Disentangling binge eating disorder and food addiction: a systematic review and meta-analysis

Abstract

Background and aims The concept of "Food Addiction" has been based on criteria of Substance Use Disorder. Several studies suggested a relationship between food addiction and eating disorders, but little is known about its extent or role. We aim at exploring if food addiction is coincident with a specific eating disorder (binge eating disorder appears the closest) or it is a separate diagnostic entity that afflicts in comorbidity with eating disorders or other conditions like obesity or even in the general population. Methods This systematic review and meta-analysis analyzed observational studies with a comparative estimation on rates of subjects affected by binge eating disorder and food addiction. Results Binge eating disorder shows higher comorbidity with food addiction compared to other eating disorders (OR = 1.33, 95% CI, 0.64–2.76; c2 = 4.42; p = 0.44;I2 = 0%), or each eating disorder [anorexia nervosa purging type (OR = 1.93, 95% CI, 0.20–18.92; p = 0.57) and restrictive type (OR = 8.75, 95% CI, 1.08–70.70; p = 0.04)], obese patients (OR = 5.72, 95% CI, 3.25–10.09; p = < 0.0001) and individuals from the general population (OR = 55.41, 95% CI, 8.16–376.10; c2 = 18.50; p < 0.0001; I2 = 0%)but has decreased prevalence when compared to bulimia nervosa (OR = 0.85, 95% CI, 0.33–2.22; c2 = 0.35; p = 0.74; I2 = 0%). Discussion and conclusions Our data show that the prevalence of food addiction in binge eating disorder is higher than in other eating disorders except in bulimia nervosa. Moreover, it is a separate diagnostic reality and can be detected in people without mental illness and in the general population. Food addiction might have a prognostic value, since in comorbidity, and should be addressed to boost treatment efficacy and patient’s recovery. Level of evidence I: Evidence obtained systematic reviews and meta-analyses.

Risk of somatic diseases in patients with eating disorders: the role of comorbid substance use disorders

“…A recent study showed that some AN patients have a non-beneficial profile of lipids (Hussain et al ., 2019 ). A similar condition is found among obese patients (Vekic et al ., 2019 ), and obesity is common in some types of USED (Gormally et al ., 1982 ; Mitchell et al ., 2015 ; Di Giacomo et al ., 2022 ). Dyslipidemia is associated with an increased risk of cardiovascular diseases (Vekic et al ., 2019 ), which are often seen in cocaine users (Talarico et al ., 2017 ).…”

Associations Between Food Addiction and Substance-Use Disorders: A Critical Overview of their Overlapping Patterns of Consumption

“…Most notably, however, an accumulating body of empirical evidence has shown that a significant proportion of those who engage in addictive-like eating do not binge eat, and vice versa — indicating that BED and FA represent idiosyncratic diagnoses [ 39 •]. Comparable is research indicating that binge drinking does not necessarily warrant an alcohol-use disorder diagnosis, with the former requiring a brief intervention and the latter requiring intensive and possibly pharmacologic treatment [ 40 ].…”

Early Life Influences on the Development of Food Addiction in College Attending Young Adults

“…Individuals with food addiction display high activation of reward systems when anticipating intake of highly palatable foods. Illicit drugs and food have been shown to cause the same feelings of grati cation through activation of the dopamine neurons in the ventral tegmental area followed by release of dopamine in the nucleus accumbens [7]. There are genetic similarities as well, including variants in the genes encoding the dopamine D2 receptor allele of the ANKKI gene and transporter and opioid receptor genes [7].…”

“…This relationship has not been well-studied to date. There is evidence of ACEs leading to the development of eating disorders [20,21], but food addiction is a separate construct than other eating disorders such as binge eating disorder, anorexia nervosa, and bulimia [7] and therefore needs separate investigation. Overall, most research on food addiction has focused on the clinical population, such as bariatric surgery candidates [10,22] and individuals with eating disorders [23], and in the population of females over age 35 [3,17].…”

“…Illicit drugs and food have been shown to cause the same feelings of grati cation through activation of the dopamine neurons in the ventral tegmental area followed by release of dopamine in the nucleus accumbens [7]. There are genetic similarities as well, including variants in the genes encoding the dopamine D2 receptor allele of the ANKKI gene and transporter and opioid receptor genes [7]. Emotionally, there are similarities between populations with substance use disorder (SUD) and food addiction, including a lack of emotional clarity, poor impulse control, higher emotional dysregulation, and higher non-acceptance of emotional responses [8].…”