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Compulsive Eating
Behavior and Food
Addiction
Emerging Pathological
Constructs
Edited by
Pietro Cottone
Boston University School of Medicine, Boston, MA, USA
Valentina Sabino
Boston University School of Medicine, Boston, MA, USA
Catherine F. Moore
Boston University School of Medicine, Boston, MA, USA
George F. Koob
National Institute on Alcohol Abuse and Alcoholism,
National Institutes of Health, Bethesda, MD, USA
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Copyright © 2019 Elsevier Inc. All rights reserved.
This book and the individual contributions contained in it are protected under copyright
by the Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and
experience broaden our understanding, changes in research methods, professional
practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described
herein. In using such information or methods they should be mindful of their own safety
and the safety of others, including parties for whom they have a professional
responsibility.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or
editors, assume any liability for any injury and/or damage to persons or property as a
matter of products liability, negligence or otherwise, or from any use or operation of any
methods, products, instructions, or ideas contained in the material herein.
Iris M. Balodis
Peter Boris Centre for Addictions Research, Department of Psychiatry and
Behavioural Neurosciences, McMaster University, St. Joseph’s Healthcare
Hamilton, Hamilton, ON, Canada
Revi Bonder
York University, Toronto, ON, Canada
Benjamin Boutrel
Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne
University Hospital, Switzerland; Division of Adolescent and Child Psychiatry,
Department of Psychiatry, Lausanne University Hospital, University of Lausanne,
Switzerland
Timothy D. Brewerton
Department of Psychiatry and Behavioral Sciences, Medical University of South
Carolina, Charleston, SC, United States
Jonathan E. Cheng
Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry,
Boston University School of Medicine, Boston, MA, United States
Pietro Cottone
Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry,
Boston University School of Medicine, Boston, MA, United States
Caroline Davis
York University, Toronto, ON, Canada
Fernando Fernández-Aranda
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona,
Spain; Ciber Fisiopatologı́a Obesidad y Nutrición (CIBERObn), Instituto de Salud
Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine,
University of Barcelona, Barcelona, Spain
Ashley N. Gearhardt
Department of Psychology, University of Michigan, Ann Arbor, MI, United States
Kirstie M. Herb
Eastern Michigan University, Department of Psychology, Ypsilanti, MI, United States
Susana Jiménez-Murcia
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona,
Spain; Ciber Fisiopatologı́a Obesidad y Nutrición (CIBERObn), Instituto de Salud
Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine,
University of Barcelona, Barcelona, Spain
xiii
xiv Contributors
Paul J. Kenny
Nash Family Department of Neuroscience, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
George F. Koob
National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health,
Bethesda, MD, United States; Neurobiology of Addiction Section, Intramural
Research Program, National Institute on Drug Abuse, Baltimore, MD, United
States
James MacKillop
Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s
Healthcare Hamilton, Hamilton, ON, United States
Gemma Mestre-Bach
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona,
Spain; Ciber Fisiopatologı́a Obesidad y Nutrición (CIBERObn), Instituto de Salud
Carlos III, Madrid, Spain
Adrian Meule
Department of Psychology, University of Salzburg, Salzburg, Austria
Catherine F. Moore
Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry,
Boston University School of Medicine, Boston, MA, United States; Graduate
Program for Neuroscience, Boston University School of Medicine, Boston, MA,
United States
Cara M. Murphy
Center for Alcohol and Addiction Studies, Brown University, Providence, RI,
United States
Katherine R. Naish
Peter Boris Centre for Addictions Research, Department of Psychiatry and
Behavioural Neurosciences, McMaster University, St. Joseph’s Healthcare
Hamilton, Hamilton, ON, Canada
Marc N. Potenza
Department of Psychiatry, Yale School of Medicine, New Haven, CT, United
States; Connecticut Council on Problem Gambling, Wethersfield, CT, United
States; Connecticut Mental Health Center, New Haven, CT, United States;
Department of Neuroscience and Child Study Center, Yale School of Medicine,
New Haven, CT, United States
Clara Rossetti
Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne
University Hospital, Switzerland; Division of Adolescent and Child Psychiatry,
Department of Psychiatry, Lausanne University Hospital, University of Lausanne,
Switzerland
Contributors xv
Valentina Sabino
Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry,
Boston University School of Medicine, Boston, MA, United States
Karen K. Saules
Eastern Michigan University, Department of Psychology, Ypsilanti, MI, United
States
Emma T. Schiestl
Department of Psychology, University of Michigan, Ann Arbor, MI, United States
Erica M. Schulte
Department of Psychology, University of Michigan, Ann Arbor, MI, United States
Eric Stice
Oregon Research Institute, Eugene, Oregon, United States
Sonja Yokum
Oregon Research Institute, Eugene, Oregon, United States
Eric P. Zorrilla
Department of Neuroscience, The Scripps Research Institute, La Jolla, CA,
United States
Preface
With the sharp increase in rates of obesity and eating disorders in Western countries,
a focus on the potential addicting properties of food has become a point of emphasis
for researchers attempting to explain behaviors and neurobiological processes that
may contribute to this growing epidemic. Drawing from analogous concepts in
the addiction literature, compulsive eating behavior has emerged as a transdiagnos-
tic construct, consisting of a pathological form of feeding that phenotypically, neuro-
biologically, and conceptually resembles compulsive-like behavior associated with
both substance/alcohol-use disorders and behavioral addictions.
Recently, the scientific community has begun to embrace and evaluate the
concept of addictive and compulsive eating behavior. A Web of Science search re-
veals a persistent, steady increase in compulsive eating research over time, coupled
with a recent explosion of “food addiction” studies following the creation and vali-
dation of new diagnostic tools in 2009 (Fig. 1). While the scientific discussion on
food addiction and compulsive eating behavior is in its nascent stage and the con-
cepts are still somewhat controversial, this research holds enormous potential for
improving treatment and prevention strategies for millions of people.
The book begins with “A History of Food Addiction” to place this concept and the
current state of research into a historical context. Furthermore, the term and diag-
nosis of “food addiction” is explained in great detail by the researchers key to its
development in “Food Addiction Prevalence, Development, and Validation of
FIGURE 1 Number of scientific publications on food addiction and compulsive eating in recent
decades.
Values were obtained by a Web of Science search for each 5-year span using the search
terms “food addiction” and “compulsive eating.”
xvii
xviii Preface
Diagnostic Tools.” Following this, we, the editors, wrote a chapter detailing on what
have been identified as the elements of compulsive eating behavior in “Dissecting
Compulsive Eating Behavior into Three Elements.” This chapter describes the ele-
ments of (1) habitual overeating, (2) overeating to relieve a negative emotional
state, and (3) overeating despite negative consequences and outlines their concep-
tion from the field of drug addiction after many behavioral and neurobiological over-
laps were observed. A more in-depth breakdown of each element follows in
Chapters 4e8. Chapter 4, “Habitual Overeating,” overviews the ways in which
eating behavior can become inflexible and rote in compulsive eating. “Reward
Deficits in Compulsive Eating” and “The Dark Side of Compulsive Eating and
Food Addiction” describe the dual processes that make up the element of overeating
to relieve a negative emotional state. In “Food Addiction and Self-Regulation,” the
inhibitory control processes that underlie overeating despite negative consequences
are discussed at length.
Other chapters serve to illustrate the overlaps among the elements of compulsive
eating behavior and between these elements and other biological mechanisms.
“Reward Processing in Food Addiction and Overeating” investigates the intersection
of striatal reward processes with prefronto-cortical control circuits. In “Interactions
of Hedonic and Homeostatic Systems in Compulsive Eating,” the elements of
compulsive eating are discussed in the context of highly relevant homeostatic
feeding mechanisms.
For updates into specific technical fields of research into compulsive eating
behavior, chapters on genetics (“Genetics and Epigenetics of Food Addiction”), neu-
roimaging (“Neuroimaging of Compulsive Disorders: Similarities of Food Addiction
with Drug Addiction”), and animal models (“Modeling and Testing Compulsive
Eating Behavior in Animals”) were included.
We have also included a chapter to address the highly relevant topic of “Sex and
Gender Differences in Compulsive Overeating.” This chapter not only does an excel-
lent and thorough job detailing the current evidence in this area but also highlights
an area of inquiry with much left to understand in terms of biological mechanistic
sex and gender differences in compulsive eating.
Furthermore, as the concept of food addiction and the consideration of forms of
pathological overeating as addictive behaviors have been fraught with debate, we
have a chapter devoted to “Addressing Controversies Surrounding Food Addiction.”
While we have a clear bias as editors of this book, this chapter serves to clarify some
of the most prominent arguments that continue to fuel discussion on this topic. We
hope to continue the discourse, while also using this book to highlight the undeni-
able breakthroughs in knowledge and mechanisms that have come about from the
food addiction concept.
In the final chapter, “Food Addiction and Its Associations to Trauma, Severity of
Illness, and Comorbidity,” the utility of, and implications for, studying food addic-
tion within the context of overall mental and physical health is discussed.
Each chapter stands on its own, and together all the chapters form a comprehen-
sive picture of what drives compulsive eating behavior, how the prevalence
Preface xix
compulsive eating, and how future therapeutic strategies may look. We have
intended that this book be a bridge between preclinical and clinical researchers
and drives further excitement in this rich and continually developing field.
Some common definitions of terms used throughout the book:
1. Binge eating: Eating within a 2-hour period of time an amount of food larger
than what most people would eat in a similar period of time under similar
circumstances and a sense of lack of control over eating during the episode.
2. Binge eating disorder: Recurrent (i.e., >1x weekly for 3 months, on average)
binge eating as defined above, coupled with marked distress regarding binge
eating and three or more cognitive symptoms (e.g., eating alone out of
embarrassment, feeling disgusted/guilty). Importantly, no compensatory be-
haviors (e.g., purging) are associated with binge eating.
3. Compulsivity: Repetitive behaviors in the face of adverse consequences as well
as repetitive behaviors that are inappropriate to a particular situation.
Compulsivity has historical roots in the symptoms related to obsessive
compulsive disorder, impulse control disorders, and substance-use disorders
and may involve engagement in compulsive behaviors to prevent or relieve
distress, anxiety, or stress.
4. Compulsive eating: Broadly defined as an irresistible, uncontrollable urge to
overeat despite efforts to control this behavior. Compulsive eating behavior
manifests as one or more of its constituent elements: habitual overeating,
overeating to alleviate a negative emotional state, or overeating despite
negative consequences.
5. Food addiction: Eating-related problems assessed by a recently created psy-
chometric measurement tool: the Yale Food Addiction Scale (YFAS). This
scale was originally modified in 2009 from the substance-dependence criteria
described by the Diagnostic and Statistical Manual (DSM, fourth ed.) and
subsequently updated to reflect changes to the substance-use disorder diag-
nosis in the DSM-5. A diagnosis of food addiction is given when a patient
displays clinically significant impairment or distress and meets criteria, such as
eating much more than intended and experiencing problems in ability to
function because of food. In the updated YFAS, a severity score is calculated
based on number of symptoms endorsed (2e3 ¼ mild, 4e5 ¼ moderate,
6þ ¼ severe). Importantly, this emerging but not fully established condition is
different from the already well-recognized feeding-related pathologies, and
further validation is necessary.
6. Overeating: Consuming an excessive amount of food relative to energy
expended.
7. Overweight/obesity: A body mass index 25 and 30 is considered overweight
and obese, respectively, as defined by guidelines set forth by the World Health
Organization. Overweight/obesity is neither necessary nor sufficient to char-
acterize compulsive eating.
xx Preface
A history of “food
addiction”
1
Adrian Meule
Department of Psychology, University of Salzburg, Salzburg, Austria
A chocolate inebriate has appeared. His addiction has been for three years, and his
general health is much impaired, principally the digestion. His only thought night and
day is how to get chocolate.
The Quarterly Journal of Inebriety, Volume 12, Issue 4, October 1890 (p. 392)
Introduction
Concepts of diseases and mental disorders are not set in stone. References to drink
madness can be found in ancient civilizations and terms such as drunkenness, intem-
perance, inebriety, dipsomania, or alcoholism were used in the 18th and 19th cen-
turies to describe substance-related addictive disorders (White, 2000). While the
fourth version of the Diagnostic and Statistical Manual of Mental Disorders
(DSM) distinguished between substance abuse and substance dependence
(American Psychiatric Association, 1994), this distinction has been repealed in its
fifth revision. The DSM-5 now lists several substance use disorders and, for the first
time, a nonesubstance-related addiction: gambling disorder (American Psychiatric
Association, 2013).
Similar dynamics can be found in the field of eating disorders. Anorexia nervosa
was the first eating disorder included in DSM-I in 1952 and appeared along pica and
rumination in DSM-II in 1968 (Dell’Osso et al., 2016). Bulimia nervosa was added
to the DSM-III in 1980. The DSM-IV yet again involved some slight changes in the
categorization of eating disorders and nowdin addition to changes made to the diag-
nostic criteria for anorexia and bulimia nervosadthe DSM-5 lists pica, rumination
disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nerv-
osa, binge eating disorder, and other specified eating disorders (e.g., night eating
syndrome).
In the light of high prevalence rates of obesity in the past decades, there is an
increased interest if certain foods may have an addiction potential and if obese
individualsdor at least a subgroup of themdcan be considered “food-addicted.”
In fact, it seems widely accepted that “food addiction” is a relatively new idea
that was conceived in the past 20 years to explain the rising obesity prevalence
(Davis, Edge, & Gold, 2014; Yau, Gottlieb, Krasna, & Potenza, 2014). Yet, is this
alleged “new disorder” really a new concept in an attempt to explain why nowadays
so many people are obese? This chapter will demonstrate that the concept of “food
addiction” actually has a long history and did not arise from the obesity pandemic.
Table 1.1 Some references and quotes demonstrating the long history of the
“food addiction” idea.
References Quote
Clouston “It is a fact that some foods are more stimulating to the brain cortex than
(1890) others, e.g., strong beef-tea than milk, flesh than bread. [.] If from
childhood upwards the possessor of such a brain has depended on
stimulating diet and drink for its restoration when exhausted, there is an
intense and irresistible craving set up for such food and drink stimulants
whenever there is fatigue. Such a brain has developed an affinity for
them, and for such alone. Milk and farinaceous diet often become
repugnant, and when taken do not satisfy the brain craving. Its owner
becomes physiologically a flesh-eater and an alcohol-drinker.” (p. 207)
Crothers “There is a special affinity for all nerve stimulants by those higher brain
(1890a) centers. Their use constantly interferes with the natural development of
brain energy from food. Thus, alcohol, tea, coffee, and other substances
have a peculiar delusive effect. [.] The diet should not include meats of
any kind, because of their stimulating character; while meats contain
much food force, they act as stimulants to a brain already over stimulated
and exhausted, and increase the peril of nervous disease. The
pathological tendency of all these cases is to become alcohol-takers and
meat-eaters, hence the diet should always be non-stimulating and
farinaceous, and should be carried out with military regularity.” (p. 285)
Crothers “A chocolate inebriate has appeared. His addiction has been for three
(1890b)a years, and his general health is much impaired, principally the digestion.
His only thought night and day is how to get chocolate.” (p. 392)
Wulff (1932)b “I have used the term “eating addiction” above without justifying why I
deem it important to call it an “addiction” and not, for example, a
compulsion. I believe that the nature of this compulsive eating can be
best characterized by the term addiction. How do addiction and
compulsion differ from each other except regarding the different
manners through which they are experienced? [.] Another
characteristic of a compulsion is the fact that its suppression produces
anxiety while suppression of a compulsive, addiction-related urge
increases the tension of the addictive desire (if withdrawal symptoms do
not complicate the picture)djust as it was observed in the cases
described here with regard to eating.” (p. 299)
Hamburger “A number of authors have described people who show extreme
(1951) preoccupation with food and weight, who episodically consume
enormous amounts of food, in short periods of time in an ‘orgiastic’
manner (episodes varying in frequency from more than once a day to
once every few weeks), and who experience guilt, shame, depression
and self-condemnation following ‘binges.’ The parallel with apparently
‘compulsive’ patterns of gambling or drinking is immediately striking.
Indeed it is this eating pattern that most readily invites the label
‘addictive’.” (p. 487)
Randolph “Food addictionda specific adaptation to one or more regularly
(1956) consumed foods to which a person is highly sensitivedproduces a
Continued
4 CHAPTER 1 A history of “food addiction”
Table 1.1 Some references and quotes demonstrating the long history of the “food
addiction” idea.dcont’d
References Quote
common pattern of symptoms descriptively similar to those of other
addictive processes.” (p. 221)
Hinkle et al. “One of the most common and difficult problems we face is that of food
(1959) addiction, both in the genesis of diabetes and in its treatment. Are there
physiological factors involved in this mechanism or is it all psychological?
What is its relation to alcohol addiction and addiction to narcotics? [.]
That is a good question, because these terms “food addiction” and
“compulsive eating” are widely used and widely misunderstood.” (p. 377)
Bell (1960) “Social custom and occupational contact, as well as medical treatment
and physiological need, can be responsible for the introduction of a
person to the chemicals involved in addiction. Food addiction is the only
one in which the chemicals and the person come together initially out of
physiological necessity.” (p. 1348)
Bell (1965) “It is important for the physician to explain that an uncontrollable need for
a drug or for alcohol is not planned; that initially these agents were used
to produce temporary improvement in wellbeing; and that addiction is a
very common type of human disability. It is helpful to compare tobacco
and food addiction to alcohol and drug addiction, and to remove as
much of the guilt and shame as possible at the first interview. The
physician has a good chance of initiating motivation if at the end of the
first interview the patient feels that he does not need to down-grade
himself in order to accept his illness.” (p. 230)
a
This quote is from an editorial for which authorship was not specified and, thus, the editor (T.D.
Crothers) is indicated as author here.
b
This article is in German and the quotes have been translated by the author of this chapter. An English
translation of some excerpts of this article can be found in Stunkard (1990).
Schulte, Avena, & Gearhardt, 2015), however, he noted that “most often involved are
corn, wheat, coffee, milk, eggs, potatoes, and other frequently eaten foods” (Ran-
dolph, 1956, p. 221). Although “food addiction” did not appear in other scientific
articles around this time, famous psychiatrist Albert J. Stunkard (1922e2014) noted
during a panel discussion in 1959 that the term “food addiction” was widely used
back then (Table 1.1; Hinkle, Knowles, Fischer, & Stunkard, 1959).
FIGURE 1.1
Excerpt from the title page of an article by Mosche Wulff. It reads “International Journal of
Psychoanalysis; Edited by Sigmund Freud; Volume 18; 1932; Issue 3; On an interesting
oral symptom complex and its relationship to addiction; Lecture at the German
Psychoanalytical Society, April 12th, 1932; By Mosche Wulff; Berlin.”
was only occasionally mentioned in scientific articles in the 1960s and 1970s, pri-
marily in the context of obesity (Table 1.1; Bell, 1960, 1965; Clemis, Shambaugh,
& Derlacki, 1966; Swanson & Dinello, 1970; Thorner, 1970).
Notably, however, some cases of bulimia nervosa or binge/purge-subtype
anorexia nervosa were described as an addiction in these decades as well (Vander-
eycken, 1994). For example, Ziolko (1966) presents a case of “hyperorexia,” which
he denotesdsimilar to Wulff (1932)das “eating addiction” (i.e., Esssucht in
German). In a report about an expert group discussion about overeating and vomit-
ing, Garrow (1976) notes that “one group of subjects with chronic anorexia nervosa
exemplify many aspects of addiction; they habitually/constantly ingest and vomit
food in large quantities” (p. 407).
In the 1980s, the excessive food restriction displayed by individuals with
anorexia nervosa was mentioned for the first time in the context of addiction (Scott,
1983). Similarly, Szmukler and Tantam (1984) described anorexia nervosa as an
addictiondwhat they called starvation dependence. For example, they note that
“patients with anorexia nervosa are dependent on the psychological and possibly
physiological effects of starvation. Increased weight loss results from tolerance to
starvation necessitating greater restriction of food to obtain the desired effect, and
the later development of unpleasant ‘withdrawal’ symptoms on eating.” (p. 309).
Finally, Marrazzi et al. (Marrazzi et al., 1990; Marrazzi & Luby, 1986) compared
anorexic phenomenology with addictive states in their auto-addiction opioid model
of chronic anorexia nervosa.
6 CHAPTER 1 A history of “food addiction”
Another approach stemming from an addiction perspective on eating was the ex-
amination of addictive personality in individuals with anorexia nervosa, bulimia
nervosa, or obesity (Davis & Claridge, 1998; Feldman & Eysenck, 1986; Kayloe,
1993; Leon, Eckert, Teed, & Buchwald, 1979). Several studies compared whether
individuals with anorexia nervosa, bulimia nervosa, or obesity scored higher than
healthy controls and similar to individuals with tobacco use, alcohol use, or
gambling disorder on certain addiction personality questionnaires (de Silva &
Eysenck, 1987; Hatsukami, Owen, Pyle, & Mitchell, 1982; Kagan & Albertson,
1986; Leon, Kolotkin, & Korgeski, 1979).
In the 1990s, a particular interest emerged on addiction-like consumption of choc-
olate. Characteristics of chocolate such as its macronutrient composition, sensory
properties, and ingredients such as caffeine and theobromine were discussed as con-
tributors to its addictive-like nature (Bruinsma & Taren, 1999; Patterson, 1993; Rozin,
Levine, & Stoess, 1991). Some studies investigated self-identified “chocolate addicts”
(Hetherington & Macdiarmid, 1993; Macdiarmid & Hetherington, 1995; Tuomisto
et al., 1999) or examined associations between “chocolate addiction” and other addic-
tive behaviors (Greenberg, Lewis, & Dodd, 1999; Rozin & Stoess, 1993).
Besides these themes, a variety of different topics were covered in one or few
single articles in the 1980s and 1990s. These include discussions of the role of en-
dorphins in terms of an addictive response in obesity (Gold & Sternbach, 1984;
Wise, 1981), substance abuse as a metaphor in the treatment of bulimia nervosa
(Slive & Young, 1986), a “foodaholics” group treatment program (Stoltz, 1984),
and some unusual case studies of addiction-like carrot consumption (Kaplan,
1996; Cerný;
Cerný, 1992). Finally, the first critical reviews were published, which
scrutinized adopting an addiction framework in the treatment of eating disorders
(Bemis, 1985) and questioned the overall “food addiction” approach based on con-
ceptual and physiological considerations (Rogers & Smit, 2000; Vandereycken,
1990; Wilson, 1991, 2000).
eating (Meule, 2011). For example, Cassin and von Ranson (2007) replaced refer-
ences to substance by binge eating in the substance dependence module of the struc-
tured clinical interview for DSM-IV axis I disorders to “diagnose” addiction-like
eating in individuals with binge eating disorder. Relatedly, Gearhardt, Corbin, and
Brownell (2009b) developed the Yale Food Addiction Scale by adapting DSM-IV
substance dependence criteria to food and eating. Scoring of this self-report ques-
tionnaire allows for a dichotomous classification of the presence or absence of
“food addiction.” It may be because of this uniqueness that the scale turned out to
be widely used in the years that followed (Meule & Gearhardt, 2014).
Current developments
In 2013, gambling disorder was the first behavioral addiction that was added as an
addictive disorder in addition to substance use disorders in DSM-5. Reflecting this
nosological change, researchers have proposed that framing addiction-like eating as
a behavioral addiction may be more appropriate than framing it as a substance-
related disorder (Hebebrand et al., 2014). This approach has intuitive appeal and,
at first glance, seems to resolve some controversies that are inherent in the
substance-based “food addiction” approach. Yet, the “eating addiction” approach
may create more problems than it solves. For example, efforts have been made to
develop self-report measures for capturing “eating addiction” (Ruddock, Christian-
sen, Halford, & Hardman, 2017). Yet, “eating addiction” may be in fact even harder
to distinguish than “food addiction” from existing concepts such as binge eatinge
related disorders (Schulte, Potenza, & Gearhardt, 2018; Vainik & Meule, 2018).
The current state of affairs can be broken down into three different views:
(1) certain foods are regarded as addictive substance(s), and, thus, so-called “food
addiction” represents a substance-related addictive disorder (Ifland et al., 2015;
Schulte, Potenza, & Gearhardt, 2017),
(2) it is not possible to identify a specific substance in foods that is addictive
(similar to nicotine in tobacco, ethanol in alcoholic beverages, tetrahydro-
cannabinol in cannabis, etc.), and, thus, so-called “eating addiction” represents
a behavioral addictive disorder (Hebebrand et al., 2014; Ruddock et al., 2017),
(3) neither “food addiction” nor “eating addiction” represent valid concepts ord
even if they aredthey are not necessary (Finlayson, 2017; Rogers, 2017;
Ziauddeen & Fletcher, 2013).
While most writings on this topic clearly take up one of these three positions, it
has also been argued that the addiction perspective on eating requires a more
nuanced view (Fletcher & Kenny, 2018). For example, Lacroix, Tavares, and von
Ranson (2018) emphasize that alternative conceptualizations of addictive-like eating
may be overlooked when the discussion is framed as a dichotomous debate between
food and eating addiction models. Such alternative views include, for example,
8 CHAPTER 1 A history of “food addiction”
Conclusions
“Food addiction” is not a new idea that emerged in the 21st century because of the
obesity pandemic. Instead, researchers have discussed for many decades whether
humans can be addicted to certain foods and whether certain eating behaviors repre-
sent an addictive behavior. The history of “food addiction” research involves different
perspectives, which range from mentioning food in the context of addiction in the late
19th century, describing binge eating as “eating addiction” in the 1930s, establishing
the term “food addiction” in the 1950s, acknowledging the addiction-like character of
binge eating in individuals with bulimia and binge/purge-subtype anorexia nervosa in
the 1960 and 1970s to characterizing the self-starvation of individuals with anorexia
nervosa as an addiction in the 1980s, and many more. Thus, research on “food addic-
tion” encompasses a long history with dynamically changing but recurring themes.
These include the types of food involved (e.g., chocolate and other foods), discussions
about the appropriateness of a “food addiction” versus “eating addiction” rationale,
and which type of individuals are involved (e.g., individuals with anorexia nervosa,
bulimia nervosa, binge eating disorder, and/or obesity).
In spite of its long history, the “food addiction” versus “eating addiction” versus
“not-an-addiction” discussion has developed to a lively debate in recent years. To
move the field forward, researchers need to generatedand agree upondtestable
predictions, which may include neural mechanisms (Fletcher & Kenny, 2018) or
whether the construct of addictive-like eating holds incremental clinical utility
over and above existing eating disorder diagnoses (Lacroix et al., 2018). Further-
more, providing an addiction framework in the prevention and treatment of eating
disorders and obesity will likely be helpful in some instances but may be unneces-
sary or even counterproductive in others (Meule, 2019). Therefore, future studies
need to systematically examine under which circumstances and for whom an addic-
tion perspective on eating is beneficial for normalizing food intake and reduce
eating-related distress.
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Another random document with
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calzarse o descalzarse el pie derecho, para significar firmeza o rompimiento
de los lazos matrimoniales, entre los gentiles recogió varios datos Tamayo,
notas, fol. 62-65.
[174] «Comprehende aquí Garcilaso las costumbres de las bodas antiguas
(paganas). Dice que alternaban el canto las que ponían a la novia en el
lecho... Las que llama aquí vírgines eran las pronubas antiguas, aunque no
vírgines, pero castas, que tenían este oficio a su cargo...» (Tamayo, notas, fol.
65.)
[175]
«Esta señora era hija del Conde de Alba de Liste, y prima y mujer del
Duque.» (Herrera, 603.)
[176] Al divino Herrera, pág. 603, le escandalizó este atrevimiento de
Garcilaso «que muy ajeno es de su modestia y pureza, y que deslustró
mucho la limpieza y honestidad de toda esta descrición.» Pero no se trata de
cosa indigna, impura ni inmodesta, sino de la casta y legítima
correspondencia del lecho conyugal, y aun solamente del deseo de D.
Fernando, no del suceso. Homero, Virgilio, y el mismo Petrarca, llegaron en
sus versos a mayores libertades. (V. Tamayo, notas 61-62.)
[177] «Toca aquí la ficción del filósofo Pródico, la cual refiere Xenofon. Y es,
que Hércules siendo mancebo, yendo por un camino llegó adonde se partían
dos caminos, y estando dudoso por cuál iría, vio venir por cada uno una
doncella, una muy hermosa, y otra robusta y varonil; cada una le rogaba que
fuese por su camino, y la muy hermosa, al parecer exterior, que era Voluptas,
el deleite, prometía en su camino muchos regalos y descansos; la otra, que
era Virtud, le prometía mal camino y muchos trabajos, pero prometía al cabo
dellos descanso y fama, al revés de la otra. Hércules dijo que más quería
trabajos con aquella condición; y fuese tras la Virtud.» (Brocense, nota 181.)
[178]A partir de este verso cuenta Garcilaso el viaje que el Duque hizo a
Alemania para intervenir en el socorro de Viena, amenazada por Solimán,
gran Sultán de Turquía. Garcilaso acompañaba al Duque en dicho viaje: año
de 1532. (Navarrete, págs. 32 y 33.)
[179] «mudable: atributo propio de los franceses.» (Herrera, pág. 605.)
[180] «Pasadas las asperezas del Pirineo recibió orden el Duque de caminar
con más rapidez, dejó su escolta y comitiva, y solo con Garcilaso, atravesó
por la posta de Francia hasta París, donde cayó enfermo, acaso de las fatigas
del viaje; su amigo le asistió esmeradamente, hasta que ya convalecido
pudieron ambos continuar adelante...» (Navarrete, pág. 40.)
[181] «Parece que es alusión a la Morbania, deidad falsa y ridícula de los
antiguos.» (Tamayo, notas, fol. 66.)
[182]«Esculapio fue gran médico, tenido por los antiguos por dios de la
medicina. Fue hijo de Apolo y padre de Padalirio y Macaón, grandes
médicos.» (Brocense, nota 182.) «Halló muchas cosas útiles a la salud de los
hombres. Fue tan excelente en la curación de los enfermos, que fuera de la
opinión de todos, dicen que restituyó a muchos desesperados a la vida y que
volvió a ella a muchos muertos. Acusado por esto ante Júpiter, lo mató con un
rayo... Enojado Apolo desta muerte, mató a los Cíclopes que fabricaron el
rayo a Júpiter.» (Herrera, pág. 606.)
[183] Repuesto D. Fernando de su enfermedad, Garcilaso y él continuaron su
viaje; llegaron al Rin, y embarcados en sus aguas, pasaron a Colonia.
[184]«Dícelo por Julio César, que pasó del Rheno (Rin) contra alemanes.»
(Brocense, nota 183.)
[185] «Fue Santa Úrsula hija de Dioneto, nobilísimo príncipe de Inglaterra;
padeció martirio con once mil vírgenes de la mesma nación en Colonia
Agripina, a la ribera del Rin, por los capitanes de Atila que la tenían cercada,
en el año de nuestra salud, 352, siendo emperador Marciano.» (Herrera, pág.
607.)
[186] Aquel tirano fue, según se cree, Giula, capitán general de Atila. (Azara.)
[187] estaba en dubio, en duda; dubio es voz latina.
[188] Emplea metafóricamente suelta la rienda a su navío, como ahora
decimos dar rienda suelta al llanto, al entusiasmo, a los deseos; de otro modo
«parecería dura esta translación del uso de los caballos al de la navegación;
pero es elegantísima, y como tal usada de los antiguos griegos y latinos de
mejor fama...» (Tamayo, notas, fol. 66.)
[189] El César Carlos V recibió en sus brazos al Duque de Alba en Ratisbona,
donde se hallaba convocada la Dieta entendiendo en el conflicto político-
religioso promovido por el protestantismo. (Navarrete, 32.) Era también
aquella ciudad punto de reunión para los caballeros que acudían al socorro
de Viena.
[190] «El Príncipe turco, Solimán, que dos años antes había sojuzgado la
Hungría y puesto, aunque infructuosamente, cerco sobre Viena, salió
segunda vez de Constantinopla con innumerables gentes, para repetir el
asedio de aquella ciudad.» (Navarrete, pág. 32.)
[191] Eran gentes de diversos pueblos y opiniones, pero con un solo
propósito e intención. Los nuestros ocupaban mucho menos terreno que los
enemigos... Este pasaje ha tenido mala interpretación en la edición de Castro.
[192] Sobrar: exceder, sobrepujar. V. Eg. I, v. 28, nota.
[193] Sobrado: el que excede a otro. V. Eg. I, v. 28, nota.
[194] En el ejército del César había alemanes, flamencos, italianos y
españoles: «El Emperador al ver la gran tempestad que sobrevenía pidió
auxilio a la Dieta, escribió al Marqués del Vasto para que recogiese toda la
infantería española que acababa de poner fin a la guerra de Florencia, y
juntase más italiana, avisó a los hombres de armas ordinarios de Flandes y
Borgoña, y pidió a los grandes y ciudades de España apercibiesen hombres
de armas y todo recaudo, preparándose a sostener solo este glorioso
empeño, en que ni el Rey de Francia ni el de Inglaterra quisieron ayudarle.»
(Navarrete, pág. 32-33.)
[195] Tirar, quitar, apartar.
[196]Su gente, no se refiere al guerrero, sino al cauto italiano, que en el valor
del Duque recordaba el de los famosos capitanes de la antigua Roma.
[197] Habla en estos versos de Cornelio Escipión el primer Africano, única
esperanza de la República, vencedor del terrible y duro Aníbal, y demoledor
de la fiera Cartago.
[198] así molesta, acaso deba interpretarse tan molesta, del mismo modo que
en frases como «no puedo dudar de un hombre tan honrado; tan cordiales
relaciones quedaron rotas»... En el castellano antiguo, tan y así tenían un
valor equivalente en comparaciones. (V. R. Menéndez y Pidal, El Cantar de
mío Cid, tomo I, parte II, § 180.) Compárense en esta misma égloga, versos
1671, 1735 y 1769. El Brocense interpretó de otro modo «dividiendo aquella
palabra, assí, en dos, a sí, que es en latín sibi», y la mayor parte de las
ediciones han seguido esta enmienda del Brocense.
[199] Se entiende mejor leyendo el pensamiento ambigo, como propone
Tamayo, fol. 67; el estado cristiano estaba en dubio, v. 1493; el suceso de
esta guerra era dudoso, v. 1578; su remedio, por consiguiente, ambiguo. Las
tropas del César apenas eran, en efecto, la mitad de las que llevaba el sultán.
(Navarrete, pág. 43.) La forma ambigo corresponde a ambiguo, como inicas a
inicuas, verso 1223, y como antigo a antiguo.
[200] «Salió, el Emperador, de Ratisbona con la caballería flamenca y un
lucido tren de artillería, pasando por el Danubio a Linz, seguido de numerosa
comitiva en barcas construidas al efecto, con el nombre de nasadas, cuya
dilatada hilera formaba una escuadra de sorprendente vista.» (Navarrete,
pág. 42.)
[201] Gran tirano: entiéndase por el Sultán de Turquía, Solimán el Magnífico,
contra quien fue toda esta expedición.
[202] «Los Cíclopes fueron unos salvajes en Sicilia, que no tenían más de un
ojo en la frente, y eso quiere decir en griego Ciclops. Dicen los poetas que
son los herreros de Vulcano, al cual llaman aquí el gran maestro.» (Brocense,
nota 191.)
[203] Nuestro lenguaje antiguo empleaba las formas esora, la hora, a esas
horas, etc., con el valor castellano actual entonces, como el francés alors y el
italiano allora; esta interpretación conviene en este caso a aquellas horas, en
vez de suponer como Tamayo, notas, fol. 68, el latinismo ora por ribera, cuyo
uso, si ha existido, debió ser rarísimo en castellano: comp. a la hora, Canc.
IV, v. 49, nota.
[204] Noticioso el Sultán de los preparativos con que acudía el Emperador,
retirose de Viena a Gratz, sin aventurarse a darle la batalla, y después
retrocedió definitivamente a Constantinopla. (Navarrete, págs. 42 y 43.)
[205]«Don Fernando estuvo en la persecución de algunos de los capitanes
enemigos, y anhelando teñir su espada en sangre turca, sintió que la suerte
no preparase a los imperiales más difíciles triunfos.» (Navarrete, pág. 43.)
Cree este autor que Garcilaso no debió tomar parte en estos sucesos por
haber sido desterrado por el Emperador desde el principio de la jornada,
cuando el Duque y el poeta llegaron a Ratisbona. (V. nota a la Canc. III, v. 3.)
[206] Cuentan que los antiguos coronaban con ramos sus naves después de
una victoria, y que tales ramos solían poner en el sagrario o capilla de popa; a
esta costumbre pudo aludir Garcilaso, aun cuando lo que dice puede también
decirse metafóricamente por las naves que volvían vencedoras.
[207] Ha dicho el Sr. Menéndez y Pelayo, Antología, XIII, pág. 54, que el
pastor Albanio, enfermo de mal de amores por la hermosa Camila, debe de
ser el Duque de Alba, D. Fernando; a esto quiero decir que no acierto a
comprender cómo a Garcilaso pudo ocurrírsele introducir dos veces al Duque
en esta Égloga con tan distinto carácter, a saber: como Duque en persona y
como pastor; como esposo enamorado, correspondido y satisfecho, y, a la
vez, como amante desesperado y loco furioso; téngase presente que
mientras Nemoroso ha estado elogiando al Duque por su prudencia y su
valor, ha tenido a sus pies al mismo Albanio, aletargado y rendido en su
locura.
[208] Es necesario leer glo-ri-o-so, como o-di-o-sas, soneto XVI, v. 1;
nuestros poetas clásicos medían a la manera latina e italiana, la-bi-os, o-di-o,
glo-ri-a, y del mismo modo los derivados fu-ri-o-so, in-ge-ni-o-so, etc. (V. Elías
Zerolo, Noticias de Cariasco y del empleo del verso esdrújulo en el siglo XVI.
Legajo de Varios, París, 1897, y F. Rodríguez Marín, Luis Barahona de Soto,
págs. 405-411.)
[209] lustre por lustro, que fue primitivamente espacio de cuatro años, y que
«el uso y abuso de los gramáticos lo ha hecho de cinco». (Herrera, pág. 267.)
Cuando la expedición a Alemania (1532) el Duque D. Fernando solo tenía
veinticinco años, y Garcilaso veintinueve.
[210] coruscar, lucir, brillar. El Dicc. Aut. solo da coruscante y corusco,
«resplandeciente, sumamente lucido y brillante».
[211]
Describe pastoralmente el tiempo de la cena, de la cual es indicio el
humo que sale por los alcores, chimeneas.
[212] Garcilaso dedicó esta Égloga, según afirmación de D. Antonio
Puertocarrero, su yerno, a D.ª María de la Cueva, esposa de D. Juan Téllez
Girón, Conde de Osuna, fundador del Colegio Mayor y Universidad de dicha
villa, y gran amigo de los hombres de letras. D.ª María, ya viuda, fue
Camarera mayor de la Reina D.ª Isabel de Valois, tercera mujer de Felipe II, y
falleció en Madrid a 19 de abril de 1566. (V. F. Rodríguez Marín, Luis
Barahona de Soto, Madrid, 1903, pág. 73.)
[213] Garcilaso no ha dejado más octavas rimas que las que componen esta
Égloga y la que nos conservó Castillejo (V. Apéndice IV): «La octava rima,
enteramente desconocida en todas las literaturas de la Península antes de
Boscán, es una de las adquisiciones más importantes que este hizo para
nuestra métrica, y quizá el género en que sobresalió más. Su modelo
inmediato, aunque no único, fueron las estancias compuestas por Bembo
para el Carnaval de la corte de Urbino en 1507.» (M. Menéndez y Pelayo,
Antología, XIII, 237.)
[214] Entiende Tamayo, fol. 68, «que es demasía sin fruto decir que la lengua
está en la boca, pues ¿adónde había de estar?,» y sin más que esto, en
algunas ediciones se ha corregido el presente verso, imprimiendo: «Mas con
la lengua muerta y fría la boca», que es la lectura que el mismo Tamayo
proponía. Yo respeto tal demasía porque he visto que Herrera, más
escrupuloso que nadie en estas cuestiones, la conserva, y el elegante
prosista Cienfuegos, hablando precisamente de la muerte de Garcilaso por la
honda impresión que causó en el espíritu del Marqués de Lombay, la repite
diciendo: «él vio fría y difunta en su boca aquella espiritosa lengua, ramillete
de las más cultas flores de la erudición y de la elocuencia...» (Vida del
Grande San Francisco de Borja, Madrid, 1726, pág. 48.)
[215] «Carta por el papel, en significación latina o italiana.» (Azara.)
[216] «En Boscán se hallan en una estancia de una canción los versos que
dicen: