Exploring the overlap between eating disorders and addiction disorders: implications for treatment

Eating disorders (EDs) are complex psychiatric conditions characterised by disturbances in eating behaviours and associated psychological impairments. Despite being traditionally distinct from addiction disorders, increasing evidence highlights significant overlaps in their neurobiological and behavioural underpinnings. This article explores the potential for EDs to be conceptualised, in part, as addiction disorders. It examines mechanisms such as the activation of dopamine reward pathways, endorphin release and the anxiolytic effects of starvation-induced ketosis, which may create addictive processes within EDs. Behavioural parallels, including impulsivity, compulsivity and neurochemical alterations in bulimia nervosa (BN) and binge-eating disorder (BED), further align these disorders with substance use disorders. Additionally, food and exercise addiction, often comorbid with EDs, are evaluated in the context of their shared neural circuits and psychosocial drivers. Distinctions between EDs and addictions are also discussed, highlighting differences in aetiology, reward mechanisms, social acceptability and recovery dynamics. Understanding EDs through the lens of addiction has profound implications for treatment, including the integration of addiction-focused therapeutic strategies and pharmacological interventions targeting dopaminergic and opioid pathways. This framework offers new insights into the aetiology, psychopathology and treatment of EDs, with the potential to improve outcomes for individuals suffering from these life-threatening disorders.