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STUDIES
Research on the DSM-IV diagnostic criteria for substance dependence shows that they can be translated to eating behavior and that many individuals with obesity and/or BED fulfill those criteria based on self-report measures such as the YFAS. With regard to the newly added criteria in DSM-5, one study shows that three out of four symptoms may be less relevant in the context of food and eating [90]. However, this was a small-sized qualitative study based on the themes that participants spontaneously mentioned during a semi-structured interview. As we have outlined above, all of the new symptoms can conceivably be applied to eating. Thus, future studies using standardized measures such as a revised YFAS are necessary for appropriately evaluating the relevance of the new SUD
criteria for food addiction.
Even if it turns out that the new symptoms, except craving, do not occur in the context of food and eating, it may still be questioned if this would disprove the existence of food addiction. As can be seen in Table 1, the diagnostic criteria as outlined in the DSM-5 do not apply to each substance to the same extent. Specifically, there are SUDs that do not cover the full range of symptoms (caffeine, hallucinogens, inhalants) or do not include intoxication (tobacco). In addition to this, the DSM criteria in general have been criticized for being rather inappropriate for tobacco [94]. Also, the DSM is criticized for its lack of focus on underlying mechanisms, which is a central component of the newly proposed RDoC system. Thus, a major test of the food addiction hypothesis will be to not only focus on the signs and symptoms linking addiction and problematic eating behavior, but also to examine the similarities and differences in the underpinnings of these conditions.
Food addiction is an emerging area of both clinical and research interest. The current review discussed several definitional and conceptual categorisations that have been put forth to quantify food addiction. However, the YFAS 2·0 concept predominates the literature. Similarly, evidence shows some similarities of food addiction with established eating disorders, particularly BED. Thus, the current review supports two main areas of contention that warrant much more research; considering food addiction as a substance-related addiction or a behavioural-related addiction and if food addiction is distinct from established eating disorders. Further research is needed to continue to delineate and clarify controversies about similarities and differences in food addiction with other concepts and established disorders.
Food addiction in the light of DSM-5
Meule, A., & Gearhardt, A. N. (2014). Food addiction in the light of DSM-5. Nutrients, 6(9), 36533671. https://doi.org/10.3390/nu6093653
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