Should food addiction be considered a mental disorder?

An online search for “food addiction” will result in references from reputable sources, including medical and mental health information websites and research papers. But while food addiction is an acknowledged condition for many, it’s not officially recognized as a mental disorder in the United States, since it’s not included in the Diagnostic and Statistical Manual of Mental Health Conditions (Fifth Edition) (DSM-5), the country’s official list of mental health conditions.

For many years, some doctors and mental health specialists have been fighting to change this. Why do they feel that food addiction should be included in the DSM and what would happen if it were? Let’s explore this fascinating issue.

What qualifies as food addiction?

First of all, it’s important to understand why so many healthcare and mental health professionals have no problem using the term “food addiction”.

As Dr. Elizabeth Hartney points out, you could say that humans are inherently addicted to food; if we go without food for a certain period of time, we experience hunger pains and other symptoms. We also feel comfort and even pleasure when we eat or are planning to eat.

These are normal feelings, of course, but in food addiction, they become extreme. Notable symptoms of food addiction include:

- eating to excess. A person with a food addiction will often feel “stuffed” after a meal, and will have deliberately eaten enough to feel this way

- feeling guilty or remorseful after eating

- recognizing that unhealthy and binge eating are having a negative effect on their body and/or health, but still feeling compelled to overeat

- hiding eating from others

- craving food but not being hungry

Why isn’t food addiction currently considered a mental disorder?

In a fascinating recent article, Dr. Claire Wilcox explains that numerous studies show food addiction has many of the same characteristics as other addictions that are recognized by the DSM.

For instance, sugar, processed and fast foods, and certain fats have been found to affect brain functions like impulse control and feeling rewarded the same way that other addictive substances do.

But, Wilcox writes, many experts worry that considering food addiction a mental disorder could have negative consequences on those who suffer from it or are at risk.

One issue is that, typically, food addiction is currently treated by encouraging healthy eating and recommending - but not insisting - that foods that contain high amounts of sugar and fat be avoided. If food addiction becomes an “official” addiction in the DSM, treatment would require totally abstaining from triggering foods. For many mental health experts, this could actually backfire and encourage those with food addiction to binge on these forbidden foods.

Some experts are also concerned that if a person is diagnosed as an addict, they may feel as if they have no real control over their impulses, as opposed to now, when food addiction is seen as something that can be modified with lifestyle changes and psychological help.

Additionally, food addiction, or some of its symptoms, are sometimes included in the symptoms for other conditions in the DSM-5, such as bulimia nervosa, rather than as a standalone condition. It's also often a comorbidity. So many experts question the point of listing it on its own.

Why do some experts think food addiction should be classified as a mental disorder?

Despite these issues, Wilcox and many other experts see enormous advantages to classifying food addiction as a mental disorder.

These include:

- requiring certain foods to have warning labels, the same way there are currently warning labels on dangerous addictive products like cigarettes

- identifying addictive foods, which might encourage addicts to avoid or eliminate them from their diet

- funding for research (When a disorder or disease is made “official”, more funding is usually the result)

Another advantage is that, despite the stigma around the word “addict,” some people might find identifying as a food addict a way to alleviate shame they felt over their condition, prompting them to seek help

Will food addiction ever be officially recognized?

The debate over food addiction’s official status has been going on for years, and there’s no sign that it will end soon.

Fortunately, the condition is recognized by many healthcare and mental health professionals, regardless of its absence from the DSM-5. This means that there are ways to get help. Patients can talk to their GP or a mental health professional who specializes in food addiction.

It’s interesting how even a condition recognized by many professionals still gets a lower status and less impactful initiatives just because it’s not included on one important list. The DSM-5 was recently modified to include prolonged grief as a mental disorder. This may mean that times are changing and other conditions might also start to be taken more seriously.

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