Why is there a debate around food addiction?

The recognition of food addiction as a mental health disorder remains unsettled, with ongoing debates about its validity. There are three primary perspectives on food addiction:^[1]

1. Substance use disorder view: Some argue that food addiction should be classified as a substance use disorder because of the addictive potential of some foods (particularly energy-dense foods which are high in fat and/or carbohydrates).
2. Behavioral-type addiction view: Others argue that food addiction aligns more with behavioral addictions like gambling.
3. Nonrecognition view: Skeptics of the concepts of food addiction and eating addictions assert that these aren’t valid concepts and they shouldn’t be recognized as mental health disorders. They contend that unless specific addictive food components can be identified, establishing an addiction to food may be challenging. Additionally, some studies show that there is often an overlap between food addiction and other eating disorders, particularly binge eating, suggesting that food addiction should perhaps not be considered a separate entity.^[2][3]

Advocates for the concept of food addiction argue that, unlike specific substances causing addiction to drugs or alcohol (e.g., ethanol, nicotine), it’s the combination of macronutrients (typically fat and carbohydrates in high-calorie foods) and food processing that affect the reward system. They note that addiction is not uniform across all substances — for instance, cocaine and nicotine have different addiction patterns, with cocaine use disorder being characterized by binge consumption followed by a break period, and nicotine having a more consistent daily-use pattern — suggesting that food addiction could have its own pattern, while still being considered an addiction.^[2][4] However, some researchers argue that due to limited data on foods’ addictive properties, food addiction might be better approached as a behavioral addiction in which food cravings play a key role, and should therefore be addressed using strategies such as stimulus control or acceptance-based behavioral techniques.^[5][6] These strategies may improve weight loss outcomes among patients with high levels of baseline food cravings by focusing on normalizing cravings, accepting thoughts about cravings rather than attempting to change them, redefining and stepping back from cravings, and acting in ways that are in accordance with one’s goals and values.^[7]