What causes bulimia, anorexia, or obesity? Specialists in the eating disorders ﬁeld agree that social, genetic, psychological, and biological factors all play a part. Many psychiatrists, psychologists, and social workers contend that eating disorders have nothing to do with addiction. We have found that many people with eating problems respond well to an addiction model when it is applied using a physical, emotional, mental, and spiritual (PEMS) approach.
Many people would call this addiction to food, and the people so affected are food addicts. We prefer the term eating addicts because it is more about the pattern of eating than the specific foods being eaten.
John Lovern, a psychologist who works with eating disorders, has developed what he called a Uniﬁed Eating Disorders Theory. In it he described all eating disorders as cyclical. This graph can represent any eating disorder, which he called food addiction.
According to the Unified Theory of Eating Disorders, any variety of eating disorder has periods of overeating and periods of undereating. What distinguishes them is the duration of the cycle — hours, days, weeks, or months, and relative intensity of the bingeing or restricting. For bulimics, the binge-purge cycle may occur many times a day or only a couple of times a week. In obesity months of overeating may alternate with months of restrictive dieting (undereating). In anorexia, weeks of restriction may be broken by brief binges (and usually purges), although what anorexics consider a binge, their family may celebrate as their ﬁrst normal meal in a long time.
Eating addiction means addiction to the biochemical imbalances that result from bingeing, food sensitivities, purging, starving, etc. There are many foods that seem to do no harm in small or moderate quantities, but invite a spiral of binges or excess eating when large quantities are eaten. For some eating addicts, it seems to matter very little what they eat, as long as they eat a lot of it. Some people do binge on salad items, and it is possible that a full stomach may cause release of some neurotransmitters that affect mood.
Starving (fasting) or very low calorie diets cause biochemical changes that resemble stimulants. Excessive amounts of these neurochemicals seem addicting, especially to those with addictive tendencies.
Vomiting, laxative abuse, excessive exercise, and other purging techniques all produce biochemical reactions in addition to the above, which may be part of the physical addiction.
The physical aspects include your behavior (what you actually eat and do), and all the biochemistry associated with food and eating, bingeing, purging, and starving.
The emotional aspects include your feelings or mood responses to food and to the conditions surrounding your eating and your addiction.
The mental aspects include all your obsession and mental mismanagement as you try to maintain the illusion that you are in control of your eating, or are just about to regain control.
The spiritual aspects include your isolation from God (or your Higher Power) and other people, including your family. They also include the characterological conﬁict as you ﬁnd yourself behaving in self-centered Ways that are at odds with your own values, beliefs, and ethics.
In rollercoaster dieting the variations are similar to those of dietary chaos, but over a much longer period. There are cycles of overeating, alternating with periods of dieting or undereating.
We identify ﬁve styles of eating addiction — anorexia, bulimia, dietary chaos, rollercoaster dieting, and obesity. This is just another model, so eating addicts may relate to more than one style. We often ﬁnd people who have experienced all ﬁve during the course of their eating addiction.
Eating addicts who are addicted to starving may ﬁt the psychiatric diagnosis anorexia nervosa. Their eating pattern is primarily fasting or restricting, with extreme distortion of body image. Most anorexics also binge and purge. Abstinence for anorexics includes abstinence from starving. For more on anorexia, see the module Anorexia nervosa.
The most prominent feature of bulimia nervosa is the binge and purge. Purging may include vomiting, laxatives, fasting, or exercise. Feelings of loss of control, fear of fat, and distorted body image distinguish the bulimic style. For further information, see the module Bulimia nervosa.
What we call dietary chaos is a pattern of eating and attempts to control food and weight. It makes eating addicts feel crazy. You may use lots of fad diets and do crazy things to control food intake or weight to give the illusion of control. Dietary chaos may have elements of bulimic behavior, like eating a diet meal followed by a pint of ice cream followed by more dieting to compensate. It spans the gap between rollercoaster dieting and bulimia.
In this style of eating addiction, there is a craziness that comes with the obsession with eating or not eating. It can be identiﬁed by the amount of energy spent focused on food, weight, diet, and appearance. With dietary chaos, healthy relationships are difﬁcult because of the obsession, insane thinking and behavior. It adversely affects signiﬁcant others.
Some other mental illnesses, like schizophrenia, can look like dietary chaos, but in these there are usually bizarre thinking patterns not directly related to the food, weight, or body image.
Giving up the illusion of control is especially important with dietary chaos. Abstinence based on a rigid food plan will make “recovery” look a lot like the disease, only with a shift in obsession from food to food plan.
Rollercoaster dieting is our term for a style of eating addiction that is probably the most common. It consists of weight cycling, with periods of bingeing or other compulsive overeating, followed by attempts to diet or cut back. Many call it the “yo-yo syndrome.” Even if you do not consider yourself a eating addict, you may be able to relate to this pattern with your weight.
With rollercoaster dieting, the variations in eating (and then in weight) will be substantial. You may be down to 130 pounds, then up to 180, then back down to 140, within a calendar year. If you average your weight over several years, however, there is usually a “creep” up the scale. Each time you diet, and then gain weight, you are teaching your body how to better conserve fat as you are trying to diet, and then how to put it back on faster when you go off your diet.
The physical dangers increase with the difference between the high and low weights, and the frequency of cycling. For rollercoaster dieting, there is probably more harm to your body than if you just stayed at your maximum weight.
Of course, the driving fear is that you will NOT stay at any upper limit, but will continue to increase. In fact, that is what usually happens, so the weight fluctuations tend to be like going backward up a rollercoaster, with each maximum being a little higher.
Since this is the most familiar form of eating addiction, the needs are those common to all eating addiction: to stop the dieting mentality and focus on abstinence from compulsive eating. Weight management is a secondary issue, with emphasis on adjusting fat intake and getting adequate carbohydrates to support a reasonable amount of exercise or other physical activity.
At times, the rollercoaster dieter will experience many of the characteristics and difficulties we describe in the module on Obesity, while at other times their lives may resemble those of the dietary chaos style.
Many eating addicts gain excess weight from their overeating. Some have never seriously tried to control it, but most have tried dozens of diets, gimmicks, spas, and weight loss programs. The module Obesity explains many of the issues involved with this disorder.
Most eating addicts will ﬁnd support and hope in Overeaters Anonymous (OA). There are other support groups that address eating disorders, some using the Twelve Steps and others who don’t, but none are nearly as large and universally available as OA. See the module Overeaters Anonymous.
Our preference for the term eating addiction is supported by some of the current scientific research. Here is an excellent article in depth from Neuroscience & Behavioral Reviews (November 2014)
Eating addiction, see also: Addiction, Alcoholism, Anorexia nervosa, Binge history, Bingeing, Biochemistry, Blackouts, Bulimia nervosa, Craving, Diet mentality, Eating plans, Exercise & activity, Food Addiction, Hunger & appetite, Moodifiers, Nutrition, Obesity, Purging, Weight.
Updated 16 Sep 2015
Addictionary 2 by Jan & Judy Wilson
is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.