In part one of this series on food addiction (FA), we looked at some of the science around the concept of food addiction, the addictive process and which foods are most likely to be a problem.

In part two, we’ll look more at social and psychological factors that can put you at risk and describe several novel factors that can also drive addiction to certain foods.

Psychosocial factors

Those with food addiction (FA) are found to often - but not necessarily always - have co-existing psychological concerns such as anxiety and depression, stress disorders like PTSD arising from adverse experiences or abuse, difficulties with impulse control and self-regulation such as attention-deficit disorders, insecure attachment styles, and addictions to other substances or behaviours as well as eating disorders.

Consumption of certain foods may begin as a coping mechanism for the above in childhood or adolescence as a temporary solution rather than starting out as the problem itself, however in time and through reward-based learning (repeated firing of dopamine and opioids) it can take on a life of its own.

For example, food can be initially used to soothe emotional pain, loneliness or suffering. It may be an attempt to regulate strong emotions or to lift energy and mood. It can be an attempt to cope with anxiety and stress disorders as calming and pleasing neurochemicals are released such as dopamine, opioids and serotonin. In addition to the ingredients in food, the act of swallowing itself stimulates the vagus nerve which can help with feeling calmer via the gut-brain axis. There are also often childhood associations with certain foods made as a coping tool or a positive habit - these are often paired with reward, bonding, and affection by a parent or caregiver (e.g., being rewarded with a ‘treat food’ - usually refined sugar - for being “good”).

Insecure attachment

Insecure attachment in infancy and childhood lays down a foundation for future mental health. Attachment impacts on release of the neuropeptide called oxytocin which helps to feel content and satiated and switches off the need to seek more. Insecure attachment can create a vulnerability to the effects of addictive opportunities (whether alcohol or drugs, sex, shopping, gambling, or certain foods etc.) if exposure to the particular thing has been paired as soothing or rewarding. An insecurely attached brain may be more impulsive, less emotionally regulated, and have less self-control - as these are capacities that develop with a secure attachment style where the caregiver/s fosters these skills. This could result in FA where the person consumes foods impulsively, in response to emotional responses (whether positive or negative), and feels unable to regulate how much they eat due to cravings and urges they may experience. Insecure attachment can be improved in adulthood by creating repeated secure attachment experiences and developing impulse control and self-regulation skills, which can in turn lessen the experience of FA.

Adverse childhood experiences

Exposure to adverse experiences in childhood or adolescence such as physical, psychological (including neglect) and sexual abuse can dysregulate your whole stress response, your appetite, as well as your metabolism and insulin response. This can create a vulnerability towards addictive seeking as a way to calm the nervous system and cope with emotional reactions and physical sensations associated with traumatic overwhelm. There can be a propensity to seek out sugar and ultra-processed foods in a vicious cycle to calm down, numb, or avoid pain and suffering. Effects of lasting post-traumatic stress can be resolved by working with someone to help re-regulate your nervous system and process the past experiences as well as create new coping skills and self-care around nutrition and lifestyle. By doing so, FA that occurs in response to underlying unresolved trauma may be alleviated.

Other mental health symptoms

Other common mental health symptoms including anxiety, low mood, emotional regulation concerns, and difficulties with attention and focus can intersect with feeling addicted to certain foods. And it’s sometimes hard to know what is causing what. But, when the addictive behaviour is ceased temporarily - through a period of abstinence from certain foods (e.g., sugar, UPFs) for a month or more - you can often see “what’s left” of these underlying psychological concerns. Interventions to help navigate different mental health symptoms - while also optimising your nutritional intake - can help address potential relapse factors in addiction to certain foods, as abstinence alone is likely to be unsuccessful because the symptoms will likely eventually bubble back up.

Experiencing an eating disorder or substance addiction can also impact on the development of an addictive relationship with food but these types of interactions are more complex than the scope of this article.

Bodily factors

There are novel bodily-based factors that come into play with FA that can make it hard to make changes to certain food consumption despite best intentions. An understanding of these is important to be set up for success in any health behaviour change.

• Chronic stress hormone (cortisol) release from adverse experiences enhances the reactivity of the reward system and motivation to get food. From a survival perspective, insufficient calories were dangerous while excessive calories (in the pre-industrial world) were not. So the priority was on seeking food (driven by a hunger hormone called ghrelin) and not on switching off from food (which is helped by an important fullness hormone called leptin). We also tend to default back to old coping strategies when under stress, hence stress is a notorious relapse risk for addictive behaviour.

• Microbiota-dysbiosis means that if you have an overgrowth of certain bacteria they will be more successful in driving your behaviour towards eating certain addictive foods than if you have a diverse healthy microbiome.

• Microbes in your gut do this using a “carrot and stick approach” that hijacks your nervous system to manipulate your eating behaviour. Microbes can change your tastebuds and create cravings for the foods that help them thrive or that suppress their microbial competitors. They may produce toxins to make you feel tired, flat and unmotivated until you eat foods that enhance their fitness to survive. Once they get what they want, you are rewarded via your opioid and cannabinoid receptors - and the creation of dopamine and serotonin. In other words, if they get what they want, they’ll reward you.

• Leptin resistance means that leptin signalling - designed to be communicated from your body’s fat cells to your brain to tell you “enough now” - becomes confused and dysfunctional. Instead, your brain tells you to continue seeking calories to save you from a perceived famine. Inflammation in the body may be a key contributor to the brain becoming confused and a vicious cycle can form keeping you craving and consuming certain foods, inflamed and potentially overweight.

• For women, your monthly hormone cycle can also impact your experience and there may be certain times of the month that are higher risk for cravings and addictive eating that hijacks your best-laid dietary changes. Usually, this is in your premenstrual window, and also during perimenopause/menopause where progesterone and estrogen are changing, which impacts cravings, leptin, and reward processes.

Potential health risks of addictive eating

Physical factors

The physical risks of addictive eating may be more chronic than acute, in that no one usually overdoses or dies from addictive intake of food or its withdrawal (which is very different for substance use disorders or anorexia and bulimia which can risk acute physical harm and even death). However, the insidious battle that comes with obsessing over what to eat, how much, and when - and the sense of loss of control - takes up significant time, mental and emotional space, and can cause distress and impairment to daily functioning. There can also be chronic health impacts resulting in the development of metabolic and chronic health problems like pre-diabetes, type 2 diabetes, gut health issues, inflammatory health problems, and autoimmunity.

The emotional toll

The secrecy of addictive eating coupled with the self-blame and shame that occurs makes it a pernicious and lonely experience. It can feel like a battle of self-control with your self-esteem being tied up in whether you have been in control of cravings and urges (“good”) or whether you succumbed (“bad”).

Yet, as we have been exploring in Part 1 and this article, is that much of the experience has environmental and biological drivers that may make a lot of eating behaviour beyond your control.

You can become hooked in a vicious cycle of cues, cravings and consumption that is driven by the foods you habitually consume and your bodily response - in the context of our modern food environment - unless you gain insight, understanding and skills to unhook.

The development of FA is insidious and can look different for different people as it depends on the co-existing psychological and social context plus what is going on in your body. While we haven’t focused on how to get free from addiction to certain foods here, it’s important to know that with knowledge of addiction, behavioural change around your food environment and intake, and the development of skills you can change your relationship with food for good.

Food freedom - and alleviation of the cravings that it brings - is possible. Stay tuned for our third and last article in this series, which will be about what getting free from FA can look like.