Metabolic & Cardiometabolic
sugar and added sweeteners is a addictive substance
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 -0.18
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
1 support 2 contradict 3 tested null 5 mixed · 11 sources, 3 independent groups
What the evidence shows
Sugar bingeing produces addiction-like brain changes in rats, but the human case rests on questionnaires rather than on sugar itself: the Yale Food Addiction Scale is internally reliable across 65 studies while measuring eating behaviour, not a substance dependence, and reviewers note the neurobiological-disease framing rests on very limited data.
The evidence (24)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Passeri A, Municchi D, Cavalieri G, Babicola L, Ventura R, Di Segni M 2023 · Front Behav Neurosci | animal | mixed | low | Narrative overview: 'In this overview, we focused on ... the hyperpalatable food effects in food addiction development; ... specific brain regions involved in both food and drug addiction; and ... animal models'. No own data; mostly animal literature. Review — zero weight. |
| van Amsterdam J, van den Brink W 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, Husain W, Trabelsi K, Ammar A, Pandi-Perumal SR, Saif Z, Potenza MN, Lin CY, Pakpour AH 2025 · Obesity reviews : an official journal of the International Association for the Study of Obesity | 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 · The Journal of international medical research | 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 K, Friuli M, Avena NM, Romano A 2026 · Pharmacol Res | animal | mixed | moderate | Narrative review, not evidence: 'This review explores the hypothesis that food addiction shares common clinical and neurochemical mechanisms with traditional forms of addiction'. Relies on animal and human studies of palatable/ultra-processed foods, not sugar alone. Review — zero weight. |
| Choroszyński M, Jurek JM, Mizia S, Hudaszek K, Clavero-Mestres H, Auguet T, Siennicka A 2025 · Nutrients | 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 RJ, Nakagawa T, Sanchez-Lozada LG, Shafiu M, Sundaram S, Le M, Ishimoto T, Sautin YY, Lanaspa MA 2013 · Diabetes | mechanism | tested-null | low | Perspective/hypothesis review on fructose, uric acid and metabolic syndrome ('we revisit the hypothesis that it is this unique aspect of fructose metabolism ...'); no human addiction data. Zero weight. |
| Gardner MH, Grigor JM, Savage AL, Barton KL 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, O'Dell LE, Zorrilla EP 2021 · Neuropharmacology | animal | mixed | moderate | Narrative review: 'Here, we review data from animal models, clinical populations and epidemiological evidence'; 'Palatable foods high in fat and/or sugar can elicit adaptation in brain reward and withdrawal circuitry akin to substances of abuse' — largely animal, palatable food rather than sugar per se. Review — zero weight. |
| Westwater ML, Fletcher PC, Ziauddeen H 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, Moirand R, Thibault R, Val-Laillet D 2020 · Nutrients | 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 CG, Blundell JE, Finlayson G 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, Rousselet M, Brunault P, Thiabaud E, Lambert S, Rocher B, Challet-Bouju G, Grall-Bronnec M 2020 · Nutrients | 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 EL, Ariel-Donges AH, Bauman V, Merlo LJ 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, Sedgmond J, Maizey L, Chambers CD, Lawrence NS 2019 · Nutrients | 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 H, Palihakkara P, Wasalathanthri S, Peng M, Abeywickrema S 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 LK, Kirch M, Singer DC, Solway E, Roberts JS, Kullgren JT, Gearhardt AN 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, Boukadida Y, Hakiri A, Homri W, Cheour M, Hallit S 2025 · Journal of eating disorders | 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, Bhatt RR, Pandit B, Osadchiy V, Alaverdyan A, Vora P, Stains J, Naliboff B, Mayer EA, Gupta A 2021 · Scientific reports | 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, Attwells S, deRuiter WK, Le TL, Dawson D, Selby P 2020 · Nutrients | 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, Tagliagambe A, Scuderi A, Dalla Ragione L, Mannarini S 2025 · Nutrients | 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 V, Sanjari Mijan M, Mehryar N, Farzadkia B, Mahmmod M, Savari S, Dolatyar MA 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, Lennerz JK 2018 · Clinical chemistry | 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, Avena N, Rada P 2018 · Frontiers in psychiatry | 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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Educational only, not medical advice. Grades and scores reflect published evidence weighted by study design and quality; see the methodology.