When someone repeatedly does something that any reasonable human being knows or ought to know that it is harmful to the self, it would be accurate to consider that individual as an addict as argued in Vella, & Pai. (2017). This is based on the hypothesis that the right to self-preservation is universally paramount to all sane humans. The individual actively causing harm to the self must be considered as desiring to stop but for some reason unable to. It is on this basis that substance abuse has been considered as a mental problem. In the recent years, the concept of addiction as a mental problem has expanded exponentially culminating in the classification of gambling addiction into the American Psychology Association’s Diagnostic and Statistical Manual of Mental Disorders number 5 of 2013 (DSM-V). Yet, only Binge Eating Disorder (BED) is included in BS-V leaving out other eating disorders such as overeating and also sex addiction were omitted, a matter that has been contested. This is based on the high congruency between eating disorders and Substance Use Disorder (SUD). Unlike drugs and gambling, eating and sex are the two fundamental activities that facilitate the survival of the human species as indicated in Valentino (2017), hence the difficulty in having them classified alongside drugs and gambling in the DSM. This research paper will evaluate the perspectives canvassed in Gold, Frost-Pineda, and Jacobs (2003) and Balodis, Grilo, and Potenza (2015) on the subject of eating disorders and their inclusion in the DSM.
The Gold, Frost-Pineda, Jacobs, W. (2003) Perspective
The article by Gold et al. (2003) takes the perspective that all eating disorders are addictions. This makes them so congruent to substance abuse that they ought to be listed in the DSM as mental disorders. The article focuses on how eating disorders in general and specifically relate to substance abuse. It compares food to substances that are abused and the effect that abusing food has on the abuser. Further, it also does a psychological analysis of eating disorders while comparing to substance abuse. A careful analysis of the article will show that throughout the study, the circumspect effort is made to ensure absolute congruency between substance abuse and food abuse from a psychological perspective. An important point of divergence that is worthy of mention before analyzing the congruency is that substance abusers refrain from food to enable the abused substances to have a more potent effect. Indeed, one of the grounds for intervention for substance abuse is due to substance abusers perennially shunning food, thus leading to exponential adverse effects.
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According to the article, eating disorders and substance abuse are based on similar psychological reward associations. A person with an eating disorder has the same unstoppable desire to eat just as a substance abuser has an unstoppable desire to the abused substance. This points to the loss of control for the abuser. Chronic relapses and pathological attachment are also endemic in both eating disorders and substance abuse. Further, both nature and nurture are seen as vulnerability contributors to both conditions. The article presents studies that suggest a genetic preponderance to eating disorders through family association and shows similarities between the same and the similar trends in substance abuse. In an interesting observation, drugs and food are used as a treatment for one another. Individuals with eating disorders are treated with addictive drugs while individuals with drug abuse problems are treated with increased amounts of the kinds of foods that have a high preponderance of addiction. The issue of denial is also canvassed. Just as people with the substance abuse problem are in denial even to themselves about the problem, so does those with eating disorders. The article argues that most eating disorders exacerbate because the victims actively deny even to themselves the fact that they have a problem. The totality of the above leads the authors to the conclusion that all eating disorders are addictions just as substance abuse, thus the two should appear together in the DSM.
Analysis of the conclusion
Many available studies including Shell and Firmin (2017) agree with the analysis made in the article by Gold et al. (2003). Most researchers have concluded that there is a major congruency between all eating disorders and substance abuse. Eating disorders all seem to take a similar trend to that taken by substance abusers. From a general perspective, the only difference between all eating disorders and substance abuse is not the behavior of the abuser but rather the substance itself, as canvassed in Vella and Pai (2017). It is on this statement that the conclusions made in Gold et al. (2003) must be found wanting. This conclusion focuses purely on behavior and ignores the implication of the substance in question. For instance, an extreme compulsion towards hugging people can be a problem but it differs exponentially from an extreme compulsion to hug a wolf based on the fact that any compulsion to hug a wolf, no matter how mild is still dangerous. Eating disorders may seem similar to substance abuse but there is no congruence.
The Perspective of Balodis, Grilo, and Potenza. (2015)
The article by Balodis et al. (2015) also canvases the subject of eating disorders from a psychological perspective. A careful study of this article will clearly indicate that unlike Gold et al. (2003), it does not seek to lump up all eating disorders into one category. This could perhaps be based on the fact that the article focuses more on the critical problem of obesity which has ravaged America thus taking more of a psychiatric approach, not just a general behavioral approach as taken by Gold et al. (2003). For a start, Balodis et al. (2015) separate the issue of food addiction in general and BED as also canvassed in Bąk-Sosnowska. (2017). BED is the only eating disorder recognized and classified in DSM-V. BED, as elaborated upon in the article, complete with scientific evidence, is clearly a psychological disorder. However, the article goes further to exonerate BED from causing obesity, a position that is also argued in Burrows et al. (2017). This is because binge eating takes place in episodes followed intermittently by episodes of eating poorly. It may, therefore, lack the momentum to lead to obesity but can still be a debilitating and harmful disorder. Overeating, however, which is commonly referred to as Food Addiction (FA), is a different issue altogether . This is the insatiable compulsion to eat and is among the major contributor to the problem of obesity in America. However, overeating is an extremely complex issue because the overeating of healthy foods would seldom be considered as an eating disorder. Instead, it is the overeating of specific foods, most of which are fatty or sugary and also cheaply available. Therefore, Balodis et al (2015), which is written over a dozen years after Gold et al (2003) does not draw substantive conclusions about eating disorders as an addiction that ought to be classified in the DSM, but rather recommends further research while indicating that the particular subject is still extremely under-researched .
Conclusion
The subject of eating disorders as a psychological problem cannot be considered as a simple and straightforward issue as Gold et al (2003) presents it. The arguments made in this article are all absolutely true and are supported by many other scholarly articles. However, their conclusion is based on the omission of another important perspective of the same problem. This perspective is represented inter alia in Balodis. (2015). First, it seeks to differentiate between BED and FA, which Gold et al (2003) use almost interchangeably. It then indicates that there is a major difference between BED which is a psychological problem and FA which has been causing a major physiological problem. This coupled with the fact that food is a basic need thus eating in itself is not a problem leads to the conclusion that eating disorders should not all be considered as psychological problems. Instead, they should be studied further to arrive at a better understanding.
References
Bąk-Sosnowska, M. (2017). Differential criteria for binge eating disorder and food addiction in the context of causes and treatment of obesity. Psychiatria Polska , 51 (2), 247-259
Balodis, I. M., Grilo, C. M., & Potenza, M. N. (2015). Neurobiological underpinnings of obesity and addiction: a focus on binge eating disorder and implications for treatment. Psychiatric Times , 32 (7), 56-59
Burrows, T., Skinner, J., McKenna, R., & Rollo, M. (2017). Food addiction, binge eating disorder, and obesity: Is there a relationship? Behavioral Sciences , 7 (3), 54. doi: 10.3390/bs7030054
Gold, M. S., Frost-Pineda, K., & Jacobs, W. S. (2003). Overeating, binge eating, and eating disorders as addictions. Psychiatric Annals , 33 (2), 117-122
Shell, A. G., & Firmin, M. W. (2017). Binge eating disorder and substance use disorder: A case for food addiction. Psychological Studies , 1-7
Valentino, T. (2017). Breaking the cycle: Sex addiction and eating disorders. Process and Addictions . 42-44
Vella, S. L., & Pai, N. (2017). What is in a name? Is food addiction a misnomer? Asian Journal of Psychiatry , 25 , 123-126
