Many people wonder, “Are eating disorders an addiction?” This is a common question, especially as more is learned about how the brain responds to both addictive behaviors and disordered eating. There are similarities between the ways some people experience eating disorders and how addiction can affect thoughts and actions.
At First Steps Recovery in Fresno County, California, we work with people who have both addiction and co-occurring mental health disorders. Here, you will find clear information about eating disorders, what addiction is, how the two may connect, and what current research says about this topic. The article also covers signs and symptoms, causes, treatment options, and answers to questions people often ask.
What are Eating Disorders?
Eating disorders are serious mental health conditions that involve unhealthy patterns of eating and thinking about food, body weight, or shape. According to the National Institute of Mental Health (NIMH), eating disorders affect people of all ages, races, genders, and backgrounds.
The most common types include anorexia nervosa, bulimia nervosa, and binge eating disorder. These conditions are different from normal eating because they involve intense distress, harmful behaviors, and changes in daily life or health.
- Anorexia nervosa: Restricting food intake, intense fear of gaining weight, and a distorted body image
- Bulimia nervosa: Cycles of binge eating followed by behaviors to prevent weight gain, such as vomiting or excessive exercise
- Binge eating disorder: Repeated episodes of consuming large amounts of food quickly, and often feeling out of control
What is Addiction?
Addiction is defined by the National Institute on Drug Abuse as a chronic, relapsing disorder involving compulsive seeking and use of a substance or engagement in a behavior, even when it leads to negative consequences.
Key features of addiction include loss of control, strong cravings, and continued involvement in the behavior despite harm. People experiencing addiction often find it challenging to stop, even when they want to.
The brain’s reward system plays an important role in addiction. Activities that bring pleasure activate specific brain circuits that release chemicals such as dopamine. Over time, repeated exposure can change how these brain circuits work.
Eating Disorders and Addiction: What’s the Connection?
Current research shows that eating disorders and addiction share several features, but they are not the same condition. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), among those receiving treatment for substance use disorders, 16% of women and 3% of men reported having an eating disorder as well. This overlap of conditions implies that these disorders are interconnected, potentially stemming from shared underlying causes or triggering factors.
As many as 35% of those who are dependent on alcohol or other substances have experienced eating disorders, a figure that is 11 times higher than that of the general population. As many as 50% of individuals with eating disorders engage in the use of alcohol or illicit drugs, a rate that is five times greater than that of the general population. Lastly, approximately one in five individuals with an eating disorder will develop a substance use disorder at some point during their lifetime.
While eating disorders and addiction are prevalent and can co-occur, when answering the question “Are eating disorders an addiction?” the consensus is that eating disorders are not addictions, but they often share similar patterns and risk factors.
Shared Brain Pathways
Both eating disorders and addiction affect similar areas in the brain, especially those related to the reward system. Dopamine, a brain chemical linked to feelings of pleasure and reward, plays a role in both conditions. In eating disorders, behaviors like restricting food or binge eating can cause changes in dopamine signaling, creating patterns similar to addiction.
Loss of Control
People with eating disorders and those with addiction often show similar behavioral patterns. They may repeat actions they feel unable to stop, even when these actions cause harm. Someone with binge eating disorder may eat large amounts of food without feeling able to control it, similar to how someone with addiction may use substances despite wanting to quit.
Common Risk Factors
Genetic, environmental, and psychological factors can increase the risk of both eating disorders and addiction. Studies show that about 25% to 35% of people with an eating disorder also have a substance use disorder at some point in their lives.
Is Anorexia Addictive?
The question “Is anorexia addictive?” comes up because anorexia shows some patterns that look like addiction. People with anorexia may experience persistent restriction of food, excessive exercise, and a strong sense of reward from these behaviors.
Many people with anorexia report feeling compelled to continue these actions, even when aware of negative health effects. They may chase a kind of “high” from weight loss or from controlling eating, which is linked to feelings of accomplishment or control.
However, anorexia does not involve a substance like drugs or alcohol. Instead, it involves a pattern of restrictive behaviors and thoughts about food and body image. While anorexia shares some features with addiction, most experts agree that anorexia is classified as an eating disorder rather than an addiction.
Are Eating Disorders an Addiction?
The question “Are eating disorders addictions?” can be explored by looking at certain patterns that appear in both conditions. Some behaviors that occur in eating disorders closely resemble those seen with addiction.
Eating disorders and substance use disorders both encompass compulsive behaviors. Just as an individual suffering from an eating disorder may feel unable to cease restricting or binging, a person with a substance use disorder may feel incapable of stopping the use of drugs or alcohol. The two conditions can exacerbate one another, complicating the process of breaking the cycle.
Obsessive Thoughts About Food or Body
People with eating disorders often experience persistent thoughts about food, weight, or body shape. These obsessions can be constant and intrusive, similar to how a person with a substance addiction might feel a strong urge or craving for their drug of choice.
Withdrawal-Like Feelings
When a person with an eating disorder cannot engage in their usual behaviors, they may experience emotional and physical symptoms. These can include irritability, anxiety, restlessness, or physical discomfort, which are similar to withdrawal symptoms in substance addiction.
Escalating Behaviors
Both eating disorders and addictions can show a pattern where behaviors become more intense and harder to manage over time. What may start as occasional dieting or overeating may progress to frequent, compulsive actions that are difficult to stop.
Similarities
- Compulsive behaviors: Both eating disorders and substance use disorders frequently involve compulsive actions. Individuals may feel compelled to partake in these behaviors, despite being aware of their detrimental effects.
- Escapism: Those afflicted with either disorder may utilize their behaviors as a means of escaping emotional or psychological turmoil. This can offer temporary respite from challenging emotions.
- Secretive behavior: Individuals with eating disorders and substance use disorders often engage in their behaviors in secrecy, frequently attempting to conceal their actions from others.
- Tolerance and withdrawal: Both disorders can result in the development of tolerance, necessitating increased amounts of the substance or behavior to attain the same effect, as well as withdrawal symptoms when the behavior is diminished or halted.
- Impact on relationships and daily life: Both disorders can significantly affect personal relationships, professional life, and daily activities. They can lead to social withdrawal and disrupt one’s capacity to meet daily obligations.
- Triggered by stress: Stress can serve as a major catalyst for both eating disorders and addiction.
- Common risk factors: These encompass genetics, family history, a background of trauma, low self-esteem, and co-occurring mental health issues such as depression and anxiety.
Differences
- Substance vs. food: The main distinction lies in the focus of the behavior. In substance use disorders, the emphasis is on the consumption of drugs or alcohol, whereas in eating disorders, the concentration is on food, body image, and the regulation of eating.
- Physical health effects: Although both categories of disorders can result in significant physical health repercussions, the specific health risks and complications vary. Substance use disorders may lead to a broad spectrum of physical and medical issues, while eating disorders typically pertain to concerns regarding weight, nutrition, and digestive health.
- Diagnostic criteria: Eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder, possess distinct diagnostic criteria that are separate from those of substance use disorders. Each disorder is characterized by its own recognized symptoms and diagnostic standards.
- Treatment approaches: While there are similarities in the treatment methods for both eating disorders and substance use disorders (such as therapy and support groups), there are also specific treatments and interventions designed to address the unique characteristics of each disorder.
Food addiction resembles drug addiction in that both can result in alterations to the brain’s structure and function. The cravings for either food or substances originate from the same neural pathways. This is also applicable to withdrawal symptoms. When an individual resists these cravings, they may experience mood fluctuations, anxiety, irritability, and various physical symptoms.
Why Do People Develop Eating Disorders and Addiction?
Eating disorders and addictions do not have a single cause. These conditions develop through a combination of genetic, biological, environmental, emotional, and psychological factors.
Genetic and Biological Factors
Studies show that both eating disorders and addictions have a genetic component. Individuals with a close family member who has struggled with these conditions may be at higher risk. Differences in brain chemicals such as dopamine and serotonin, which affect mood and reward, have been observed in people with eating disorders and addictions.
Environmental Influences
- Social pressures: Media messages and peer pressure about appearance or substance use
- Traumatic experiences: Abuse, neglect, or other adverse childhood events
- Family environment: Family conflict, substance use, or eating disorder history
Emotional and Psychological Traits
Certain personality traits are more common in people with eating disorders and addictions. Traits such as perfectionism, impulsivity, and high sensitivity have been noted in research. Many individuals with these conditions experience difficulty managing emotions and may have low self-esteem.
Eating Disorders and Addiction Treatment
Treatment for eating disorders and addiction often requires an integrated approach, especially when both conditions occur together. At First Steps Recovery, we provide dual diagnosis care, meaning services are designed to treat both eating disorders and substance use disorders within the same treatment plan.
Therapy and Counseling
Evidence-based therapies form the core of treatment for both eating disorders and addiction. These therapies include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and trauma-informed care. These approaches target the thoughts, emotions, and behaviors linked to both conditions.
Medical Support
Medical care is an essential part of treatment, especially for individuals with physical health concerns related to eating disorders, addiction, or both. Medical teams monitor vital signs, nutrition, and any withdrawal symptoms.
Continuing Care
Recovery from eating disorders and addiction is usually ongoing, so continuing care is built into treatment plans. This includes outpatient therapy, support groups, and check-ins with medical or counseling staff.
Eating Disorders and Addiction FAQs
Can someone have both an eating disorder and a substance use disorder at the same time?
Yes, it’s possible to have both conditions simultaneously, which is called a dual diagnosis or co-occurring disorders. Research shows that people with eating disorders are more likely to also struggle with substance use.
Do eating disorders require the same treatment as addiction?
While there are similarities in treatment approaches, eating disorders require specialized care that addresses food, nutrition, and body image issues. Treatment plans are tailored to address the specific needs of each condition.
What makes eating disorders different from food addiction?
Eating disorders involve complex thoughts and behaviors about food, weight, and body image, while food addiction typically refers to compulsive eating of specific foods. Eating disorders are classified as mental health conditions, not addictions.
Moving Forward with Recovery
Recovery from eating disorders and addiction is possible with the right support and treatment. Many people have found help by working with professionals who understand both eating disorders and substance use disorders.
At First Steps Recovery in Fresno County, CA, we use a team approach that combines medical, psychological, and nutritional support. Treatment plans are developed for each person, with adjustments made as progress is monitored. For more information or to discuss treatment options, contact First Steps Recovery. Support is available for individuals and families, and all inquiries are handled with confidentiality and compassion.
Dr. Curl is the Medical Director and primary on-site provider for First Steps Recovery. He is a Board Certified Internist and Addiction Medicine Specialist having attended the David Geffen School of Medicine at UCLA and completing his residency at Mount Auburn Hospital with Harvard Medical School. Following several years work as an internist and physiatrist (physical medicine and rehabilitation). Dr. Curl completed the Addiction Medicine Fellowship at Howard University in Washington DC and participated as a RAM Scholar (Research in Addiction Medicine). While part of the fellowship, Dr. Curl pursued research investigating the barriers to expanding and improving medication for opioid use disorder. Following his fellowship, Dr. Curl spearheaded the Opiate Use Disorder outpatient clinic and worked in the Department of Psychiatry and Behavioral Sciences within the Howard University Hospital. In 2023, Dr. Curl completed his Board Certification in Addiction Medicine.
