REVIEW article
Front. Psychiatry
Sec. Addictive Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1621742
This article is part of the Research TopicUltra-Processed Food Addiction: Moving toward Consensus on Mechanisms, Definitions, Assessment, and InterventionView all 12 articles
The Battle Over "Food Addiction"
Provisionally accepted
- Pediatric Endocrinology, University of California, San Francisco, San Francisco, CA, United States
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Despite decades of nutrition, obesity, and diabetes research, and worsening prevalences and severities of virtually every chronic metabolic disease, the scientific community remains divided over the existence and veracity of the concept of food addiction. There are numerous rationalizations — 1) you need food to survive, (of which “Food is Medicine” is the latest mantra); 2) people with obesity should not be stigmatized as “mentally ill”; 3) people with obesity should instead adhere to “personal responsibility”; 4) the data are incomplete and not strong enough; 5) it’s correlation but not causation; 6) everyone is exposed, but not everyone is addicted; 7) there is no “withdrawal” phenotype; and 8) it’s not “food addiction” but “eating addiction”. All are in play, yet more health care dollars are diverted to the treatment of food-related disease every year. While various ingestible chemicals (e.g. nicotine, cocaine, heroin, alcohol) are clearly addictive, it appears to be a stretch by some scientists to argue that individual substances found in food (e.g. sugar, caffeine), or the food itself (e.g. ultraprocessed food), rise to meet the same criteria. Symposia on food addiction proliferate and journal debates continue. The definition of addiction consists of numerous criteria, including public health demographics, biochemistry, imaging, animal trials, clinical trials, and economics. None of these have proven to be “slam dunks” to align a general consensus. But paramount for scientific acceptance is the delineation of mechanism. This article will review the history of the controversy, the data on which foods are most likely to be addictive, the two mechanisms involved in the pathogenesis of food addiction and relate it to the most likely culprits, and the role of the food industry in promulgating false narratives, in order to provide a rational way forward from this debate.
Keywords: food addiction, sugar, Insulin, Dopamine, Leptin, Food Industry, ultraprocessed foods
Received: 01 May 2025; Accepted: 05 Aug 2025.
Copyright: © 2025 Lustig. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Robert H. Lustig, Pediatric Endocrinology, University of California, San Francisco, San Francisco, 94143-2205, CA, United States
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