Worried about overeating?

For many of us, eating certain foods can be a comfort: a pick-me-up during a tough task; a reward after a long day at work; a filling end to a lovely dinner.

But some people have a compulsive and uncontrolled urge to eat certain foods, especially hyper-tasty “junk” foods. This can affect their daily functioning and their ability to fulfill social, work or family roles.

People struggling with addictive eating may have intense cravings that are not related to hunger, as well as increased levels of tolerance for large amounts of food and feelings of withdrawal.

Instead of hunger, these cravings can be caused by low mood, mental illness (depression and anxiety), high levels of stress or increased emotions.

“Food addiction” or “addictive eating” is not yet a disorder that can be diagnosed in a clinical setting. Yet patients often ask healthcare professionals how to handle their addictive eating habits.

These healthcare providers generally recognize their patients’ addictive eating behaviors, but may be unsure of appropriate treatments.

Food addiction is commonly assessed using the Yale Food Addiction Scale.

The science of addictive eating is still emerging, but researchers are increasingly noticing that addiction and reward pathways in the brain triggered by stress, increased emotions, and mental illness are linked to the urge to overeat.

How common is it?

Many factors contribute to overeating. The abundance of fast food, advertising for junk food and the very tasty ingredients in many processed foods can make us eat whether we are hungry or not.

However, some people report lack of control over their eating and seek help for this. About one in six people (15 to 20 percent) report addictive eating patterns or addictive behaviors around food.

While food addiction is higher among people with obesity and mental illness, it affects only a subset of these groups.

How do you tell if you have a problem?

Food addiction typically occurs with foods that are very tasty, processed and high in combinations of energy, fat, salt and sugar while having low nutritional value. This can include chocolate, confectionery, takeaway food and pastries.

These foods can be associated with high levels of reward and can therefore occupy your thoughts. They can lift your spirits or cause a distraction from anxious or traumatic thoughts, and over time you may need to eat more to get the same feelings of reward.

But for others, it may be an addiction to a feeling of satiety or a feeling of reward or contentment.

There is ongoing debate about whether it is constituents of food that are addictive or the behavior of eating in itself that is addictive, or a combination of the two.

Given that people consume foods for a variety of reasons and people may form habits around certain foods, it may be different for different people.

It often starts in childhood

Through our research that explored the experiences of adults, we found that many people with addictive eating attribute their behavior to experiences that occurred in childhood.

These events are very varied. They range from traumatic events to the use of dieting or restrictive eating methods or are related to poor body image or body dissatisfaction.

Our recent research found that addictive eating in adolescence is associated with poorer quality of life and lower self-esteem, and it appears to increase in severity over time.

Children and adolescents tend to have fewer addictive eating behaviors or symptoms than adults. Of the 11 symptoms on the Yale Food Addiction Scale, children and adolescents generally have only two or three, while adults often have six or more, which is classified as severe food addiction.

The correlations we observed in adolescents are also seen in adults: Increased weight and poorer mental health are associated with a greater number of symptoms and incidence of food addiction.

This highlights that some young people will need mental health, eating disorders and obesity in a combined treatment approach.

We also need to identify early risk factors to enable targeted, preventive action in younger age groups.

How is it treated?

The underlying causes of addictive eating are different, so treatments may not be uniform.

A wide range of treatments are being tested. These include passive approaches such as self-help support groups and medications such as naltrexone and bupropion, which target hormones involved in hunger and appetite. There is also bariatric surgery to help with weight loss. The most common procedure in Australia is the abdominal band, where an adjustable band is placed around the upper part of the abdomen to apply pressure and reduce appetite.

However, few of the available self-help support groups include involvement or input from qualified health professionals. Although they provide peer support, these may not be based on the best available evidence, with few evaluated for effectiveness.

Medication and obesity surgery involve health professional inputs and have been shown to be effective in achieving weight loss and reducing symptoms of food addiction in some people.

However, these may not be suitable for some people, such as those in the healthy weight range or with complex underlying health conditions. It is also crucial that people receiving medication and surgery are advised to make dietary and other lifestyle changes.

Other holistic, personalized lifestyle approaches, which include diet, physical activity as well as mindfulness, show promising results, especially when designed with consumers and healthcare professionals.

Our new treatment program

We are also creating new holistic approaches to dealing with addictive eating. We recently tested an online intervention tailored to the personalities of individuals.

Provided by dietitians and based on behavior change research, trial participants received personal feedback on their symptoms of addictive eating, diet, physical activity, and sleep, and formulated goals, distraction lists, and mindfulness plans, which contributed to an overall plan of action. .

After three months, participants reported that the program was acceptable and feasible. The next step in our research is to test the treatment for efficacy. We are conducting a research trial to determine the effectiveness of treatment in reducing symptoms of food addiction and improving mental health.

This is the first study of its kind, and if it proves to be effective, it will be translated into clinical practice.

Tracy Burrows is Professor of Nutrition and Dietetics at the University of Newcastle in Australia, and Megan Whatnall is a post-doc researcher in nutrition and dietetics at the University of Newcastle. This article was first published on The Conversation.