People often talk about emotional eating as a “food addiction.” The same goes for being “addicted” to shopping, gambling, and other behaviors – even positive ones like exercise. It’s true that these behaviors can sometimes seem to take on a life of their own and make you feel like you’re just going along for the scary ride. Some professionals who work with these behavioral disorders refer to them as “process addictions” to distinguish them from chemical addictions. But they still hold on to the addiction metaphor because, although there are no outside substances being introduced into the body, these behaviors can look and feel just any chemical addiction.
But are they the same? And if not, is there a problem with using the term to describe these behaviors? They do seem like addictions on the surface, and it may be handy to use the term as a metaphor. But there’s an important difference, and I believe using the term addiction to describe behavioral disorders that are not physical addictions tends to blur that distinction. The difference is that emotional eating and other behaviors are compulsions, not addictions. A compulsion is something you feel you have to do; an addiction is something you can’t live without. That may sound like a distinction without a difference, so I’ll explain.
There are three unique characteristics of a chemical addiction. The first is that a substance that is not normally used by the body and has an effect on the brain, is introduced into the body. The second is the body develops a tolerance to this substance so that it gradually becomes less effective in producing a response. This is due to the body accommodating to it by increasing whatever compensatory mechanisms are necessary to get back to normal functioning even with this new element in its system. The third is physical withdrawal that occurs once the body has gotten back to its normal functioning in spite of this substance, and is then deprived of it. Because then, having it is the new “normal” and being without it is abnormal. This is what creates a chemical dependence. Depending on what the substance is, the effects of withdrawal can range from a headache, as with caffeine, to seizures or even death, as with alcohol. That’s why, in many cases, the addict literally can’t live without it.
To review, the features unique to addictions are (1) the non-vital substance, (2) tolerance, and (3) physical dependence. The last one happens only after tolerance has developed and is caused by the need to prevent withdrawal symptoms. Until tolerance develops, it’s called substance abuse, which may produce a response in the brain – a high or low or a perceptual distortion, for example, depending on what the substance is. But it’s not yet an addiction until the brain adjusts to that effect and the person needs it just to go on feeling normal. At that point, the user may then increase the dosage until it produces the effect again.
So how does that differ from a compulsion? Compulsions do not involve introducing a chemical substance into the body that is not part of its normal functioning. A compulsion is a behavior that you feel you have to do, usually to avoid or control an intolerable sense of anxiety. An addiction is something that if you don’t do, you’ll get sick or die.
While food is a chemical substance, you can’t live without it because any organism, including a human one, relies on nutrition as a normal and necessary part of its functioning. Therefore, it does not meet the first criterion of introducing a non-vital substance. It is also not something whose effects you can develop a tolerance to since its main effect is delivering nutrients to the body, not altering the working of the brain. So it fails the second criterion too. The third feature of addiction, physical dependence, is certainly true of food, but that’s how the body functions normally, not a response that the body develops to compensate for a foreign chemical in its system. Strike three.
Emotional eating, therefore, is a psychological compulsion to do something that would otherwise cause emotional distress, not physical withdrawal. The force that drives the behavior, in my view, is the need to counteract feeling controlled by certain external forces by acting out against those or other external forces. The goal is to even one’s perception of the playing field in the ongoing tension between external demands and internal autonomy.
The reasons that it is important to be careful about using the term addiction, is that the comparison, if it is not clear, could suggest that the treatment of an emotional compulsion should follow the model of treating a physical addiction. The problem with that is the first step in that treatment is to abstain. And as I’ve been saying all along, trying that with any foods would only make things worse.