The Thing About Compulsive Overeating

Food Addiction

The thing about compulsive overeating is, there are a lot of things about it. It’s a very hefty subject with many fascinating areas of inquiry. For women, the hormones involved in the monthly cycle are implicated as compulsive-eating triggers. But males can be compulsive eaters, too — what’s up with that?

What does it mean to be compelled? Is compulsion the same as addiction? Is there a connection between compulsive eating and obsessive-compulsive disorder? Do we need different approaches for adult obesity and childhood obesity? So many questions.

And, really, isn’t all eating compulsive? It’s a hardwired basic instinct. Whether the object is a nipple or a wooly mammoth, we’re programmed to look for food and then to ingest it, because we must eat to live. But, for various reasons, in some humans the normal, sane, and necessary compulsion to eat becomes monstrously deformed into a compulsion to overeat, even against the organism’s own best interests. Instead of eating to live, we live to eat. At that point, the compulsion to eat is no longer healthy, but pathological. It’s prolonged suicide, slow-motion self-annihilation. And deep inside we know it. So, why don’t we stop?

What is the difference between compulsive eating and compulsive overeating? Seems like if there is a compulsive element at all, it is inescapably in the “overeating.” Overeating is consuming more calories than we burn, taking on more fuel than we need to power the engine.

“Binge eating” and “compulsive overeating” seem to be used pretty much interchangeably. An easy-to-read summary of the diagnostic criteria for binge eating, from the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition), can be found on a page offered by the Eating Disorder Referral and Information Center. In recommending treatment options, the group makes this point emphatically:

… people with binge eating disorder may require treatment that focuses on their binge eating before they try to lose weight. Further, even those who are not overweight are frequently distressed by their binge eating and may benefit from treatment.

Sounds like they’re saying, it’s an addiction whether or not it makes you fat. Body mass index is not the issue. The issue is addiction. Take care of that, and you’re on your way to a better life. But… the theory of addiction transfer suggests that it’s all one habit, regardless of the substance of choice or the process of choice.

A lot of anecdotal evidence backs this up. People swap food for gambling. (Interestingly, in casino capitol Las Vegas, Nevada, you can go to a meeting of Compulsive Eaters Anonymous every day of the week.) Or they trade liquor for opiates, but the same compulsion is at the root.

We quoted Meghan Vivo:

People who struggle with compulsive behavior… often find that they overcome one addiction only to develop another months or even years later. Research suggests that the same biochemical processes are at work in multiple types of impulse-control disorders… Each of these behaviors triggers the same reward sites in the brain, resulting in cravings that are difficult to resist.

Here is the gist of a substantial article on food addiction written by Harriet Hall:

Dr. Kendall Gerdes is a former president of the American Academy of Environmental Medicine… He described the concept of food addiction as a powerful tool to free patients from compulsive eating.

When people talk about the science or the research or the findings, it’s good to remember that a lot of the science is derived from animal experiments. Some people don’t even believe that results from small mammals can mean so much when applied to humans.

In studies such as “Dopamine D2 receptors in addiction-like reward dysfunction and compulsive eating in obese rats” (Johnson, P.M., & Kenny, P.J., 2010), when the validity of human comparison is not doubted, many interesting conclusions can be drawn. This is one of the topics covered in Dr. Pretlow’s paper, “Addiction To Highly Pleasurable Food as a Cause of The Childhood Obesity Epidemic: A Qualitative Internet Study,” which will be published in the print version of Eating Disorders: The Journal of Treatment and Prevention (Volume 19 #4, July/Aug/Sept, 2011) and is already present online.

Your responses and feedback are welcome!

Source: “Eating Disorder Referral and Information Center ,”
Source: “Food Allergies and Food Addiction,” Science-Based Medicine, 05/04/10
Image by Rennett Stowe, used under its Creative Commons license.

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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