Mechanisms of Addiction in Eating and Weight Disorders

Eating and weight disorders are associated with a variety of comorbid disorders (Chaps. 24–26 in this book). There is clear evidence of an association between overweight or obesity, eating disorders, and alcohol use disorder. In particular, binge eating disorder (BED) and bulimia nervosa (BN), i.e., those eating disorders associated with binge eating, seem to be associated with alcohol consumption, while anorexia nervosa (AN) is not or to a lesser extent associated with alcohol use disorders in studies (Bahji et al. 2019). Much of the research focuses on the comorbidity of clinically diagnosed substance use disorders and eating and weight disorders. However, symptom-level investigations provide important insights. For example, several studies showed a negative relationship between the frequency of drinking alcohol and BMI, but a positive relationship between the intensity of consumption (“binge drinking”) and BMI. The results of these studies suggest that the comorbidities between eating and weight disorders and substance use disorders observed at the diagnostic level could be due to pathological behavior patterns based on similar mechanisms and being attributable to similar underlying vulnerability factors. Against this background, this chapter aims to provide an overview of the current state of research on the importance of mechanisms of behavior of dependence in the development of eating and weight disorders. Furthermore, the concept of “food addiction” will be addressed. Finally, treatment options will be discussed.