Obesity, eating disorders and food addiction – three diseases and three treatments

Nowadays there is so much talk about healthy and ‘pathological’ eating that it can get quite confusing. Is a food addict always obese or overweight? Do all people struggling with obesity and overweight have a food addiction? And do food addicts also have eating disorders? Are people who suffer from bulimia or binge eating disorder also food addicts? The answer is that everyone’s different. Yet, these conditions often overlap. Phil Werdell and Mary Foushi from ACORN in my opinion have a very clear way of describing the overlaps and differences between obesity, eating disorders and food addict.

In a nutshell, Werdell and Foushi say that obesity, eating disorders and chemical dependency on food are three distinct medical diseases, and each needs to be treated differently. There are some people who just have the problem of being overweight or obese. We could call them ‘normal eaters’ who are obese. There are also those who eat over their feelings; we call them emotional eaters. They often have eating disorders due to unresolved emotional issues and/or trauma. And then there are those who have become chemically dependent on specific food(s). They have a substance use disorder like alcoholism or other drug addictions, and we call them food addicts.

Not all overweight people are food addicted, and not all food addicted people are obese.  However, many who are food addicted also have eating disorders and are overweight or obese.  It’s important that each of these diseases is diagnosed separately because each needs a different solution.

So, how would you help a normal eater who is overweight or obese? Well, they would probably be totally capable of going on a diet and exercise plan to lose weight. They may simply have become obese or overweight due to not paying attention to their lifestyle and food choices. On the other hand, when emotional eaters become overweight or are using unhealthy ways to control their weight like severe restriction or purging, eating disorder therapy can help them resolve underlying problems, and they become more like normal eaters. They will be able to eat all foods in moderation. The latest research does say that many of those with eating disorders also have the characteristics of food as a substance use disorder. There is a strong correlation between binge eating disorders and food addiction. And if you have an eating disorder AND a food addiction,  eating disorder therapy doesn’t work. Why? Because it often deals with the underlying issues (emotional trauma etc) but it doesn’t tackle the food.

The treatment for food addiction has to start with the elimination of all food substances which trigger bingeing.  Food addiction needs to be treated as a brain disease, like all other addictions. Most food addicts need long term because food addiction is a chronic issue that doesn’t go away.  But it can be arrested (and your life transformed) through daily recovery activities.

According to David Kessler, a pediatrician, author and former Commissioner of the US Food and Drug Administration a huge percentage of people in the US are misdiagnosed because the medical profession is not aware of these difference in obesity, eating disorders and food addiction and what different solutions they need.

Do you find it confusing? Are you wondering what applies to you? To get clearer on what might be the best treatment for you, check out these self-assessment resources. They are very effective tools in giving you clarity and what might be happening with your food. If you need help, feel free to get in touch.