Welcome to your introduction on behavioural addictions. As part of our advocacy plan for substance use disorders, Stigma Ends at CU has chosen to expand its focus to include behavioural addictions. This shift acknowledges behaviours that can become harmful, similar to substance use when they start to impact individuals and communities significantly. But what exactly are behavioural addictions, and how do they differ from substance use disorders?
Behavioural addictions refer to compulsive behaviours that produce short-term rewards but lead to negative consequences in the long run (Robbins & Clark, 2015). Unlike substance use disorders, which involve physical dependence on drugs or alcohol, behavioural addictions stem from activities such as gambling, gaming, shopping, and eating. Behavioural addictions share many similarities with substance use disorders, including cravings, loss of control, and continued engagement despite negative consequences (Griffiths, 2017). However, unlike substance use disorders, behavioural addictions do not involve the ingestion of an external substance that alters brain chemistry. This distinction has led some to question whether behavioural addictions warrant the same level of concern as substance use disorders (Billieux et al. 2015). Others argue that the neurobiological changes associated with compulsive behaviours, such as alterations in dopamine pathways, suggest that behavioural addictions should be treated with similar urgency.
One of the primary controversies surrounding behavioural addictions is the lack of universally accepted diagnostic criteria. Some behavioural addictions, like gambling disorders, are formally recognized in diagnostic manuals such as the DSM-5, however, others like internet gaming disorder or food addiction, remain under consideration or have limited recognition (Robbins & Clark, 2015). The absence of clear boundaries between normal, chronic, or excessive behaviours complicates efforts to define these conditions.
For example, one of the most debated topics within behavioural addictions is food addiction (Ahmed et al., 2022). Food addiction is characterized by an inability to control the consumption of highly palatable, often calorie-dense foods, even without hunger (Bocarsly & Avena, 2021). It shares symptoms with other addictions, such as intense cravings, binging, and feelings of guilt or shame after eating.
Yet, despite these parallels, food addiction remains controversial. Critics argue that the term pathologizes normal eating behaviours, particularly in a culture already fraught with diet-related stigma. Others contend that labelling certain foods as “addictive” oversimplifies the complex biological and psychological factors contributing to overeating, such as emotional distress, genetics, and environmental cues. Moreover, the food addiction framework risks conflating eating disorders like binge eating disorder (BED) with addiction, potentially leading to misdiagnosis and ineffective treatments (Hauck et al., 2020).
Understanding the controversy surrounding food addiction is critical for effective advocacy. If food addiction is valid, it may justify the development of targeted interventions, such as behavioural therapies and public health campaigns that address the addictive properties of certain foods. Conversely, mislabeling behaviours as addictive could perpetuate harmful stigmas and undermine support for those struggling with eating disorders or other health conditions.
As Stigma Ends at CU and the world integrates behavioural addictions into our advocacy efforts, we must navigate complex and often controversial topics like food addiction. By examining these issues, we can better understand the nuanced relationship between compulsive behaviours and health, ultimately fostering a more inclusive and effective approach to addiction treatment and prevention.
Author: Sarah Vieira
References:
Ahmed, S. H., Avena, N. M., Berridge, K. C., Gearhardt, A. N., & Guillem, K. (2022). Food addiction. In Neuroscience in the 21st century: From basic to clinical (pp. 4193-4218). Cham: Springer International Publishing.
Billieux, J., Schimmenti, A., Khazaal, Y., Maurage, P., & Heeren, A. (2015). Are we overpathologizing everyday life? A tenable blueprint for behavioural addiction research. Journal of Behavioral Addictions, 4(3), 119–123. https://doi.org/10.1556/2006.4.2015.009
Bocarsly, M. E., & Avena, N. M. (2021). Animal Models of Binge-Eating Palatable Foods: Emergence of Addiction-Like Behaviors and Brain Changes in the Rat. Animal Models of Eating Disorders, 173-185.
Griffiths, M. D. (2017). Behavioural addiction and substance addiction should be defined by their similarities not their dissimilarities. Addiction, 112(10), 1718-1720.
Hauck, C., Cook, B., & Ellrott, T. (2020). Food addiction, eating addiction and eating disorders. Proceedings of the Nutrition Society, 79(1), 103-112.
Robbins, T. W., & Clark, L. (2015). Behavioral addictions. Current opinion in neurobiology, 30, 66-72.
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