Food addiction: A perspective

Abstract

ABSTRACT Food addiction (FA) refers to an excessive and dysregulated consumption of high-calorie foods that are hyperpalatable. Although it does not feature in the current classificatory systems of psychiatric disorders, it has gained prominence as a result of the obesity pandemic. It shares many features with addictive disorders and eating disorders such as binge eating disorder and bulimia nervosa. Changes in the brain–gut–microbiome interactions, genetic polymorphisms (dopamine, opioid, leptin, and melanocortin-4 receptor), and altered connectivity in various brain circuits are some of the etiological factors for the development of FA. Depression, anxiety, emotional dysregulation, impaired decision-making, high impulsivity and neuroticism, lower conscientiousness, and extraversion are some of the risk factors for FA. When confronted with excess stress or burnout, predisposed individuals consume food for comfort-seeking and to avoid unpleasant emotions placing them at a greater risk of FA. Lifestyle modification, cognitive behavior therapy, pharmacotherapy, cognitive training, psychobiotics, low carbohydrate ketogenic therapy, self-help groups, virtual reality, and neuromodulation techniques can be incorporated into the management of FA. Unless FA and its comorbidities are identified and managed appropriately, it will impede weight loss, and the results of interventions for the management of obesity will not be sustained. Preventive strategies include early identification and management of at-risk adolescents, incorporating programs promoting healthy food choices and eating habits, and more regulation of pleasurable foods in child and youth settings. The onus of taking responsibility to implement measures to curb FA lies with the food industry, governments through statutory regulations, and the society at large.