Statistically, there is a large overlap between addiction and eating disorders such as anorexia, bulimia, and binge eating. About half of people with eating disorders will also struggle with substance abuse, compared to around 10 percent in the general population. Of people with addiction, about a third will also have an eating disorder. Why is there such a high correlation between addiction and eating disorders?
First, eating disorders actually resemble addiction in several ways. People with eating disorders obsess about food–whether it’s eating it or not eating it. They suffer cravings even when they aren’t hungry. They may have rituals built around food. Whether they eat too much or not enough, they tend to avoid situations where they may have to eat in front of others. People with anorexia or bulimia may exercise obsessively to offset calories. Like any addiction, these behaviours may escalate over time. Often, they will see their behaviour is becoming destructive but they will be unable to stop. People with eating disorders of any kind will typically hide it from friends and family.
The circumstances that give rise to eating disorders are similar to those around addiction. The behaviour is often triggered by stress. People who are prone to being impulsive or obsessive are more likely to develop eating disorders and addictions, and these traits appear to have a genetic component. As with any addiction, disordered eating may be triggered by trauma, depression, or anxiety.
Chemically, there may be something similar happening in the brain. Foods high in fat and sugar cause a large dopamine spike in the brain. It’s not as big as, say, heroin, but it’s about twice normal levels, and possibly higher in people prone to food addiction. It’s less clear what chemical feedback might encourage anorexia, as almost all of the symptoms of undernourishment are bad.
Treating an eating disorder is slightly different to treating an addiction. With addiction, abstinence is typically the best approach, but clearly that’s not possible with food. People with eating disorders have to face their problem several times a day, which requires relearning their attitudes towards food and usually learning to accept themselves or even see themselves more realistically. The good news is that despite this difficulty, eating disorders often respond well to treatment, which usually includes therapy and sometimes medication. When seeking treatment for addiction and eating disorders, it helps to find a treatment center that can address both simultaneously.