Professor John Blundell from the Institute of Psychological Sciences at the University of Leeds warns the term “food addiction” is being used far too freely.
Some have likened food addiction to drug addiction, and then used this term to associate it with overeating, and as a clinical explanation for the obesity epidemic, implicating millions of people.
The use of the term “food addiction” is a step towards medicalization and implies that normal human social behavior is pathological.
Forms of eating therefore become an illness. This attitude is not helpful and has huge implications for the way in which people view their own behavior and their lives.
The concept of food addiction comes from a combination of experimental data, anecdotal observations, scientific claims, personal opinions, deductions and beliefs.
It is an over-simplification of a very complex set of behaviors.
The existing evidence fails to define the precise characteristics of the actual foods concerned or the eating environment that underlies the assumed addiction risk.
This is in contrast to drug addiction, where the molecule is identified and its pharmacological effect on the brain is characterized.
Some have likened food addiction to drug addiction, and then used this term to associate it with overeating
Animal studies have shown changes to specific brain regions in those given a sugary diet – and human brain scans show activation of reward systems in the same part of the brain when sweet tastes are consumed.
Therefore, it is not surprising that reward centres are activated when sweet foods are consumed, as we know that the reward circuits in the brain have been established through evolution as signalling systems that control our appetite.
Many stimuli influence these areas of the brain and, in addition, there is an intrinsic drive to consume carbohydrate-rich foods to satisfy a basic metabolic need of the brain.
Sweetness is a major signal for such foods but the science has not yet assessed this fully and much more work is needed before we could say that food is addictive.
Attributing food addiction as the single cause underlying the development of obesity, despite the existence of numerous other very plausible explanations, is unhelpful, particularly for those trying to live more healthy lives.
Prof. John Blundell many people may potentially latch on to the concept of food addiction as an excuse to explain their overeating – the premise that it’s “not my fault” and therefore, “I can’t help it”.
This removes the personal responsibility they should feel and could act on – and they infer that their eating is a form of disease.
Food addiction may offer an appealing explanation for some people but the concept could seriously hinder an individual’s capacity for personal control.
Binge eating disorder does exist – but it is a rare clinical condition affecting fewer than 3% of obese people.
Sufferers have a strong compulsion to eat, which persists alongside the sense of a loss of control.
Addiction-like food behavior may be a component of the severe and compulsive form of binge eating disorder.
DSM-5, an update to one of the most important manuals in mental health – known as the bible of psychiatry – is to be published later.
Controversy and criticism has surrounded work on the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Some say the rulebook will turn normal behavior, like grief or childhood temper tantrums, into mental illness.
The manual is used mainly in the US, but is influential around the world.
This is the first update to the volume since 1994. Experts in mental health have been taking account of the latest scientific developments to update ways of diagnosing mental disorders.
The exact changes will be presented at a meeting of the American Psychiatric Association (APA).
There will be new categories including binge eating disorder, disruptive mood dysregulation disorder and hoarding disorder. Meanwhile Asperger’s syndrome will become part of autism spectrum disorders rather than having a section of its own.
The publication will have no effect on how people are diagnosed in countries which use guidelines from the World Health Organization (WHO).
Controversy and criticism has surrounded work on the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Prof. Peter Kinderman, head of the Institute of Psychology at the University of Liverpool, said: “[DSM-5] will lower many diagnostic thresholds and increase the number of people in the general population seen as having a mental illness.”
He said “normal grief” would now be classed as a major depressive disorder and childhood temper tantrums would be a symptom of disruptive mood dysregulation disorder.
Also: “A wide range of unfortunate human behaviors, the subject of many new year’s resolutions, will become mental illnesses – excessive eating will become <<binge eating disorder>>, and the category of <<behavioral addictions>> will widen significantly to include such <<disorders>> as <<internet addiction>> and <<s** addiction>>.”
There is also criticism of the way DSM classifies diseases based on symptoms. There are efforts to harness advances in genetics and neuroscience to diagnose people based on the cause rather than the symptoms of the illness.
The director of the US government’s National Institute of Mental Health said DSM had a “lack of validity”.
Dr. Thomas Insel posted a blog saying: “Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.
“In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.”
In some areas the distinction between disorders is narrowing. Autism, attention deficit-hyperactivity disorder, bipolar disorder, major depressive disorder and schizophrenia are all classed as separate disorders based on their symptoms.
However, research published in the Lancet medical journal in February showed all five disorders shared several genetic risk factors.
Dr. David Kupfer, the chair of the DSM-5 task force, said: “The changes to the manual will help clinicians more precisely identify mental disorders and improve diagnosis while maintaining the continuity of care.
“We expect these changes to help clinicians better serve patients and to deepen our understanding of these disorders based on new research.”
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