With the cost of American health care set to increase substantially, the search is on to start forcing people to curb preventable diseases, like those related to obesity.

But it may not be a choice, according to some psychologists. The same way that people can be addicted to drugs and alcohol, they can have an unhealthy relationship with food. 

More than one-third of U.S. adults are obese, according to the Centers for Disease Control and Prevention, putting them at greater risk for heart disease, stroke, type 2 diabetes and certain types of cancer. The estimated annual medical cost of obesity could have been as high as $147 billion in 2008 U.S. dollars, and obese people pay an average of $1,429 more in medical expenses than those of normal weight.

In a new paper, scholars said that people with impulsive personalities were more likely to report higher levels of food addiction, which the psychologists catalog as a compulsive pattern of eating that is similar to drug addiction, and this in turn was associated with obesity.  

"The notion of food addiction is a very new one, and one that has generated a lot of interest," said James MacKillop, associate professor of psychology at the University of Georgia. "My lab generally studies alcohol, nicotine and other forms of drug addiction, but we think it's possible to think about impulsivity, food addiction and obesity using some of the same techniques."

Their analysis used the Yale Food Addiction Scale and the UPPS-P Impulsive Behavior Scale, to determine levels of food addiction and impulsivity among the 233 participants. Researchers then compared these results with each participant's body mass index. They found that impulsive behavior was not necessarily associated with obesity, but impulsive behaviors can lead to food addiction.

That is, just because someone exhibits impulsive behavior does not mean they will become obese, but an increase in certain impulsive behaviors is linked to food addiction, which appeared to be the driving force behind higher BMI in study participants.

The contemporary food industry has created a wide array of eating options, including foods that are high in fat, sodium, sugar and other flavorful additives. The authors speculate that these might produce cravings much like illicit drugs.

"Modern neuroscience has helped us understand how substances like drugs and alcohol co-opt areas of the brain that evolved to release dopamine and create a sense of happiness or satisfaction,"
said. "And now we realize that certain types of food also hijack these brain circuits and lay the foundation for compulsive eating habits that are similar to drug addiction."

Published in Appetite.