An evaluation of food addiction as a distinct psychiatric disorder

Int J Eat Disord. 2020 Oct;53(10):1610-1622. doi: 10.1002/eat.23350. Epub 2020 Jul 29.

Abstract

Objective: To evaluate the state of the literature for whether food addiction may warrant consideration as a distinct psychiatric disorder in the Diagnostic and Statistical Manual (DSM) using Blashfield et al.'s (1990; Comprehensive Psychiatry, 31(1), 15-19) five criteria. This framework was utilized because it has recently been applied to examine the diagnostic utility of several eating disorder phenotypes. The criteria are: (a) at least 50 journal articles published on the proposed syndrome in the past 10 years; (b) proposal of diagnostic criteria and assessment measures; (c) clinician reliability in diagnosis; (d) cohesiveness of the proposed diagnostic criteria; and (e) differentiation from similar, existing diagnostic categories.

Method: For each criterion, a literature review was conducted to examine if the minimum qualification had been met, and key findings were discussed.

Results: Two of the criteria (literature and differentiation) have been empirically supported to extent specified. Two criteria (diagnostic criteria and syndrome) have been partially fulfilled, due to only having self-report assessment measures and no examination of the odds ratios for meeting more than one symptom, respectively. Clinician reliability has not yet been evaluated.

Discussion: The existing literature suggests that food addiction may warrant consideration as a proposed diagnostic category in the DSM, though future research is needed to fulfill Blashfield et al.'s (1990; Comprehensive Psychiatry, 31(1), 15-19) criteria. The development of a semi-structured interview would be an impactful contribution for addressing these gaps.

Keywords: DSM; classification of mental disorders; eating disorders; food addiction; nosology; substance use.

Publication types

  • Review

MeSH terms

  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Food Addiction / diagnosis*
  • Humans
  • Male
  • Mental Disorders / diagnosis*
  • Reproducibility of Results