An evaluation of food addiction as a distinct psychiatric disorder

Abstract

Objective: To evaluate the state of the literature for whether food addiction may warrant consideration as a distinct psychiatric disorder in the Diagnostic and Statistical Manual (DSM) using Blashfield et al.'s (1990; Comprehensive Psychiatry, 31(1), 15-19) five criteria. This framework was utilized because it has recently been applied to examine the diagnostic utility of several eating disorder phenotypes. The criteria are: (a) at least 50 journal articles published on the proposed syndrome in the past 10 years; (b) proposal of diagnostic criteria and assessment measures; (c) clinician reliability in diagnosis; (d) cohesiveness of the proposed diagnostic criteria; and (e) differentiation from similar, existing diagnostic categories. Method: For each criterion, a literature review was conducted to examine if the minimum qualification had been met, and key findings were discussed. Results: Two of the criteria (literature and differentiation) have been empirically supported to extent specified. Two criteria (diagnostic criteria and syndrome) have been partially fulfilled, due to only having self-report assessment measures and no examination of the odds ratios for meeting more than one symptom, respectively. Clinician reliability has not yet been evaluated. Discussion: The existing literature suggests that food addiction may warrant consideration as a proposed diagnostic category in the DSM, though future research is needed to fulfill Blashfield et al.'s (1990; Comprehensive Psychiatry, 31(1), 15-19) criteria. The development of a semi-structured interview would be an impactful contribution for addressing these gaps.

Food addiction comorbid to mental disorders: A nationwide survey and register‐based study

“…Food addiction was also prevalent among those with anorexia nervosa (42.5%), which is consistent with results from other studies where prevalence rates in the range from 50% to 70% have been reported (Burrows et al, 2018; Granero et al, 2014; Meule & Gearhardt, 2019). The high prevalence of food addiction in anorexia nervosa can seem somewhat counterintuitive, but may be explained by a subjective experience of control‐loss and over‐eating (resulting in high scores on items reflecting these symptoms) rather than actual addiction‐like consumption (Schulte et al, 2020; Treasure, Leslie, Chami, & Fernández‐Aranda, 2018).…”

“…The validity and applicability of the food addiction construct has been subject to debate (Hebebrand et al, 2014; Long, Blundell, & Finlayson, 2015; Ziauddeen & Fletcher, 2013)—with a particular focus on whether the phenotype should rather be considered as a behavioral addiction (Schulte, Potenza, & Gearhardt, 2016). However, this discussion has faded over the past years during which the scientific literature on food addiction has increased substantially (Schulte, Wadden, & Allison, 2020). Recently, Schulte et al (2020) conducted a comprehensive review of the literature on food addiction by applying Blashfield et al's criteria for new diagnostic constructs (Blashfield, Sprock, & Fuller, 1990).…”

“…However, this discussion has faded over the past years during which the scientific literature on food addiction has increased substantially (Schulte, Wadden, & Allison, 2020). Recently, Schulte et al (2020) conducted a comprehensive review of the literature on food addiction by applying Blashfield et al's criteria for new diagnostic constructs (Blashfield, Sprock, & Fuller, 1990). They concluded that a large body of literature now supports the validity and clinical utility of food addiction.…”

“…Specifically, there is empirical support for key aspects such as “literature” (more than 50 articles in scientific journals over the past decade) and “differentiation” (food addiction can be distinguished from other conditions). Also, there is partial support for the “syndrome” criterion (food addiction represents a cluster of frequently co‐occurring symptoms) and “diagnostic criteria” (the formal criteria for food addiction defined by the YFAS 2.0) (Schulte et al, 2020). Relatedly, Fletcher and Kenny have discussed the pros and cons of the food addiction construct, concluding that food addiction is important for advancing our understanding of the etiologically complex mechanisms behind obesity and substance use disorder (Fletcher & Kenny, 2018).…”

Symptoms of Addictive Eating: What Do Different Health Professions Think?

“…Addictive eating is not currently classified as a distinct eating, substance-related or addictive disorder [ 1 ]. However, approximately 15–20% of the population self-report symptoms that align with addictive eating [ 2 ], while 66–86% of general community samples endorse the concept of addictive eating [ 3 ].…”