Food addiction

Addiction and dependence glossary[1][2][3][4]
• addiction – a medical condition characterized by compulsive engagement in rewarding stimuli despite adverse consequences
• addictive behavior – a behavior that is both rewarding and reinforcing
• addictive drug – a drug that is both rewarding and reinforcing
• dependence – an adaptive state associated with a withdrawal syndrome upon cessation of repeated exposure to a stimulus (e.g., drug intake)
• drug sensitization or reverse tolerance – the escalating effect of a drug resulting from repeated administration at a given dose
• drug withdrawal – symptoms that occur upon cessation of repeated drug use
• physical dependence – dependence that involves persistent physical–somatic withdrawal symptoms (e.g., fatigue and delirium tremens)
• psychological dependence – dependence that involves emotional–motivational withdrawal symptoms (e.g., dysphoria and anhedonia)
• reinforcing stimuli – stimuli that increase the probability of repeating behaviors paired with them
• rewarding stimuli – stimuli that the brain interprets as intrinsically positive or as something to be approached
• sensitization – an amplified response to a stimulus resulting from repeated exposure to it
• substance use disorder - a condition in which the use of substances leads to clinically and functionally significant impairment or distress
• tolerance – the diminishing effect of a drug resulting from repeated administration at a given dose

A food addiction or eating addiction is a behavioral addiction that is characterized by the compulsive consumption of palatable (e.g., high fat and high sugar) foods – the types of food which markedly activate the reward system in humans and other animals – despite adverse consequences.[5][6] Sugary and high fat food have both been shown to increase the expression of ΔFosB, an addiction biomarker, in the D1-type medium spiny neurons of the nucleus accumbens;[5] however, there is very little research on the synaptic plasticity from compulsive food consumption, a phenomenon which is known to be caused by ΔFosB overexpression.[5] Psychological dependence has also been observed with the occurrence of withdrawal symptoms when consumption of these foods stops by replacement with low fat or sugar food.[5] Professionals address this disorder by means of behavior therapy.[7]

Description

Food addiction, refers to compulsive overeaters who engage in frequent episodes of uncontrolled eating (binge eating). The term binge eating means eating an unhealthy amount of food while feeling that one's sense of control has been lost.[8] People who engage in binge eating may feel frenzied, and consume a considerable amount of calories before stopping. The after effects of bingeing in this way is generally followed by feelings of guilt and depression; for example,[9] some will cancel their plans for the next day because they "feel fat."[10] Binge eating also has implications on physical health, due to excessive intake of fats and sugars, which can cause numerous health problems.

Unlike individuals with bulimia nervosa, compulsive overeaters do not attempt to compensate for their bingeing with purging behaviors, such as fasting, laxative use, or vomiting. When compulsive overeaters overeat through binge eating and experience feelings of guilt after their binges, they can be said to have binge eating disorder (BED).[8]

In addition to binge eating, compulsive overeaters may also engage in grazing behavior, during which they continuously eat throughout the day.[8] These actions result in an excessive overall number of calories consumed, even if the quantities eaten at any one time may be small.

During binges, compulsive overeaters may consume between 5,000 and 15,000 food calories daily (far more than is healthy), resulting in a temporary release from psychological stress through an addictive high not unlike that experienced through drug abuse.[9] Compulsive overeaters tend to show brain changes similar to those of drug addicts, a result of excessive consumption of highly processed foods.[11]

For the compulsive overeater, ingesting trigger foods causes the release of the neurotransmitters serotonin and dopamine.[9] This could be another indicator that neurobiological factors contribute to the addictive process. Conversely, abstaining from addictive food and food eating processes causes withdrawal symptoms for those with eating disorders.[9] The resulting decreased levels of serotonin in the individual may trigger higher levels of depression and anxiety.[12]

Eventually, compulsive overeaters continuously think about food. Food is in the preeminent positions of their minds; when deprived of it, the person may engage in actions similar to those of hard drug addicts, including an uncontrollable search for the substance, and in devious behaviour, such as stealing or lying.[13][14][15] The problem of obesity is becoming a worldwide problem. A sugar tax is set to be introduced in Ireland to minimise the consumption of harmful foods and drinks.[16]

Signs and symptoms

A food addiction features compulsive overeating, such as binge eating behavior, as its core and only defining feature. There are several potential signs that a person may be suffering from compulsive overeating. Common behaviors of compulsive overeaters include eating alone, consuming food quickly, and gaining weight rapidly. Other signs include significantly decreased mobility and the withdrawal from activities due to weight gain. Emotional indicators can include feelings of guilt, a sense of loss of control, depression and mood swings.[9]

Potential negative effects

Left untreated, compulsive overeating can lead to serious medical conditions. For example, compulsive overeating usually results in weight gain and obesity, although it is not the only cause thereof. In addition, compulsive overeating could potentially lead to high cholesterol, diabetes, heart disease, hypertension, sleep apnea, and major depression. Additional long-term side effects of the condition include kidney disease, arthritis, bone deterioration, and stroke. In severe cases, compulsive overeating can result in death.

Other negative effects may include the amount of money that is wasted on food and the feelings of low self-esteem that usually accompany bingeing.

Management

See also: Jaw wiring

Compulsive overeating is treatable with nutritional assistance and medication. Psychotherapy may also be required, but recent research has proven this to be useful only as a complementary resource, with short-term effectiveness in middle to severe cases.[17][18]

Lisdexamfetamine is an FDA-approved appetite suppressant drug that is indicated for the treatment of binge eating disorder.[19] The antidepressant fluoxetine is a medication that is approved by the Food and Drug Administration (FDA) for the treatment of an eating disorder, specifically bulimia nervosa. This medication has been prescribed off-label for the treatment of binge eating disorder (BED). Off-label medications, such as other selective serotonin reuptake inhibitors (SSRIs), have shown some efficacy, as have several atypical agents, such as mianserin, trazodone and bupropion.[20][21] Anti-obesity medications[22] have also proven very effective. Studies suggest that anti-obesity drugs, or moderate appetite suppressants, may be key to controlling BED.[23]

Many eating disorders are thought to be behavioral patterns that stem from emotional struggles; for the individual to develop lasting improvement and a healthy relationship with food, these affective obstacles need to be resolved.[24] Individuals can overcome compulsive overeating through treatment, which should include talk therapy and medical and nutritional counseling. Such counseling has been recently sanctioned by the American Dental Association in their journal article cover-story for the first time in history in 2012: Given “the continued increase in obesity in the United States and the willingness of dentists to assist in prevention and interventional effort, experts in obesity intervention in conjunction with dental educators should develop models of intervention within the scope of dental practice”.[25] Moreover, Dental appliances such as conventional jaw wiring and orthodontic wiring for controlling compulsive overeating have been shown to be “efficient ways in terms of weight control in properly selected obese patients and usually no serious complications could be encountered through the treatment course.[26] Finally, several twelve step programs exist to help members recover from compulsive overeating and food addiction.[9]

Epidemiology

A review on behavioral addictions listed the estimated the lifetime prevalence rate (i.e., the proportion of individuals in the population that developed the disorder during their lifetime) for food addiction in the United States as 2.8%.[5]

Summary of addiction-related plasticity

Form of neuroplasticity
or behavioral plasticity		 Type of reinforcer Sources
Opiates Psychostimulants High fat or sugar food Sexual intercourse Physical exercise
(aerobic)		 Environmental
enrichment
ΔFosB expression in
nucleus accumbens D1-type MSNs		 ↑ ↑ ↑ ↑ ↑ ↑ [5]
Behavioral plasticity
Escalation of intake Yes Yes Yes [5]
Psychostimulant
cross-sensitization		 Yes Not applicable Yes Yes Attenuated Attenuated [5]
Psychostimulant
self-administration		 ↑ ↑ ↓ ↓ ↓ [5]
Psychostimulant
conditioned place preference		 ↑ ↑ ↓ ↑ ↓ ↑ [5]
Reinstatement of drug-seeking behavior ↑ ↑ ↓ ↓ [5]
Neurochemical plasticity
CREB phosphorylation
in the nucleus accumbens		 ↓ ↓ ↓ ↓ ↓ [5]
Sensitized dopamine response
in the nucleus accumbens		 No Yes No Yes [5]
Altered striatal dopamine signaling ↓DRD2, ↑DRD3 ↑DRD1, ↓DRD2, ↑DRD3 ↑DRD1, ↓DRD2, ↑DRD3 ↑DRD2 ↑DRD2 [5]
Altered striatal opioid signaling No change or
↑μ-opioid receptors 		↑μ-opioid receptors
↑κ-opioid receptors 		↑μ-opioid receptors ↑μ-opioid receptors No change No change [5]
Changes in striatal opioid peptides ↑dynorphin
No change: enkephalin 		↑dynorphin ↓enkephalin ↑dynorphin ↑dynorphin [5]
Mesocorticolimbic synaptic plasticity
Number of dendrites in the nucleus accumbens ↓ ↑ ↑ [5]
Dendritic spine density in
the nucleus accumbens		 ↓ ↑ ↑ [5]

See also

References

  1. ↑ Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 15: Reinforcement and Addictive Disorders". In Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. pp. 364–375. ISBN 9780071481274.
  2. ↑ Nestler EJ (December 2013). "Cellular basis of memory for addiction". Dialogues Clin. Neurosci. 15 (4): 431–443. PMC 3898681Freely accessible. PMID 24459410.
  3. ↑ "Glossary of Terms". Mount Sinai School of Medicine. Department of Neuroscience. Retrieved 9 February 2015.
  4. ↑ Volkow ND, Koob GF, McLellan AT (January 2016). "Neurobiologic Advances from the Brain Disease Model of Addiction". N. Engl. J. Med. 374 (4): 363–371. doi:10.1056/NEJMra1511480. PMID 26816013.
  5. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Olsen CM (December 2011). "Natural rewards, neuroplasticity, and non-drug addictions". Neuropharmacology. 61 (7): 1109–1122. doi:10.1016/j.neuropharm.2011.03.010. PMC 3139704Freely accessible. PMID 21459101. Functional neuroimaging studies in humans have shown that gambling (Breiter et al, 2001), shopping (Knutson et al, 2007), orgasm (Komisaruk et al, 2004), playing video games (Koepp et al, 1998; Hoeft et al, 2008) and the sight of appetizing food (Wang et al, 2004a) activate many of the same brain regions (i.e., the mesocorticolimbic system and extended amygdala) as drugs of abuse (Volkow et al, 2004). ... As described for food reward, sexual experience can also lead to activation of plasticity-related signaling cascades. ... In some people, there is a transition from “normal” to compulsive engagement in natural rewards (such as food or sex), a condition that some have termed behavioral or non-drug addictions (Holden, 2001; Grant et al., 2006a). ... the transcription factor delta FosB is increased during access to high fat diet (Teegarden and Bale, 2007) or sucrose (Wallace et al, 2008). ...To date, there is very little data directly measuring the effects of food on synaptic plasticity in addiction-related neurocircuitry. ... Following removal of sugar or fat access, withdrawal symptoms including anxiety- and depressive-like behaviors emerge (Colantuoni et al, 2002; Teegarden and Bale, 2007). After this period of “abstinence”, operant testing reveals “craving” and “seeking” behavior for sugar (Avena et al, 2005) or fat (Ward et al, 2007), as well as “incubation of craving” (Grimm et al, 2001; Lu et al, 2004; Grimm et al, 2005), and “relapse” (Nair et al, 2009b) following abstinence from sugar. In fact, when given a re-exposure to sugar after a period of abstinence, animals consume a much greater amount of sugar than during previous sessions (Avena et al., 2005)."Table 1"
  6. ↑ Hebebrand J, Albayrak Ö, Adan R, Antel J, Dieguez C, de Jong J, Leng G, Menzies J, Mercer JG, Murphy M, van der Plasse G, Dickson SL (November 2014). ""Eating addiction", rather than "food addiction", better captures addictive-like eating behavior". Neurosci Biobehav Rev. 47: 295–306. doi:10.1016/j.neubiorev.2014.08.016. PMID 25205078.
    •Evidence for addiction to specific macronutrients is lacking in humans.
    •'Eating addiction' describes a behavioral addiction. ...
    We concur with Hone-Blanchet and Fecteau (2014) that it is premature to conclude validity of the food addiction phenotype in humans from the current behavioral and neurobiological evidence gained in rodent models. ... To conclude, the society as a whole should be aware of the differences between addiction in the context of substance use versus an addictive behavior. As we pointed out in this review, there is very little evidence to indicate that humans can develop a “Glucose/Sucrose/Fructose Use Disorder” as a diagnosis within the DSM-5 category Substance Use Disorders. We do, however, view both rodent and human data as consistent with the existence of addictive eating behavior.
  7. ↑ Ho, Karen S. I.; Nichaman, Milton Z.; Taylor, Wendell C.; Lee, Eun Sul; Foreyt, John P. (1995). "Binge eating disorder, retention, and dropout in an adult obesity program". International Journal of Eating Disorders. 18 (3): 291–4. doi:10.1002/1098-108X(199511)18:3<291::AID-EAT2260180312>3.0.CO;2-Y. PMID 8556026.
  8. 1 2 3 Saunders, Ronna (January 1, 2004). ""Grazing": A High-Risk Behavior". Obesity Surgery. 14: 98–102. doi:10.1381/096089204772787374. Retrieved October 27, 2014.
  9. 1 2 3 4 5 6 Goldberg, Joseph (August 21, 2014). "Food Addiction". WebMD. WebMD. Retrieved October 27, 2014.
  10. ↑ Goldsmith, Toby D. (2013-01-30). "Bulimia: Binging and Purging". Psych Central. Retrieved 2014-02-01.
  11. ↑ Nolen-Hoeksema, Susan (2014). (ab)normal Psychology. New York, NY: McGraw-Hill Education. p. 348. ISBN 9781308211503.
  12. ↑ Kriz, Kerri-Lynn Murphy (May 2002). The Efficacy of Overeaters Anonymous in Fostering Abstinence in Binge-Eating Disorder and Bulimia Nervosa (PhD Thesis). Virginia Polytechnic Institute and State University.
  13. ↑ Sheppard, Kay (1993). Food Addiction: The Body Knows. ISBN 978-1-55874-276-5.
  14. ↑ "Are You a Food Addict?". Food Addicts Anonymous. Retrieved 2014-02-01.
  15. ↑ "Food Addiction - Signs, Symptoms & Treatment". Addictions.com. Retrieved 2014-02-01.
  16. ↑ http://www.irishtimes.com/search/search-7.1213540?q=sugar%20tax
  17. ↑ "Binge-eating disorder Treatment at Mayo Clinic - Diseases and Conditions". Mayo Clinic. 2012-04-03. Retrieved 2014-02-01.
  18. ↑ Johnson, Bankole A.; Ait-Daoud, Nassima; Wang, Xin-Qun; Penberthy, J. Kim; Javors, Martin A.; Seneviratne, Chamindi; Liu, Lei (2013). "Topiramate for the Treatment of Cocaine Addiction". JAMA Psychiatry. 70 (12): 1338–46. doi:10.1001/jamapsychiatry.2013.2295. PMID 24132249. Lay summary – ScienceDaily (October 25, 2013).
  19. ↑ "Vyvanse Prescribing Information" (PDF). United States Food and Drug Administration. Shire US Inc. January 2015. Retrieved 24 February 2015.
  20. ↑ White, Marney A.; Grilo, Carlos M. (2013). "Bupropion for Overweight Women with Binge-Eating Disorder". The Journal of Clinical Psychiatry. 74 (4): 400–6. doi:10.4088/JCP.12m08071. PMC 4021866Freely accessible. PMID 23656848.
  21. ↑ Calandra, Carmela; Russo, Rina Giuseppa; Luca, Maria (2011). "Bupropion Versus Sertraline in the Treatment of Depressive Patients with Binge Eating Disorder: Retrospective Cohort Study". Psychiatric Quarterly. 83 (2): 177–85. doi:10.1007/s11126-011-9192-0. PMID 21927936.
  22. ↑ "Obesity Treatment at Mayo Clinic - Diseases and Conditions". Mayo Clinic. 2013-06-07. Retrieved 2014-02-01.
  23. ↑ McElroy, Susan L.; Guerdjikova, Anna I.; Mori, Nicole; O'Melia, Anne M. (May 7, 2012). "Pharmacological management of binge eating disorder: Current and emerging treatment options". Therapeutics and ClinicalRisk Management: 219–41. doi:10.2147/TCRM.S25574. PMC 3363296. PMID 22654518. Retrieved October 31, 2014.
  24. ↑ "Factors That May Contribute to Eating Disorders". NEDA. Retrieved October 27, 2014.
  25. ↑ Curran, Alice E.; Caplan, Daniel J.; Lee, Jessica Y.; Paynter, Lauren; Gizlice, Ziya; Champagne, Catherine; Ammerman, Alice; Agans, Robert (November 2010). "Dentists' Attitudes about Their Role in Addressing Obesity in Patients: A national survey". Journal of the American Dental Association. 141 (11): 1307–1316. doi:10.14219/jada.archive.2010.0075.
  26. ↑ K. Al-Dhubhani, Mohammed; M. Al-Tarawneh, Ahmad (November 2014). "The Role of Dentistry in Treatment of Obesity—Review". Saudi Journal of Dental Research. doi:10.1016/j.sjdr.2014.11.005.

Further reading

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