Food addiction: Where the ‘cold turkey’ method never works
On the surface, compared to other vices such as drugs or alcohol, overeating may sound relatively harmless. But numbers suggest that junk food, far more accessible than the most illicit controlled substances, may be just as addictive, if not more so.
The University of Michigan, between 2022 and 2023, polled a national sample of adults age 50 to 80, and found that 13% met the standard for addiction to highly processed food over the past year — 44% of the sample indicated at least one criteria for addiction to highly processed food.
The study also found that older adults in the sample who self-reported their mental health as “fair” or “poor” were at least three times more likely to meet the standard for food addiction compared to those who self-reported as “good,” “very good,” or “excellent.”
Despite this, there is no officially-recognized definition for what “food addiction” really is. It is not listed as a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, which was last updated in 2013. Furthermore, there is even some debate over whether overeating can even be classified as a type of addiction at all.
“For some reason, it's not one that people seem to run to get help. I'm not sure if it's still kind of in the closet or what,” said John Neyman, who has worked as a licensed therapist for nearly four decades.
Now based in Buffalo Township, Neyman provides therapy for numerous problems, including food-related addictions, which make up a tiny portion of the hundreds who come to him for help each year.
Out of the 30 to 40 patients on average that see Neyman in a given week, only a tenth of them are there to seek treatment for a food-related addiction, such as binge eating, bulimia or anorexia.
Neyman theorizes that this may simply be due to embarrassment and/or reluctance.
“I think with addictions of alcohol or drugs … a lot of times they get to the end of the rope and they want help,” Neyman said. “With food addiction, there’s still that whole embarrassment and cover-up, and, I think, it's easier to cover up as well.”
Becky Mehr, director of outpatient nutrition services at the Renfrew Center, an organization that treats eating disorders, highlighted a distinct difference between food and other types of addiction.
“When we’re talking about food addiction, it’s usually compared with substance use disorders, and things we can maybe survive without, meaning drugs, alcohol and tobacco,” she said. “But we can’t survive without food. Food is a basic need for life.”
Whatever food addiction is, or isn’t, more research is going into it today than ever before. In 2009, Yale University’s Rudd Center for Food Policy and Obesity released the first version of the Yale Food Addiction Scale — a 25-question survey designed to assess the level of food dependence in individuals, according to the Diagnostic and Statistical Manual’s definition of an “addiction.”
The Yale Food Addiction Scale asks participants about their monthly food-related behaviors, with answers on a seven-point scale ranging from “never” to “every day.” Questions include, “I avoided work, school or social activities because I was afraid I would overeat there,” and “I didn't do well at work or school because I was eating too much.”
Certain types of junk food are emphasized in the scale, such as sugary, starchy and salty treats. Indeed, multiple studies have found troubling similarities between overeating and other, more well-studied forms of addiction, including illicit drugs.
A 2002 study led by Johns Hopkins University professor Carlo Colantuoni found that a group of laboratory mice exhibited symptoms similar to opioid withdrawal after being administered sugar for a period of time and then having it taken away. These symptoms included anxiety, excessive teeth chattering and reluctance to go through a maze.
Despite some similarities, the concept of food addiction is not the same as binge eating disorder. Unlike food addiction, binge eating disorder is listed as a formal diagnosis in the Diagnostic and Statistical Manual, and there are specific criteria that define binge eating disorder.
According to a study conducted by five psychiatrists from the University of Novi Sad in Serbia, there are some key similarities and differences between food addiction and binge eating disorder.
Some major differences are that binge eating disorder sufferers are known to eat for short-term pleasure to ignore mental problems and are known to be conscious about their weight and body image. Those with a food addiction, on the other hand, tend to deny they have such an addiction in the first place.
Bulimia nervosa is similar to binge eating in many ways, including its psychological triggers and potentially damaging effects on the body. However, unlike with binge eating disorder, bulimia sufferers “purge” after their binge eating, due to low self-esteem and fear of gaining weight.
Neyman says that there is no easy solution to food addiction, and it starts with confronting each patients’ self-image.
“The core solution is to change your thinking. You have to change the neurons in the brain,” Neyman said. “We have to change some core philosophies and beliefs when it comes to food addictions because some addictions with food … they visualize their body. They might be skinny, but they see themselves as overweight or such.”
But the most direct way to tackle food-related addictions, Mehr said, is to either seek help from an outside source or make serious lifestyle changes.
“I think they should seek support from a therapist and a registered dietitian with experience in treating eating disorders or emotional disorders,” Mehr said.
