Genetic predisposition accounts for 40-60% of the vulnerability to addiction, highlighting its nature as a medical condition.
Factors like early exposure, trauma, and socioeconomic conditions play critical roles in the development of SUD.
Some behaviors that appear harmful may serve important regulatory functions for individuals struggling with emotional distress. This module examines food addiction—a controversial concept with significant research support—and non-suicidal self-injury, both of which can be understood as maladaptive attempts to cope with overwhelming emotions. Understanding the function of these behaviors is essential for compassionate, effective treatment.
By the end of this module, you will be able to:
How we speak about addiction affects patient care and recovery. Use person-first language to reduce bias.
Food addiction proposes that certain foods (particularly highly palatable, processed foods) can trigger addiction-like responses in vulnerable individuals, characterized by:
Arguments FOR Food Addiction:
Arguments AGAINST:
The brain's reward system evolved to reinforce survival behaviors. Addictive substances create a dopamine surge that far exceeds natural stimuli:
Highly palatable foods (high sugar, fat, salt combinations) activate reward pathways:
| Finding | Implication | |---------|-------------| | Dopamine release in NAc | Same reward pathway as drugs | | Opioid system activation | Pleasure response | | Tolerance-like effects | May need more for same satisfaction | | Withdrawal-like symptoms | Irritability, craving when restricted |
Food scientists engineer processed foods to maximize palatability:
Note: This doesn't mean these foods are "addictive substances" in the same way as drugs, but they may exploit similar neural mechanisms.
Research suggests certain food characteristics are associated with addiction-like eating:
Examples: Chocolate, ice cream, pizza, chips, cookies, cake
Rarely implicated: Vegetables, fruits, plain meats, whole grains
The Yale Food Addiction Scale (YFAS) is a 25-item self-report measure assessing addiction-like eating using DSM criteria for substance use disorders adapted for food.
| Population | Prevalence | |------------|------------| | General population | 5-10% | | Overweight/obese | 15-25% | | Bariatric surgery candidates | 30-50% | | Binge Eating Disorder | 50-70% |
Recurrent episodes of binge eating characterized by:
Episodes associated with 3+ of:
Frequency: At least once weekly for 3 months Distress: Marked distress about binge eating No compensatory behaviors (distinguishes from bulimia)
Significant overlap but not identical:
Gold standard for BED and problematic eating:
Addresses emotional regulation:
FDA-approved for BED:
Off-label:
Non-suicidal self-injury is the deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned.
Common Methods:
| Population | Lifetime Prevalence | |------------|---------------------| | Adolescents | 15-20% | | Young adults | 10-15% | | Adults | 5-6% | | Clinical populations | 40-80% |
Understanding WHY someone self-injures is crucial for treatment:
Emotion Regulation (most common):
Self-Punishment:
Communication/Influence:
Anti-Dissociation:
Anti-Suicide (paradoxically):
Self-injury may work through the endogenous opioid system:
Mechanism:
Evidence:
This mechanism may also explain:
Method, Frequency, Severity:
Function:
Suicidality:
Comorbidities:
Dialectical Behavior Therapy (DBT):
Cognitive Behavioral Therapy:
Mentalization-Based Therapy:
No medications specifically approved for NSSI
How we speak about addiction affects patient care and recovery. Use person-first language to reduce bias.
Both food addiction/binge eating and NSSI share:
Many of these behaviors develop in context of:
Key Message: These behaviors often make sense as survival strategies in context, even when they become harmful.
Shreya, 19, presents with her mother who is concerned about cuts on Shreya's arms and recent weight gain. Shreya admits to cutting herself when "things get too overwhelming" and eating "until I feel numb" several times weekly. She has history of childhood sexual abuse. She says cutting and eating are "the only things that help."
Discussion Questions:
Part 3 Complete! Next: Part 4: Resolution & Future, beginning with Module 14: Treatment & Recovery →
External links
Use one of the external tools below to explore "Food Addiction & Self-Harm: Maladaptive Coping". Check clinical claims against approved sources.
External links
Use one of the external tools below to explore "Food Addiction & Self-Harm: Maladaptive Coping". Check clinical claims against approved sources.