The overconsumption of sugar is a major health problem in the UK, leading to many adverse health conditions. But is this caused by addiction?
Some people suggest sugar should be considered an addiction. According to the charity Public Health Collaboration (PHC), which focuses on raising awareness of food addiction, around 10 million people in the UK – 20% of the population – are addicted to sugar and highly processed foods.
However, many in the scientific community believe that there is not enough evidence to suggest this. The ICD-10, the World Health Organisation’s document classifying diseases, doesn’t recognise either sugar or food addiction.
The health risks
So, what are the health risks of sugar? Well, for one thing, it can lead to very poor physical health. According to the NHS, overconsumption of free sugars can contribute to weight gain, a leading cause of type-2 diabetes, cardiovascular disease, and even some types of cancer. Sugar is also a leading cause of tooth decay.
Lack of evidence
Many in the scientific community believe that there is little to no evidence to suggest that sugar should be considered as an addiction.
One study, published in 2021, analysed the functional magnetic resonance imaging (fMRI) data responding to sweet tastes with that related to addiction. The article questioned whether a desire for sweet tastes could be described in the same terms as addiction.
“We believe the neurobiologies of reward value and addiction to be distinct and disagree with application of the addiction model to sweet food overconsumption,” it says. “Most hypotheses of sugar “addiction” attribute the hedonics of sweet foods as the equivalent of ‘addiction’.”
Another study, published in 2017, found that while studies on animals suggested sugar could become addictive, subsequent studies on humans did not have the same results.
“The current findings indicate that sugary foods contribute minimally to 'food dependence' and increased risk of weight gain,” the study suggests.
“Instead, they are consistent with the current scientific notion that food energy density, and the unique individual experience of eating, plays an important role in determining the reward value of food and promoting excessive energy intake.”
Is sugar an addiction?
However, others suggest that sugar can be addictive. “Eating sugar releases opioids and dopamine in or bodies,” Dr. Bunmi Aboaba, a food addiction expert known as the ‘food addiction coach’, told FoodNavigator. “This is the link between added sugar and addictive behaviour. Dopamine is a neurotransmitter that is a key part of the ‘reward circuit’ of the brain associated with addictive behaviour.”
While the negative health associations of sugar are common knowledge, it is not widely considered to be an addictive substance. But it follows the ‘same addiction pathway’ as other addictions, according to Dr. Aboaba.
“Pre-occupation of the substance, followed by consumption which sets off a phenomenon of cravings, followed by out-of-control consumption, then withdrawal, then the whole cycle begins again,” she said, describing sugar addiction.
“Ask someone who is addicted to sugar and [you’ll get] phrases like ‘felt compelled,’ ‘felt driven,’ ‘couldn't stop when I started,’ ‘have to have my fix,’ ‘feel anxious when I don't have sugar’ etc . . . all similar behaviours to other addictions. The come down ‘sugar crash’ is also indicative.”
Treating it as an addiction
Whether or not it can be categorised as an addiction in the medical sense, some people believe that treating it as one would reduce the stigma surrounding excessive sugar consumption. “I completely agree with this,” Dr. Jen Unwin, from Public Health Collaboration, told FoodNavigator. “Studies have shown that explaining this can reduce stigma and increase understanding of why some people lose control of their sugar consumption.”
One study, published in the journal Nutrients in 2019, pointed out the similarities between sugar and other addictions and highlighted the need for an increased awareness of the impact of food addiction in the wider population.
The paper found that overeating is often perceived ‘to be the product of personal choice to a greater extent’ than alcoholism, which increases the level of blame towards the addicted, and the stigma it holds.
Analysing a range of literature on the impact of the ‘food addiction model,’ the idea that overconsumption of certain foods stems from addiction, the paper found that, in many cases, it reduces stigma directed towards people who overeat, regardless of whether they’re obese.
The stigma may decrease, according to much of the literature examined by the study, because it reduces the presence of personal failings, such as lack of willpower, within people’s perception of the problem (however, other literature assessed suggested the idea of food addiction could increase stigma, because of the stigma attached to the idea of ‘addiction’ in general).
The paper concludes that characterising sugar addiction as a substance abuse disorder is less stigmatising than characterising it as a behavioural addiction, as the former is associated less with personal control. The less one thinks a food addict is in control of their actions, therefore, the less stigmatised they will be.
According to Dr. Unwin, the addiction model would “also lead to the development and evaluation of treatment programs which is currently lacking.” One such audit, which treated perceived food addiction using a low carbohydrate approach across three locations (the UK, Sweden, and North America), successfully reduced weight and food cravings across many of its participants. Their mental wellbeing also improved relative to before the audit.
What the industry can do
Dr. Aboaba believes that, up until now, the food industry has been part of the problem. “Practices such as processing, packaging and distribution of ultra-processed foods in particular have somewhat of an effect on disordered eating behaviours such as binge eating (along with compensatory behaviours), food cravings and dieting,” she told FoodNavigator.
“The food industry has helped to cultivate the national obsession of diet culture, weight and shape resulting in restriction and when it goes wrong, overeating and weight gain.”
But by focusing on the right factors, she told us, the industry can change. “The food Industry can start by stopping normalisation of large portion sizes,” Dr. Aboaba tells us. “Larger serving and portion sizes increase the risk of binge eating behaviours.
“Stop labelling diet and health products which are misleading as we now can see that it’s leading to disordered eating behaviour. The food industry should set up food environments that support health emphasising the role of ‘Real Foods.’”
It’s not just the labelling, suggested Dr. Unwin, but the composition of food itself. “There are many actions that food companies can take such as reducing unnecessary sugars and sugar substitutes in their products,” she added. “Not using multiple different names for sugar in the ingredient list for example.
“Labelling could also be improved. Numbers of teaspoons of sugar in a serving would make it easier for people to stick to the daily guideline amounts. But also, consumers should be encouraged to buy fresh real food and prepare it at home.”
However, the responsibility, in her view, doesn’t just lie with the food industry but with the government as well. “It's frustrating that government don’t do more to address this urgent issue, which is driving soaring rates of obesity, diabetes, and other chronic conditions. I don’t think food companies will make significant changes unless they are mandated to do so.”
Article updated on 21 April 2023 with inclusion of mainstream scientific view on 'sugar addiction', with reference to the Appetite article published in 2017 and the International Journal of Environmental Research and Public Health article published in 2021
Sourced From: International Journal of Environmental Research and Public Health
‘Sugars and Sweet Taste: Addictive or Rewarding?’
Published on: 17 September 2021
DOI: https://doi.org/10.3390/ijerph18189791
Authors: D. Greenberg, J. V. St. Peter
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‘Eating dependence and weight gain; no human evidence for a 'sugar-addiction' model of overweight’
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‘Ethical, Stigma, and Policy Implications of Food Addiction: A Scoping Review’
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Sourced From: Frontiers in Psychiatry
‘Low carbohydrate and psychoeducational programs show promise for the treatment of ultra-processed food addiction’
Published on: 28 September 2022
DOI: https://doi.org/10.3389/fpsyt.2022.1005523
Authors: J. Unwin, C. Delon, H. Giæver, C. Kennedy, M. Painschab, F. Sandin, C.S. Poulsen and D.A.Wiss