Thus far, we have defined substance use/abuse as addiction, but we have not identified the type of addiction or substance used to achieve it. Addictions include an obsessive/compulsive desire for a substance, an obsessive/compulsive repetition of a behavior, or a combination of both. Behavioral addiction and substance addiction have a high rate of co-occurrence, suggesting the two conditions may share a common cause. The two addictions have similar mechanisms of action in the brain. Both substance abuse and engaging in addictive behaviors targets the brain’s reward system and produces feelings of pleasure. Other similarities between substance addiction and behavioral addiction include: euphoria resulting from use or behavior, cravings, psychological and physical withdrawal symptoms, loss of control, development of tolerance, perceiving mind-altering effects, and denial of problems, even with evidence.
Addictions are manifested by the substance itself, hereditary, social network, socioeconomic status, stress, parental involvement, and personal history, such as physical or sexual abuse, or neglect. In turn, the culprits of addiction include drugs, alcohol, gambling, cell phone/social media, exercise, pornography/sex, shopping, video games, and even food and eating. The problem with food is that abstinence is impossible; we need it to live. Yet, an obsessive/compulsive desire for food can still be classified as both a behavioral and substance addiction.
Food addiction is characterized by poorly controlled intake of highly-palatable, calorically-dense, foods. Food Addiction is a chronic and progressive disease characterized by our seeking the foods or food behaviors we are addicted to, eating/doing them compulsively and having a great deal of difficulty controlling these urges despite harmful consequences. Once addicted, eating certain foods changes the brain in ways that make abstaining from one’s “trigger foods” very hard. The most common addictive foods are foods high in sugar, flour, fat, grains and salt or some combination of these. The body becomes chemically dependent on one or more substances and needs these substances to function “normally”. Subsequently, obesity is rising, and effective treatments are needed.In theory, there should be a considerable overlap in the characterizing behaviors, symptoms, risk factors and underlying neurobiological characteristics between substance addiction and what can be thought of as food addiction. Then, is it possible that insurance reimbursed impatient rehabilitation programs for SUD be applied to and reimbursed similarly to FA?
Common Clinical Characteristics
Several Studies support this theory by indicating that risk factors for food addiction are similar to substance use disorders. R. Hardy et. Al. conducted a mixed factorial designed study limiting the ability to directly compare FA with SUD by assessing the effect of posttraumatic stress disorder (PTSD), depression, childhood and adult trauma exposure, as well as presence and severity of emotion dysregulation on eating behavior, in a sample of women who either meet criteria for no addiction, food addiction only or SUD only. This allowed for him to assess the shared behaviors associated with both addictions.
Participants were 229 women drawn from a large study of risk factors for PTSD in a low socioeconomic, urban minority population. Women, ages of 18 and 65, were recruited from waiting rooms in the diabetic, gynecology, and primary care medical clinics at Grady Memorial Hospital, Atlanta, Georgia. All participants underwent demographic collection, structured clinical interviews and completed several inventories, questionnaires and analyzed by several scales; chi square analysis was used to assess group differences (R. Hardy).
The results of Hardy’s study showed that women with SUD or food addiction have similar PTSD and depression symptom profiles and exhibited more problems with emotional dysregulation as compared to women with no addictions. These findings, generated from a direct comparison between food addiction and SUD, provide critical evidence that these addictions share many clinical characteristics, particularly emotion dysregulation profiles.
In conclusion, the findings outlined common features of food addiction and SUD. It is possible that FA and SUD have similar chemical pathways and may respond to similar types of treatment. This is worthy of future investigation and research on food addiction, particularly research the various psychological, behavioral and neurobiological characteristics that are unique to food addiction (R. Hardy).
Stress, Cues, and Eating Behavior
Similar behavioral characteristics are correlated between SUD and FA including irregular eating patterns that result in the overconsumption of high fat, high sugar (HFHS) foods according to M.K. Stojek et.al. The application of addiction paradigms such as stress inductions, cue reactivity, and behavioral economic assessments were performed to study the motivation for HFHS foods (Stojek). This study used a mixed factorial design with repeated measures on time.
133 participants were recruited from the local community through advertising in newspapers, buses, and via flyers on bulletin boards. All participants underwent demographic collection, questionnaires, visual analog scales, structured clinical interviews and completed several inventories, and a single experimental session lasting 4.5 hours. Participants were instructed not to eat two hours prior to their session and their food consumption was verified via a food recall interview. A manualized protocol for guided imagery was followed.
The goal of this study was to use a novel stress induction and a cue reactivity paradigm to understand motivation for HFHS foods measured by both experiential craving and a behavioral economic index of RRVfood (relative reinforcing value of foods) in a community adult sample. exposure to a stressful personalized script had no effect on subjective craving or RRVfood. Consistent with hypotheses, however, exposure to food cues significantly increased craving and RRVfood compared to neutral cues. Contrary to the hypothesis, interaction effects of stress and cues were not present, meaning that stress did not potentiate craving nor RRVfood following exposure to environmental cues of HFHS foods.
In summary, acute exposure to food cues significantly increased subjective craving and the RRVfood, but the stress manipulation did not affect motivation for food, and the combination of cues and stress did not differentially affect motivation. This conclusion requires more research as other studies report opposite results regarding the behaviors between stress manipulation directly affecting the motivation for food.
The problem is worldwide. FA leading to obesity is the root of most of terminal conditions and diseases plaguing our nation. Additional treatments are warranted to combat this epidemic. In addition, further research is paramount.
