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How Common is Food Addiction?



sharma-obesity-food-addiction1Although 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.

10 Comments

  1. This is the first evaluation study on the prevalence of food addiction in the general population. The most important finding from this paper is the fact that food addiction is significantly correlated with the severity of obesitty indexed by virtually all obesity measures used in the study in not only food addicts but people who do not meet the diagnostic criteria of food addiction. The study provided the evidence that food addiction contributes to obesity in the common form of obesity in the general population. this will be followed by more questions to be answered. Is the prevalence of food addiction similar in other populations? Is there any siginificant difference between Caucasians and other populations? Is dietary intake an important player? How much genetics play in food addiction? A new wave of research in this field is coming!

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  2. I fully agree that “making consumption more difficult (taxing, banning, punishing)” is of VERY limited help! Our experience with Calogenetic Balance, based on the measurement of the individual metabolic rate and on the intake of the FAVOTITE foods and drinks within the own caloric requirement, can be of help even in cases of food addiction!! See our poster at the ECO2013 http://www.vitasanas.ch/wp/wp-content/uploads/2013/06/poster_calogenetic_balance_eco_liverpool_2013.jpg
    Kind regards from Switzerland

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  3. If I’m understanding the findings correctly, 5% of the population may be “food addicts.” I find this very significant if we consider that in our culture the “food addict” label is applied very broadly and casually to a vast percentage of people who struggle with a weight problem. Just the word “addict” is a loaded term that can impact a person’s self-image and influence how they attempt to address what they might perceive as the true cause of their weight problem.

    Bias against larger people is driven by assumptions about their judgment and behavior and the persistent belief that if you deal with weight, there’s “something wrong” with you. We will not make progress against the obesity problem in North America until we address the full range of complex factors that contribute to weight management.

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  4. Dear Dr. Sharma,

    I find even the concept of being addicted to something that’s vital to survival, puzzling. To sugar, yes. But not food itself.

    As someone who’s struggled with weight and an eating disorder all her life, I wouldn’t at all describe what goes on as addiction. I experience it as the same full blown “body panic” I’ve seen in other starvation survivors. I’ve eaten with concentration camp survivors, and though the ones I’ve met don’t struggle with weight, they have no control over the way they wolf down food as it’s presented. They can’t help it.

    As someone who works with abused animals who’ve been starved, they often have a lifelong struggle with binging and aggressive food guarding. These creatures may have to be fed in a separate area from the others, as they become dangerous when food is present. I could hardly label that as addiction. It’s simply the physical and emotional self ensuring survival. Addiction to heroin, alcohol, etc., is its opposite.

    I wish those labeling post-starvation responses would interview Holocaust survivors and the directors of animal rescues. There is a tremendous amount of information to be gleaned.

    I experience the same response to food, after years of starvation. I was a VERY competent dieter. I am now significantly overweight, and any attempt to diet leads to overwhelming feelings of full body panic. It is not “addiction.” I’m reacting out of a survival instinct, not one of self harm and self destruction.

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  5. Hi Dr Sharma,

    I identify as a food addict, and can tell you that, like other addictions, the 12 step approach that was offered via Overeaters Anonymous worked best for me. While most people who attend these meetings do not have a weight problem, I did. Using the abstinence program, I went through a dramatic weight loss (284lbs lost in total). My abstinence for me, of course, is not abstaining from all foods, but from foods that can trigger a binge. I don’t eat sweets, candy, savory snacks, and eat three meals a day, nothing in-between, one day at a time.

    I only wish health care professionals knew about this program and offered it to those at the end of their rope.

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  6. I looked quickly at the table of results in the study, and it seems that food addicts did NOT est more fat or protein than the others (there was a small, non-significant trend only). Did I miss something?

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  7. Food addicts ate more fat and protein expressed in percentage if you look at the last three lines of Table 5. There is a great interest in potential difference between food addicts and non food addicts, especially with non food addicts but equally obese in the research field.

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  8. Are you having trouble controlling the way you eat? Many of us with this problem have found help in Food Addicts in Recovery Anonymous (FA). FA is a program based on the Twelve Steps of Alcoholics Anonymous. The program offers help and recovery to those whose connection with food can be understood as a form of addiction. There are no dues or fees and the meetings include no weigh-ins. Membership is international and includes men and women, adolescents, and the elderly. All are welcome.

    People who find help in FA vary greatly. Some of us have been diagnosed as morbidly obese while others are undereaters. Among us are those who were severely bulimic, who have harmed themselves with compulsive exercise, or whose quality of life was impaired by constant obsession with food or weight. We tend to be people who, in the long-term, have failed at every solution we tried, including therapy, support groups, diets, fasting, exercise, and in-patient treatment programs.

    Some of our members have been in continuous recovery (maintaining a stable, healthy weight and enjoying freedom from obsession with food, weight, bingeing, or bulimia) for over twenty-five years. Members with five to ten years of recovery are increasingly common.

    FA has over 350 meetings throughout the United States in large and small cities such as Boston, San Francisco, Los Angeles, New York, Charlotte, Grand Rapids, Atlanta, Fort Lauderdale, Austin, and Washington, D.C. Internationally, FA currently has groups in England, Canada, Germany, New Zealand and Australia. If you would like more information about FA, please check out our website. If there aren’t any meetings in your area, you can contact the office, where someone will help you.

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  9. Though late in seeing this report, I found this finding very interesting, and goes with what I have been thinking so long. But unlike as an aberration, I think ,evolution of sweet tooth was a historical necessity, since man essentially being a fruitivore,needs it to distinguish the ripe sweet ones, from the bitter. poisenous fruits . In the modern living we rely mostly on visual cues( like Tv and the like) to select the food and at best smell, losing the relevance of sweetness altogether. Those who have retained the original one continue to eat more and become obese or overweight, because sweetened foodstuffs are every where,Nevertheless,an interesting finding..

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