Abstract
SUMMARY Eating disorders show some similar features to substance abuse and dependence, but this does not justify viewing them as an addiction. Neither tolerance nor withdrawal reactions to food have been demonstrated. Evidence for “carbohydrate craving” is lacking, and other ostensibly common features (e.g., loss of control over eating, preoccupation with food) have biobehavioral explanations that do not invoke addiction. While not an addiction, eating disorders have been reliably linked to substance abuse and dependence in clinical and community samples. However, the association is not a specific one, and the mechanisms that explain it are unknown. Independent familial transmission of eating and substance use disorders indicates that they do not derive from a single, shared etiological mechanism. Clinicians should routinely screen for substance abuse in eating disorder patients and vice versa.
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