Lived Experience and Defining Addictive-Like Eating: a Synthesis of Qualitative Research

Abstract

Addictive-like eating has engendered much controversy, in part because it has been ill-defined. Qualitative research has described individuals’ experiences and definitions of addictive-like eating, providing insights about its central features. The aim of the present review was to synthesize the latest qualitative research on addictive-like eating, to identify features that are common across individuals’ experiences. We sought to understand how people with lived experience of addictive-like eating define and conceptualize this phenomenon, to answer the question, “What is addictive-like eating?” We conducted this review using qualitative meta-synthesis methodology. Searches of four databases identified 13 English-language qualitative studies of addictive-like eating or food addiction. After assessing research quality, we retained seven articles focused on lived experiences and definitions of addictive-like eating or food addiction, published between 2014 and 2019. Themes identified included, in order of descending frequency and prominence in representation within lived experiences, loss of control over eating, psychological and functional preoccupation, emotional eating and shame, health- and weight-related distress, consequences of addictive-like eating, and role of context and food environment. Overall, we observed only modest alignment between lived experiences of addictive-like eating and DSM-5 substance use disorder criteria. Lived experiences and views of addictive-like eating differ substantially and meaningfully from substance use disorder criteria and related measures. We propose a working definition of addictive-like eating for use in future study of this construct, and, particularly, scale development efforts that adequately represent the breadth, depth, and weighting of addictive-like eating features.