College Life: Are Eating Disorders an Addiction?

Contributor: Roseann Rook, CADC, Clinical Addictions Specialist for Timberline Knolls

Article -  Cross Addiction - roseannrook photoFor decades, eating disorders were viewed as everything from a silly game played by teen girls, to an attention-getting gimmick. Today, the mental health community knows that eating disorders are complex and dangerous diseases; what’s more, an eating disorder, not unlike in the case of drugs or alcohol, is an addiction.

What exactly is an addiction? The American Society of Addiction Medicine (ASAM) defines addiction as “memory of previous exposures to rewards (food, alcohol, drugs work etc.) leads to a biological and behavioral response to external cues.

Cravings are triggered, leading to addictive behaviors.” Notice that the definition of addiction includes both a biological and a behavioral aspect.

Behavioral Component:

The similarity of behaviors between substance use disorder and eating disorders is best shown in the following shortened version of the Diagnostic Statistical Manual (DSM 5) criteria for substance use disorder. Eating disorder has been placed where the words substance use appeared.

  • Acting on eating disorder behaviors become more often or over a longer period of time intended.

  • Persistent desire or unsuccessful efforts to cut down or control food/behaviors.

  • Great deal of time spent in activities necessary to obtain, use or recovery from the effects of the eating disorder behaviors.

  • Craving or strong desire to act on eating disorder behaviors.

  • Recurrent eating disorder behaviors resulting in a failure to fulfil major role obligations at work, school, or home.

  • Continued behaviors despite having persistent or recurrent social interpersonal problems caused or exacerbated by the effects of eating disorder.

  • Important social, occupational or recreation activities given up or reduced due to eating disorder behaviors.

  • Eating disorder behaviors continued despite knowledge of having persistent or recurrent physical or psychological problem caused or exacerbated by behaviors

  • Tolerance, as defined by either of the following:
    • need for increased amount of acting out in the behavior to achieve the desired effect.
    • diminished effect with current behaviors.
  • Withdrawal, as manifested by either of the following:
    • characteristic of withdrawal symptoms when not acting on behaviors
    • turning to another addiction to relieve or avoid withdrawal symptoms
  • Biological Component:

    book-216198_640Biologically speaking, the “high” and “reward” of eating disorder behavior is no different than in any other addiction. The human brain has reward centers which are activated when a person eats or drinks something they like, has sex, exercises or receives praise.

    It feels good; therefore, we will do it again. This is a natural human trait and actually was required to live and reproduce. The same reward system can be activated by artificial means such as certain behaviors as well as substances. The result is the same: we like it, so we do it again.

    In fact, eating disorders and substance abuse often go together. The American Psychological Association estimates that about 5 million Americans suffer from a diagnosable eating disorder.

    And according to a 2007 analysis of government data, roughly one-third and one-quarter of people with bulimia and binge eating disorder, respectively, will also have an alcohol or drug problem at some point in their lives.*

    Anorexia as an Addiction

    For the world at large, it is hard to understand how an extremely thin woman can perceive herself as fat; yet, it happens all the time. For many of us being hungry does not feel good, much less provide us with a high; yet, for an anorexic it absolutely does.

    Starvation in anorexia reduces serotonin and thus reduces anxiety. Starvation can actually provide them with more energy and a sense of control. Both are seen as very rewarding.

    Bulimia as an Addiction

    In bulimia, the drug-like changes in the brain from purging also results in a high or acts as a calming or numbing feeling which reinforces the behavior.

    Binge Eating Disorder as an Addiction

    Overeating may be easier to identify as an addiction, since it is something put into the body that causes chemical changes in the brain. Certain foods have been proven to cause a “high,” which also results in a crash, causing the same addictive cycle as drugs or alcohol. Food also affects the brain as a numbing or calming feeling.

    Eating disorders in any form serve a purpose for the person engaging in the behavior, which is impossible for people without an addiction to understand. The one thing we can all relate to is not wanting to sit in emotional pain and would invite a “quick fix;” however, without an addictive gene there is no benefit to such behavior. The same holds true for substance abusers.

    Characteristics to Maintain an Eating Disorder

    feet-60001_640Several characteristics are needed to maintain an eating disorder such as minimizing, rationalizing, and justifying behaviors called denial” in the addiction world. Eating disorder behavior results in getting what you need at any cost, mental, emotional or physical.

    It results in behaviors never imagined before, such as lying, cheating, and stealing just like alcoholics and drug addicts. Women have been arrested for stealing food, moms have left their young children alone to go buy binge food, college students can’t focus in class because they can only think about food, body image or planning the next purge.

    Courses of Treatment

    Perceiving an eating disorder as an addiction also means the course of treatment is similar. The 12 steps, such as Overeaters Anonymous, Eating Disorders Anonymous and Anorexia and Bulimic Anonymous, follow the same 12 steps as Alcohol Anonymous, as well as embrace individual and family therapy. An addiction is an addiction — not one is more serious than the next.

    If you have a food-related disorder, please get help; no one can fight an addiction alone.

    About Timberline Knolls:

    Located in suburban Chicago, Timberline Knolls is a leading private residential treatment center for females (ages 12 – 65+) with eating disorders, substance abuse, trauma, mood and co-occurring disorders. For more information, call 877.257.9611 today.



    Community Discussion – Share your thoughts here!

    What are your thoughts on Eating Disorders as an addiction? Have you found similarities in your eating disorder recovery?

    The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

    Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on January 13th, 2015
    Published on