How Common is Food Addiction?

Although there is little doubt that food addiction exists, the question of how common this may be remains a matter of debate.

Now a study by Pardis Pedram and colleagues from Memorial University, Newfoundland, examine this issue in a paper just published in PLoS One.

The study looks at 652 adult volunteers (415 women, 237 men) recruited from the general population.

‘Food addiction’ was assessed using the Yale Food Addiction Scale (YFAS), a questionnaire consists of 27 items that assess eating patterns over the past 12 months. The YFAS translates the Diagnostic and Statistical Manual IV TR(DSM-IV TR) substance dependence criteria in relation to eating behaviour (including tolerance and withdrawal symptoms, vulnerability in social activities, difficulties cutting down or controlling use, etc.). The criteria for ‘food addiction’ are met when three or more symptoms are present within the past 12 months together with clinically significant impairment or distress.

Based on these criteria, ‘food addiction’ was present in 5.4% of participants (6.7% in females and 3.0% in males) and increased with obesity status.

Interestingly enough, the clinical symptom counts of ‘food addiction’ were positively correlated with all body composition measurements across the entire sample (p<0.001) – not just in those with higher BMI.

Nevertheless, “food addicts” substantially heavier (11.7 kg), had 4.6 units higher BMI, and had 8.2% more body fat than “non-addicts”. Furthermore, food addicts consumed more calories from fat and protein than controls.

Thus, this study shows that as many as 1 in 20 (or 5%) of the general population may have a diagnosis of “food addiction”. Those who do are substantially heavier than individuals who do not meet these criteria.

Furthermore, individual symptoms of “food addiction” are associated with higher body weight across the entire range of BMI suggesting that even mild to moderate signs of “addiction” (below the threshold of a formal diagnosis) may contribute to weight gain in the general population.

As with all addictions, simply warning about the “evils” or making consumption more difficult (taxing, banning, punishing) is of limited help in addressing the problem. In addition, given that total “food-abstinence” is not an option, the best you can hope for is “harm-reduction” – a rather conservative goal for any addiction.

Clearly, not recognising the potential role of food addiction as a contributor to the obesity epidemic means missing the boat on providing appropriate care to individuals with this condition.

As with other addictions, “Simply say no” approaches are naive at best in addressing the problem.

@DrSharma
Edmonton, Alberta

p.s. Three co-authors of this paper (Danny Wadden, Peyvand Amini and Farrell Cahill) are graduates of the Canadian Obesity Network’s annual Summer Bootcamp.