Psychiatry determines whether a person is dependent on alcohol or another drug by asking patients seven basic questions. These questions are based on The Diagnostic and Statistical Manual of Mental Disorders (DSM), which is the standard reference used by psychiatrists around the world for diagnosing and categorizing mental and emotional problems. The DSM establishes criteria related to tolerance, withdrawal, difficulty controlling use, desire to cut down, and specific negative consequences. It defines a person substance-dependent if he or she answers YES to three or more of the seven questions. Here I have adapted these questions to focus specifically on food.

Think about your own experience with eating, and answer these questions as honestly as possible.

1. Tolerance: Has your use of food increased over time? 

2. Withdrawal: When you stop eating, have you ever experienced physical or emotional withdrawal? Have you experienced irritability, anxiety, shakes, or sweats?

3. Difficulty Controlling Your Use: Do you sometimes eat more, or for a longer time than you would like? Do you sometimes eat to numb your feelings? Does one episode of bingeing lead to more episodes?

4. Negative Consequences: Have you continued a pattern of disordered eating even though there have been negative consequences to your mood, self-esteem, health, job, or family?

5. Neglecting or Postponing Activities: Have you ever put off or reduced social, recreational, work, or household activities because of your eating patterns or your weight?

6. Spending Significant Time or Emotional Energy: Have you spent a significant amount of time obtaining, using, concealing, planning, or recovery from your eating patterns? Have you spent a lot of time thinking about eating? Have you ever concealed or minimized your eating habits? Have you ever thought of schemes to avoid getting caught?

7. Desire to Cut Down: Have you sometimes thought about cutting down or controlling your eating? Have you ever made unsuccessful attempts to change your eating patterns? 

When you are rigorously honest with yourself, you may find the answer YES rings true to many of these questions about your relationship with food.

Recognizing that you are controlled by an addictive process is the first step to breaking free of its stranglehold on your life. The wealth of information that is now available about breaking an addiction to alcohol and other drugs yields valuable insights for recovery from food addiction and eating disorders. Perhaps the most important is that food addiction is not your fault and that with the proper care and professional support, you can resume control over your choices and reclaim a healthy relationship with food.

Additional Articles on Food Addiction:

Davis, C. (2013). A narrative review of binge eating and addictive behaviors: shared associations with seasonality and personality factors. Frontiers in Psychiatry, 4(183), 1-9.

Gearhardt, A., Grilo, C., DiLeone, R., Brownell, K. & Potenza, M. (2011). Can food be addictive? Public health and policy implications. Addiction, 106(7), 1208-1212.

Meule, A. (2011). How prevalent is “food addiction”? Frontiers in Psychiatry, 2, 1-6.

Volkow, N. & O’Brien, C. (2007). Issues for DSM-5: Should obesity be included as a brain disorder? The American Journal of Psychiatry, 164(5), 708-710.

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