Though food addiction is not considered a diagnosable condition in the DSM-5, a new analysis suggests that ultra-processed food has highly palatable features, which may lead to addictive behavior in some people.
In an analysis published on October 9 in the British Medical Journal, scientists from the United States, Brazil, Spain, and the Fralin Biomedical Research Institute at VTC are calling for more research into the potential for ultra-processed food to contribute to food addiction.
While not in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5),the Yale Food Addiction Scale (YFAS) — a measure of food addiction using DSM-5 criteria for substance use disorder — has provided new insight into whether ultra-processed food has addictive qualities.
According to the study's authors, two recent systematic reviews of research, which included 281 studies from 36 countries, found the overall prevalence of ultra-processed food addiction using YFAS was 12% in children and 14% in adults.
Moreover, this prevalence rate is much like the rates of addiction to other substances such as alcohol (14%) and tobacco (18%). YFAS also identified that food addiction prevalence is around 32% in people with obesity who had bariatric surgery and over 50% in individuals with binge eating disorder (BED). The scientists believe this supports the validity of food addiction as a diagnosis. But why would ultra-processed foods trigger addictive behavior, and could classifying these foods as addictive have global health implications?
Can ultra-processed foods be addictive?
The researchers suggest that not all foods can trigger addictive behavior, typically characterized by excessive substance intake, loss of control over substance consumption, extreme cravings, and continued substance use despite negative health consequences.
However, ultra-processed foods may have potentially addictive ingredients. And the analysts say that for some people, these foods can evoke behaviors that may meet DSM-5 criteria for substance use disorder.
According to the analysts, potentially addictive ultra-processed food ingredients include:
- Refined carbohydrates or added fats because they evoke similar dopamine release as substances like alcohol and nicotine.
- Flavor additives and texturizers because they increase the desire for consumption due to their unnaturally savory taste and mouthfeel.
- Artificial sweeteners due to their actions in the gut.
Moreover, a recent University of Kansas study found that from 1980 to 2001, food brands owned by tobacco companies were more hyperpalatable, making it difficult for people to stop consuming these products.
The scientists are calling for more research into how ultra-processed foods' features increase their addictive potential. They would also like to identify which foods could be considered addictive and see the development of clinical guidelines for preventing, treating, and managing ultra-processed food addiction.
"There is converging and consistent support for the validity and clinical relevance of food addiction," said corresponding author Ashley Gearhardt, a psychology professor at the University of Michigan. "By acknowledging that certain types of processed foods have the properties of addictive substances, we may be able to help improve global health."
The researchers also suggest that policies, including ultra-processed food and beverage taxes, mandatory warning labels and reformulation of products, and other marketing regulations, could help combat the addictive nature of these foods.
In the U.S., one state has already passed regulations to control some ingredients found in ultra-processed foods. In California, Governor Gavin Newsom recently signed California Assembly Bill 418 (AB418) into law, which effectively bans the manufacture or sale of four food additives in the state. It's the first law in the U.S. to ban these additives from store shelves.
- University of Michigan. Yale Food Addiction Scale.
- Addiction. US tobacco companies selectively disseminated hyper-palatable foods into the US food system: Empirical evidence and current implications.
- British Medical Journal. Social, clinical, and policy implications of ultra-processed food addiction.
- Virginia Tech. International team of scientists says identifying some foods as addictive could stimulate research, shift attitudes.