The term ‘food addiction’ makes us all addicts

People like food, need food, but addicted to it in the clinical sense? That’s quite a big call. 

Even worse, some stories that have started to appear in some of the populist media are claiming that foods are engineered specifically to make us drooling addicts who are unable to control the urge to keep eating, and eating, and eating.

And while it’s easy enough to dismiss this sort of absurd claims because of where they are being reported, it’s a fact that some academic circles are now promoting the notion that obesity is the result of food addiction, rather an energy imbalance. That is unfortunate.

The New Zealand Food & Grocery Council recently attended a symposium on this very subject, hosted by the University of Otago. We did so because we were hoping to get a better understanding of the scientific consensus (if any) in this field.

But rather disappointingly we found that although there was little evidence, there seemed to be a desperate desire to cement the formal terminology surrounding “food addiction​” into academic discussion, despite the fact that so far there’s a paucity of evidence mostly derived from limited rat studies.

This is an important point that often is missed in discussions. What academics promoting the fat addiction theory seldom make clear is that the evidence they cite is mostly based on rat studies which, while interesting, are limited because (to point out the obvious) humans and rats differ in more ways than one!

Animal studies are frequently cited as a reason to single out certain addictive foods or ingredients, which can be very misleading. It’s these studies that have been the basis for often repeated but misleading lines that sugar is apparently as addictive as heroin – a claim that does not bear even the simplest scrutiny when one attempts to compare a person eating too many donuts with an addicted intravenous drug user.

Yes, consuming sugar causes the brains of rats to release opioids as a sign of pleasure. But glucose is the only fuel that can be used by brain cells so it’s probably not surprising that the poor lab rats get switched on when they receive it, and react accordingly.

Such results do not mean sugar is as addictive as heroin, which also causes the brains of rats to release opioids. Since rats lack a pre-frontal cortex, that’s just one of the obvious ways they differ from humans!

It’s clear that “food addiction​” has become the latest fashionable phrase to be used interchangeably to describe a wide range of non-clinical situations. As readers of FoodNavigator-Asia are well aware, just because food is enjoyable and desirable by some doesn’t mean it’s addictive for the majority of the population.

Neither should the fact that companies seek to produce products that consumers might want to buy and enjoy be seen as some dark plot when preparing appetising food for families is a goal shared not only by food companies, but every home cook.

Imagine a world in which the food is a beige gloop, so unappetising that people don’t want to eat? Sadly, when food is unappealing, awful under-nutrition is a more common problem than obesity in this type of environment, so this is clearly not a solution for improving the health of our population.

The term “addiction​” has entered the vernacular to mean “desire​”, “interest​”, and “enjoyment​”. So, in casual conversation, New Zealanders are frequently saying they might be “addicted​” to things like rugby union, reality TV shows, Facebook, Mum’s lemon cheesecake, etc.  

Children generally adore toys, but does that mean they’re addicted? Of course not. The word is used frequently when many of us indulge in something a little more often that we should (or think we should).

Strictly speaking, “addiction​” should be used only to describe clinically significant conditions that involve the continued repetition of a behaviour despite adverse consequences.

It is well established that adverse addictions, such as gambling, smoking, drugs, compulsive and obsessive over-consumption of many foods which can be anything from alcohol to carrots (hard to believe, but true), can be clinically significant.

Now, in no way am I trying to minimise these issues for people who struggle with genuine addictions and obsessive compulsions, but it’s also clear that these behaviours do not apply to the population as a whole.

There’s also the very important point that food consumption is different from other vices in one important respect: all human beings have the compulsion to eat, usually at least three times a day.

To stop eating and starve has adverse consequences, so in this one respect we may somewhat unhelpfully all be prone to a potential diagnosis of food addiction.

In fact, bearing in mind that most people would admit that their days are significantly disrupted by stopping to prepare and eat food, if they were to complete the questionnaire​ based on the Yale Food Addiction model (access it by clicking this link​ – though it was playing up at the time of publishing) many could be judged as “might be food dependent​”.

Since we all have to stop what we’re doing at some time during the day and eat to survive, wouldn’t most people fit this definition? Except for the minority of people with a mental health issue vis à vis food, trying to redefine obesity in terms of an addiction when every human on the planet is dependent on food for survival has significant pitfalls.

What really irks in the discussion by some academics on food addiction is that only certain foods are being fingered as being so-called potentially addictive. They include:

• Sweets such as ice cream, chocolate, doughnuts, cookies, cake, candy and ice cream
• Starches such as white bread, rolls, pasta and rice
• Salty snacks such as chips, pretzels and crackers
• Fatty foods such as steak, bacon, hamburgers, cheeseburgers, pizza and French fries
• Sugary drinks colloquially known in New Zealand as fizzy drinks.

This list is based on what compulsive over-eaters most frequently say they consume too much of, although these foods, on their own and when consumed in moderation as part of a healthy balanced diet, all have an appropriate place.

Most experts will tell you it’s dangerous to mix personal clinical health interventions and population health approaches. I’ve been advised that even if food addiction exists as a clinically significant diagnosis, it belongs in the realm of personal mental health, along with other addictions.

In general, many reviews indicate that the vast majority of overweight people do not have convincing behavioural or neurological signs of true addiction, and this was freely admitted at the University of Otago event. As such, this remains a poor premise for a mainstream public health intervention.

Rather than focusing on the development of this new theory, our efforts are surely better placed in promoting useful solutions on what we know to be true – for example, there seems to be precious little effort or funding going into the promotion of good nutrition and exercise.

Macro theories can be interesting. In reality, a collective dumping on fizzy drinks by academics is not likely to make a jot of difference to the individual who struggles with his or her weight.

However, since we all make something like 200 food-related decisions a day, focusing on strategies to make some of these decisions relate to ongoing health and wellbeing is probably a good start.

Let’s start promoting the carrot and stop waving the stick.