47: Food Addiction

Food addiction is a somewhat controversial topic.  Can you really be “addicted” to something necessary for life (i.e., food, air, water)?  Based upon the Diagnostic and Statistical Manual of Mental Disorders (DSM) and Yale Food Addiction Scale (YFAS), the technical answer is, yes.In today’s episode, The Nutrition Grouch asks whether the identification of food addiction is helpful to clients and practitioners in losing weight or whether it provides a “permission structure” enabling them to continue eating junk food and becoming an excuse for their ultimate failure.Based on the YFAS, 25% of people with overweight or obesity are food addicted but interestingly, so are 11% of normal weight individuals.  Is food addiction concept creep or a simple expression such as “I’m starving” or “I’m freezing” or is there something more to it?While there’s no clear answer to any of these questions, the frontline therapies for people with and without food addiction for weight loss are very similar: medications, lifestyle modification, and bariatric surgery.  We love to blame individuals for addictions; however, culture and environment are often overlooked, ignored or downplayed.Some of the topics in today’s episode include: Food addiction as concept creep (0:28)Is food addiction a permission structure to eat junk food? (3:51)Food addiction OR life circumstances and food environment? (5:53)Sometimes your best still just isn’t good enough (7:52)I’m a defender of fast food, carbs, and ultra processed food (15:36)Junk food in “selective moderation” (15:57)Nutrition rules, self-binding, and setting boundaries (17:26)Eliminate problematic foods you can’t control from your diet (18:14)The two most accepted methods for identifying food addiction (21:15)Food addiction prevalence: 25% with overweight/obese and 11% lean individuals (27:07)Food addiction may be relatively short lived, transient, and self-correcting (31:08)Is food addiction real? Yes, but you may have to squint to see it (31:48)How do we treat food addiction? (32:20)There’s essentially no difference in how you treat someone with or without food addiction (37:08)I prefer “level of problematic eating” to the term food addiction (39:19)Chocolate, sex, nicotine, cocaine, and amphetamines (41:40)What heroin users during the Vietnam war taught us about addiction (45:00)The woman who just couldn’t stop eating McDonalds (48:12)I can’t put food addiction in the same category as other addictions (49:47)