Eating disorders are a complex condition that involves a complex interaction between the person and the environment.
Some feel strongly that eating disorders are distinct from addictions, but we believe it is helpful to at least look at the similarities and consider their overlap. It is also known that many of us who have eating disorders also suffer from other addictions, including substance abuse, compulsive shopping, gambling, and sex addiction.
Thus, we are looking at addiction processes with the help of the book In the Realm of Hungry Ghosts: Close Encounters with Addiction, by Gabor Maté, MD.
There has been significantly more funding for drug and alcohol addiction than for eating disorders, which is why we find it helpful to observe the overlap from a chemical and genetic standpoint.
“The constellation of behaviors we call addiction is provoked by a complex set of neurological and emotional mechanisms that develop inside a person.”  Addiction research has found biological, chemical, neurological, psychological, medical, emotional, social, political, economic, and spiritual contributing factors.
From a neurobiological standpoint, addictions engage the brain’s attachment, reward and incentive-motivation systems. The engagement of these systems reduces the rational thinking and impulse control areas in the cortex.
There are four dominant brain systems involved in addiction, all of which exhibit signs of being out of balance compared to non-addicted brains:
- The opioid attachment-reward system
- The dopamine-based incentive-motivation apparatus
- The self-regulation areas of the prefrontal cortex
- The stress-response mechanism
It has been frequently observed that people who struggle with addictions also suffer from co-existing mental disorders including depression, anxiety, post-traumatic stress disorder, attention deficit disorder and obsessive-compulsive disorder.
Eating disorders and addictions may appear like “bad habits,” but they are much deeper than a habit. They are firmly entrenched behaviors that we use to moderate our inner state of being. They can literally rewire our brains.
Addictions serve an important purpose in the life of the person who is addicted. Most importantly, the addiction gives the person a temporary sense of relief. Unfortunately, the relief is short-lived, resulting in the addictive cycle of continuously seeking more.
Several personality traits are found among people who become addicted to substances or behaviors, including:
- Poor self-regulation
- Lack of basic differentiation
- Lack of a healthy sense of self
- A sense of deficient emptiness
- Impaired impulse control
People who are addicted exhibit the following:
- Loss of integration into family and culture
- A sense of exclusion, isolation, and powerlessness
- A sense of shame and the belief of being inherently “bad”
- Utilizing deception and manipulation, regardless of the consequences, to pursue the addiction
Regardless of what we are addicted to, an addiction is defined as:
- Feeling compelled to do something
- A preoccupation with doing something
- Persistently doing something despite negative consequences
- Relapse despite a deep desire to stop
- Craving the action when we are not doing it
Can you see eating disorders on this list? Most of us with eating disorders:
- Feel compelled to restrict, binge and/or purge food
- Are preoccupied with our body weight, our next meal, or our desire to feel complete emptiness in our stomachs
- Persist in our eating disorder behaviors even when our families beg us to stop and we are shown evidence of negative health, emotional and productivity consequences
- Commit to ending the behavior, only to repeatedly relapse
- When abstaining from our behavior, we crave the “high” that we received from the behavior
All of us who have addictions are seeking something outside to soothe our inner state of mind. But this is not obvious to us. The paradox of addiction is that we are seeking something to curb our insatiable emptiness, yet we do not see that link as long as we are stuck in the addiction.
We crave our eating disorder behavior because we believe it soothes our deep sense of lack and emptiness. And yet our addiction never actually soothes us because it is not what we really need.
“The addict is never satisfied. His spiritual and emotional condition is one of impoverishment, no matter how much he achieves, acquires, or possesses. In the hungry-ghost mode, we can never be satiated.” 
Many of us who work through our eating disorders find that they contain an entire language of which we were unaware. While in our addiction, we believed our eating disorder was a harmless, even healthy, friend. But in order to emerge from the disorder, we must learn the language our eating disorder was using to communicate.
Our eating disorders mask a deep pain in our psyche. At some point, we learned that we must not speak of this deep pain, and thus we adopt an eating disorder or other addiction in order to manage our deep discontent. Pain must emerge in some way and, for us, it is through our eating disorders.
Addictions displace our ability to truly feel emotions and express them in a natural, healthy way. The longer we remain in our eating disorders, the further underground we force our vulnerability. It is only when we bring our vulnerability into the light and see that the eating disorder was a maladaptive coping mechanism for our pain that we can heal.
When we are addicted, we are not in charge. We are not making a choice. We are compelled in unseen and unobserved ways to pursue a behavior that hurts us even as we firmly believe it is the only way we can survive. To imagine a life without our eating disorders is incomprehensible because our sense of self, our sense of worth, is innately connected to the disorder.
Finally, eating disorders share addiction’s central dilemma: “if recovery is to occur, the brain, the impaired organ of decision making, needs to initiate its own healing process. An altered and dysfunctional brain must decide that it wants to overcome its own dysfunction: to revert to normal—or, perhaps, become normal for the very first time.” 
Luckily for us, full recovery is 100% possible. Many of us have made a full recovery from our eating disorders. We have gone beyond abstaining from our eating disorder behaviors and achieve full sobriety. Don’t ever lose hope!
 The book In the Realm of Hungry Ghosts: Close Encounters with Addiction by Gabor Mate provides comprehensive and deeply compassionate insight into addictions and the people who live with them. Although the main focus of the book is people who are addicted to substances, behavioral addictions are also explored, including Dr. Maté’s own behavioral addictions.