Metabolic & Cardiometabolic
sugar and added sweeteners is-addictive-in humans meeting formal addiction criteria analogous to drugs of abuse
In plain terms: Is sugar addictive in people the way drugs are?
Contested Metabolic & Cardiometabolic 🔬 Includes disconfirming
Part of: • Added sugar
RefutedContestedStrong support
consensus score -0.15
Sugar-bingeing produces addiction-like brain changes in rats, but human evidence that sugar per se meets clinical addiction criteria is weak and contested — what human food addiction exists tracks eating behavior/palatable-food combinations more than sugar as a specific substance.
📅 Last reviewed: 2026-07-14 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: Population patterns (Observational)
MechanismIn-vitroAnimalObservationalRCTMeta-analysis
How the studies fall
3 support 5 contradict 4 tested null 12 mixed · 24 sources, 8 independent groups
The evidence (24)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Passeri A et al 2023 · study_type: animal | animal | mixed | low | Overview review of shared neural circuits/behavioral phenotypes between drug and food addiction; states food addiction lacks agreement on definition/diagnostic status, and explicitly notes protocol heterogeneity across animal models as a li |
| van Amsterdam 2025 · J Psychopharmacol | observational | mixed | low | Systematic review notes sugar triggers dopaminergic reward like addictive substances but frames sweet-liking as a treatment modifier, evidence in humans remaining indirect. |
| Jahrami H et al 2025 · study_type: meta-analysis | meta-analysis | tested-null | moderate | Meta-analysis (65 studies) of Yale Food Addiction Scale reliability in humans found high internal consistency (alpha=0.85) and good test-retest reliability, but this concerns measurement reliability of the construct, not whether the constru |
| Ratković D et al 2023 · study_type: observational | observational | contradicts | low | Narrative review (51 human studies) comparing binge-eating disorder and 'food addiction' concludes food addiction is a controversial, non-consensus construct still needing further characterization to distinguish it from BED. |
| Hough 2026 · Pharmacol Res | animal | mixed | moderate | Review argues ultra-processed foods high in refined sugar and fat engage mesolimbic dopamine pathways with addiction-like features, drawing heavily on animal data. |
| Choroszyński M et al 2025 · study_type: observational | observational | tested-null | low | Human validation study (n=344 Polish adults) of the FitMIND Sweets Addiction Scale adapted from YFAS 2.0; found good internal consistency including tolerance/withdrawal subscales but only moderate correlation with actual sweets consumption |
| Johnson 2013 · Diabetes | mechanism | tested-null | low | Notes sugar/fructose reward pathways but does not establish clinical human addiction criteria. |
| Gardner 2025 · J Nutr Sci | observational | tested-null | low | Validates a refined-sugar problematic-eating questionnaire capturing addictive-like behaviours, supporting measurable behaviour but not establishing pharmacological addiction. |
| Serafine KM et al 2021 · study_type: animal | animal | mixed | moderate | Review integrating animal, clinical, and epidemiological evidence describing overlapping neurobiological/metabolic substrates between palatable food and drug reward circuitry, and shared genetic risk loci; but data described come predominan |
| Westwater 2016 · Eur J Nutr | observational | contradicts | moderate | Review concludes little human evidence supports sugar addiction; sugar-specific addictive effects seen in rats arise mainly under intermittent-access conditions and don't cleanly translate to humans. |
| Constant A et al 2020 · study_type: mechanism | observational | contradicts | moderate | Multidisciplinary review states food addiction is not recognized as a diagnosis in DSM-5 or ICD-11, remains poorly understood mechanistically, and its relationship with obesity/SUD needs further exploration; notes altered reward/inhibitory- |
| Long 2015 · Obes Facts | observational | contradicts | moderate | YFAS-based food addiction is often assumed to be a neurobiological disease on very limited data; may reflect strong habits/binge eating rather than a distinct sugar addiction. |
| Fauconnier M et al 2020 · study_type: observational | observational | mixed | low | Cross-sectional study of 195 women with eating disorders found very high YFAS-defined food addiction prevalence (83.6% overall, up to 97.6% in bulimia), most often met via craving/impaired-control criteria, but framed within disordered-eati |
| Gordon 2018 · Nutrients | observational | supports | moderate | Systematic review finds each addiction criterion supported by at least one study, but strongest for brain-reward/impaired-control; overall construct remains inconsistent and not established as a substance addiction to sugar. |
| Adams RC et al 2019 · study_type: observational | observational | mixed | moderate | Human review applying DSM-5 substance-use-disorder criteria to overeating concludes several DSM-5 criteria have limited applicability to food, so 'food addiction' likely applies only to a minority of cases. |
| Kodithuwakku 2026 · Eur J Nutr | observational | contradicts | moderate | YFAS-derived 'sugar addiction' scores were unrelated to BMI or actual sugar intake and instead tracked sweet+fat sensory preference, undercutting a sugar-specific addiction. |
| Loch 2026 · Addiction | observational | mixed | moderate | Nationally representative survey finds measurable ultra-processed food addiction phenotypes in older US adults, but the construct is food-based not sugar-specific. |
| Fekih-Romdhane F et al 2025 · study_type: observational | observational | mixed | low | Cross-sectional human study (schizophrenia patients vs siblings vs controls, n=267) using mYFAS 2.0 found higher food-addiction prevalence in patients (32.1%) linked to metacognitive/psychological distress factors, not substance-specific ph |
| Ravichandran S et al 2021 · study_type: observational | observational | mixed | moderate | Human resting-state fMRI study (n=150 obese adults, YFAS-diagnosed food addiction subgroup) found altered reward-network connectivity (brainstem-orbitofrontal, salience network) correlated with food cravings, suggesting dopaminergic reward |
| Zawertailo L et al 2020 · study_type: mechanism | observational | mixed | low | Narrative review of overlap between food addiction and tobacco use disorder in humans, citing shared dopaminergic circuitry, gut microbiota, and early-life risk factors as commonalities. |
| Rossi AA et al 2025 · study_type: observational | observational | mixed | low | Cross-sectional human study (n=559) found food addiction (YFAS 2.0) moderates the emotional-eating-to-uncontrolled-eating pathway driven by reflective-functioning deficits; frames 'food addiction' as an amplifier of emotional/behavioral dys |
| Skryabin 2026 · Behav Brain Res | observational | mixed | moderate | Review concludes addictive-like responding is plausible only for rapidly-delivered refined-sugar vehicles in vulnerable individuals and overlaps with binge eating, not a universal drug-like addiction. |
| Lennerz B et al 2018 · study_type: mechanism | mechanism | supports | moderate | Narrative review argues high-glycemic-index carbohydrates trigger addiction-like behavioral and neurochemical (dopamine/insulin) responses in humans, citing behavioral similarity to drugs of abuse and shared neurobiological circuits, though |
| Wiss DA et al 2018 · study_type: mechanism | observational | supports | low | Review of sugar addiction evolution/mechanism explicitly poses whether there is 'sufficient empirical evidence of sugar addiction' and frames dopaminergic reward findings mostly from animal/mechanistic work, concluding the evidence for suga |
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