Features of Addiction in Binge-Eating Disorder: Considerations for Screening and Treatment

Alexandra Paul,1,2 Aleena Ghanta,1,2 Ariana M Chao1– 3 1Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA; 2Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; 3Johns Hopkins University School of Nursing, Baltimore, MD, USACorrespondence: Ariana M Chao, Johns Hopkins University School of Nursing, 525 N Wolfe St, Baltimore, MD, 2120, USA, Tel +1-410-955-4766, Email ariana.chao@jhu.eduAbstract: Similarities have been reported between the diagnostic and associated characteristics of binge-eating disorder (BED) and substance-related and non-substance-related disorders. This has resulted in interest in using addiction models to inform clinical care for people with BED. The purpose of this paper was to review features of addiction in BED with a focus on clinical implications. First, we briefly summarize similarities and differences in diagnostic and mechanistic features and symptoms for BED and food addiction, substance-related disorders, and non-substance-related disorders. Then we review aspects of addiction in BED that have clinical implications for screening and treatment of this condition. Similarities in diagnostic criteria between BED and substance-related and non-substance-related disorders include loss of control, greater use than intended, continued use despite adverse consequences, and marked distress. Addiction models may help inform aspects of clinical care of BED, particularly for shared antecedents and mechanisms underlying both disorders and to enhance engagement in treatment. Yet, there are large gaps in evidence regarding the effects of many aspects of addiction models to BED. More research is needed to examine the safety and efficacy of using addiction theories and frameworks for clinical strategies for BED.Keywords: addiction, binge-eating disorder, eating disorder, substance-related disorders, treatment