Goal: The goal of this Handout is to briefly acquaint health professionals with key evidence that chronic overeating may be a kind of substance use disorder (SUD) manifesting as addiction to processed foods.
Purpose: The purpose of the handout is to encourage health professionals to support patients and clients in efforts to abstain from processed foods in the same manner that drug addicts abstain from drugs of abuse. In addition, it is hoped that the handout will help health professionals refrain from encouraging processed-food-addicted clients to use addictive foods.
It is also hoped that the handout will help health professionals reconsider recommending ‘weight-loss’ regimens to food addicts. Through mechanisms of hunger and even, malnutrition, weight-loss regimens can make food addiction worse and should be avoided by food addicts. Weight-loss has been observed in the course of treating food addiction by eliminating processed foods and establishing routines of well-balanced, fully portioned meals of unprocessed, high-fiber foods.
This hand-out reviews key studies showing that the brains of obese people exhibit dysfunctional patterns that are similar to those of drug addicts. It summarizes how overeating behavior conforms to the DSM 5 SUD diagnostic criteria. The handout briefly reviews the evidence that particular processed foods have addictive characteristics.
Research into processed foods shows addictive properties for sugar and sweeteners, flour, gluten, dairy, processed fats, excessive salt, and caffeine. When combined, poly-substance characteristics can intensify the addictive properties of the food product.
The addictive properties of sugar are perhaps the most studied. Rats have been shown to choose sugar, high fructose corn syrup, and saccharine over cocaine and heroin. Rats have shown a sugar withdrawal syndrome similar to that of morphine . Sugar activates the dopamine pathway .
Gluten and flour made from gluten-grains contains a gluteomorphine that appears to activate the opiate pathways . Salt has been observed to be used by morphine addicts in withdrawal, presumably as a replacement for morphine.  Processed fat appears to activate the opiate  and endocannabinoid  pathways in the brain.  Dairy contains a casomorphine which has been shown to bind to opiate receptors in the brain.  Caffeine has intoxication and withdrawal diagnoses in the DSM 5.  In the treatment of processed food addiction, these would all be classified as addictive or “trigger foods” which the food addict should abstain from.
Application of the DSM 5 SUD Diagnostic Criteria to overeating shows that overeating meets the criteria for an addiction. The criteria and their manifestation in overeating are described below.
There are observations and studies of loss of control over processed foods that meet the DSM 5 criteria for the diagnosis of an addiction. Although processed foods are quite different from drugs and alcohol as they are perceived and used in our culture, nonetheless the eating patterns that result from their use are similar to addictive behavior.
28. Kozak, A.T. and A. Fought, Beyond alcohol and drug addiction. Does the negative trait of low distress tolerance have an association with overeating? Appetite, 2011. 57(3): p. 578-81.