Metabolic Medical Newsletter #4 | October 2025 | The Hidden Epidemic of Food Addiction

Jocelyn Foran, MD, FRCPC, DABOM, MHP

Confronting the hidden epidemic of food addiction: Food indulgence can lead to compulsive eating.

Not long ago, many dismissed the idea that food could be addictive. How could something essential to life be a threat to health? No one is “addicted” to air, water, or sunlight, so why would food be any different? Our relationship with food is personal: we choose what enters our bodies. But what if it didn’t feel like a choice? 

Many of us have lost control over our eating habits. After forty years of corporate food manipulation and marketing, food addiction is prevalent all around us. In just one century, we have replaced deaths caused by starvation with those from over-consumption. Addiction comes from the Latin word “addictus,” meaning slave. Many of us have become slaves, especially to sugar and starches. Why do we overeat, and why do we choose foods that we know are harmful to our health, relationships, and goals?

Eating behaviours range from normal eaters to emotional eaters and then food addicts. Even the “normal” eaters, who can limit portions and consider negative consequences, may experience hedonic “creep” in their consumption for pleasure, flavour, and novelty. Our reward pathways are our “soothe” pathways. From birth, we have Pavlovian conditioning, as our primitive, “lizard” brain motivates us to seek out sweets. Breastmilk was our first experience with something sweet and safe at the same time. 

At least 15% of the population experiences food functioning like a “drug,” similar to cigarettes or alcohol. Sugar is the common thread connecting food addiction. When we consume sugar (or starch), our blood glucose levels spike, triggering a dopamine “pleasure” response, followed by a glucose crash as insulin works to protect our blood vessels. This energy-hungry brain then urges us to seek more quick energy: more carbs, more sugar. Unknowingly, millions of us repeat this cycle every few hours, refuelling on “healthy” sugar-filled yogurts and granola bars.¹ Those suffering from food addiction live with a chronic chemical and behavioural dependence on certain foods.² Our most common trigger foods include cookies, ice cream, chips, pasta, bread, pizza, pop, and chocolate. For some, the amount of food matters; “volume addicts” find so much comfort in eating that they cannot stop. Emotions may trigger cravings, but the chemical dopaminergic rewards maintain the food addict’s behaviour. One is too many, and a thousand is never enough.  

Interestingly, we aren’t usually addicted to nourishing, whole foods. They don’t spike our glucose levels or cause crashes. Broccoli and pork chops simply don't activate our reward pathway like a fireworks display. 

It’s the damaging, “hyper-palatable,” ultra-processed, carbohydrate-rich foods that spike dopamine and impair our self-regulation. Now, our ancestral physiology is overwhelmed by Uber Eats available 24/7. These “drug” foods encourage secretive, hoarding, and even risky behaviors. Among those living with bulimia nervosa or binge eating disorder, 70-90% also experience food addiction and may suffer severe electrolyte imbalances with fatal cardiac arrhythmias. Around 80% of food addicts develop obesity along with other co-morbidities such as diabetes, high blood pressure, depression, atherosclerosis, osteoarthritis, and sleep apnea. Those affected by food addiction often continue consuming despite knowing the consequences. This drives chronic disease and is the reason many turn to bariatric surgery and GLP1 agonists, desperate to alter their metabolic course. 

At its core, food addiction is misunderstood and underdiagnosed, often hidden in plain sight. Medicine still lacks a formal diagnostic code for food addiction, and most physicians are not familiar with how to diagnose it. Since its creation in 2009, the Yale Food Addiction Scale (YFAS) and the practical CRAVED scoring systems have served as valuable tools for screening and identifying those with food addiction.³,⁴ In simple terms, the CRAVED system involves six questions, with three “yes” answers suggesting possible addiction.

Compulsion to eat

Reaching for more

Avoid activities

Volume uncontrolled

Elimination causes withdrawal symptoms

Damage/ disease, but continued use

Why do we develop these harmful relationships with food? There are relational roots to unhealthy eating habits. Some of us experience emotional hunger that needs soothing. If our needs weren’t met in childhood, we turned to food for comfort, numbing, and escape. Advertising and marketing tell us this is “normal.” Coke says “open happiness.” This neon sign promotes the idea that there isn’t a problem that ice cream can’t fix! Internal pain is soothed through external substances. Food is used to resolve problems, only to become the problem itself. 

The neon sign humorously suggests that ice cream is a universal remedy, highlighting the ironic cycle of using food to address emotional issues. Photo of the sign taken by the author.

In general, we either have addictions or connections, and for many, addictions feel safer and less judgmental than some connections. As a maladaptive coping mechanism, emotional eating needs to be replaced by learning how to speak our needs, have difficult conversations, and set boundaries. We need to learn the tools to voice our needs and feel safe saying, “I’m hurt.” Until this emotional hunger for safety and acceptance is met and firm food boundaries are established, this maladaptive coping mechanism will sabotage any weight loss efforts. The high recidivism rate of eating disorders, weight loss diets, bariatric surgery, and even GLP1 agonists reflects this unaddressed root cause. Often, the addict tries to find comfort by moderating their trigger food but will ultimately struggle with persistent weight gain and worsening depression and other comorbidities. Safe boundaries through trigger abstinence and connection are critical to recovery, just as they are for alcohol and all other substance use disorders. The addiction isn’t the addict's fault, but it is their problem to solve. Recovery is empowering, not punitive.

No program has navigated the waters of addiction better or longer than Alcoholics Anonymous. Their 12-step program supports abstinence while addressing the original spiritual crisis and creating community. Likewise, most food addiction programs model this well-worn path, knowing that trigger food abstinence without support is a setup for failure. 

Relapse is an inevitable part of change. Humans are very good at self-sabotage. Fear, stress, and uncertainty about the future pull us back to familiar comforts, even if they are harmful. Failure is a learning opportunity to do better next time. Admittedly, remission from food addiction is the hardest to maintain. It’s like the alcoholic going into a bar and ordering water three times a day for the rest of their life.⁵

There is hope and life beyond food addiction. Restoring the qualities that make us human offers healing, structure, and stability. By abstaining from trigger foods and ultra-processed foods, we can focus on real, single-ingredient, whole foods free of sugar and grains to reduce cravings, regulate blood glucose, decrease inflammation, and restore normal hormone signaling. Recovery requires healing through mindful eating, understanding the gut-brain axis, respecting circadian rhythms, and building connection and community. No one wants to be addicted. Addiction steals self-worth and autonomy, replacing them with shame, disgust, disease, depression, and self-loathing that erode our spirits. It claims too many lives prematurely. We all deserve joy, empathy, and food sobriety. As Dr. Gabor Maté reminds us, “Don’t ask ‘Why the addiction?’ Ask ‘Why the pain?’” 

References:

1. Hyman M. It’s Time to Treat Sugar Like Cigarettes. Time. May 1, 2024. Accessed [September 22, 2025]. https://time.com/6973208/sugar-america-transparency-essay/

2. Tarman V. Food Junkies. 2nd ed. Toronto, ON: Dundurn Press; 2019.

3. Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale Food Addiction Scale. Appetite. 2009;52(2):430-436. doi:10.1016/j.appet.2008.12.003

4. Unwin J, Delon C, Giæver H, et al. Low carbohydrate and psychoeducational programs show promise for the treatment of ultra-processed food addiction. Front Psychiatry. 2022;13:1005523. Published 2022 Sep 28. doi:10.3389/fpsyt.2022.1005523

5. Ede G. When food makes you hungry. Presented at: IFAAC Conference 2025; 2025; London, England.