Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications

May combine two claims.

In rodent studies, early life adversity (ELA) induces alterations in DA neuronal activity and synaptic function, impacting reward-directed behavior and partially accounting for individual variation along the mesolimbic DA projection.

“In rodent studies, early life adversity (ELA) has been shown to induce alterations in DA neuronal activity and synaptic function [15], impacting reward-directed behavior and partially accounting for individual variation along the mesolimbic DA projection [16].”

• cites [15] Kim, 2017, Early adverse experience and substance addiction: Dopamine, oxytocin, and glucocorticoid pathways, Ann. N. Y. Acad. Sci. sourceNot checked yet

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• cites [16] Neugut, 2014, Effects of maternal care on the development of midbrain dopamine pathways and reward-directed behavior in female offspring, Eur. J. Neurosci. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

It is not clear whether neurochemical associations are a cause of addiction-like overeating or a consequence.

“To date, it is not clear whether these neurochemical associations are a cause of addiction-like overeating or a consequence [6].”

• cites [6] Saules, 2018, Overeating, Overweight, and Substance Use: What Is the Connection?, Curr. Addict. Rep. sourceNot checked yet

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Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Improved knowledge of biopsychosocial mechanisms contributing to food addiction may decrease stigma associated with obesity and disordered eating behavior.

“Discussion of various public health and policy considerations are based on the concept that improved knowledge of biopsychosocial mechanisms contributing to food addiction may decrease stigma associated with obesity and disordered eating behavior.”

Classified as probably not a substantial claim.

There is a gap in understanding how various forms of stress, trauma, and adversity link to addiction-like eating in real-world settings, particularly when viewed in social context, as well as over the lifespan.

“At present, there is a gap in our understanding of how various forms of stress, trauma, and adversity link to addiction-like eating in real-world settings, particularly when viewed in social context, as well as over the lifespan.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The changing global food landscape in the past four decades has increased access to convenient "snack" foods and decreased time spent preparing foods at home.

“The changing global food landscape in the past four decades have increased access to convenient “snack” foods and decreased time spent preparing foods at home [2].”

• cites [2] Hall, 2018, Did the Food Environment Cause the Obesity Epidemic?, Obesity sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The Nutrition Transition theory describes a global trend toward consumption of processed foods that are low in fiber and high in added sugars and fats.

“The Nutrition Transition theory describes a global trend toward consumption of processed foods that are low in fiber and high in added sugars and fats [1].”

• cites [1] Popkin, 1993, Nutritional Patterns and Transitions, Popul. Dev. Rev. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Chronic stress dysregulates the reward system, promotes addiction-like eating, and contributes to the development of obesity.

“More recently it has been shown that chronic stress dysregulates the reward system, promotes addiction-like eating, and contributes to the development of obesity [17].”

• cites [17] Wei, 2019, Chronic stress increases susceptibility to food addiction by increasing the levels of DR2 and MOR in the nucleus accumbens, Neuropsychiatr. Dis. Treat. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Changes that occur in obesity show that food reinforcement adapts, strongly implicating biological underpinnings.

“However, similar to other addictions, changes that occur in obesity show that food reinforcement adapts, strongly implicating biological underpinnings.”

May combine two claims.

fMRI studies have linked ELA to blunted subjective responses to reward-predicting cues and to altered connectivity in the extended reward network, leading to increased vulnerability to FA and obesity later in life.

“Functional magnetic resonance imaging (fMRI) studies have linked ELA to blunted subjective responses to reward-predicting cues [29], and to altered connectivity in the extended reward network, leading to increased vulnerability to FA and obesity later in life [30].”

• cites [29] Dillon, 2009, Childhood Adversity Is Associated with Left Basal Ganglia Dysfunction During Reward Anticipation in Adulthood, Biol. Psychiat. sourceNot checked yet

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• cites [30] Osadchiy, 2019, History of early life adversity is associated with increased food addiction and sex-specific alterations in reward network connectivity in obesity, Obes. Sci. Pract. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Biopsychosocial models were originally proposed by Engel as a new way to understand health and disease, by considering influence from various domains.

“Biopsychosocial models were originally proposed by Engel as a new way to understand health and disease, by considering influence from various domains [32].”

• cites [32] Engel, 1977, The need for a new medical model: A challenge for biomedicine, Science sourceNot checked yet

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May combine two claims.

FA is one potential pathway linking the food environment to obesity, however there is a "backdoor path" through SES to STA, as well as a pathway that may not include FA.

“Taken together, FA is one potential pathway linking the food environment to obesity, however there is a “backdoor path” [100] through SES to STA, as well as a pathway that may not include FA (i.e., through the built environment).”

• cites [100] Greenland, 1999, Causal Diagrams for Epidemiologic Research, Epidemiology sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

With the validation of the Yale Food Addiction Scale (YFAS) in 2009 and the updated YFAS 2.0 in 2016, FA in humans has been operationalized across hundreds of studies.

“With the validation of the Yale Food Addiction Scale (YFAS) in 2009 [42] and the updated YFAS 2.0 in 2016 [43], FA in humans has been operationalized across hundreds of studies.”

• cites [42] Gearhardt, 2009, Preliminary validation of the Yale Food Addiction Scale, Appetite sourceNot checked yet

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• cites [43] Gearhardt, 2016, Development of the Yale Food Addiction Scale Version 2.0, Psychol. Addict. Behav. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

FA is one driver of obesity, although there are several others.

“Figure 1 proposes that FA is one driver of obesity, although there are several others, including some not captured by the model (discussed further in Section 2.1).”

May combine two claims.

ED research has identified significant overlap between FA and bulimia nervosa (BN), with FA symptoms improving when BN symptoms remit.

“For example, ED research has identified significant overlap between FA and bulimia nervosa (BN), with FA symptoms improving when BN symptoms remit [47].”

• cites [47] Meule, 2014, Food Addiction and Bulimia Nervosa, Eur. Eat. Disord. Rev. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Impulsivity hinders inhibitory control and is associated with increased intake of food and drugs, often heightened in response to novel stimuli.

“Impulsivity hinders inhibitory control and is associated with increased intake of food [80] and drugs [81], often heightened in response to novel stimuli [82].”

• cites [80] Nederkoorn, 2009, The interactive effect of hunger and impulsivity on food intake and purchase in a virtual supermarket, Int. J. Obes. sourceNot checked yet

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• cites [81] Trifilieff, 2014, Imaging addiction: D2 receptors and dopamine signaling in the striatum as biomarkers for impulsivity, Neuropharmacology sourceNot checked yet

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• cites [82] Savage, 2014, Regulation of novelty seeking by midbrain dopamine D2/D3 signaling and ghrelin is altered in obesity, Obesity sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

It remains unclear if dietary restraint/restriction is a cause or consequence of FA symptoms.

“It is well-established that dietary restraint/restriction can lead to rebound bingeing [45] yet it remains unclear if this is a cause or consequence of FA symptoms (discussed in Section 5.1).”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Risk estimates between childhood adversity and adult obesity would likely be higher after adjusting for diagnoses often associated with dietary restriction and weight control.

“Therefore, risk estimates between childhood adversity and adult obesity would likely be higher after adjusting for these diagnoses often associated with dietary restriction and weight control, however this has not been formally tested.”

May combine two claims.

The maltreatment-obesity association is not spurious due to confounding through the home food environment; testing found limited confounding influence.

“However, after testing, researchers have found limited confounding influence [95] which supports arguments in favor of biological mechanisms.”

• cites [95] Mason, 2018, Is the childhood home food environment a confounder of the association between child maltreatment exposure and adult body mass index?, Prev. Med. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

In a study of postmortem brain structures, investigators were unable to detect a change in MOR expression, suggesting different epigenetic signatures associated with addictions and ELA.

“In this study of postmortem brain structures, the investigators were unable to detect a change in MOR expression, suggesting different epigenetic signatures associated with addictions and ELA.”

• cites [147] Lutz, 2018, Epigenetic Regulation of the Kappa Opioid Receptor by Child Abuse, Biol. Psychiatry sourceNot checked yet

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May combine two claims.

A meta-analysis of 1781 people documented significantly decreased hippocampal volumes following ELA, with weaker evidence of increased amygdala volumes.

“A meta-analysis of 1781 people documented significantly decreased hippocampal volumes following ELA, with weaker evidence of increased amygdala volumes [128].”

• cites [128] Calem, 2017, Meta-analysis of associations between childhood adversity and hippocampus and amygdala volume in non-clinical and general population samples, Neuroimage Clin. sourceNot checked yet

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May combine two claims.

Individuals with higher ACE scores were more likely to report not finishing high school, unemployment, and living below the poverty level.

“To illustrate further, a recent study showed that individuals with higher ACE scores were more likely to report not finishing high school, unemployment, and living below the poverty level [108].”

• cites [108] Metzler, 2017, Adverse childhood experiences and life opportunities: Shifting the narrative, Child. Youth Serv. Rev. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

The "neuroimmune network hypothesis" proposes that ELA amplifies the communication between the brain and the immune system, promoting low grade peripheral inflammation.

“The “neuroimmune network hypothesis” proposes that ELA amplifies the communication between the brain and the immune system, promoting low grade peripheral inflammation [122].”

• cites [122] Hostinar, 2018, Future Directions in the Study of Early-Life Stress and Physical and Emotional Health: Implications of the Neuroimmune Network Hypothesis, J. Clin. Child. Adolesc. Psychol. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

NR3C1 is the most studied gene to date related to abuse and neglect.

“Notwithstanding, NR3C1 has been linked to prenatal stress [140] and is the most studied gene to date related to abuse and neglect [141].”

• cites [141] Mitchell, 2015, DNA methylation, early life environment, and health outcomes, Pediatric Res. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Addictions may promote compromised parenting increasing the possibility that suboptimal care may be provided to the next generation.

“In social context, addictions may promote compromised parenting increasing the possibility that suboptimal care may be provided to the next generation.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Taq1A polymorphisms at the D2 receptor influence impulsive behavior.

“Taq1A polymorphisms at the D2 receptor has been well-studied and known to influence impulsive behavior [154].”

• cites [154] Jentsch, 2014, Dissecting impulsivity and its relationships to drug addictions, Ann. N. Y. Acad. Sci. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

The "glucocorticoid cascade hypothesis" posits that stress hormones impair brain function which further increases cortisol levels.

“The “glucocorticoid cascade hypothesis” posits that stress hormones impair brain function which further increases cortisol levels [123].”

• cites [123] Sapolsky, 1986, The neuroendocrinology of stress and aging: The glucocorticoid cascade hypothesis, Endocr. Rev. sourceNot checked yet

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May combine two claims.

Higher allostatic load (AL) scores were associated with poorer cognitive and physical functioning, increasing the risk of cardiovascular diseases independent of sociodemographic risk factors.

“A landmark study showed that higher AL scores were associated with poorer cognitive and physical functioning, increasing the risk of cardiovascular diseases independent of sociodemographic risk factors [119].”

• cites [119] Seeman, 1997, Price of adaptation—Allostatic load and its health consequences. MacArthur studies of successful aging, Arch. Intern. Med. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Developmental programming of the HPA axis and subsequent regulation of the stress response might impact addiction susceptibility, thereby increasing intake of substances known to activate reward pathways, including highly palatable food.

“It is not implausible that developmental programming of the HPA axis and subsequent regulation of the stress response might impact addiction susceptibility, thereby increasing intake of substances known to activate reward pathways, including highly palatable food.”

May combine two claims.

Methylation at the mu-opioid receptor (MOR) gene is most strongly associated with drug addiction as well as incentive motivation for processed food.

“While methylation at the mu-opioid receptor (MOR) gene is most strongly associated with drug addiction [144] as well as incentive motivation for processed food [145,146], decreased methylation at the kappa-opioid receptor (KOR) in the anterior insula has been shown in child abuse [147] (discussed further in Section 4.1).”

• cites [144] Belzeaux, 2018, Focusing on the Opioid System for Addiction Biomarker Discovery, Trends Mol. Med. sourceNot checked yet

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• cites [145] Giuliano, 2015, The role of the opioid system in binge eating disorder, CNS Spectr. sourceNot checked yet

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• cites [146] Pucci, 2019, Preclinical and Clinical Evidence for a Distinct Regulation of Mu Opioid and Type 1 Cannabinoid Receptor Genes Expression in Obesity, Front. Genet. sourceNot checked yet

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May combine two claims.

Cumulatively elevated biomarkers link to decreased inhibitory control, highlighting the potential for disordered eating to become very difficult to overcome, similar to drug addiction.

“This research suggested that these cumulatively elevated biomarkers link to decreased inhibitory control, highlighting the potential for disordered eating to become very difficult to overcome, similar to drug addiction.”

Classified as probably not a substantial claim.

Stress leads to changes in brain CRF that have a direct impact on addiction.

“The central thesis in Koob’s allostatic view of stress and addiction is that stress leads to changes in brain CRF that have a direct impact on addiction [175].”

• cites [175] Koob, 2019, Addiction and Stress: An Allostatic View, Neurosci. Biobehav. Rev. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

The association between STA and addiction behaviors also exists in the opposite direction.

“Importantly, not only does STA increase addiction behaviors, some authors have suggested this association also exists in the opposite direction [181,182].”

• cites [181] Jacques, 2019, The impact of sugar consumption on stress driven, emotional and addictive behaviors, Neurosci. Biobehav. Rev. sourceNot checked yet

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• cites [182] Evans, C., and Cahill, C. (2016). Neurobiology of opioid dependence in creating addiction vulnerability. F1000Research, 5. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Increased CRF alters serotonin release in the brain which facilitates DA in the accumbens.

“It has also been suggested that increased CRF alters serotonin release in the brain which facilitates DA in the accumbens [176].”

• cites [176] Forster, 2018, Negative consequences of early-life adversity on substance use as mediated by corticotropin-releasing factor modulation of serotonin activity, Neurobiol. Stress sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

Repeated altered activity in the DA system and sustained activation of the CRF system leads to allostasis and negative emotional states.

“It has been proposed that repeated altered activity in the DA system and sustained activation of the CRF system leads to AL and negative emotional states [174].”

• cites [174] George, 2012, Allostasis and addiction: Role of the dopamine and corticotropin-releasing factor systems, Physiol. Behav. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Food addiction can be considered as a partial mediator in the stress-obesity pathway, likely resulting from one or many biologically embedded pathways.

“FA can be considered as a partial mediator in the stress-obesity pathway, likely resulting from one or many of the biologically embedded pathways described herein.”

May combine two claims.

Both chronic stress and long-standing alcohol use promote PFC dysfunction.

“Both chronic stress and long-standing alcohol use promote PFC dysfunction [172].”

• cites [172] Blaine, 2017, Alcohol, stress, and glucocorticoids: From risk to dependence and relapse in alcohol use disorders, Neuropharmacology sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

The DA and GC systems are both highly involved in substance addictions, and ELA may induce long-lasting alterations in these systems.

“To illustrate, the DA and GC systems are both highly involved in substance addictions, and ELA may induce long-lasting alterations in these systems.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Changes in CRF activity that result from chronic alcohol exposure within the extended amygdala network are thought to be a key factor in withdrawal symptoms.

“Changes in CRF activity that result from chronic alcohol exposure within the extended amygdala network is thought to be key factor in withdrawal symptoms [173].”

• cites [173] Becker, H.C. (2018). Influence of stress associated with chronic alcohol exposure on drinking. Neuropharmacology, 122. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

GCs are hypothesized to decrease DA uptake subsequently increasing synaptic DA.

“A recent review of preclinical data suggests three mechanisms by which DA and GCs interact: (1) GCs upregulate tyrosine hydroxylase (rate-limiting enzyme in DA synthesis) (2) GCs down-regulate monoamine oxidase (enzyme responsible for DA removal) and (3) GCs are hypothesized to decrease DA uptake subsequently increasing synaptic DA [189].”

• cites [189] Mukhara, 2018, Stress as a Risk Factor for Substance Use Disorders: A Mini-Review of Molecular Mediators, Front. Behav. Neurosci. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The KOR system plays an important role in behavioral stress responses and has been implicated in stress-induced maladaptive responses.

“The KOR system plays an important role in behavioral stress responses and has been implicated in stress-induced maladaptive responses [190].”

• cites [190] Karkhanis, 2017, International Review of Neurobiology, Int. Rev. Neurobiol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The potentiation of fear learning by chronic opioid pretreatment was not observed when opioids were given after the traumatic event and lasted beyond discontinuation of drug exposure.

“These changes were not observed when opioids were given after the traumatic event, and potentiation lasted beyond discontinuation of drug exposure.”

• cites [185] Pennington, 2019, Chronic opioid pretreatment potentiates the sensitization of fear learning by trauma, Neuropsychopharmacol sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Individual differences in neural response to food cues under stress have been observed in human neuroimaging studies, lending support to differential susceptibility.

“To illustrate further, individual differences in neural response to food cues under stress have been observed in human neuroimaging studies [167], lending support to differential susceptibility.”

• cites [167] Wonderlich, 2018, The impact of neural responses to food cues following stress on trajectories of negative and positive affect and binge eating in daily life, J. Psychiatr. Res. sourceNot checked yet

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May combine two claims.

The most direct physiological pathway is dominated by cortisol, which stimulates fat storage and changes dietary behavior through increased reward sensitivity and increased appetite.

“The most direct physiological pathway is dominated by cortisol, which stimulates fat storage and changes dietary behavior through increased reward sensitivity (DA and opioid systems) and increased appetite (arcuate nucleus in the hypothalamus) [165].”

• cites [165] Michels, N. (2019). Biological underpinnings from psychosocial stress towards appetite and obesity during youth: Research implications towards metagenomics, epigenomics and metabolomics. Nutr. Res. Rev., 282–293. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Variability in stress-related genes may contribute to the ability of certain individuals to remain abstinent from heroin, possibly due to higher stress resilience.

“It has also been suggested that variability in stress-related genes may contribute to the ability of certain individuals to remain abstinent from heroin, possibly due to higher stress resilience [180].”

• cites [180] Levran, 2018, Genetic variations in genes of the stress response pathway are associated with prolonged abstinence from heroin, Pharmacogenomics sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Withdrawal can produce elevated levels of GCs and increase release of CRF in the central nucleus of the amygdala.

“Withdrawal can produce elevated levels of GCs and increase release of CRF in the central nucleus of the amygdala [175].”

• cites [175] Koob, 2019, Addiction and Stress: An Allostatic View, Neurosci. Biobehav. Rev. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Dieting is stressful, which may explain why engaging in dieting behaviors aimed at losing weight can actually have the opposite effect.

“Dieting is stressful, which may explain why engaging in dieting behaviors aimed at losing weight can actually have the opposite effect.”

May combine two claims.

Reduced MOR has been observed in comorbid binge eating disorder and obesity and across SUDs.

“Meanwhile, reduced MOR has been observed in comorbid binge eating disorder and obesity [191] and across SUDs [144] which strongly suggest neurochemical overlap in these conditions, and which can persist despite weight loss or periods of drug abstinence.”

• cites [191] Joutsa, 2018, Binge eating disorder and morbid obesity are associated with lowered mu-opioid receptor availability in the brain, Psychiatry Res. Neuroimaging sourceNot checked yet

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• cites [144] Belzeaux, 2018, Focusing on the Opioid System for Addiction Biomarker Discovery, Trends Mol. Med. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Extreme diets intended for health reasons which impair daily function have been described as orthorexia nervosa, which appears to be a growing problem.

“Extreme diets intended for health reasons which impair daily function have been described as “orthorexia nervosa” which appears to be growing problem [197].”

• cites [197] Dunn, 2016, On orthorexia nervosa: A review of the literature and proposed diagnostic criteria, Eat. Behav. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Restrained eating moderates the link between food environment and FA, as well as the link between FA and obesity.

“Based on available data linking FA and EDs (Section 1.2), it is proposed that restrained eating moderates the link between food environment and FA, as well as the link between FA and obesity (Figure 1).”

May combine two claims.

Individuals who are the target of weight stigma have been shown to decrease self-control and perceived capacity for weight management.

“Individuals who are the target of weight stigma have been shown to decrease self-control and perceived capacity for weight management [207].”

• cites [207] Major, B., Rathbone, J.A., Blodorn, A., and Hunger, J.M. (2020). The Countervailing Effects of Weight Stigma on Weight-Loss Motivation and Perceived Capacity for Weight Control. Personal. Soc. Psychol. Bull., 146167220903184. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

A dieting intervention on 121 females showed that monitoring increases perceived stress, while restricting increases cortisol output.

“A dieting intervention on 121 females which included monitoring and restricting showed that monitoring increases perceived stress, while restricting increases the cortisol output [198].”

• cites [198] Tomiyama, 2010, Low calorie dieting increases cortisol, Psychosom Med. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

Individuals engaging in dietary restraint are predicted to display higher levels of FA severity.

“In other words, individuals engaging in dietary restraint are predicted to display higher levels of FA severity.”

May combine two claims.

Reduced MOR across binge eating disorder, obesity, and SUDs strongly suggests neurochemical overlap in these conditions, and this can persist despite weight loss or periods of drug abstinence.

“Meanwhile, reduced MOR has been observed in comorbid binge eating disorder and obesity [191] and across SUDs [144] which strongly suggest neurochemical overlap in these conditions, and which can persist despite weight loss or periods of drug abstinence.”

• cites [191] Joutsa, 2018, Binge eating disorder and morbid obesity are associated with lowered mu-opioid receptor availability in the brain, Psychiatry Res. Neuroimaging sourceNot checked yet

  Not checked in the free run.

• cites [144] Belzeaux, 2018, Focusing on the Opioid System for Addiction Biomarker Discovery, Trends Mol. Med. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

Any change in stress neurobiology is likely to influence reward.

“Any change in stress neurobiology is likely to influence reward.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The timing of adversity explains more variability in DNA methylation than the accumulation or recency of exposure.

“It has been suggested that the timing of adversity explains more variability in DNA methylation than the accumulation or recency of exposure [216].”

• cites [216] Dunn, 2019, Sensitive periods for the effect of childhood adversity on DNA methylation: Results from a prospective, longitudinal study, Biol. Psychiatry sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

FA can increase internalized weight stigma among individuals.

“While the FA explanation for weight control has been shown to decrease weight stigma among groups [212,213] it has been suggested that FA can increase internalized weight stigma among individuals [214].”

• cites [214] Cassin, S.E., Buchman, D.Z., Leung, S.E., Kantarovich, K., Hawa, A., Carter, A., and Sockalingam, S. (2019). Ethical, Stigma, and Policy Implications of Food Addiction: A Scoping Review. Nutrients, 11. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The experience of stigmatization increases cortisol, which may drive food consumption by sensitizing the reward system.

“Similar to dieting, the experience of stigmatization increases cortisol, which may drive food consumption by sensitizing the reward system [203].”

• cites [203] Tomiyama, 2014, Weight stigma is stressful. A review of evidence for the Cyclic Obesity/Weight-Based Stigma model, Appetite sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

Altered neurochemistry from SUD and/or ELA/STA will impact the degree of success with dietary restraint.

“It is likely that altered neurochemistry from SUD and/or ELA/STA will impact the degree of success with dietary restraint.”

May combine two claims.

A recent fMRI study showed that successful restrained eaters had stronger activation in the middle frontal gyrus and cerebellum, suggesting that food temptations may trigger processes of positive inhibition in some, but not others.

“A recent fMRI study showed that “successful” restrained eaters had stronger activation in the middle frontal gyrus and cerebellum (associated with executive function and inhibition) suggesting that food temptations may trigger processes of positive inhibition in some, but not others [200].”

• cites [200] Su, 2019, Why Do Most Restrained Eaters Fail in Losing Weight?: Evidence from an fMRI Study, Psychol. Res. Behav Manag. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

In a large national sample (n = 5129), weight discrimination was associated with overeating, specifically convenience foods, and less regular meal timing.

“In a large national sample (n = 5129), weight discrimination was associated with overeating (specifically convenience foods) and less regular meal timing [206].”

• cites [206] Sutin, 2016, Weight discrimination and unhealthy eating-related behaviors, Appetite sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Theories of weight loss based on low-calorie dieting are failing, likely due to neurochemical, endocrine, and gastrointestinal factors not adequately captured by simple models of energy balance.

“More recently it has become clear that theories of weight loss based on low-calorie dieting are failing, likely due to neurochemical, endocrine, and gastrointestinal factors which are not adequately captured by simple models of energy balance.”

Probably not a substantial claim: may not pass S3 (load-bearing).

A stress-induced increase in KOR function may promote drug seeking by reducing DA transmission.

“According to some authors, it is possible that a stress-induced increase in KOR function promotes drug seeking by reducing DA transmission [190].”

• cites [190] Karkhanis, 2017, International Review of Neurobiology, Int. Rev. Neurobiol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

ELA can alter the physiological response to various forms of psychosocial STA across multiple body systems, which can have a cumulative impact on health behaviors over the lifespan.

“Importantly, ELA can alter the physiological response to various forms of psychosocial STA across multiple body systems, which can have a cumulative impact on health behaviors over the lifespan.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

Obesity frameworks should incorporate weight stigma as an important cause and consequence of the epidemic, suggested herein as a form of STA that can also become biologically embedded.

“Furthermore, obesity frameworks should incorporate weight stigma as an important cause and consequence of the epidemic, suggested herein as a form of STA that can also become biological embedded.”

May combine two claims.

Cross-sectional data (NHANES 2005-2014) has shown that higher consumption of ultra-processed foods is associated with excess weight and is more pronounced in females.

“Cross-sectional data (NHANES 2005–2014) has shown that higher consumption of ultra-processed foods is associated with excess weight and is more pronounced in females [229].”

• cites [229] Juul, 2018, Ultra-processed food consumption and excess weight among US adults, Br. J. Nutr. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

FA research which began in animal models has since been described in human neuroimaging studies which capture neurobiological and behavioral overlap between FA and SUDs.

“FA research which began in animal models has since been described in human neuroimaging studies which capture neurobiological and behavioral overlap between FA and SUDs.”

May combine two claims.

If reward-related neuroadaptations associated with addiction persist over time, addressing only the underlying factors may fail to create lasting changes in eating behavior, suggesting that policies targeting the food environment will also be important.

“Meanwhile, if reward-related neuroadaptations associated with addiction persist over time, addressing only the underlying factors may fail to create lasting changes in eating behavior, suggesting that policies targeting the food environment will also be important.”

Classified as probably not a substantial claim.

The role of dietary restraint has been included as an important psychological factor that should be accounted for when conceptualizing FA and obesity.

“Finally, the role of dietary restraint has been included as an important psychological factor that should be accounted for when conceptualizing FA and obesity, particularly given the strong relationship between ELA and EDs, as recently reviewed elsewhere [46].”

• cites [46] Wiss, D., and Brewerton, T. (2020). Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint. Nutrients, 12. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

People gained weight on the ultra-processed diet and lost weight on the unprocessed diet in the recent trial.

“Not surprisingly, people gained weight on the ultra-processed diet and lost weight on the unprocessed.”

• cites [228] Hall, 2019, Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake, Cell Metab. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Sugar, salt, and fat added to foods make them more palatable and reinforce drug-like behavior with loss of control, continued use despite consequences, binge episodes, and other similarities with traditional drugs of abuse.

“Sugar, salt, and fat added to foods make them more palatable and reinforce “drug-like” behavior with loss of control, continued use despite consequences, binge episodes, and other similarities with traditional drugs of abuse.”

Probably not a substantial claim: may not pass S2 (checkable).

Body weight is not simply a choice, as implied by food addiction data.

“decrease weight stigma based on FA data implying that body weight is not simply a “choice””

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Mediating mechanisms such as allostatic load, the HPA axis, DNA methylation, and altered reward sensitivity (i.e., dopamine systems) have scientific merit.

“Mediating mechanisms such as AL, the HPA axis, DNA methylation, and altered reward sensitivity (i.e., dopamine systems) have scientific merit”

May combine two claims.

Identifying certain foods as addictive may encourage collective efforts to avoid them and is associated with support for policies to curb their use.

“Identifying certain foods to be addictive may encourage collective efforts to avoid them [231] and is associated with support for policies to curb their use [232] similar to how public health officials addressed Big Tobacco.”

• cites [231] Ruddock, 2017, Food Addiction Beliefs Amongst the Lay Public: What Are the Consequences for Eating Behaviour?, Curr. Addict. Rep. sourceNot checked yet

  Not checked in the free run.

• cites [232] Moran, 2016, Believing that certain foods are addictive is associated with support for obesity-related public policies, Prev. Med. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

A study from Spain showed that four or more servings per day of ultra-processed foods is associated with a 62% increased hazard for all-cause mortality, where each additional serving increased all-cause mortality by 18%.

“A study from Spain showed that four or more servings per day of ultra-processed foods is associated with a 62% increased hazard for all-cause mortality, where each additional serving increased all-cause mortality by 18% [230].”

• cites [230] 2019, Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study, BMJNot checked yet

  Not checked in the free run.

May combine two claims.

Greater awareness of the biological mechanisms discussed is likely to reduce weight stigma, which is a known barrier for individual help-seeking behaviors in those with obesity as well as SUDs.

“Greater awareness of the biological mechanisms discussed herein are likely to reduce weight stigma, which is a known barrier for individual help-seeking behaviors in those with obesity [224] as well as SUDs [225].”

• cites [224] Tomiyama, A.J., Carr, D., Granberg, E.M., Major, B., Robinson, E., Sutin, A.R., and Brewis, A. (2018). How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Med., 16. sourceNot checked yet

  Not checked in the free run.

• cites [225] Yang, 2017, Stigma and substance use disorders, Curr. Opin. Psychiatry sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

Reducing exposure to addiction-like eating can improve executive functioning.

“At a minimum, it is reasonable to predict that reducing exposure to addiction-like eating can improve executive functioning.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Improving the early childhood environment might impact obesity risk and therefore should be a public health priority.

“This paper has reviewed evidence to suggest that improving the early childhood environment might impact obesity risk and therefore should be a public health priority.”

May combine two claims.

Stress proliferates over the life course and across generations, widening health disparities between advantaged and disadvantaged groups.

“Stress proliferates over the life course and across generations, widening health disparities between advantaged and disadvantaged groups [242].”

• cites [242] Thoits, 2010, Stress and Health: Major Findings and Policy Implications, J. Health Soc. Behav sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The impact of low SES can become embedded into inflammatory processes, the HPA axis, and neural function/structure, all of which are epigenetically controlled.

“The impact of low SES can become embedded into inflammatory processes, the HPA axis, and neural function/structure, all of which are epigenetically controlled [135].”

• cites [135] Demetriou, 2015, Biological embedding of early-life exposures and disease risk in humans: A role for DNA methylation, Eur. J. Clin. Investig. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

SES indicators are upstream determinants of health while biological factors are more proximate determinants.

“SES indicators are upstream determinants of health while biological factors are more proximate determinants [221].”

• cites [221] Bortz, 2005, Biological basis of determinants of health, Am. J. Public Health sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S2 (checkable).

Biopsychosocial approaches that consider the cumulative interplay between social and biological factors are helpful when conceptualizing multiple systems driving substance-related disorders, whether it be alcohol, drugs, nicotine, or food.

“Biopsychosocial approaches that consider the cumulative interplay between social and biological factors are helpful when conceptualizing multiple systems driving substance-related disorders, whether it be alcohol, drugs, nicotine, or food [243].”

• cites [243] Wiss, 2019, A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health, Front. Public Health sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

Low SES and neighborhood disadvantage remain important drivers of early life adversity, particularly within the context of the obesity epidemic.

“Low SES and neighborhood disadvantage remain important drivers of ELA, particularly within the context of the obesity epidemic.”

Probably not a substantial claim: may not pass S4 (based).

Unregulated promotion of addictive foods by the food industry are major contributors of obesity, particularly in the face of disadvantage and distress.

“We propose that unregulated promotion of addictive foods by the food industry are major contributors of obesity, particularly in the face of disadvantage and distress.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

Food addiction treatment does not always require specific food abstinence but does warrant reduced exposure and harm reduction strategies.

“FA treatment does not always require specific “food abstinence” but it does warrant reduced exposure and harm reduction strategies.”

Probably not a substantial claim: may not pass S2 (checkable).

Cultural shifts around food norms will be necessary for personalized precision nutrition interventions to be successful.

“In order for these strategies to be successful, cultural shifts around food norms will be necessary.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Food addiction is both an individual and collective health problem.

“Furthermore, FA is both an individual and collective health problem”

Probably not a substantial claim: may not pass S2 (checkable).

The food addiction construct may help reduce stigma associated with addiction-like behaviors, including obesity.

“which may help reduce stigma associated with addiction-like behaviors, including obesity.”