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ATLANTA — About 1 in 8 Americans over the age of 50 struggle with an unhealthy relationship with highly processed foods that goes well beyond the occasional binge or midnight snack, according to a recent survey.
Known as food addiction, the condition isn’t limited to older adults: Previous data on food addiction has focused primarily on young and middle-aged adults up to around 50, said lead author Ashley Gearhardt. from the last study. Michigan Medicine research and pioneer in the field of food addiction studies.
The results have been similar for the younger age groups included in previous studies, with about 14 percent of adults and 12 percent of children meeting criteria for food addiction, Gearhardt said.
Symptoms resemble typical signs of addiction: intense cravings, inability to cut down on highly processed foods, also known as junk food or comfort food, despite the negative consequences, signs of withdrawal and loss of control over eating, said Kristin Kirkpatrick, a dietitian at the Cleveland Clinic, who was not involved in the research.
People may also do inconvenient or harmful things to satisfy their urges. “I care a lot about this job because I talk to people and they say, ‘I know I’m killing myself. I know I have uncontrolled type 2 diabetes, (but) the pull of this food, this donut is so strong I’ll drive 40 minutes out of my way even though we have food at home. And I’ll go eat a dozen of those, even though I might go into diabetic shock,” said Gearhardt, who is also an associate professor of psychology at the University of Michigan.
Despite its apparent prevalence, food addiction has not been officially recognized as an actual addiction, disorder, or diagnosis by the American Psychiatric Association. Diagnostic and Statistical Manual of Mental DisordersThe manual used by health professionals as an authoritative guide in diagnosing mental disorders.
The body of research on food addiction has recently reached the point where it can support a proposal for inclusion in the manual, Gearhardt said, but is currently working on one that he hopes to submit within a year.
“If you just look at the studies, they’re still in the place where they’re saying, ‘We need more research,’ but if we use these criteria that are similar to what we have for tobacco and alcohol (addictions), they’re seeing a lot of similar correlations.” Kirkpatrick said.
Because food addiction isn’t in the Diagnostic and Statistical Manual of Mental Disorders, healthcare providers can’t diagnose someone with it, Gearhardt said. But as research in this area continues, some medical professionals and nutritionists have come to recognize the condition and the need to address it.
“It’s not a standard part of our diagnostic training that we do,” Gearhardt added, but “people reporting this addiction to highly processed foods are suffering.”
Most people who seek treatment for food addiction are probably diagnosed with binge eating disorder “because that’s the closest thing we have, to which we can offer a diagnosis code so they can get treatment,” he said. Oatmeal. But the type of treatment that would be offered for food addiction would be very different, because not all people who report food addiction binge, and the underlying neurology of food addiction and binge eating disorder is not They are the same.
Food hijacks the brain
The criteria that define food addiction revolve specifically around highly processed foods, rather than all foods, because of how the brain responds to their consumption, the experts said.
It’s not so much the sugar or carbs themselves that are addictive, but “how they’re delivered in ultra-processed foods that also have additional compounds, chemicals, ingredients that aren’t natural,” Kirkpatrick said.
“The actual chemical pathway of what’s happening is really this opening up of reward systems,” he added. “You eat the food, you get a spike in dopamine, in serotonin, you get all these feel-good spikes. But then once they go down, you start to feel bad and you need more.”
This change in the way the brain works “resembles addictions to things like morphine, nicotine or even alcohol,” said Nicole Avena, a New York state neuroscientist with expertise in nutrition, diet and addiction.
Ultra-processed foods make up 70% of packaged food in the US and account for about 60% of the calories consumed by Americans, Kirkpatrick said.
“Some people would argue that these shouldn’t be called foods, that they are actually processed and refined man-made substances that we have created that deliver abnormally high levels, at a rapid rate, of rewarding ingredients like sugar, like fat, that our brain really doesn’t seem to know exactly how to manage that level of food reward because it really exceeds what exists in nature,” Gearhardt said.
living with food addiction
Not all people who eat highly processed foods develop an addictive relationship with them. For those that do, experts believe there could be a number of reasons.
A person’s brain chemistry may play a role, as well as a family history of problematic or addictive relationships with substances, the experts said. People who are stressed, depressed, anxious or dealing with trauma might eat these types of foods to deal with negative emotions, Kirkpatrick said.
Those who are food insecure are more likely to choose highly processed foods, Kirkpatrick said, especially if that’s all they have access to, making them more prone to food addiction.
Some people with food addiction eat highly processed foods over the course of a day, Gearhardt said, while others binge and then feel gross or sluggish and say they’ll never do it again. Over time, eating too many highly processed foods can affect people in terms of overall health consequences, including obesity, cancer, premature death, cardiovascular disease, dementia and diabetes, according to previous research.
When people try to cut back on these foods, they may experience withdrawal symptoms such as irritability, agitation or lack of energy, Gearhardt said. “And people report that over time they eat more and more of these foods to get the same level of enjoyment they used to in the past.”
Food addiction and failed attempts to change can cause an “incredible feeling” of guilt, shame, hopelessness and frustration, Gearhardt said.
Loneliness and social isolation can be contributing factors or consequences of food addiction. In Michigan Medicine research, addiction to highly processed foods was seen in 51% of participating women and 26% of men who said they often felt isolated from others, compared to 8 % of women and 4% of men who rarely felt isolated.
Food addiction can also affect your wallet. And temptation is everywhere: at the office when someone brings donuts to work, at the gas station, at parties, in checkout lines at stores.
“Often, at the end of the day, the stress, the constant pull of having to use willpower to try to resist, can trigger another binge, continuing the cycle,” Gearhardt said.
‘A controversial issue’ among researchers
Scientific opinion on whether food addiction is real is still mixed, Kirkpatrick said. Some researchers wonder where the line should be between overdoing it with highly processed foods from time to time and losing control.
“Right now, it’s still a controversial issue,” Gearhardt said. “Where there is consensus is that when we look at how people consume these highly processed foods, there is relative agreement that yes, we do see these signs of addiction.”
“There was a huge debate about whether tobacco was addictive that went on for decades, even though hundreds of thousands of people were dying,” Gearhardt said. “It wasn’t like other addictions: you’re not intoxicated, it was legal, people could drive their car while smoking a cigarette.”
The debate is now more about the role of food and whether it is truly addictive, he added.
“We’re in a similar space now, where highly processed food changes our paradigm again, because it’s like, ‘Well, we all need food to eat,'” he added. “But we don’t need these highly processed, man-made, novelty, intensely rewarding, unnatural foods.”
Change your relationship with food
Effectively tackling food addiction more broadly is likely to require a combination of individual choices and policy changes, Kirkpatrick said.
“Because we’ve been stuck in this place where we’re just discussing whether it exists, the development (of) treatment models has been frankly delayed,” Gearhardt said. “So, I don’t have the science to say, ‘This is the best treatment for this addiction,’ which is unfortunate.”
Although food addiction, on a superficial level, is all about diet, working with a therapist to figure out how you got there and how to overcome it is critical, experts said. A therapist could also help you learn to deal with stress in healthier ways, such as writing in a journal or going for a walk.
However, the therapist must work in conjunction with a dietitian, Kirkpatrick said.
“The people who are least likely to lose control are people who, for the most part, have fairly healthy behaviors,” he said. “They follow, let’s say, a Mediterranean diet, they cook, they eat a lot of plants and they do it most of the day.”
If you’re struggling with food addiction, recovery could be difficult because in the US, the food system is “essentially setting us up for failure,” Avena said. “But it’s possible to get help and… navigate this food environment so that they can be happy and healthy.”
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