It can be difficult to identify the differences between food addiction and an eating disorder. SunCloud Health in Illinois is one of the only treatment centers that actively assesses each, makes a distinction between the two (diagnostically and clinically) and treats both conditions using an integrated, trauma–informed approach. Because trauma related disorders, psychiatric co-occurring disorders and medical commodity are the rule with food addiction, we treat not only the food addiction but all that comes along with it.
What Is Food Addiction?
Food addiction is best conceptualized as a substance use disorder or addiction involving certain food types or food substances. Although there is a great deal of overlap and co-occurrence with eating disorders (ED), food addiction and ED are distinct conditions. This is much like hypertension and high cholesterol—they frequently occur together in the same person and yet are separate diagnoses. Food addiction is not the same as the formal eating disorder known as Binge Eating Disorder. It is also not the same as clinical obesity.
Importantly, food addiction is not yet formally recognized by the DSM-5, although a group of researchers and clinicians are advocating for its inclusion. Similarly, an international food addiction consensus group has submitted a proposal for it to be included in the next revision of the International Classification of Diseases (ICD-11).
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Do Some Foods Have a Higher Addiction Potential Than Others?
A significant portion of the American population can, and does, consume all different types of foods with seemingly little in the way of adverse consequences. Another segment of the population carries a sensitivity to certain types of foods, typically highly processed, calorie-dense, hyper-palatable foods. Many people with food addiction experience a loss of control when eating foods with rapidly absorbed, processed carbohydrates, added fats, and/or high amounts of added sugar.
Many of these foods would be considered ultra-processed foods (UPFs), but not all of the foods people can become addicted to would be considered UPFs. It is important to state that foods with addiction potential, like other substances with addiction potential, are not inherently bad or harmful. Cocaine, for example, is a useful local anesthetic and vasoconstrictor when used under medical oversight. UPFs can be lifesaving in many situations, and some actually confer health benefits. Addiction at its root is a disease of brain reward and related circuitry with biological, psychological, social, and spiritual manifestations of the illness. Treatment of addiction is inherently weight-neutral and targets the various dimensions of the illness. This is a critical thing to keep in mind when treating anyone with food addiction, particularly if they have a co-occurring eating disorder.
It is also vital to distinguish “fear foods” from trigger foods. Fear foods are foods feared for reasons relating to an eating disorder or a pathological desire to shape/alter body size or shape. Trigger foods are foods that elicit a chemical response in the brain’s reward center that renders a person without adequate autonomy and choice in determining whether to continue to eat or stop eating in any given context.
What Targeted Treatments are Available for Food Addiction?
We utilize a variety of assessments including the Eating Disorder Examination Questionnaire (EDE-Q) and the Modified Yale Food Addiction Scale 2.0 (mYFAS2.0) to gain a holistic picture of each patient. This along with semi-structured clinical interviews helps us best identify and accurately diagnose what is an eating disorder, what is food addiction, and who has one, the other or both. We utilize these tools to create a full treatment plan which focuses on:
- Stabilization of the body, mind, and brain
- Providing a varied and flexible meal plan, eliminating foods that trigger dopamine spikes
- Decreased overall exposure to or even abstinence from triggering substances for certain people (specific food items, types, or ingredients; often context or setting specific)
- Enjoyable and meaningful movement
- Cognitive behavioral therapies like CBT, DBT, and RO-DBT
- Active treatment of co-occurring conditions like PTSD, EDs, mental health diagnoses, and chronic medical conditions
- Pharmacotherapy or medication management
Our nutrition experts understand the struggles those with food addiction face and:
- Teach patients to nourish their body with healthful foods
- Facilitate a positive relationship with food, free from negative or distorted thoughts
- Improve body image and decrease internalized weight stigma
- Facilitate trauma healing for weight-based discrimination and harms
- Help patients learn to listen to and trust the body’s internal cues for hunger and fullness, following the principles of Intuitive Eating and weight neutrality
- Demonstrate the skills needed to achieve food–freedom and peace of mind
Working Towards Each Patient’s Health Goals
SunCloud Health is aligned with the principles of weight neutral medicine. Our model values all bodies and sizes, focuses on objective measures of health rather than weight or BMI, and prioritizes patient autonomy. We recognize that being in a larger body does not equate to being in poor health, nor does living in a smaller body equate to health.
As part of our commitment to respecting choice and autonomy, we honor requests to explore using medications, including GLP-1s when medically appropriate, as part of comprehensive care plans. These conversations are always individualized and guided by the available evidence base, patient preferences and their identified set of treatment goals.
Our nutritional plans focus on individual preferences, cultural preferences, flexibility, and adequate nourishment. Individualized nutritional approaches tailored to each person’s needs are designed to achieve desired medical, mental health, and functional outcomes. We take a non-diet approach targeting overall health, sustainability, and freedom.
How is Food Addiction Different and Similar to Substance Use Disorder?
The modern food landscape is full of highly processed, hyper-palatable, highly rewarding foods. These foods were designed to trigger reward centers in the brain so that consumers consume more, crave more, and purchase more. This reward activation is very similar to what is seen with compulsive use of drugs and other substances with addiction potential. A large body of evidence has substantiated that people with pre-existing mental health conditions and developmental trauma are at an increased risk of addiction.
Like other substance use disorders, there are multiple ways of treating food addiction. Overall treatment philosophies can include harm reduction strategies, abstinence-based models, and blended approaches. We actively address co-occurring eating disorders, PTSD and stressor related disorders, medical conditions, and psychiatric illnesses. We stand firm in our belief that you don’t have to forfeit your physical health to find lasting recovery from mental illness, eating disorders, and/or food addiction.
We also facilitate participation in mutual support groups, peer recovery communities and other sources of community support to reduce the terrible burden of isolation and shame associated with loss of control eating. A sense of belonging and connectedness is often cited as one of the most profound changes people experience as they heal from food addiction.
Video: Kimmy Haynes shares an honest perspective on setbacks, growth, and continuing forward through the recovery journey.
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SunCloud Health’s Research on Food Addiction
We invite you to look at the research we have published on food addiction as part of our on-going commitment to providing leading care:
- Dismantling the myth of “all foods fit” in eating disorder treatment in Journal of Eating Disorders
- First do no harm: the impact of assessing for ultra-processed food addiction on dietary restraint in patients with and without eating disorders during residential treatment in Journal of Eating Disorders
- Food Addiction Screening, Diagnosis and Treatment: A Protocol for Residential Treatment of Eating Disorders, Substance Use Disorders and Trauma-Related Psychiatric Comorbidity in Nutrients
- PTSD, complex PTSD and the dissociative subtype of PTSD in patients with eating disorders in Journal of Eating Disorders
- Keshen, A., Koning, E., Allison, K. C., Amaro, A., Bartel, S., Belliveau, P., Boniferro, L., Brar, S., Butalia, S., Bulik, C. M., Chao, A. M., Couturier, J., Dennis, K., Dixon, L., El-Ziftawi, D., Gao, C., Gamberg, S., Goldstone, A. P., Dalle Grave, R., … Wnuk, S. (in press).Consensus-based clinical and research recommendations for use of glucagon-like peptide-1 receptor agonists in the context of eating disorders: A modified Delphi study. World Psychiatry.
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Explaining SunCloud’s Integrated ModelWhy is an integrated treatment model essential to successfully treating patients?
Dr. Kim Dennis, Co-Founder and Medical Director at SunCloud Health, discusses the vital role the integrated model (that she is pioneering at SunCloud Health) plays in the success of treating patients with co-occurring disorders and underlying trauma. How does SunCloud create an authentic culture of patient support?