Compulsive eating is a common symptom of different conditions, including obesity, binge eating disorder and bulimia. One hypothesis is that contemporary food products promote compulsive eating via addiction-like mechanisms. However, what is the addictive substance in food, and what is the phenotypic overlap between obesity / eating disorders and addictions are questions that remain unresolved. In this review, we applied a multilevel framework of addiction, which encompasses the ‘drug’ (certain foods), the person's mindset, and the context, to improve understanding of compulsive eating. Specifically, we reviewed evidence on the addictive properties of specific foods, the neurocognitive systems that control dietary choices, and their interaction with physical, emotional and social contexts. We focused on different target groups to illustrate distinct aspects of the proposed framework: the impact of food and contextual factors were examined across a continuum, with most studies conducted on healthy participants and subclinical populations, whereas the review of neurocognitive aspects focused on clinical groups in which the alterations linked to addictive and compulsive eating are particularly visible. The reviewed evidence suggest that macronutrient composition and level of processing are associated with the addictive properties of food; there are overlapping neuroadaptations in reward and decision-making circuits across compulsive eating conditions; and there are physical and social contexts that fuel compulsive eating by exploiting reward mechanisms and their interaction with emotions. We conclude that a biopsychosocial model that integrates food, neurobiology and context can provide a better understanding of compulsive eating manifestations in a transdiagnostic framework.

强迫进食是不同疾病的常见症状，包括肥胖、暴食症和贪食症。一种假设是，当代食品通过类似成瘾的机制促进强迫性进食。然而，食物中的成瘾物质是什么，肥胖/饮食失调和成瘾之间的表型重叠是什么，这些问题仍未解决。在这篇综述中，我们应用了一个多层次的成瘾框架，其中包括“药物”（某些食物）、人的心态和背景，以提高对强迫性进食的理解。具体来说，我们审查了有关特定食物的成瘾特性、控制饮食选择的神经认知系统以及它们与身体、情感和社会环境相互作用的证据。我们专注于不同的目标群体，以说明所提出框架的不同方面：食物和背景因素的影响是在一个连续统一体中进行的，大多数研究是针对健康参与者和亚临床人群进行的，而对神经认知方面的审查则侧重于临床群体与上瘾和强迫饮食有关的变化尤其明显。审查的证据表明，大量营养素的组成和加工水平与食物的成瘾性有关；在强迫性饮食条件下，奖励和决策回路中存在重叠的神经适应；并且存在通过利用奖励机制及其与情绪的相互作用来助长强迫性进食的物理和社会环境。