A commentary on the associations among 'food addiction', binge eating disorder, and obesity: Overlapping conditions with idiosyncratic clinical features.
TL;DR: It is argued in this paper that despite a positive relationship between obesity and addictive tendencies towards food, it is over-inclusive to model obesity as an addiction disorder, especially given the multi-faceted etiology and current pervasiveness of weight gain worldwide.
About: This article is published in Appetite.The article was published on 2017-08-01. It has received 122 citations till now. The article focuses on the topics: Food addiction & Binge eating.
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01 Jan 2016
TL;DR: Volkow et al. as mentioned in this paper reviewed recent advances in the neurobiology of addiction to clarify the link between addiction and brain function and to broaden the understanding of addiction as a brain disease.
Abstract: This article reviews scientific advances in the prevention and treatment of substance-use disorder and related developments in public policy. In the past two decades, research has increasingly supported the view that addiction is a disease of the brain. Although the brain disease model of addiction has yielded effective preventive measures, treatment interventions, and public health policies to address substance-use disorders, the underlying concept of substance abuse as a brain disease continues to be questioned, perhaps because the aberrant, impulsive, and compulsive behaviors that are characteristic of addiction have not been clearly tied to neurobiology. Here we review recent advances in the neurobiology of addiction to clarify the link between addiction and brain function and to broaden the understanding of addiction as a brain disease. We review findings on the desensitization of reward circuits, which dampens the ability to feel pleasure and the motivation to pursue everyday activities; the increasing strength of conditioned responses and stress reactivity, which results in increased cravings for alcohol and other drugs and negative emotions when these cravings are not sated; and the weakening of the brain regions involved in executive functions such as decision making, inhibitory control, and self-regulation that leads to repeated relapse. We also review the ways in which social environments, developmental stages, and genetics are intimately linked to and influence vulnerability and recovery. We conclude that neuroscience continues to support the brain disease model of addiction. Neuroscience research in this area not only offers new opportunities for the prevention and treatment of substance addictions and related behavioral addictions (e.g., to food, sex, and gambling) but may also improve our understanding of the fundamental biologic processes involved in voluntary behavioral control. In the United States, 8 to 10% of people 12 years of age or older, or 20 to 22 million people, are addicted to alcohol or other drugs. 1 The abuse of tobacco, alcohol, and illicit drugs in the United States exacts more than $700 billion annually in costs related to crime, lost work productivity, and health care. 2-4 After centuries of efforts to reduce addiction and its related costs by punishing addictive behaviors failed to produce adequate results, recent basic and clinical research has provided clear evidence that addiction might be better considered and treated as an acquired disease of the brain (see Box 1 for definitions of substance-use disorder and addiction). Research guided by the brain disease model of addiction has led to the development of more effective methods of prevention and treatment and to more informed public health policies. Notable examples include the Mental Health Parity and Addiction Equity Act of 2008, which requires medical insurance plans to provide the same coverage for substance-use disorders and other mental illnesses that is provided for other illnesses, 5 and the proposed bipartisan Senate legislation that From the National Institute on Drug Abuse (N.D.V.) and the National Institute of Alcohol Abuse and Alcoholism (G.F.K.) — both in Bethesda, MD; and the Treatment Research Institute, Philadelphia (A.T.M.). Address reprint requests to Dr. Volkow at the National Institute on Drug Abuse, 6001 Executive Bld., Rm. 5274, Bethesda, MD 20892, or at nvolkow@ nida . nih . gov.
739 citations
TL;DR: Overall, findings support food addiction as a unique construct consistent with criteria for other substance use disorder diagnoses, and suggests that certain foods, particularly processed foods with added sweeteners and fats, demonstrate the greatest addictive potential.
Abstract: The diagnostic construct of “food addiction” is a highly controversial subject. The current systematic review is the first to evaluate empirical studies examining the construct of “food addiction” in humans and animals. Studies were included if they were quantitative, peer-reviewed, and in the English language. The 52 identified studies (35 articles) were qualitatively assessed to determine the extent to which their findings indicated the following addiction characteristics in relation to food: brain reward dysfunction, preoccupation, risky use, impaired control, tolerance/withdrawal, social impairment, chronicity, and relapse. Each pre-defined criterion was supported by at least one study. Brain reward dysfunction and impaired control were supported by the largest number of studies (n = 21 and n = 12, respectively); whereas risky use was supported by the fewest (n = 1). Overall, findings support food addiction as a unique construct consistent with criteria for other substance use disorder diagnoses. The evidence further suggests that certain foods, particularly processed foods with added sweeteners and fats, demonstrate the greatest addictive potential. Though both behavioral and substance-related factors are implicated in the addictive process, symptoms appear to better fit criteria for substance use disorder than behavioral addiction. Future research should explore social/role impairment, preoccupation, and risky use associated with food addiction and evaluate potential interventions for prevention and treatment.
155 citations
Cites background from "A commentary on the associations am..."
...Finally, while multiple studies have shown that obesity, binge eating disorder, and food addiction are separate constructs [26,27], their distinct etiologies leave much to be clarified....
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...Some have erroneously conceptualized food addiction as either obesity or binge eating [22–25], yet mounting evidence indicates that these constructs are distinct [26,27]....
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...Although there is substantial overlap between food addiction and binge eating symptoms, the two constructs are not synonymous [26,27]....
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TL;DR: A significant, positive relationship exists between food addiction and mental health symptoms, although the results of the present study highlight the complexity of this relationship.
Abstract: BACKGROUND: The present study systematically reviewed the literature aiming to determine the relationships between food addiction, as measured by the Yale Food Addiction Scale (YFAS), and mental health symptoms. METHODS: Nine databases were searched using keywords. Studies were included if they reported: (i) YFAS diagnosis or symptom score and (ii) a mental health outcome, as well as the association between (i) and (ii). In total, 51 studies were included. RESULTS: Through meta‐analysis, the mean prevalence of food addiction diagnosis was 16.2%, with an average of 3.3 (range 2.85–3.92) food addiction symptoms being reported. Subanalyses revealed that the mean number of food addiction symptoms in populations seeking treatment for weight loss was 3.01 (range 2.65–3.37) and this was higher in groups with disordered eating (mean 5.2 3.6–6.7). Significant positive correlations were found between food addiction and binge eating [mean r = 0.602 (0.557–0.643), P < 0.05], depression, anxiety and food addiction [mean r = 0.459 (0.358–0.550), r = 0.483 (0.228–0.676), P < 0.05, respectively]. CONCLUSIONS: A significant, positive relationship exists between food addiction and mental health symptoms, although the results of the present study highlight the complexity of this relationship.
141 citations
Cites background from "A commentary on the associations am..."
...Introduction ‘Food addiction’ (FA) has emerged in recent times as a possible contributor to the increasing prevalence of obesity and being overweight, the changing food environment, and the doubling of mental health conditions between 1995 and 2005 ((1,2))....
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TL;DR: Food addiction constitutes a medicalization of common eating behaviours, taking on the properties of a disease.
Abstract: The concept of addiction is loaded with connotations and is often used for its political as much as its medical utility The scientific case for 'food addiction' as a clinical phenotype currently rests on its association with generic diagnostic criteria for substance-related disorders being applied to everyday foods and eating-related problems This has fused the concept of obesity with addiction regardless of whether it fits the definition The hedonic, or reward, system can account for the ingestion of foods and drugs, confirming that they share neural substrates that differentiate liking and wanting These are normal processes that are recruited for natural homeostatic behaviours and can explain the phenomenon of hedonic overeating as a consequence of human motivation pushed to extremes by an obesogenic environment Food addiction constitutes a medicalization of common eating behaviours, taking on the properties of a disease The use of this medical language has implications for the way in which society views overeating and obesity
120 citations
TL;DR: The overlap between BED and FA is demonstrated, and the possible unique differences between the forms of disordered eating are highlighted, as was demonstrated to produce stronger correlations with FA symptoms.
Abstract: Existing research suggests that there is an overlap between binge eating disorder (BED) and the construct of ‘food addiction’ (FA). The objective of this study was to determine the overlapping features of BED and FA through a comparison of the individual scales of commonly used tools including the Binge Eating Scale (BES) and the Yale Food Addiction Scale (YFAS) in a sample of Australian adults. Adults (>18 years of age) were invited to complete an anonymous online survey on FA. Binge eating was assessed through the BES and addictive eating behaviours were assessed through the YFAS (n = 1344). The prevalence and severity of both FA and binge eating increased across weight categories. The overall correlation between the total score from the BES and FA symptoms was r = 0.76, p < 0.001; for females it was r = 0.77, p < 0.001, and for males it was r = 0.65, p < 0.001. Total BES score and the BES emotion factor were most often associated with FA symptoms, as was demonstrated to produce stronger correlations with FA symptoms. In contrast, the BES behaviour factor was less strongly associated to FA with the majority of correlations <0.6. This study demonstrates the overlap between BED and FA, and highlights the possible unique differences between the forms of disordered eating.
106 citations
Cites background from "A commentary on the associations am..."
...In addition, recent research highlights the associations between patterns of compulsive overeating, including binge eating with ‘food addiction’ [22]....
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References
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TL;DR: Analyses of changes over the decade from 2005 through 2014, adjusted for age, race/Hispanic origin, smoking status, and education, showed significant increasing linear trends among women for overall obesity and for class 3 obesity but not among men.
Abstract: Importance Between 1980 and 2000, the prevalence of obesity increased significantly among adult men and women in the United States; further significant increases were observed through 2003-2004 for men but not women. Subsequent comparisons of data from 2003-2004 with data through 2011-2012 showed no significant increases for men or women. Objective To examine obesity prevalence for 2013-2014 and trends over the decade from 2005 through 2014 adjusting for sex, age, race/Hispanic origin, smoking status, and education. Design, Setting, and Participants Analysis of data obtained from the National Health and Nutrition Examination Survey (NHANES), a cross-sectional, nationally representative health examination survey of the US civilian noninstitutionalized population that includes measured weight and height. Exposures Survey period. Main Outcomes and Measures Prevalence of obesity (body mass index ≥30) and class 3 obesity (body mass index ≥40). Results This report is based on data from 2638 adult men (mean age, 46.8 years) and 2817 women (mean age, 48.4 years) from the most recent 2 years (2013-2014) of NHANES and data from 21 013 participants in previous NHANES surveys from 2005 through 2012. For the years 2013-2014, the overall age-adjusted prevalence of obesity was 37.7% (95% CI, 35.8%-39.7%); among men, it was 35.0% (95% CI, 32.8%-37.3%); and among women, it was 40.4% (95% CI, 37.6%-43.3%). The corresponding prevalence of class 3 obesity overall was 7.7% (95% CI, 6.2%-9.3%); among men, it was 5.5% (95% CI, 4.0%-7.2%); and among women, it was 9.9% (95% CI, 7.5%-12.3%). Analyses of changes over the decade from 2005 through 2014, adjusted for age, race/Hispanic origin, smoking status, and education, showed significant increasing linear trends among women for overall obesity ( P = .004) and for class 3 obesity ( P = .01) but not among men ( P = .30 for overall obesity; P = .14 for class 3 obesity). Conclusions and Relevance In this nationally representative survey of adults in the United States, the age-adjusted prevalence of obesity in 2013-2014 was 35.0% among men and 40.4% among women. The corresponding values for class 3 obesity were 5.5% for men and 9.9% for women. For women, the prevalence of overall obesity and of class 3 obesity showed significant linear trends for increase between 2005 and 2014; there were no significant trends for men. Other studies are needed to determine the reasons for these trends.
2,392 citations
TL;DR: The literature on the incidence, prevalence and mortality rates of eating disorders is discussed, with anorexia nervosa the most striking and binge eating disorder is more common among males and older individuals.
Abstract: Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increase in the high risk-group of 15–19 year old girls. It is unclear whether this reflects earlier detection of anorexia nervosa cases or an earlier age at onset. The occurrence of bulimia nervosa might have decreased since the early nineties of the last century. All eating disorders have an elevated mortality risk; anorexia nervosa the most striking. Compared with the other eating disorders, binge eating disorder is more common among males and older individuals.
1,481 citations
TL;DR: It is concluded that neuroscience continues to support the brain disease model of addiction, which has led to the development of more effective methods of prevention and treatment and to more informed public health policies.
Abstract: This article reviews scientific advances in the prevention and treatment of substance-use disorder and related developments in public policy. In the past two decades, research has increasingly supported the view that addiction is a disease of the brain. Although the brain disease model of addiction has yielded effective preventive measures, treatment interventions, and public health policies to address substance-use disorders, the underlying concept of substance abuse as a brain disease continues to be questioned, perhaps because the aberrant, impulsive, and compulsive behaviors that are characteristic of addiction have not been clearly tied to neurobiology. Here we review recent advances in the neurobiology of addiction to clarify the link between addiction and brain function and to broaden the understanding of addiction as a brain disease. We review findings on the desensitization of reward circuits, which dampens the ability to feel pleasure and the motivation to pursue everyday activities; the increasing strength of conditioned responses and stress reactivity, which results in increased cravings for alcohol and other drugs and negative emotions when these cravings are not sated; and the weakening of the brain regions involved in executive functions such as decision making, inhibitory control, and self-regulation that leads to repeated relapse. We also review the ways in which social environments, developmental stages, and genetics are intimately linked to and influence vulnerability and recovery. We conclude that neuroscience continues to support the brain disease model of addiction. Neuroscience research in this area not only offers new opportunities for the prevention and treatment of substance addictions and related behavioral addictions (e.g., to food, sex, and gambling) but may also improve our understanding of the fundamental biologic processes involved in voluntary behavioral control. In the United States, 8 to 10% of people 12 years of age or older, or 20 to 22 million people, are addicted to alcohol or other drugs. 1 The abuse of tobacco, alcohol, and illicit drugs in the United States exacts more than $700 billion annually in costs related to crime, lost work productivity, and health care. 2-4 After centuries of efforts to reduce addiction and its related costs by punishing addictive behaviors failed to produce adequate results, recent basic and clinical research has provided clear evidence that addiction might be better considered and treated as an acquired disease of the brain (see Box 1 for definitions of substance-use disorder and addiction). Research guided by the brain disease model of addiction has led to the development of more effective methods of prevention and treatment and to more informed public health policies. Notable examples include the Mental Health Parity and Addiction Equity Act of 2008, which requires medical insurance plans to provide the same coverage for substance-use disorders and other mental illnesses that is provided for other illnesses, 5 and the proposed bipartisan Senate legislation that From the National Institute on Drug Abuse (N.D.V.) and the National Institute of Alcohol Abuse and Alcoholism (G.F.K.) — both in Bethesda, MD; and the Treatment Research Institute, Philadelphia (A.T.M.). Address reprint requests to Dr. Volkow at the National Institute on Drug Abuse, 6001 Executive Bld., Rm. 5274, Bethesda, MD 20892, or at nvolkow@ nida . nih . gov.
1,063 citations
TL;DR: The Yale Food Addiction Scale (YFAS) is a sound tool for identifying eating patterns that are similar to behaviors seen in classic areas of addiction, and predicted binge-eating behavior above and beyond existing measures of eating pathology, demonstrating incremental validity.
1,049 citations
TL;DR: While average volume of consumption was related to all disease and injury categories under consideration, pattern of drinking was found to be an additional influencing factor for CHD and injury, and Alcohol is related to many major disease outcomes, mainly in a detrimental fashion.
Abstract: Aims As part of a larger study to estimate the global burden of disease attributable to alcohol:
• to quantify the relationships between average volume of alcohol consumption, patterns of drinking and disease and injury outcomes, and
• to combine exposure and risk estimates to determine regional and global alcohol-attributable fractions (AAFs) for major disease and injury categories.
Design, methods, setting Systematic literature reviews were used to select diseases related to alcohol consumption. Meta-analyses of the relationship between alcohol consumption and disease and multi-level analyses of aggregate data to fill alcohol–disease relationships not currently covered by individual-level data were used to determine the risk relationships between alcohol and disease. AAFs were estimated as a function of prevalence of exposure and relative risk, or from combining the aggregate multi-level analyses with prevalence data.
Findings Average volume of alcohol consumption was found to increase risk for the following major chronic diseases: mouth and oropharyngeal cancer; oesophageal cancer; liver cancer; breast cancer; unipolar major depression; epilepsy; alcohol use disorders; hypertensive disease; hemorrhagic stroke; and cirrhosis of the liver. Coronary heart disease (CHD), unintentional and intentional injuries were found to depend on patterns of drinking in addition to average volume of alcohol consumption. Most effects of alcohol on disease were detrimental, but for certain patterns of drinking, a beneficial influence on CHD, stroke and diabetes mellitus was observed.
Conclusions Alcohol is related to many major disease outcomes, mainly in a detrimental fashion. While average volume of consumption was related to all disease and injury categories under consideration, pattern of drinking was found to be an additional influencing factor for CHD and injury. The influence of patterns of drinking may be underestimated because pattern measures have not been included in many epidemiologic studies. Generalizability of the results is limited by methodological problems of the underlying studies used in the present analyses. Future studies need to address these methodological issues in order to obtain more accurate risk estimates.
988 citations