A recent study suggests approximately 75% of Americans eat excess amounts of sugar.  From cupcakes to pies to ice cream, sugar is found in many foods. I, like many of you, enjoy sweets. (My Achilles' heel is cheesecake.

The notion of food addiction arose out of the drug addiction model because there are similarities, such as people reporting a loss of control, withdrawal and cravings for sugar. 

In a narrative review published in the British Journal of Sports Medicine the scientist James J DiNicolantonio and cardiologist James H O'Keefe (Saint Luke’s Mid America Heart Institute, Kansas) said that “Consuming sugar produces effects similar to that of cocaine, altering mood, possibly through its ability to induce reward and pleasure, leading to the seeking out of sugar.” Their work cites rodent studies that show that sweetness is preferred even over cocaine, and that mice can experience sugar withdrawal. Additionally, DiNicolantonio said that the consumption of sugar was a grave concern. “In animals, it is actually more addictive than even cocaine, so sugar is pretty much probably the most consumed addictive substance around the world and it is wreaking havoc on our health.” 

Notwithstanding the findings, few studies have examined sugar addiction in humans and most evidence is from animal studies. Animal research shows there are neurobiological differences between drugs and sugar, for example the dopaminergic response to sugar (and other foods) reduces after repeated exposure and with predictive cues (such as smells), while it does not with drugs.  Addictive-like behaviors such as bingeing occur only in animal studies where sugar is given intermittently rather than as often or as much as desired and likely due to pleasant taste rather than neurobiological effects. In humans the research does not show increased dosage of sugar having increased potency and therefore increased addictive potential. In summary, addictive-like consumption of sugar is different to drug addiction in both neurobiology and behavior. 

While little evidence supports sugar as an addictive substance, it may be that sweetness or palatability is central to addictive-like eating. The glycemic index (GI) or glycemic load (GL) may play a role in the food addiction to sweet foods, although no mechanistic link has been suggested. 

Perhaps aspects of sugar or sweet foods are a craving rather than an addiction. Cravings for palatable foods like chocolate differ from drug cravings in their intensity, frequency and duration. Food cravings are short lived and subside whereas drug cravings do not. It is also suggested that the combination of liking and restraint combine to make thoughts of liked foods (such as chocolate) more pre-occupying and this is experienced as a craving. Or put simply, not allowing yourself to eat something highly pleasurable makes you want it even more.  

DiNicolantonio JJ, O’Keefe JH, Wilson WL Sugar addiction: is it real? A narrative review Br J Sports Med 2018;52:910-913.