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Unformatted text preview: R EVIEW A RTICLE Food Addiction An Examination of the Diagnostic Criteria for Dependence Ashley N. Gearhardt, MS, William R. Corbin, PhD, and Kelly D. Brownell, PhD Abstract: The evidence for foods addictive properties is steadily growing. In addition to clinical and evolutionary plausibility, the possibility of addiction to food is supported by animal model research and increasingly by research with humans. Much as classic drugs of abuse hijack the brain, accumulating evidence with food suggests a similar impact, but with weaker effects. Although neu- robiological evidence for food addiction is compelling, dependence as conceptualized with respect to alcohol and other drugs of abuse is fundamentally a behavioral disorder. Thus, we review the current state of food addiction research in the context of each of the diagnostic criterion for dependence (ie, tolerance, withdrawal, loss of control) and briefly explore other relevant addiction topics such as expectancies, reinforcement, and incentive salience. There is sub- stantial evidence that some people lose control over their food consumption, suffer from repeated failed attempts to reduce their intake, and are unable to abstain from certain types of food or reduce consumption in the face of negative consequences. Although there is some evidence for other dependence criterion, further research is needed to examine tolerance and withdrawal to high-fat sweets, time spent in obtaining, using, and recovering from excess food con- sumption and the degree to which important activities are given up due to overconsumption. As science continues forward and both the public and elected leaders become aware that food may trigger an addictive process, this information will likely be used to inform policy. Thus, researchers need to carefully consider the implications of their work and the way in which the results may be interpreted. Key Words: food, addiction, overeating, obesity ( J Addict Med 2009;3: 17) O besity is a pressing public health concern in all parts of the world 1 and obesity has now become the second leading preventable cause of death in the United States. 2 The picture is most dire for children, where estimates suggest that the current generation of children may be the first to have a lower life expectancy than their parents. 3 It is essential to identify the factors causing the in- creased rates of obesity in hopes that more effective preven- tion and treatment approaches can be developed. Recent work with both animals and humans has raised the potentially important possibility that foods can trigger biologic and psychologic processes similar to those seen with classic drugs of abuse. The potential scientific, policy, and legal implica- tions are striking. Thus, it is important to get a clear view of the state of the science and to help cultivate the next gener- ation of work in the field. The aim of this article is to review the available science, to highlight gaps in knowledge, and to...
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- Fall '08