Food Addiction Treatment, Signs and Causes

Food is not only a necessity of life it’s also a source of pleasure and a means of social engagement.

We use food to comfort ourselves, to nurture our loved ones, and to celebrate our holidays and special events. But for some individuals, the need to consume food becomes compulsive and uncontrollable. In these individuals, food turns into a source of addiction. Although they may try to control their addictive behavior through dieting or self-regulation, they tend to turn back to overeating in response to stress, anger, or emotional pain.

Unlike alcohol or illicit drugs, food is necessary for physical survival. Yet like drugs and alcohol, food triggers brain chemicals that create feelings of pleasure and comfort, like dopamine, a neurotransmitter that plays an important role in the brain’s natural reward system. For people who suffer from food addiction, consuming large quantities of food — usually highly palatable foods rich in fat, sugar, or starch — initially offers a rush of pleasurable sensations or a release from emotional distress. Yet these positive responses are soon followed by feelings of shame, guilt, and physical discomfort. Professional treatment is often required to break the cycle of addictive overeating and restore a healthy relationship to food.

The Centers for Disease Control and Prevention has found that 35 percent of adults in the US are obese, indicating that overeating is a serious threat to public health. Although food addiction can certainly lead to weight gain, not everyone who suffers from this disorder is obese or even overweight. A study of adults of varying weights published in Frontiers in Psychiatry revealed the following results:

  • 10 percent of underweight respondents met the criteria for food addiction
  • 6.3 percent of normal weight respondents met the criteria
  • 14 percent of overweight respondents met the diagnostic criteria
  • Over a third of obese respondents met the diagnostic criteria

It is interesting to note that in this study sample, food addiction was more common among underweight individuals than among normal-weight respondents. Rather than looking at individuals’ weights or body types to determine whether they have a problem with food addiction, the journal stresses that it is important to look at behaviors, such as compulsive eating, the inability to stop addictive food behaviors, and feelings of low self-worth or remorse after overeating.

Defining Food Addiction

food addictionThe word “addiction”is usually associated with substances that are potentially harmful or illegal, such as alcohol, tobacco, or street drugs. However, in some cases, the brain and body can become dependent on healthy substances like food. Like alcoholism or drug dependency, food addiction can be characterized by the following addictive behaviors:

  • Obsessive food cravings, combined with a preoccupation with obtaining and consuming food
  • The continued misuse of food (through binge eating or compulsive overeating) in spite of serious health consequences
  • Repeated attempts to stop overeating, followed by relapse into addictive behaviors
  • Loss of control over how much, how often, and where overeating occurs
  • A negative impact on work, family life, financial status, or social activities as a result of overeating
  • The need to consume more food in order to get the same sense of emotional release or comfort
  • A pattern of eating alone in order to avoid negative attention from others

At first glance, food addiction might seem relatively harmless compared to an addiction to alcohol, cocaine, methamphetamine, or heroin. However, compulsive overeating can take a severe toll on physical and emotional health.

Addictive food consumption often focuses on foods that are high in sugar, fat, or salt — all of which are dense in calories and potentially harmful to the health of the heart. The health risks of food addiction include:

  • Obesity
  • Diabetes
  • High cholesterol
  • High blood pressure
  • Heart disease
  • An increased risk of stroke or heart attack
  • Depression
  • Social isolation

People who struggle with food addiction may also use drugs or alcohol to numb feelings of depression and low self-worth. The continuous effort and failure to control compulsive eating or bingeing can result in feelings of hopelessness or despair that may even lead to suicidal thoughts or suicide attempts.

When Eating Becomes Food Addiction

In a culture where food is so widely available, and where eating is often used as a source of entertainment or emotional comfort, overeating is not uncommon. However, there are certain red flags that indicate that eating has become an addictive behavior rather than a healthy source of nutrition or gratification:

  • Engaging in frequent binges, or the consumption of larger-than-normal quantities of food at a very fast speed
  • Consistently eating to the point of physical discomfort or pain
  • Consuming food instead of working, engaging in social activities, or spending time with family
  • Experiencing problems at work, school, or home because of overeating
  • A consistent pattern of eating in response to depression or anxiety, or to soothe feelings of anger, sadness, or loneliness
  • Experiencing feelings of guilt, remorse, or self-loathing as a result of one’s failure to stop overeating

Compulsive overeating, followed by feelings of guilt and self-loathing, occurs in several different eating disorders.

Some of these disorders involve a pattern of binge eating followed by purging through intensive food restriction, compulsive exercise, or self-induced vomiting, while others do not have a purging component:

  • Binge eating disorder: One of the most common forms of food addiction, binge eating disorder is marked by repeated episodes of overeating to the point of physical discomfort. These episodes, called binges, often occur in response to emotional distress or anxiety and result in feelings of shame, guilt, and self-loathing. The National Eating Disorders Association estimates that 3.5 percent of American women and 2 percent of American men suffer from binge eating disorder. Binge eating disorder, also known as compulsive overeating, is now included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the official diagnostic resource for mental health professionals.
  • Bulimia nervosa: Like binge eating, bulimia is characterized by compulsive overeating episodes that cause guilt, shame, and self-loathing. But unlike binge-eating disorder, people with bulimia feel the need to purge the body of excessive calories. Purging may take the form of vomiting, laxative abuse, compulsive exercise, or restrictive eating. Because of this purging behavior, people with bulimia are less likely to be overweight or obese; however, the health risks of binging and purging are severe. Frequent self-induced vomiting can cause severe dehydration, heart problems, malnutrition, damage to the teeth and gums, and even brain damage or blindness.
  • Night eating syndrome: In this form of food addiction, binges occur primarily late at night. Individuals with night eating syndrome may consume large amounts of food at night, while feeling little or no hunger during the day. This phenomenon may be caused by a disturbance in normal waking-sleeping rhythms; however, there is also a component of emotional release involved with these eating episodes. People with night eating syndrome report that the condition gets worse when they are under stress. According to Today’s Dietitian, many people with night eating syndrome use food as a way to relax or soothe themselves when they are unable to sleep due to stress or anxiety.

Because consuming food is such a normal part of everyday life, it is important to be able to distinguish between healthy eating, overeating, and food addiction. Eating in a healthy manner involves choosing mostly nutritious foods and consuming no more than the body needs to maintain a normal weight. Overeating is defined as consuming more food — either in terms of quantity or caloric content — then the individual needs to fuel day-to-day activities and maintain a healthy weight.

Food addiction involves an established pattern of compulsive overeating, usually performed in isolation from others, that impairs daily functioning. In order to meet the criteria for binge eating disorder, as defined by the DSM-5, individuals must engage in binge eating at least once a week for three months, and these episodes must cause considerable emotional distress.

Underlying Causes

There are several popular theories about the causes of food addiction. Scientists have determined that in certain individuals, the body’s response to certain types of food, especially sweet or fatty foods, is similar to the response to drugs or alcohol. BMB Reports proposes that the compulsion to overeat arises in a neurochemical pathway responsible for rewarding positive behaviors. Dopamine, one of the primary neurotransmitters involved in this pathway, is released in response to binge eating episodes, resulting in a high that could be compared to the effects of alcohol or drugs.

An individual’s family background may play a part in food addiction. People who come from families where food is used as a means of reward, comfort, self-expression, or control are more likely to display unhealthy behaviors around food consumption in adulthood. Children who grow up watching their parents engage in overeating or frequent dieting, with periods of restriction alternating with overeating and subsequent feelings of shame or guilt, are also at risk of becoming addicted to food.

Depression, anxiety, and substance use disorders are common among people who suffer from binge eating disorder. According to Social Work Today, many individuals with eating disorders have a history of abuse or trauma and a tendency to turn to drugs or alcohol as well as food for comfort. Cultural or familial pressures to meet a certain physical ideal create the potential for body image distortion and negative feelings about one’s shape or size, which can lead to patterns of restrictive eating and binging.

Although dieting does not cause food addiction, restrictive eating can definitely be a risk factor for developing this disorder. After a period of depriving oneself of food, the body may experience a rebound effect, in which the individual consumes large amounts of calories in order to compensate for a period of food restriction. In addition to the metabolic effects of dieting, the emotional impact of food restriction may cause dieters to feel that they “deserve”to binge on foods that were forbidden during the diet.

Treatment for Food Addiction

getting help

Treating food addiction is a multidimensional process that must address the individual’s emotional, physical, and psychological needs.

Destructive eating habits can be hard to break, especially if these episodes are a result of underlying mental health issues. The co-occurrence of alcohol or drug abuse requires a component of substance abuse treatment as well as specialized attention to the eating disorder itself.

The goals of food addiction treatment include helping the client replace dysfunctional eating patterns with healthy ones, addressing co-occurring depression or anxiety, and helping the client develop a stronger, more positive self-image.

Some of the most effective therapeutic modalities for treating food addiction are listed below:

  • Cognitive Behavioral Therapy (CBT): CBT is a learning-based therapy that can help clients identify and change the thought patterns that lead to overeating. At the same time, CBT helps clients develop new coping strategies to deal with the stressors and triggers that lead to binging. CBT can be used individually, in one-on-one therapy, or in group therapy sessions with other clients who are struggling with the same issues.
  • Medication: Medications used to treat depression or anxiety have been used to help control the urge to overeat. Specifically, drugs in the SSRI (selective serotonin reuptake inhibitors) category have shown positive results with binge eating disorder, bulimia, and eating disorders. Popular SSRIs include citalopram (Celexa), fluoxetine (Prozac), escitalopram (Lexapro), sertraline (Zoloft), and paroxetine (Paxil). As an added benefit, SSRIs can help to relieve symptoms of co-occurring depression or anxiety in people with food addiction.
  • Solution-focused therapy: This practical approach to therapy engages clients in developing and implementing solutions to specific issues in their lives. For instance, a client who overeats in response to work-related pressure can learn how to delegate more effectively or improve time management in order to reduce the level of stress on the job.
  • Trauma therapies: Overeating can be a means of figuratively “swallowing”or “stuffing down”unresolved traumas or emotional pain. Specific modalities that target unprocessed trauma, such as Seeking Safety or Eye Movement Desensitization Reprocessing (EMDR) can be utilized to help clients overcome suppressed pain so that they no longer need to overeat for comfort.
  • Nutritional counseling and dietary planning: People with food addiction may need to relearn healthy eating habits. They may also have nutritional deficiencies as a result of their eating patterns. By working with a nutritionist or registered dietitian, these clients can develop a healthier approach to making food choices and planning meals.
Food addiction treatment can take place on an inpatient basis, through a residential facility, or in an outpatient setting at a clinic, hospital, or rehab center. Inpatient treatment is often recommended for individuals who have serious co-occurring medical issues, or who have been diagnosed with other mental health issues or substance use disorders. Outpatient treatment, including intensive outpatient programs and partial hospitalization programs (PHPs) are suitable for clients who have a strong support system in place, who are motivated to pursue treatment, or who have responsibilities or obligations that prevent them from staying at a treatment facility fulltime.
Binge eating disorder and other forms of food addiction are becoming increasingly common in the United States. At the same time, the health problems caused by obesity have reached epidemic proportions. Although food addiction may not seem as serious as drug or alcohol abuse, this disorder can cause tremendous emotional distress, as well as damage to the individual’s physical and psychological wellbeing. With compassionate, comprehensive treatment, clients can learn how to change their compulsive eating habits and create happier, healthier lives.

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