Can food be addictive? We know smoking can, because we’ve identified the precise agent that gets the body hooked: Nicotine.

Opiates and some prescription medicines are powerfully physically addictive. The withdrawal from each of these makes you sick.

Most of the things we talk about as being addictive these days – sex, exercise, porn, the internet, video games and yes, food – tend to be seen as more a behavioural problem than a chemical one.

These activities stimulate the pleasure and craving centres of the brain. We enjoy, we want more.

But do we really become enslaved in the same way a heroin junkie forgets everything else in the world but getting stoned? Is a burger truly a fix?

And if so, how many of us are addicted to food?

And what kind of food might that be? A paper in the British Medical Journal takes a crack at answering these questions.

The study that caused a stir

This study analysed 281 studies from 36 different countries. It found the overall pooled prevalence of food addiction was 14 per cent in adults and 12 per cent in children.

This reported prevalence, the authors write, “is similar to the levels of addiction seen for other legal substances in adults”.

For example, 14 per cent for alcohol and 18 per cent for tobacco (remembering that in many countries people continue to smoke like chimneys).

But, the authors report, with some dismay, “the level of implied addiction in children is unprecedented”.

In populations “with defined clinical diagnoses, prevalence of food addiction reaches 32 per cent in people with obesity having bariatric surgery”. And more than 50 per cent in those with binge eating disorder.

These findings used a tool called The Yale Food Addiction Scale (YFAS).

The scale assesses “all 11 symptom criteria for substance use disorder in DSM-5, including diminished control over intake, cravings, withdrawal, and continued use despite negative consequences”.

The DSM-5 is the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.

The authors of the study report that food addiction, based on the YFAS, “is also associated with core mechanisms of addiction”. 

These include reward-related neural dysfunction, and impulsivity, “as well as poorer physical and mental health and lower quality of life”.

All up, this paper makes an argument for the “validity and clinical relevance of food addiction”.

What remains a more open question, the authors write, “is the types of foods that are addictive”.

Ultra processed foods, the guilty party

The suspicion is – and the evidence points to – ultra processed foods.

These are the ready-to-eat foods that are often packaged for long shelf lives. They include potato chips, sugary drinks, packaged cakes and biscuits, frozen meals like pasta dishes and pizzas, and deli meats containing preservatives.

A growing number of researchers believe these foods are so addictive, that people use them in the same way junkies use drugs.

This remains controversial and some clarification needs to be made here.

Many news outlets, when reporting on the study, jumped the gun.

How? They conflated the findings on prevalence of food addiction and the known dangers of ultra processed foods (UFPs).

That is, they reported that 12 per cent of children were straight-out addicted to UPFs. That might well be true.

The YFAS certainly asks people “to report on intake of foods with high levels of refined carbohydrates or added fats, such as sweets and salty snacks”.

But, it could be true that food addiction … is an addiction to all kinds of food.

However, the authors make this point: “Not all foods have addictive potential.”

It’s UPFs that are “most strongly implicated in the behavioural indicators of addiction”.

These include “excessive intake, loss of control over consumption and intense cravings”. And, of course, “continued use despite negative consequences”.

This is why the researchers want to see UPFs classified as addictive substances, like nicotine or opiates.

If this were done, they say, “we may be able to help improve global health”.