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 makes 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 of addiction. The definition has evolved over the years and the current definition of addiction has been centered on substance abuse. Some of the criteria for substance dependence can include the 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 the 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 a 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”.
How Does It Apply to Addiction?
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 are not centered on the 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 types 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 for 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.
Eating Disorders and Young People
Eating disorders in the teenage and young adult populations can have devastating effects, especially for girls. According to the American Academy of Child and Adolescent Psychiatry, about 1 in 10 young women in the United States suffer from an eating disorder. Anorexia nervosa and bulimia are the most common forms of eating disorders seen in young women. Both anorexia nervosa and bulimia are also found in the young male population, but to a lesser extent.
While the exact cause of eating disorders is largely unknown, there are certain factors that point to an increased risk of developing an eating disorder among teenagers. Those factors include societal pressures where premiums are placed on having the ideal body. Even if a teenager has a normal and healthy weight, there can be perceptions they are overweight. Eating disorders can also develop because of self-esteem issues.
For those who participate in sports like wrestling and running where maintaining an ideal weight is emphasized, teenagers can run an increased risk of developing eating disorders. Other behavioral factors and traits such as perfectionism, anxiety, or rigidity can also play a role in the development of eating disorders in young people. Poor nutrition, stress and tension, and following food fads also need to be weighed into consideration.
As outlined by the Mayo Clinic, symptoms that may be seen in young people with eating disorders include the following:
- Insomnia or trouble sleeping
- Difficulty in concentrating
- Irregularities in the menstrual cycle (for girls)
In regards to long-term effects, young people suffering from eating disorders may also develop more serious and even life-threatening conditions such as muscle wasting and bone loss. Tooth decay and thinning hair are also seen with chronic eating disorders in young people. Heart and digestive problems can occur as well as delayed growth and development. Depression can also be an issue and depressive thoughts can lead to suicidal thoughts or behavior.
Treatment for eating disorders in the teenage demographic requires a multidimensional approach. The use of individual and family therapy along with medications and nutritional guidance is seen as being the most effective. What also needs to be addressed are any co-existing issues such as depression, anxiety, and substance abuse.