and Addictive Disorders
G. TERENCE WILSON
The binge eating that is a prominent feature of many eating disorders shares many similarities with substance abuse. People with binge eating and substance abuse report cravings to consume the substance. Both groups experience a sense of loss of control and report using the substance to regulate their emotional state and cope with stress. Both become preoccupied with their problem, make repeated attempts to stop, and seek to keep it secret. Many experience both eating and alcohol or drug problems, sometimes simultaneously. Accordingly, binge eating (and, by extension, eating disorders) have been viewed as addictive disorders.
The addiction model of binge eating (and eating disorders) assumes that particular individuals are biologically vulnerable to certain foods that can cause chemical dependence; that patients must abstain from these toxic foods (chemicals); and that since eating disorders and addictive disorders are essentially different expressions of the same underlying problem, the treatment of eating disorders should not differ fundamentally from that of substance abuse.
The similarities between binge eating and substance abuse may seem obvious, but they obscure fundamentally important differences. Addiction or chemical dependency is characterized by the phenomena of tolerance, physical dependence, and withdrawal reactions. No credible scientific evidence shows that these phenomena apply to eating disorders. The biological consequences of food hardly make it an addictive substance, just as the biological effects of activities such as sex, sleep, and exercise do not make these behaviors physiologically addictive. Starvation, or the withdrawal of food, produces a specific constellation of physiological and psychological symptoms, including irritability and