Debate Over Food Addiction

Within the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA), substance dependence is conceptualized as a psychiatric disorder marked by the compulsive use of psychoactive substances—despite the occurrence of significant adverse consequences affecting physical health, interpersonal relationships, or occupational performance. The core diagnostic criteria outlined in the DSM encompass the following dimensions:

• Impaired control over use (consumption of the substance in quantities or over durations exceeding initial intentions, repeated unsuccessful efforts to cut down or discontinue use, and devoting substantial time to procuring, using, or recovering from the substance’s effects);

• Social and occupational impairment (failure to fulfill major role obligations at work, school, or home due to substance use, along with interpersonal conflicts or withdrawal from social activities);

• Hazardous use (persistent substance consumption in situations where it is physically dangerous or exacerbates pre-existing medical or psychological conditions);

• Pharmacological indicators (the development of tolerance—requiring increased doses to achieve the desired effect—and the emergence of withdrawal symptoms, including both physical and psychological distress upon cessation or reduction of use).

While the APA does not formally recognize "food addiction" as a discrete diagnostic entity, this term is employed herein to describe patterns of excessive, compulsive eating that mirror the behavioral and neurobiological mechanisms of substance dependence. It is critical to distinguish compulsive eating from food addiction; research by C. G. Long, J. E. Blundell, and G. Finlayson revealed that 56.8% of individuals diagnosed with binge-eating disorder exhibited symptoms aligned with addictive processes. A growing body of literature explores the overlaps between DSM-defined substance use disorders and excessive eating, highlighting:

• Loss of control over the amount and frequency of food intake;

• Recurrent, unsuccessful attempts to reduce consumption or eliminate specific foods;

• Persistent eating despite adverse health outcomes (e.g., obesity, type 2 diabetes) or psychological distress (e.g., guilt, depressive symptoms).

The fifth edition of the DSM (DSM-5) introduced a new diagnostic subcategory—non-substance-related disorders—which includes gambling disorder but excludes excessive eating due to insufficient empirical evidence supporting its classification as an addiction. Nonetheless, the debate regarding the addictive potential of certain foods persists. Among the most robust assessment tools currently available is the Yale Food Addiction Scale (YFAS), designed to measure behaviors analogous to those observed in substance dependence, thereby facilitating further research into this contested phenomenon.