The American Psychiatric Association's selected criteria for substance dependency [aka addiction] appears below. The author speculates the same criteria may be used to determine whether an individual suffering from Anorexia, Bulimia, or Binge Eating Disorder displays the same characteristics. Listed below are the [7] criteria per the APA committee and task force for Substance Dependency. Can you identify some [or all] of these characteristics as it relates to your relationship with food or behaviors related to eating and/or dieting such as exercise, etc.?
- TOLERANCE
- WITHDRAWAL
- MORE FOR LONGER PERIOD THAN INTENDED
- UNSUCCESSFUL EFFORT TO CUT BACK OR CONTROL
- SIGNIFICANT TIME TO OBTAIN OR RECOVER FROM EFFECTS
- DECREASED ACTIVITIES DUE TO DEPENDENCY
- CONTINUES DESPITE CONSEQUENCES
To be clear, there is a definitive relationship between most eating disorders and these "symptoms" that define an "addiction"... [email: mlerner@milestonesprogram.org for referrences].
Applying and identifying each of these criteria as it relates to your particular eating disorder requires an underestanding each criterion. That said, what follows are a series of questions corresponding to each:
- TOLERANCE:
Do you experience a progression of having to do more of the ED behavior [binge eating, restricting, and/or purging, etc.] over time to achieve similar effects as when first beginning?
- WITHDRAWAL
Have you ever experienced emotional or physical symnptoms such as depression, increased anxiety, loss of concentration, severe irritability, dizziness, etc., when you have abstained from your eating disorder for any period of time?
- MORE FOR LONGER THAN INTENDED
Do you find yourself engaging in the eating disorder behavior for longer periods of time than first intended [binge eating for longer than intended, not eating for increasing periods of time, etc.]
- UNSUCCESSFUL EFFORTS TO "CUT BACK"
Attempts to abstain from your eating disorder [Not binge eating, not restricting, not purging, reducing exercise, etc.] met with relapses back into the ED. Not being able to "stay stopped"
-SIGNIFICANT TIME TO OBTAIN OR RECOVER FROM ED
Have you experienced an inordinate amount of time taken to recover from the effects of your ED or excessive time to be able to engage in your ED activities [food preparation, lost work or social engagements cancelled, etc.]?
-DECREASED ACTIVITIES DUE TO ED
Looking back, have you noticed yourself beginning to isolate socially and avoid social activities and other "once pleasurable" activities due to your eating disorder?
-CONTINUE WITH YOUR ED DESPITE CONSEQUENCES
Have you continued to engage in your eating disorder behavior[s] despite physical, emotional, social consequences such as medical problems resulting from your ED, noticing a greater degree of anxiety and depression as a result of your ED, isolating yourself from friends and family, etc.?
From am medical standpoint, exhibiting three [3] or more of these symptoms [criteria] meets the definition of an addiction. In our experience at Milestones, more than 90% of our residents describe themselves as meeting six[6] or more of these characteristics. Perhaps this is more reflective of the "stage" at which they entered treatment. In any case, you can decide for yourself if you have an addictive relationship with your eating disorder. All it takes is an open and honest review of your relationship with food and body image and a willingness to take action to recover. Some of us refer to this as "H.O.W." - Honesty, Open Mindedness, and Willingness.
Marty Lerner, Ph.D.
CEO and Executive Director, Milestones In Recovery
MilestonesProgram.Org
800-347-2364
Dr. Lerner is the founder and executive director of the Milestones in Recovery Eating Disorders Program located in Cooper City, Florida. A graduate of Nova Southeastern University, Dr. Lerner is a licensed and board certified clinical psychologist who has specialized in the treatment of eating disorders since 1980. He has appeared on numerous national television and radio programs that include The NPR Report, 20/20, Discovery Health, and ABC’s Nightline as well authored several publications related to eating disorders in the professional literature, national magazines, and newspapers including USA Today, The Wall Street Journal, New York Times, Miami Herald, Orlando and Hollywood Sun Sentinels. An active member of the professional community here in South Florida since finishing his training, Dr. Lerner makes his home in Davie with his wife Michele and daughters Janelle and Danielle and their dog, Reggie.