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Food addiction - fact or fiction

Wednesday, June 17, 2009 Posted by Travis Saunders
Photo by Marina Komolova

One topic that never fails to generate a lively discussion is the relationship between obesity and personal responsibility.  For example, in response to a post on psychological exams for bariatric surgery patients, one anonymous reader commented that:

I don't have a gym membership. I'm not even all that active. I live in a bad neighbourhood and i'm floating right around the Canadian poverty line. I'm not obese. When I see a little extra belly building over the winter, I watch how much I eat and try to expend a few extra calories in the comfort of the tiny living room. By blaming any other extraneous factors other than caloric-imbalance, we take away the inherent power from individuals to take charge of their own weight.

While it is convenient to villify obese individuals for their perceived lack of self-control, the evidence suggests that the situation is not so simple.  This topic is explored in depth in this week's special issue of the International Journal of Obesity (IJO) titled "Obesity in a Modern World: When Pleasure Meets Homeostasis".

In a review article in this supplemental issue of IJO, Dr A Dagher of McGill Univesity examines the parallels between drug abuse and food "addiction", and discusses the implications for the current obesity epidemic.The crux of the issue is this; appetite is controlled by two separate systems. The homeostatic system, which is related to energy needs, and the hedonic system, which is focused on palatability and perceived rewards.  If you eat a sandwhich because you are hungry, that is the homeostatic system at work.  If you eat a sandwhich because you had a craving for a Fluffernutter sandwhich, even though you weren't hungry, that's the hedonic system.  

I'm not sure how I feel about food addiction as a disease just yet, (Dr Dagher seems to have reservations about the term as well), but I have to admit there are some interesting similarities between drug-abuse and chronic over-eating.  Both appetite and drug cravings are triggered by reward-associated stimuli - think of smokers who crave a cigarette when they see others lighting up, or the incredible allure of frying bacon.  Further, both food and all drugs of abuse affect the secretion of dopamine, and blockade of dopamine receptors abolishes the cravings for both. Finally, both drug abuse and chronic over-eating are more common in individuals with a heightened drive for reward, otherwise known as impulsivity.  These individuals require more stimuli (be it food, drugs, or adrenaline) to achieve a given level of pleasure or reward.  This last point, as well as possible links between obesity and Attention Deficit Hyperactivity Disorder, is examined in depth in an article by Dr C Davis from the University of Toronto in the same issue of IJO.

Whether or not food addiction is an actual disease seems beside the point to me.  It seems clear that food intake is influenced by hedonic stimuli.  We happen to live in an environment which is completely saturated with these same hedonic stimuli, which target us, and our children, on an almost continual basis.  Think of the ubiquitous ads for McDonald's and Coca-Cola - these are exactly the types of hedonic stimuli which have been shown to increase food intake.  So is it any surprise then that we have an obesity epidemic, as millions of people are constantly being tempted to eat more than they need to?  This very quickly leads to questions of free will and free markets and other thorny issues, but it becomes quite clear that advertising that promotes food intake is not in our societal best interest.  Should we ban food advertising just like we banned cigarette advertising?  I won't go that far... yet.  However, it's becoming increasingly clear that like drug abuse, obesity is not always as simple as sheer will power.

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Related Posts:

1.  Psychological exams for obesity surgery. 
2.  High fructose corn syrup is ruining everything.
3.  Misguided ad campaigns.

Dagher, A. (2009). The neurobiology of appetite: hunger as addiction International Journal of Obesity, 33 DOI: 10.1038/ijo.2009.69

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11 Response to "Food addiction - fact or fiction"

  1. Anonymous Said,

    You can technically get addicted to anything. So Fact...but i doubt it explains more than a tiny, tiny percentage of individuals...and doesn't change your responsibility, it just makes it harder.

    Posted on June 17, 2009 at 11:42 AM

  2. Anonymous Said,

    "Hedonic system?" I've been exposed to a great deal of psych and biology and have never heard that phrase before. I googled it and had one hit in a similar context, but it was essentially just a list of terms. I understand that there is an addictive response based on stimulus in the pleasure center of the brain. I understand that some folks overeat because it feels good and there is a bio-chemical feedback with in the brain. I even understand that some folks have a poor bio-chemical feedback for satiation. In regards to obesity, I'd suggest you collect high school yearbooks from the last hundred years. First you'll notice the benefits of better nutrition. Then you'll notice the problems of obesity. This especially becomes clear over the last 20 years. The observation that there weren't a lot of obese people until recently should tell you whether or not this is a disease. A disease by any definition is going to occur regardless of the decade. You may not have crack addicts in the thirties, but you will have alkies sleeping in alleys. By the same token the great lack of morbidly obese folks should tell you it is a matter of control and responsibility. Not a disease. That is most frequently an excuse, not a reality.

    Posted on June 17, 2009 at 1:50 PM

  3. Lauri Said,

    Truly, for some of us, it is NOT a matter of willpower alone. 24 years I gave up cigarettes cold turkey. 6 years ago, I gave up all grains (gluten sensitivity). Yet I am still overweight. We used to marvel at my extremely large grandmother and how little she ate, and how she never lost weight, even during an extended stay in the hospital on a restricted diet. I am beginning to wonder if there is an (un)discovered virus or genetic component.

    My diet is very healthy, more vegetables than anything, some meats and cheeses, no potatoes, occasional rice, little sugar (love the 80% chocolate!). My teenage daughter eats poptarts and frozen waffles, chicken tenders and fries every day. She's a size 0. It may catch up with her. If there's justice in this world.

    It's not a disability. It's not a disease, but it's also not a matter of simply cutting calories/exercising. I am far more fit and healthy than my daughter, but you can't tell from looking at us.

    Posted on June 17, 2009 at 5:37 PM

  4. luv my coughee Said,

    As a self described food addict, I take full responsibilty for every pound I've gained since I was 15. From 15 - 38 I knew nothing about food addiction, only that I couldn't stop eating. I'd fought through nicotine use, alcohol and drug use, diet coke, nicorette misuse, etc. I just couldn't stop eating. When the concept of food addiction was presented to me, and I put down the sugar and flour, weighed and measured everything I ate, the compulsion to continually eat finally went away.

    I cannot explain the compulsion any better then to ask you to hold your breath, and try not to give in and get some oxygen. That is how I needed food.

    Do I still crave? Yes, I do. But it is different, and I think it is more like "regular" people. They can choose. So today if I feel depressed, happy, sad, tired, or mad, I can consciously make a decision to NOT eat, and find something else to feel better. Before, there was nothing else, no conscious decision, no options but to eat.

    I commend your efforts. Good luck... oh, and if you can, please look at bariatric patients turning to alcohol, drugs, and/or regaining their weight do to compulsive action of eating in bulk no longer being available to them.

    Posted on June 17, 2009 at 8:02 PM

  5. Travis Saunders, MSc Said,

    Thanks for the insightful comments. I don't always agree with them, but it's great to have an opportunity for some discussion. On that note, why is it that when people disagree with me, they tend do it anonymously? I like it when people (thoughtfully) disagree because it stimulates the conversation, but if you stand by your comments I encourage you to put your name beside it, just as Peter and I do.

    @ Anonymous

    Hedonic "system" might not be the best wording, but I assure you there is plenty of research on the hedonic control of eating. For example, a google search of "hedonic eating", turns up several pages of research.

    "A disease by any definition is going to occur regardless of the decade". Obesity has occurred throughout history, it is just more prevalent now. This is because obesity, like other diseases, is influenced by the environment. Look at any other disease - smallpox, cardiovascular disease, cancer, multiple sclerosis - and we see changes in prevalence over time as the disease interacts with the environment. So I don't see why that would make obesity any different.

    @ Lauri,

    Thanks for your comments. Coincidentally, there is evidence to suggest that both viruses and genetics can make people more likely to become obese. They do not guarantee obesity, but they can predispose an individual. As the saying goes, "Genes load the gun, environment pulls the trigger".

    @ luv my coughee

    Thanks for sharing your story. You bring up a very good question about bariatric surgery patients turning to other compulsive behaviors since over-eating may be more difficult for them post-surgery. Unfortunately it is an area which I know very little about at the moment. I will keep my eyes open for research on the topic, in the meantime you may be interested in the website of Dr Arya Sharma (, who discusses bariatric surgery far more eloquently, and far more regularly than Peter and I.

    Posted on June 17, 2009 at 11:51 PM

  6. Richard Eis Said,

    When talking about addiction i meant full on, all consuming, cannot stop yourself addiction. Not, ooh i think i'll have another biscuit...addiction.

    I was trying to get in early before the flood of people declaring that the extra biscuit they had was because they are addicted/diseased/not really responsible for their actions.

    Which didn't really happen though Lauri is defying physics apparently.

    Posted on June 18, 2009 at 4:00 AM

  7. Lauri Said,

    Richard, my (adopted)son has addiction issues and I have educated myself on the matter. They vary from person to person as well item to item. If my son has a Dr. Pepper on Monday and a Dr. Pepper on Tuesday, there damn well better be one available on Wednesday. True, he can stop at a couple a day, but he has to have them, like we have to have water and sleep. Addiction isn't only like the guy who drinks to excess daily or lights one cigarette with another. And, for the record, my son's addictions also include drugs; he substitutes one with another: nicotine for cannabis, caffeine for nicotine, the cycle is endless. It would be nice if he would find religion, preferably with a diety that forbids it all, but even that can be addictive, too.

    For people with a food addiction, they may be able to eat 3x a day (albeit large meals) or may consume entire boxes and bags of goods in one sitting. An occasional splurge is fine; for them, the splurge comes daily.

    I don't have a food addiction. I have no problems with addictions as evidenced (I hope) by my ability to cut off a 7 year smoking habit and my cutting all grains out -- haven't looked back. I know what they do to my body and it's not pleasant so it makes it easier to avoid.

    I'm not sure what physics has to do with that though.

    Unless you mean what I eat and how I am still overweight. That's not physics, that nature. I'm well over 40 and post-menopausal. And looking forward to the day you that you are too :)!

    Posted on June 19, 2009 at 10:53 AM

  8. wriggles Said,

    Food addiction is a nonsense bourne of loose defintion of 'addiction' and the refusal to recognise that eating is not a choice but a necessity of living.

    Compulsive eating is not food addiction, it's the normal eating urge, ramped up to (a higher) or it's highest setting often it is provoked by trying to reduce weight.

    IOW, it's usually a defense mechanism to prevent or stop weight loss.

    Posted on July 3, 2009 at 9:34 AM

  9. Travis Saunders, MSc Said,

    @ wriggles,

    Those are good points. As I mentioned earlier, this whole issue of addiction/not addiction is more semantics than anything. In the end, does it really matter what we call it, so long as we find better ways of treating it?

    Posted on July 3, 2009 at 9:38 AM

  10. uncdiss Said,


    Just like cocaine addiction is a disregulated pathway in brain the same can be said for food (and I suspect other "addicting" stimuli, ie video games, cutting yourself).

    I agree with Travis that it is a bit semantic, one issue I think that needs to be delved into is the evolutionary development of these reward systems and how they relate to the modern environment. Just as rising cancer rates and psychosis can be seen as consequences of our evolutionary heritage I think more "diseases states" should be looked into with this frame of mind.

    As high and mighty as we think we are there are still powerful underlying circuitry events in the brain wired to pleasure and satiation centers which for all of our cognitive ability controls a great deal of our lives.

    Our civilization has been hyperadvanced compared to how far our biology has come in the same time frame.

    I wonder how often our ancestors were food secure and had an overwhelming abundance of food? I wonder how many times they were satisfied like a coke or double chocolate fudge cake can stimulate the brain today?

    I think these are all aspects of "food addiction" as well as many other "social ills" that we should consider.

    Posted on July 5, 2009 at 1:19 PM

  11. Travis Saunders, MSc Said,

    Excellent comment uncdiss. You said exactly what I have been trying (but failing) to articulate for some time.

    Posted on July 5, 2009 at 7:14 PM


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We are PhD students in the School of Kinesiology and Health Studies at Queen's University in Kingston, Ontario. Our research focuses on the relationships between obesity, physical activity, and health risk. This blog is our attempt to consider the many "cures" for obesity that we read about on a daily basis. Enjoy.


The opinions expressed here belong only to Peter and Travis and do not reflect the views of any organization. Any medical discussion on this page is intended to be of a general nature only. This page is not designed to give specific medical advice. If you have a medical problem you should consult your own physician for advice specific to your own situation.

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