In both the research and clinician communities, the similarities between eating disorders and addictions have been considerably noted in studies and research literature. The compulsive nature of binging, purging, self-starvation and other similar behaviors can be self-perpetuated to a point that some have asked if eating disorders are a form of addiction. However, putting the label of addiction on eating disorders can be a slippery slope. If eating disorders do indeed fit the description of an addiction it make sense to treat it as an addiction. However, if the behaviors and compulsions seen in eating disorders are seen only on a superficial level, treatments may be ineffective.
If eating disorders are going to be considered an addiction, there needs to be a solid working definition regarding addiction. The definition has evolved over the years and the current definition of addiction has been centered on substance abuse. Some of the criteria of substance dependence, can include difficulty of controlling use, continued use of substance regardless of negative consequences, unsuccessful attempts to limit or stop use, tolerance to the substance and the presence of withdrawal symptoms once use of the substance has ceased.
It is important to note that in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), physiological addiction is not required for diagnosis of substance dependence. The definition of what an addiction is can broaden to include more process addictions. This broader definition can include behaviors such as gambling, compulsive shopping, gaming and eating disorders. Eating disorders can be possibly seen as an addiction because the “substance” of food is the subject of preoccupation and the person who has an eating disorder has difficulty controlling their “use” of food and behaviors related to food. Denial is also a common thread between substance abuse and eating disorders and some anorexics, for example feel that starvation can bring on a “high”.
However, an issue with using an addiction model in relation to eating disorders is the question of what the person with an eating disorder is addicted to. For some, the addiction is toward a certain food in which that food starts the chain of binging and/or purging. For others, the addiction aspects is not centered on food itself but the control of eating food. Others point to the way of life someone with an eating disorder has and the mental and physical energy that person exerts in order to perpetuate the addictive behavior.
Another consideration is the societal and cultural expectations regarding eating and body image. Issues such as general perceptions on acceptable body type for men and women and dieting practices across cultures and societies must also be weighed in the addiction discussion regarding eating disorders. Also, in using the substance abuse model of addiction to explain eating disorders, there are no explanations on the phenomena of self-starvation or deprivation. Food deprivation, as an example, is actually a root cause of binge eating and other eating disorder symptoms like weight preoccupation.
In some respects, the approach of looking at eating disorders as addictions can be helpful in the fact that they share common ground with those with substance abuse issues. There are shared social, cultural and physical issues that make an addiction model apropos for use of treatment options like Twelve Step programs. However, there are issues that are specific to eating disorders that need to be addressed and