Current Status of Evidence for a New Diagnosis: Food Addiction-A Literature Review

Abstract

Food addiction is considered an important link for a better understanding of psychiatric and medical problems triggered by dysfunctions of eating behaviors, e. g., obesity, metabolic syndrome, binge eating disorder, or bulimia nervosa. At behavioral level, food addiction has high degrees of similarity with other eating disorders, a phenomenon that creates difficulties in finding specific diagnostic criteria. Food addiction has been also described as “eating addiction” or “eating dependence” by several researchers, who placed the emphasis on the behavior and not on the food itself. High-sodium foods, artificially flavored-foods, rich carbohydrate- and saturated fats-containing foods are triggers for the activation of the same neural pathways, therefore they act similarly to any drug of abuse. Food addiction is considered a disorder based on functional negative consequences, associated distress and potential risks to both psychological well-being and physical health. A clinical scale was validated for the quantification of the eating addiction severity, namely the Yale Food Addiction Severity Scale (YFAS), constructed to match DSM IV criteria for substance dependence. Using this instrument, a high prevalence of food addiction was found in the general population, up to 20% according to a meta-analytic research. The pathogenesis of this entity is still uncertain, but reward dysfunction, impulsivity and emotion dysregulation have been considered basic mechanisms that trigger both eating dysfunctions and addictive behaviors. Genetic factors may be involved in this dependence, as modulators of higher carbohydrate and saturate fat craving. Regarding the existence of potential therapeutic solutions, lorcaserin, antiepileptic drugs, opioid antagonists, antiaddictive agents are recommended for obesity and eating disorders, and they may be intuitively used in food addiction, but clinical trials are necessary to confirm their efficacy. In conclusion, a better understanding of food addiction's clinical profile and pathogenesis may help clinicians in finding prevention- and therapeutic-focused interventions in the near future.

Therapeutic management of buying/shopping disorder: A systematic literature review and evidence-based recommendations

“…This rationale is similar to other BAs, e.g., food addiction, physical exercise addiction, Internet addiction, etc. ( 7 ). Cultural factors might contribute to the pathogenesis of B/SD because it has been reported mainly in developed countries ( 3 ), but this could be a bias due to the higher income and increased accessibility to the products when compared to low and medium-income countries.…”

Dissociative experiences of compartmentalization are associated with food addiction symptoms: results from a cross‐sectional report

“…Over the last years the construct of Food Addiction (FA) has attracted interest in both clinical and research fields, mainly in relation to certain forms of obesity, to eating disorders (EDs), especially binge-type EDs, and to addictive behaviors [ 1 – 3 ]. To date there is still not an unequivocal definition of FA, and debates have been occurring on whether FA is an independent nosographic condition or not, and whether it should be conceptualized as a form of ED or as a form of addictive disorder [ 2 , 4 , 5 ]. FA has been conceptualized as a behavioral pattern characterized by uncontrolled and dysregulated consumption of hyper-palatable and highly processed foods (i.e., containing refined carbohydrates and/or added fats such as pizza or French-fries) [ 3 , 6 , 7 ], as well as a behavioral pattern with clinical (e.g., continued overuse despite negative consequences) and neurophysiological (e.g., altered dopamine expression) overlaps with addiction, certain forms of obesity, and binge-type EDs [ 1 , 2 , 5 ].…”

Current Trends and Perspectives in the Immune Therapy for Substance Use Disorders

“…Because there is a limited choice of drugs available for the treatment of SUDs, and these options are often criticized for the high rates of relapse, new strategies are acutely needed for these patients ( 9 ). The need to re-configure SUDs therapeutic management using a long-term approach, and not treatments focused only on the acute episodes of substance abuse, is supported by evidence like patients' lack of insight, high rate of treatment discontinuation, high risk of complications, and personality factors that are maintaining the addictive patterns ( 9 – 11 ). Therefore, a change of paradigm from orally-administered medicines to long-acting injectable treatments may be beneficial for patients, and the use of intramuscular injectable extended-release naltrexone is the first step in this direction ( 10 , 12 ).…”