Today’s Press headlines feature "Third of Kiwis 'need to kick food addiction'".
The quote is attributed to Professor Doug Sellman, Director of the National Addiction Centre and is a call for more funding to support this group. My first reaction was “Give someone a hammer and everything looks like a nail.” Alas, I can’t leave it with my prejudices.
What evidence is there for food addiction and for one third of New Zealanders being addicted to food?
I searched the medical literature (PubMed) for any work relating to New Zealand and food addiction. I found one article from the NZ Medical Journal co-authored by Professor Sellman: Addictive overeating: lessons learned from medical students’ perceptions of Overeaters Anonymous. (N Z Med J. 2010 Mar 19;123(1311):15-21.). The research is a synthesis of the reports of 72 fifth-year medical students who, as part of their training, attended a meeting of Overeaters Anonymous. The 'results' are a series of quotations which pick up on some themes and includes the concept of the attendees talking about the concept of addiction.
A brief look at the review literature on PubMed revealed that the concept of 'food addiction' is new and by no means an established addiction. One paper, How Prevalent is “Food Addiction”? (Front Psychiatry. 2011; 2: 61), talks about how few tools there are to assess food addiction. One tool – a questionnaire –(the Yale Food Addiction Scale) has recently undergone some validation studies. In normal weight participants food addiction, according to this scale, was diagnosed in 8.8 and 11.4 percent. In one study of obese participants it was 25 percent. Interestingly there was very little correlation between diagnosis of food addiction and Body Mass Index in these studies. A second freely available review asks the question Does Food Addiction Really Exist? (Obesity Facts 2012 19;5(2):165-179). The authors note that in some individuals the underproduction of the hormone leptin “has a pronounced effect on the reward system, thus suggesting an indirect link between overeating and ‘chemical’ addiction”. Their major conclusions are:
“Because of the current rather limited evidence of the addictive behavior of specific food ingredients or additives, we currently conclude that food addiction can best be classified as a behavioral addiction at this time. However, because there is not sufficient (i.e., reliable and valid) data on its diagnostic criteria, we would not recommend adding ‘food addiction’ as a diagnostic entity in DSM-V” (the 5th edition of the American Psychiatric Society’s Diagnostic and Statistical Manual of Mental Disorders).
“We conclude that overeating may be viewed as food addiction in a small subgroup of obese individuals”.
Disclaimer: I have no expertise in psychiatry or eating disorders.
Claimer: I can’t find any published research to support the contention that one third of New Zealanders are addicted to food.
This item first appeared on SciBlogs.