1. Understanding the Science of Food Addiction Nicole M. Avena, Ph.D. New York Obesity Research Center Columbia University

2. Disclosures Dr. Avena has received research funding from Gilead Sciences, Bioprojet, the National Institutes of Health, and National Eating Disorders Association; has consulted for groups, pharmaceutical and biotechnology companies and legal entities on issues related to diet and nutrition; has edited journals and journal sections; has given academic lectures in grand rounds, CME events and other clinical or scientific venues; and has generated books or book chapters for publishers health-related texts.

3. Learning Objectives Upon completion of this activity attendees should be able to: Have a thorough understanding of the current literature regarding and knowledge of food addiction. Discuss ways to manage food addiction via possible prevention and treatment approaches.

4. Outline of the presentation The problem of obesity A discussion of the many factors contributing to the obesity epidemic Background on food-reward and select associated brain systems Defining an addiction and contrasting it with “normal” rewarding experiences Assessment of “food addiction” in empirical studies Managing and mitigating “food addiction”

5. Obesity in the World The Economist (2012)

6. Obesity in the US  ~69% of adults in the U.S. are overweight, of which ~36% are obese.  Being obese or overweight is associated with multiple comorbid health concerns (e.g., heart disease, diabetes).  Increased body weight can also have psychological, economical, and social consequences.

7. Why are so many people overweight or obese?

8. Portion size and portion creep

9. Food Acquisition is Easier Than it Used to Be

10. Added Sugar Consumption in the United States Added sugar, as measured here, includes: white, brown and raw sugar, syrup, honey, and molasses that were eaten separately or used as ingredients in processed or prepared foods such as breads, cakes, soft drinks, jams, and ice cream. The National Cancer Institute (2010)

13. Consumption of Added Sugars in Children and Adolescents Added sugars have been reported to constitute approximately 16% of children and adolescents’ daily caloric intake. Ervin et al. (2012)

14. Hedonic eating vs. caloric need People sometimes eat because they want to eat, not because they have to eat (people may eat because of boredom, stress, etc.) Foods that are rich in fats and sugars, and consequently calories, taste good. Palatable food is ubiquitous for most people in our society. Food is a part of our social lives.

15. Obesity is an endpoint, with multiple contributing factors Obesity Sedentary lifestyle Genetic vulnerability Food accessibility Social norms regarding food Stress and endocrine factors Increases in portion sizes Genetic disorders (Prader- Willi syndrome) Food Reward (addiction?)

16. Who thinks food can be addictive?

18. Food Addiction in Food Advertising

19. Food Addiction in Popular Media

20. Food Addiction in Groups