We propose that highly processed foods share pharmacokinetic properties (e.g. concentrated dose, rapid rate of absorption) with drugs of abuse, due to the addition of fat and/or refined carbohydrates and the rapid rate the refined carbohydrates are absorbed into the system, indicated by glycemic load (GL). The current study provides preliminary evidence for the foods and food attributes implicated in addictive-like eating.
The prevalence of obesity in the United States continues to increase, with more than 85% of adults projected to be overweight or obese by 2030 . Health care costs associated with obesity currently comprise almost 10% of national health care expenditures  and are projected to increase to 15% over the next 15 years . There has been little success at preventing excessive weight gain or developing weight loss treatments that are effective long-term . Multiple causes contribute to the obesity epidemic, such as increased energy intake, increased availability and ease of access to foods, larger portion sizes, and decreased physical activity [4–6]. Although the causes of obesity are multifactorial, one potential contributing factor is the idea certain foods may be capable of triggering an addictive response in some individuals, which may lead to unintended overeating.
Gearhardt et al.  developed and validated the Yale Food Addiction Scale (YFAS), which uses DSM-IV criteria for substance dependence to quantify symptoms of addictive-like eating (see Table 1). “Food addiction” is characterized by symptoms such as loss of control over consumption, continued use despite negative consequences, and an inability to cut down despite the desire to do so . Addictive-like eating has been associated with increased impulsivity and emotional reactivity, which are similarly implicated in substance-use disorders . Thus, “food addiction” may share common behavioral attributes with other addictive disorders. Neuroimaging studies have also revealed biological similarities in patterns of reward-related dysfunction between “food addicts” and substance-dependent individuals. Individuals endorsing symptoms of “food addiction” exhibit increased activation in reward-related regions (e.g., striatum, medial orbitofrontal cortex) in response to food cues, consistent with other addictive disorders . Further, higher scores on the YFAS have been associated with a composite genetic index of dopamine signaling . This multilocus genetic profile has been related to dopamine signaling capacity, which may also be a risk factor for addictive disorders [12,13].
Which foods may be addictive?
Schulte, E. M., Avena, N. M., & Gearhardt, A. N.
In Study One, participants (n = 120) completed the Yale Food Addiction Scale (YFAS) followed by a forced-choice task to indicate which foods, out of 35 foods varying in nutritional composition, were most associated with addictive-like eating behaviors. Using the same 35 foods, Study Two utilized hierarchical linear modeling to investigate which food attributes (e.g., fat grams) were related to addictive-like eating behavior (at level one) and explored the influence of individual differences for this association (at level two).
120 undergraduates participated in Study One and 384 participants recruited through Amazon MTurk participated in Study Two.
The current study provides preliminary evidence that not all foods are equally implicated in addictive-like eating behavior, and highly processed foods, which may share characteristics with drugs of abuse (e.g. high dose, rapid rate of absorption) appear to be particularly associated with “food addiction.”
In summary, the current study found that highly processed foods, with added amounts of fat and/or refined carbohydrates (e.g., sugar, white flour), were most likely to be associated with behavioral indicators of addictive-like eating. Additionally, foods with high GL were especially related to addictive-like eating problems for individuals endorsing elevated symptoms of “food addiction.” Individuals endorsing symptoms of addictive-like eating behavior may be more susceptible to the large blood sugar spike of high GL foods, which is consistent with the importance of dose and rate of absorption in the addictive potential of drugs of abuse. Collectively, the findings provide preliminary evidence for the foods and food attributes implicated in “food addiction” and for proposed parallels between pharmacokinetic properties of drugs of abuse and highly processed foods. As an important next step in the evaluation of “food addiction,” future studies should also expand on the current findings by measuring biological responses and directly observing eating behaviors associated with highly processed foods in order to examine whether addictive-like mechanisms, such as withdrawal and tolerance, may be present.
food addiction, sugar, YFAS, refined carbohydrates
Schulte, E. M., Avena, N. M., & Gearhardt, A. N. (2015). Which foods may be addictive? The roles of processing, fat content, and glycemic load. PloS one, 10(2), e0117959. https://doi.org/10.1371/journal.pone.0117959