Monday, October 14, 2013

Is food addiction a step closer to formal diagnostic status?

Food addiction is not yet recognised as a mental disorder but certain obese individuals clearly display addictive-like behaviour towards food. To achieve a formal diagnostic status, ‘food addiction’ requires a stronger evidence base to support the claim that certain ingredients have addictive properties identical to addictive drugs of abuse. This topic is up for debate in the session, ‘Binge eating obesity is a food addiction'.

This year's fifth edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders) recognises ‘binge eating disorder’ (BED) as distinct from Anorexia nervosa and Bulimia nervosa, but it remains debatable whether BED is underpinned by an addiction disorder and should be prevented and treated like other addictive disorders.

The new category ‘Substance related and addictive disorders’ in DSM-5 combines the DSM-IV categories of substance abuse and substance dependence into a single disorder measured on a continuum from mild to severe.

Importantly, the term ‘dependence’ is not used any more in DSM-5, because most people link dependence with addiction when, in fact, dependence can be a normal body response to a substance.

Speaking at the 26th ECNP Congress Professor Suzanne Dickson, neuroscientist from the Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden said, “the introduction of ‘addictive disorders’ allows classification of behavioural addiction for the first time, for example with pathological gambling, but this does not apply to food addiction.

Although there might be neurobiological and clinical overlaps between ‘addictive-like’ overeating and substance related and addictive disorders, a major difference is that is that food consumption, unlike alcohol, cocaine, or gambling or internet gaming behaviour, is necessary for survival.”

“A subgroup of obese patients indeed show ‘addictive-like’ properties with regard to overeating, such as loss of control,” continued Prof Dickson, “but this does not automatically mean they are addicted.”

According to some studies, at least 10-15 percent of obese individuals suffer from BED. However, BED also occurs in people that are normal weight.

The term ‘food addiction’ has been coined by the popular press and by many sufferers as a reasonable explanation for their predicament. Studies exploring the brains of obese patients that score highly for food addiction on the Yale

Food Addiction Scale show that certain areas known to be involved in reward and addiction have an altered response to both images of appetising foods and even to the taste of food.

However, more evidence is needed to support inclusion of food addiction as a diagnostic category.

Prof Dickson said: “This evidence itself is insufficient to support the idea that food addiction is a mental disorder.

- Medicalxpress