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Other Activity (or Behavioral) Addictions: Food Addiction

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.

There are several similarities between eating disorders and substance use disorders. These include cravings; a perceived loss of control; using substance/food to regulate emotions, and to cope with stress; repeated attempts to stop the maladaptive behavior; secretiveness; denial; and negative psychological and social consequences. However, should we consider eating disorders an addiction? The answer to this question will depend on the type of eating disorder.

woman being offered lots of foodBeing significantly overweight (obese) is not itself a mental health disorder. Usually, we do not even think of it as an eating disorder. However, obesity is the best candidate for consideration as an addiction. When we view obesity as an addiction, food becomes the addictive substance. However, food is dissimilar to the usual addictive substances in at least two ways. First, it is quite possible to have a full and complete life without alcohol and other drugs. Therefore, people's recovery efforts frequently involve developing abstinence. However, it is not possible to sustain life without food. Therefore, a recovering person cannot completely abstain from the use of their addictive substance (food). Second, food does not create intoxication as most drugs do. Food addiction (obesity and binge eating) might be the most similar to a tobacco use disorder (e.g., cigarettes) because nicotine is not typically intoxicating. Although researchers do not consider food intoxicating, many people report a "sugar high." However, this "high" appears to be a subjective emotional state, more than a physiological one.

Unlike obesity and binge eating, Anorexia has major dissimilarities with addiction. Severe food restriction may create a heightened form of arousal, similar to intoxication. However, this kind of intoxication does not impair functioning as intoxication usually does. Anorexia is opposite of addiction in that it reflects an excessive degree of control over urges (hunger). In contrast, addiction is associated with under-control of impulsive urges. Addiction usually involves impulsive behavior to achieve immediate gratification. In contrast, anorexia arises from a highly developed capacity to delay gratification.