Food.

Is it…

-guilty or innocent?

-good or bad?

-addictive?

What do you think?

Here’s another one…

Which of the following aspects make food something that we personify, argue about, and/or feel guilty or superior about?

1. the food itself
2. our eating behavior
3. our (misguided) desires
4. the latest diet trend or food tribe moralizing, demonizing, or exalting certain food categories
5. our society’s diet and wellness culture context
6. weight bias and stigma
7. healthism (the belief that being healthy and attractive is a moral objective within a culture and that the current accepted societal body type is a virtue.)

Pick all that apply.

I’m sure many will have various opinions and the options chosen will differ from person to person.

Sticky topic, right? (Pun kind-of intended. :))

We’ve come to a bit of a turning point in my series on eating disorders.

In this post, I will finish off my arguments on the controversial topic of labeling food, or specific eating behaviors, as addictive.

Let’s get started with an overview. (If you really want to get up-to-speed, click for part I and part II.)

Can (and Should) We Diagnosis Food as an Addiction?

In short, although food addiction is often referred to and accepted in wellness and health circles, it technically has NOT been officially classified as such. (source, source, source, source)

As I noted in part II on identifying food as an addiction, there’s major issues that still need to be resolved before it can be a true diagnosis. These include:

1. How to distinguish between food addiction and other eating disorders, as the behavior could be similar, but the treatments would differ. Confusion could cause harm if one treats an eating disordered pattern as an addiction and promotes restriction.
2. The definition itself, criteria, and treatments are not agreed upon among experts. Quantification scales have been extrapolated from substance use disorders and not validated to specifically diagnose food addiction. (It’s hard to test validity of a scale when you don’t even have a universally accepted measurement and characteristics.)
3. The conflicting evidence between mechanisms, theories, and associations in studies and actual human trial results. (Hungry, sweet-deprived rodents partake in sugar binges, non-restricted rats and people don’t.)

In this post, I’ll continue with the next set of issues. As I did in part II, I’ll lay out the outline first, then expand on them. Here are some more reasons why we should be cautious in labeling food as addictive:

4. There is no universal food that creates an addictive response in people. Unlike all forms of alcohol, by which an alcoholic can get drunk on, this is not the case for someone “addicted” to food.
5. Disordered eating often co-exists with other mental health disorders. Could we be focusing on the symptom and not treating the real imbalance, a brain health issue?
6. Labeling something that our body needs to function as “addictive” should not be taken lightly. When cutting out or restricting any food, the body needs external interventions to function properly. With alcohol, one stops drinking and one’s body, mind, and spirit recover. Although additional support may be needed, alcohol does not need to be replaced.

Now, let’s dive in more deeply.

Reason 4: There’s No Universal Food That Causes Addiction

Is Your Downfall a Cookie or a Cheese Curl?

As stated above, if someone is addicted to alcohol, the form of it doesn’t really matter. Similarly, a desperate addict will take a line or a smoke. So, can we really label “sugar” addictive when some can eat one form with impunity and not another?

Although alcohol causes harm to the body, many can drink with no negative social and emotional consequences, if done in moderation. They are not alcoholics. The problem is NOT alcohol itself.

If one can eat a potato chip, but not a twinkie without overindulging, or vice versa, are they a food addict? If so, are both foods substance of abuse, even though one can be enjoyed with moderation?

The fact is, there is no agreed upon food that universally produces the same response in those who have a predisposition to “food addiction.”

The same foods can have different effects based on many factors. These aspects differentiate between what foods are “off bounds” or “tempting” to one person versus another. These include:

• Personal preference
• One’s past experiences with that food
• Biochemical individuality
• Genetics
• Ethnicity
• Microbiome health
• Hyperpalability
• All the socioeconomic and cultural factors that contribute to eating behavior

The 2018 review article, “Food addiction: a valid concept?” explores the controversy from both angles. It states:

First, the addictive substance remains undiscovered—a problem that cannot be considered trivial. The model rests on a central assertion that either some category of foods, or some specific nutrients, exert a direct effect on the brain, enacting changes that ultimately hijack reward-related behaviors. Some have argued that sugar is the culprit though, as a whole, the evidence for sugar addiction remains deeply unconvincing [8]. Alternatively, others maintain that the refined and excessively palatable combinations of sugars and fats in Western diets increase addiction liability. But, as of now, no addictive substance has been identified. Second, there are crucial questions relating to how food addiction fits into the overall schema of problematic eating.

This leads us to number five.

Reason 5: Is It the Chicken or the Egg?

Is “food addiction” more a symptom than a disorder?

What is considered a “food addiction” has a high degree of comorbidity with other mental health issues. So, is food really “addictive” or is it a symptom of another mental health issue or coping skill? As stated in, “Current Status of Evidence for a New Diagnosis: Food Addiction- A Literature Review:”

Some authors even state that dual diagnosis is the rule, rather than the exception, especially in clinical samples (8). (source)

Here lies my biggest concerns:

• If we focus on behavior and preach an abstinence model for food, could we then set up people to shame and blame themselves when the underlying issue is not the food, but a mental health condition?
• Could we contribute to more eating disorders, orthorexia, and/or binge-eating disorders by promoting restriction?

I covered this a bit in part II when I discussed differentiating between eating disorders and food addiction.

I am seriously disturbed by this possibility.

Reason 6: Is Food Addiction/ Withdrawal as Dangerous as Crack or Alcohol Use/Withdrawal?

Addiction is not to be taken lightly.

According to Amen Clinics:

Addiction, also known as a substance use disorder (SUD), involves the harmful use of illicit drugs, prescription medications, and/or alcohol. Addiction occurs when habitual use of a substance or multiple substances changes the way the brain experiences pleasure.

There are biological, psychological, social, and spiritual (i.e., beliefs, core values, purpose, and morals) symptoms that emerge when one is addicted, and it can lead to dire consequences in every area of one’s life.

SUD is a complex topic that merges brain health with mental health. If one is truly “addicted” to food where it negatively effects one’s life, as does an illicit drug, substance of abuse, or alcohol, it is a serious matter.

We would find many “food addicts” unable to function and partaking in ilegal and harmful behaviors such as violence, drinking while under the influence of McDonald’s, and more.

Some may argue junk food is just as dangerous as drugs because people are wasting money on empty calories and/or damaging their health. But is that REALLY the same thing or is it a rationalization for healthism disguised as a concern for a supposed mental health issue?

And… isn’t it just as damaging to health to avoid social connection with people who eat differently than you and miss out on events because of fear of food?

Honestly… this is a very tender topic for me.

Conclusion: Can Food or Eating be Addicting?

Here’s the bottom line in my opinion.

All “addictions” have a mental, physical, and spiritual aspect. Society and cultural messages of shaming and perfectionism around food and body size could easily make one subconsciously “act out.” This can involve one using extreme eating patterns, in the name of health, only to find they are trapped in a damaging behavior.

As stated in the Washington Post article, “Could social media and diet trends be contributing to a little-known eating disorder?”:

There are just two criteria for diagnosing an eating disorder: distress and impaired function. If you or someone you know feels anxiety around food or eating, or starts to miss out on life because of their eating habits, it’s time to seek help. “Once a person starts to isolate from social events, like refusing to go to a birthday party because they feel they can’t eat what’s offered, or not wanting to eat with friends at restaurants, they’ve reached an extreme,” Merwin says. (source)

Herein lies the extreme cognitive dissonance for me:

Aren’t we causing impaired function (food restriction) and distress (food mortality) “treating” the very thing we are aiming to remediate?

Concerningly, the very people who have eating disorders and need support for these behaviors are turning for help to practitioners entrenched in diet and wellness culture. These experts could unknowingly, and perhaps with good intention, be promoting and partaking in eating disordered behavior themselves.

Which brings me back to my original statement, “Is Diet and Wellness Culture Contributing to Eating Disorders?”

Hmmm….

I feel we need to address the root cause of why, not spend our time arguing about labels, shaming, and vilifying certain food groups. It’s the same sick cycle, when the current dietary trend loses steam, and the weight cycling becomes evident (again), the “evil” food transforms into something angelical.

I personally have experience working with clients who have felt “addicted” to a certain food. After healing their relationship with nutrition and their body and balancing brain, emotional, spiritual, and physical health, they were then able to eat it again with enjoyment and moderation. Some even experienced that, after a time, they didn’t even like the “treat.” It was more that it was a “forbidden treasure,” and a psychological reward. After this realization, they were able to move onto something else more rewarding and nurturing to their mind-body.

For many, this took debunking diet and wellness culture beliefs and uncovering other mental health disorders, misguided coping skills, and/or unrelenting stress.

This is my experience clinically and personally, coming from a previous proclaimed “sugar addict.” I admit, I may have a select sample, but it hasn’t failed me or my clients yet, if they are willing.

In a follow up I want to address eating disorders specifically. I will address why a program that focuses on acceptance and emotional coping might be more helpful than trying to restrict, shame, and control the behavior that results from one already feeling out of control.

I’d love to hear what you think. Please comment below.

A Request:

I do ask all healthcare providers to be aware of the potential dangers of mental health labels and to not confuse opinion and selected literature citations as final proof. The science and psychology is not fully settled at the time of my writing this. Let’s recognize this and be accountable. (DSM-V doesn’t classify food as an addiction.)

For all consumers, please know you are not alone. If you are struggling with eating and it is causing you distress and to miss out on events because of the food there, please reach out to an eating disorder specialist. Preferably, find one who is also awake to the dangers of diet and wellness culture and will not perpetuate the sick cycle.

Please comment below and share this message with those who need it.

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Many blessings.

*Important Note:

If you struggle with mental health, please reach out for professional mental health support.

You may also wish to consider implementing holistic resources and partnering with a naturopathic doctor.

For example, I offer mind-body support for general mood issues using a functional medicine and wellness-oriented approach.