Elsevier

Appetite

Volume 130, 1 November 2018, Pages 286-292
Appetite

Moving beyond the “eating addiction” versus “food addiction” debate: Comment on Schulte et al. (2017)

https://doi.org/10.1016/j.appet.2018.06.025Get rights and content

Abstract

In a recent commentary, Schulte et al. (2017) argued that addictive-like eating should be conceptualized as a substance use disorder rather than a behavioural addiction, and noted that many parallels that Hebebrand et al. (2014) drew between addictive-like eating and behavioural addictions apply likewise to substance use disorders. However, we argue that many of the arguments advanced by Schulte et al. (2017) in support of a substance-based food addiction model, including the important role played by ingested substances, are nonspecific. That is, these arguments apply equally well to behavioural addictions and other mental disorders, notably eating disorders, which raises the question of whether the phenomenon of addictive-like eating is encompassed by existing eating disorder diagnoses. Similarities between addictive-like eating and substance use, no matter how compelling, do not ensure the validity or clinical utility of a substance-based food addiction model and should not drive the conceptualization of addictive-like eating. The present commentary discusses problems with Schulte et al.’s (2017) arguments for substance-based food addiction, and draws attention to alternative conceptualizations of addictive-like eating which risk being overlooked when this conversation is framed as a dichotomous debate between the food and eating addiction models.

Section snippets

The role of ingested substances

In support of the substance-based food addiction model, Schulte et al., 2017a, Schulte et al., 2017b cite evidence for the key role played by ingestion of food in the development of addictive-like eating. They note that the ingestion or absorption of a specific rewarding substance is a defining feature shared by substance use disorders and addictive-like eating, whereas behavioural addictions typically lack an ingested substance. The instrument most frequently used to operationalize

Beyond the “eating addiction” versus “food addiction” debate

The question of how to conceptualize addictive-like eating has often been framed as a debate between two perspectives: substance based “food addiction” and behavioural “eating addiction” (Hebebrand et al., 2014; Schulte et al., 2017). Narrowly framing the question of how best to conceptualize addictive-like eating by contrasting these two models may overlook other potentially valid ways to conceptualize addictive-like eating. At least three other conceptualizations of addictive-like eating have

Future directions

To move toward a valid conceptualization of addictive-like eating, we must generate predictions - ideally falsifiable - to test the theories of eating addiction and food addiction models. Specifically, research is needed to determine to what degree the construct of addictive-like eating holds incremental clinical utility over and above existing eating disorder diagnoses, and to elucidate the mechanisms that drive addictive-like eating.

As a first step toward examining these questions,

Conclusions

The main arguments advanced by Schulte et al., 2017a, Schulte et al., 2017b in support of a substance-based food addiction model—i.e., the important roles played by behaviour and ingested substances– are nonspecific. That is, these arguments apply equally well to behavioural addictions and other mental disorders, including eating disorders. The existing evidence of differential addictive potential of foods is preliminary and insufficient to validate the food addiction model. To support such a

Author note

This work was supported by the Fonds de recherche du Québec - Santé (FRQS), Montreal, QC, and by Mitacs Globalink, Canada.

Conflicts of interest

None.

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