Food cravings are extremely common and often brought on by a variety of mental and physical factors. Many people will experience these urges or occasionally overeat, but for those with a food addiction, it’s more than just a craving; it’s a lack of control around food despite the consequences. Vikki Ratliff, MSW, LCSW, and Nicole Mazzola-Helmkamp, MSW, LCSW, PPG – Weight Management & Bariatric Surgery, explain the complexities behind the condition, why it’s not included in prominent mental health references or resources, and where people can turn for help when needed.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), a guide used by health professionals to diagnose mental disorders, there is no listing for food addiction, not even in the Substance-Related and Addictive Disorders section. The substance-related conditions that are mentioned include:
- Alcohol
- Caffeine
- Cannabis
- Hallucinogens
- Inhalants
- Opioids
- Sedatives
- Hypnotics
- Anxiolytics
- Stimulants
- Tobacco
- Other (or unknown) substances [1]
With that said, the DSM-5-TR does mention groups of repetitive behaviors (like exercise addiction, sex addiction, shopping addiction, etc.), but it refers to them as “other behavioral addictions.” The DSM-5-TR doesn’t currently recognize or specifically list each one because there is a lack of sufficient peer-reviewed evidence and criteria for non-substance addictions. [1]
Food addiction within mental health
Knowing this information, you might wonder where food addiction falls in terms of mental health. If we look in the DSM-5-TR, it categorizes issues with food underfeeding and eating disorders. These are described as persistent disturbances of eating or eating-related behaviors that result in the altered consumption or absorption of food and significantly impair physical health or psychological functioning. [1] Disorders and conditions listed within the DSM-5-TR that meet the criterion include diagnoses such as pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa and binge-eating disorder. It might also interest you to know that obesity isn’t included in the DSM-5-TR as a mental disorder, either. However, the disease seems to be associated with several other disorders like binge eating, depressive and/or bipolar disorders.
Possible causes of food addiction
According to research, food addiction may have various potential causes, such as a genetic predisposition, early life stress or trauma, and environmental factors. [3] [6]
Signs of food addiction
Patients experiencing a self-diagnosed food addiction describe it as an overwhelming urge (or craving) for a particular type of food. This desire can include highly processed, sugary and fatty foods that have been shown to trigger or activate the reward centers in the brain, leading to cravings and compulsive eating behavior. [2]
Curbing the cravings
When treating patients who face these strong desires and cravings toward food, we often utilize the same steps we use to help those individuals with a diagnosed addictive disorder. [5] Some of these techniques involve:
- If you’re feeling the urge to eat due to a craving, try to wait it out.
- Focus on replacing your past overeating with new positive activities.
- Don’t try to do this alone. There are professionals and resources available to assist you.
- Remind yourself that your cravings are temporary, and they will pass.
- It’s crucial that you prepare and have a strategy for when things get really bad because, at some point, they will.
- Don’t become complacent with your eating.
- If you do overeat, don’t give up.
- Let go of old habits and develop new rituals.
- Understand that you’ll have to make sacrifices beyond giving up the food you crave.
Although the DSM-5-TR doesn’t support mental health providers diagnosing patients with a “food addiction,” it’s important to understand that this lack of diagnosis does not detract from a patient’s feelings towards an intense craving for food.
Treatment options
A multidisciplinary approach is often the best option when treating someone for food addiction. Cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) can help patients identify triggers for overeating and develop coping skills to manage cravings and regulate emotions. [2] [4] Lifestyle changes that can help manage the condition include:
- Improving diet quality
- Engaging in regular exercise
- Practicing stress-management techniques [7]
Seeking support
If you are struggling with eating or food addiction, please speak with a mental health provider. Though they might not diagnose you, they can help you cope with how food impairs your physical and/or psychological health and establish healthier life habits.
If you or someone you know needs help with mental health or addiction, please call the Parkview Behavioral Health HelpLine at 260-471-9440 or 800-284-8439 anytime, 24 hours a day. For immediate assistance or medical intervention, call 911 for emergency care.
References
[1] American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (DSM-5-TR) Gearhardt, A. N., Corbin, W. R., & Brownell, K. D. (2011). Preliminary validation of the Yale Food Addiction Scale. Appetite, 52(2), 430-436.
[2] Gearhardt, A. N., White, M. A., Masheb, R. M., Morgan, P. T., Crosby, R. D., & Grilo, C. M. (2014). An examination of the food addiction construct in obese patients with binge eating disorder. International Journal of Eating Disorders, 47(6), 638-642.
[3] Hebebrand, J., Albayrak, Ö., Adan, R., Antel, J., Dieguez, C., de Jong, J., ... & Dickson, S. L. (2014). “Eating addiction”, rather than “food addiction”, better captures addictive-like eating behavior. Neuroscience & Biobehavioral Reviews, 47, 295-306.
[4] Katterman, S. N., Kleinman, B. M., Hood, M. M., Nackers, L. M., & Corsica, J. A. (2014). Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: A systematic review. Eating Behaviors, 15(2), 197-204.
[5] Tips for Avoiding Relapse. Therapist Aid. (n.d.). Retrieved February 20, 2023, from http://www.therapistaid.com/
[6] Pursey, K. M., Stanwell, P., Gearhardt, A. N., Collins, C. E., & Burrows, T. L. (2014). The prevalence of food addiction as assessed by the Yale Food Addiction Scale: A systematic review. Nutrients, 6(10), 4552-4590.
[7] Wadden, T. A., Butryn, M. L., & Byrne, K. J. (2011). Efficacy of lifestyle modification for long-term weight control. Obesity Research, 12(S1), 151S-162S
