overeating: Concerned About Overeating: What’s food addiction and how to get over it

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For many of us, eating certain foods can be comforting: a pick-me-up during a challenging task; A reward after a long day at work; A saturated end to a lovely dinner.

But some people have a compulsive and uncontrolled craving for certain foods, especially “fast” foods with excessive flavour. This can affect their daily functioning and their ability to perform social, work or family roles.

People with addictive eating may experience food cravings, which are not related to hunger, as well as increased levels of tolerance to large amounts of food and a feeling of withdrawal.

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Rather than hunger, these cravings may be driven by bad moods, mental illness (depression and anxiety), high levels of stress, or heightened feelings.

“Food addiction” or “addictive eating” is no longer a diagnosable disorder in a clinical setting.

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However, patients often ask health professionals how to manage their addictive food intake.

These health providers generally acknowledge their patients’ addictive eating behaviors but may be unsure of appropriate treatments.

Food addiction is most commonly assessed using the Yale Food Addiction Scale.

The science of addictive eating is still emerging, but researchers are increasingly noticing that addiction and reward pathways in the brain stem from stress, heightened emotions, and mental illness are linked to cravings to overeat.

How common is it?

Many factors contribute to overeating. The abundance of junk food, junk food ads, and the super-delicious ingredients of many processed foods may prompt us to eat whether we’re hungry or not.

However, some people report an inability to control their food, beyond admiration and desire, and seek help for this.

About one in six people (15-20%) report addictive eating patterns or addictive behaviors around food.

While food addiction is higher among people with obesity and mental health conditions, it affects only a subset of these groups.

How do you know if you have a problem?

Food addiction typically occurs with foods that are highly palatable, processed, and high in a combination of energy, fat, salt, and/or sugar while being low in nutritional value.

This may include chocolate, sweets, prepared foods, and baked products.

These foods may be associated with high levels of reward and may therefore preoccupy your thoughts. They may raise your mood or distract from anxious or distressing thoughts, and over time, you may need to eat more to get the same feelings of reward.

However, for others, it can be an addiction to feelings of fullness or a sense of reward or satisfaction.

There is an ongoing debate about whether food components are addictive, the eating behavior itself is addictive, or a combination of the two.

Given that people consume foods for a wide variety of reasons, and people can form habits around certain foods, it may be different for different people.

Through our research exploring adult experiences, we have found that many people with eating addiction attribute their behaviors to experiences that occurred in childhood.

These events are very diverse. They range from traumatic events, to dieting or restrictive eating practices, or are associated with poor body image or body dissatisfaction.

Our recent research found that addictive eating in the teenage years is associated with poorer quality of life and lower self-esteem, and appears to increase in severity over time.

Children and teens tend to have fewer addictive eating behaviors or symptoms than adults. Of the 11 symptoms of the Yale Food Addiction Scale, children and adolescents generally have only two or three, while adults often have six or more symptoms, which is classified as severe food addiction.

The associations we observed in adolescents are also seen in adults: weight gain and poor mental health are associated with a greater number of symptoms and a greater prevalence of food addiction.

This highlights that some teens will need mental health, eating disorder and obesity services, in a combined treatment approach.

We also need to identify early risk factors to enable targeted preventive interventions in younger age groups.

How is it treated?
The reasons behind addictive eating are varied, so treatments cannot be one-size-fits-all.

A wide range of treatments are tried. These include:

  • Passive methods such as self-help support groups
  • Trials of drugs such as naltrexone and bupropion, which target hormones linked to hunger and appetite and reduce energy intake
  • Bariatric surgery to help lose weight. The most common procedure in Australia is gastric banding, in which an adjustable band is placed around the top of the stomach to put pressure on and reduce appetite.

However, few self-help support groups available include participation or input from qualified health professionals. While providing peer support, these may not be based on the best available evidence, with little evaluation of effectiveness.

Medications and bariatric surgery involve the input of health professionals and have been shown to be effective in losing weight and reducing food addiction symptoms in some people.

However, these may not be appropriate for some people, such as those in a healthy weight range or those with complex underlying health conditions. It is also important that people receiving medications and surgery are advised to make dietary and lifestyle changes.

Other holistic and personalized lifestyle approaches that include diet and physical activity in addition to mindfulness show promising results, particularly when they are designed in conjunction with consumers and health professionals.

Our Emerging Therapy Program
We’re also creating new holistic ways to manage addictive eating. We recently experimented with an online intervention tailored to individuals’ personalities.

Presented by dietitians and based on behavior change research, trial participants received personalized feedback on their symptoms from eating, diet, physical activity, and sleep, and formulated goals, distraction lists, and mindfulness plans, contributing to an overall action plan.

After three months, participants reported that the program was acceptable and feasible. The next step in our research is to try the treatment for efficacy. We are conducting a research trial to determine the effectiveness of treatment in reducing food addiction symptoms and improving mental health.

This is the first study of its kind, and if found to be effective it will translate into clinical practice.

The authors are with Newcastle University. This article was published by PTI from Conversation.

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