kuder–Richardson α was 0.78. Prevalence of the J-YFAS 2.0-diagnosed mild, moderate, and severe FA was 1.1%, 1.2%, and 1.0%, respectively. High uncontrolled eating and emotional eating scores of the 18-item Three-Factor Eating Questionnaire (TFEQ R-18) (p < 0.001), a high Kessler Psychological Distress Scale score (p < 0.001), frequent desire to overeat (p = 0.007), and frequent snacking (p = 0.003) were associated with the J-YFAS 2.0-diagnosed FA presence. The scores demonstrated significant correlations with the J-YFAS 2.0-diagnosed FA symptom count (p < 0.01). The highest attained body mass index was associated with the J-YFAS 2.0-diagnosed FA symptom count (p = 0.026). The TFEQ R-18 cognitive restraint score was associated with the J-YFAS 2.0-diagnosed FA presence (p < 0.05) and symptom count (p < 0.001), but not with the J-YFAS 2.0-diagnosed FA severity. Like the YFAS 2.0 in other languages, the J-YFAS 2.0 has a one-factor structure and adequate convergent validity and reliability. Full article

(This article belongs to the Special Issue Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications)

12 pages, 1711 KiB

Open AccessArticle

Increasing Chocolate’s Sugar Content Enhances Its Psychoactive Effects and Intake

by Shanon L. Casperson, Lisa Lanza, Eram Albajri and Jennifer A. Nasser

Nutrients 2019, 11(3), 596; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11030596 - 12 Mar 2019

Cited by 13 | Viewed by 7975

Abstract

Chocolate elicits unique brain activity compared to other foods, activating similar brain regions and neurobiological substrates with potentially similar psychoactive effects as substances of abuse. We sought to determine the relationship between chocolate with varying combinations of its main constituents (sugar, cocoa, and fat) and its psychoactive effects. Participants consumed 5 g of a commercially available chocolate with increasing amounts of sugar (90% cocoa, 85% cocoa, 70% cocoa, and milk chocolates). After each chocolate sample, participants completed the Psychoactive Effects Questionnaire (PEQ). The PEQ consists of questions taken from the Morphine-Benzedrine Group (MBG), Morphine (M,) and Excitement (E) subscales of the Addiction Research Center Inventory. After all testing procedures, participants completed the Binge Eating Scale (BES) while left alone and allowed to eat as much as they wanted of each of the different chocolates. We found a measurable psychoactive dose–effect relationship with each incremental increase in the chocolate’s sugar content. The total number of positive responses and the number of positive responses on the E subscale began increasing after tasting the 90% cocoa chocolate, whereas the number of positive responses on the MBG and M subscales began increasing after tasting the 85% cocoa chocolate sample. We did not find a correlation between BES scores and the total amount of chocolate consumed or self-reported scores on the PEQ. These results suggest that each incremental increase in chocolate’s sugar content enhances its psychoactive effects. These results extend our understanding of chocolate’s appeal and unique ability to prompt an addictive-like eating response. Full article

(This article belongs to the Special Issue Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications)

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Review

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36 pages, 1077 KiB

Open AccessReview

Food Addiction: Implications for the Diagnosis and Treatment of Overeating

by Rachel C. Adams, Jemma Sedgmond, Leah Maizey, Christopher D. Chambers and Natalia S. Lawrence

Nutrients 2019, 11(9), 2086; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11092086 - 04 Sep 2019

Cited by 57 | Viewed by 19019

Abstract

With the obesity epidemic being largely attributed to overeating, much research has been aimed at understanding the psychological causes of overeating and using this knowledge to develop targeted interventions. Here, we review this literature under a model of food addiction and present evidence according to the fifth edition of the Diagnostic and Statistical Manual (DSM-5) criteria for substance use disorders. We review several innovative treatments related to a food addiction model ranging from cognitive intervention tasks to neuromodulation techniques. We conclude that there is evidence to suggest that, for some individuals, food can induce addictive-type behaviours similar to those seen with other addictive substances. However, with several DSM-5 criteria having limited application to overeating, the term ‘food addiction’ is likely to apply only in a minority of cases. Nevertheless, research investigating the underlying psychological causes of overeating within the context of food addiction has led to some novel and potentially effective interventions. Understanding the similarities and differences between the addictive characteristics of food and illicit substances should prove fruitful in further developing these interventions. Full article

(This article belongs to the Special Issue Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications)

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18 pages, 613 KiB

Open AccessReview

Ethical, Stigma, and Policy Implications of Food Addiction: A Scoping Review

by Stephanie E. Cassin, Daniel Z. Buchman, Samantha E. Leung, Karin Kantarovich, Aceel Hawa, Adrian Carter and Sanjeev Sockalingam

Nutrients 2019, 11(4), 710; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11040710 - 27 Mar 2019

Cited by 30 | Viewed by 8612

Abstract

The concept of food addiction has generated much controversy. In comparison to research examining the construct of food addiction and its validity, relatively little research has examined the broader implications of food addiction. The purpose of the current scoping review was to examine the potential ethical, stigma, and health policy implications of food addiction. Major themes were identified in the literature, and extensive overlap was identified between several of the themes. Ethics sub-themes related primarily to individual responsibility and included: (i) personal control, will power, and choice; and (ii) blame and weight bias. Stigma sub-themes included: (i) the impact on self-stigma and stigma from others, (ii) the differential impact of substance use disorder versus behavioral addiction on stigma, and (iii) the additive stigma of addiction plus obesity and/or eating disorder. Policy implications were broadly derived from comparisons to the tobacco industry and focused on addictive foods as opposed to food addiction. This scoping review underscored the need for increased awareness of food addiction and the role of the food industry, empirical research to identify specific hyperpalatable food substances, and policy interventions that are not simply extrapolated from tobacco. Full article

(This article belongs to the Special Issue Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications)

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Other

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15 pages, 756 KiB

Open AccessDiscussion

Fat Addiction: Psychological and Physiological Trajectory

by Siddharth Sarkar, Kanwal Preet Kochhar and Naim Akhtar Khan

Nutrients 2019, 11(11), 2785; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11112785 - 15 Nov 2019

Cited by 24 | Viewed by 6508

Abstract

Obesity has become a major public health concern worldwide due to its high social and economic burden, caused by its related comorbidities, impacting physical and mental health. Dietary fat is an important source of energy along with its rewarding and reinforcing properties. The nutritional recommendations for dietary fat vary from one country to another; however, the dietary reference intake (DRI) recommends not consuming more than 35% of total calories as fat. Food rich in fat is hyperpalatable, and is liable to be consumed in excess amounts. Food addiction as a concept has gained traction in recent years, as some aspects of addiction have been demonstrated for certain varieties of food. Fat addiction can be a diagnosable condition, which has similarities with the construct of addictive disorders, and is distinct from eating disorders or normal eating behaviors. Psychological vulnerabilities like attentional biases have been identified in individuals described to be having such addiction. Animal models have provided an opportunity to explore this concept in an experimental setting. This discussion sheds light on fat addiction, and explores its physiological and psychological implications. The discussion attempts to collate the emerging literature on addiction to fat rich diets as a prominent subset of food addiction. It aims at addressing the clinical relevance at the community level, the psychological correlates of such fat addiction, and the current physiological research directions. Full article

(This article belongs to the Special Issue Food Addiction and Eating Addiction: Scientific Advances and their Clinical, Social and Policy Implications)

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