Aberdeen U professor explains why "food addiction" isn't a thing https://www.futurelearn.com/courses/nutrition-wellbeing/1/steps/45346 You may not be able to see the video if you're not signed in. This is a website full of educational videos and this one is in the context of a nutrition course, if you'd like to join me (comments veer from shitlord gold to hilariously delusional) Transcript of the speech for those who can't open the video: TL:DR: Professor explains food addiction is not comparable to substance addiction, it is medically recognized as a behaviour problem rather than substance problem. It's not the food, it's the dumb obeasts! PROFESSOR JULIAN MERCER: We hear a lot about food addiction in the popular media and we bandy the word addiction around very casually to describe our relationships with a wide range of everyday activities. But are people really addicted to chocolate, sugar, or contemporary palatable foods or, for example, mobile phone use in the same way that they can become physically addicted to alcohol, nicotine, or heroin. Internet and newspaper headlines may scream that fast food is as addictive as heroin, but do we really believe this? We all have to eat in order to survive. There are two important questions here. Since weight gain, body fat accumulation, and obesity are driven by the over consumption of calories relative to energy expenditure, if food addiction does exist, is it responsible for, or a major contributor, to the current obesity epidemic. If we accept that food addiction exists, how many people are realistically likely to be affected, relative to the prevalence of overweight and obese in the general population, currently running at over 50% of the adult population in many developed countries. To resolve these questions, first we need to define what we're talking about. There are a number of different definitions of addiction. Until recently, the medically established diagnosis of addiction was limited to Substance-Related Disorders only, with the disorder defined as a chronic relapsing brain disease. The key issue here is that a defined substance was required for it to be a medical diagnosis. Importantly, the internationally recognised Reference Manual of Mental Disorders was updated in 2013. It Is now effectively divided addiction into Substance-Related Disorders and Non-Substance Related Disorders. At present, gambling disorder is the only defined Non-Substance Related Disorder. Evidence for other behavioural addictive disorders, such as sex addiction or internet gaming, was considered to be too weak. Nevertheless, the new classification opens the door for other behavioural addictions to be included in future diagnostic schemes. Food ingestion is satisfying if we are hungry, palatable food is appealing to us and rewarding because it activates specific parts of the brain, naturally triggering signals in the opioid and dopamine systems. These are neural pathways associated with pain relief and euphoria, amongst other functions. Many of the neural signals active in food reward are also involved in addictive behaviour. These same systems are triggered when we used drugs or alcohol. Drugs can activate these same systems because their chemical structures mimic those of natural signals. Despite this superficially appealing link, this overlap, in itself, does not validate the concept of food addiction. Activation of the brain by specific foods is likely to have developed during our evolution. Where, for example, the instant energy high sugar foods give the body, or the high energy density of fat, would make these the dietary components of choice. There would be a survival advantage to preferentially consuming these foods, with the brain reinforcing the motivation to consume such foods by associating them with pleasure or reward. However, in our current environment, the reward properties of palatable food appear able to override purely energy demand-led processes, and could therefore drive over consumption of calories, and consequently, weight gain and obesity. Whereas drugs and alcohol are made of just one identifiable chemical molecule, foods are a mix of hundreds or thousands of different chemicals, making direct comparison problematical. Importantly to date, there is no strong scientific evidence for a single nutritional compound, or mixture of compounds in food, having addictive-like properties. Those who overeat do not generally target specific nutrients, but rather a range of palatable foods. Consequently, food addiction cannot be diagnosed according to any set of criteria which have general medical or psychological recognition. Based on current knowledge, the term food addiction appears inappropriate. By contrast, disorders of eating behaviour can resemble the addictive, behavioural patterns observed in substance dependency. Currently, the greatest clinical similarity between an abnormal food consumption behaviour and drug addiction, exists in binge-eating disorder, an eating disorder characterised by binge eating without subsequent purging episodes and which is prevalent within the obese, human population. It has been proposed that food addiction represents the extreme end of the continuum of over eating, and might be a more disturbed variance of binge-eating disorder. Brain imaging studies in obese or drug addicted individuals have shown similar activation patterns when subjects are exposed to palatable food or drugs of abuse. However, although eating disorders, such as binge-eating disorder, have behavioural characteristics that resemble addiction, they do not always lead to obesity. Undoubtedly many people eat more than is healthy. But how many people have a relationship with food that borders on an eating disorder, i.e. That is characterised by clinically significant and regular overeating. No single food substance or specific neurobiological mechanism can account for the fact that many people overeat and develop obesity. As in many aspects of everyday life, our relationships with food fall along a continuum, with eating disorders and conditions verging on addiction at extreme ends. In contrast, the gradual accumulation of excess body weight over prolonged periods of time, years or decades, that characterises the development of overweight and obesity in the majority of the population in some developed countries, is the outcome of marginal overeating. It Is almost certainly inappropriate to invoke food addiction or eating addiction in this context. Acceptance of the proposition that food is addictive is unhelpful to most people trying to address their own weight problems, as the terminology implies a passive process. Recognition of the behavioural component implicit in eating addiction is likely to be more useful and informative to individuals, but we need to define what this term means, how to diagnose it, who's affected, and how viable therapies can be developed. An integration of food addiction into Substance-Related Disorders under the Common Criteria, would imply a form of chemical addiction for which there's no evidence base. By contrast, there is evidence to suggest that food addiction, or rather eating addiction, might be better viewed as a form of behavioural addiction, a known Substance-Related Disorder, and thus be an explanation for over-eating in a sub-group of obese individuals. Such a diagnosis, even in a small sub-group of individuals, could result in changes in clinical practise.