No. Obesity, eating disorders and chemical dependency on food are three very different medical problems. Some have only one of these medical problems, though it is not unusual for people to have all three.
Obesity is entirely a physical disease. It is caused by excessive calorie intake and/or not using enough calories – and, occasionally, by a metabolic or other medical dysfunction.
Using Body Mass Index (BMI) and established medical standards, the Center for Disease Control has found that a third of the U.S. population is obese and another third is overweight. (CDC, 2010) Historically, between 10% and 30% of overweight and obese adults are able to lose substantial weight and keep it off by dieting either on their own or with the help of commercial diet programs. Since being able to control one’s weight in a healthy manner generally disqualifies a person from being diagnosed with an Eating Disorder or a Substance Use Disorder on food, this shows that there are a substantial number of overweight and obese people who are not food addicted.
Eating Disorders are a psycho-social disease. It is caused by early family dysfunction, trauma and/or unhealthy social norms for body weight and beauty. Using the characteristics established by the American Psychiatric Association, a recent Harvard University study found that 1.8% of the U.S. population is Anorexic, 2.6% is Bulimic, and 3.8% had Binge Eating Disorder. (Hudson et al, 2007)
Food addiction is a chemical dependency. It is caused by the changes in the brains of some people in reaction to the biochemistry of a specific food, several foods or volume of food in general. Using the American Psychiatric Association’s criteria for Substance Use Disorder, Dr. David Kessler, former Commissioner of the U.S Food and Drug Administration and Dean of Yale University Medical School, found that 50% of the obese, 30% of the overweight and 20% of the normal weight adults in a randomized sample were food addicted. (Kessler, 2007) If this initial study represents the U.S. adult population, there are 70 million food addicted adults.
The most difficult cases are those who are food addicted and eating disordered – or have some other addiction or mental illness coexisting with chemical dependency on food. About 80% of the tens of thousands of Overeaters Anonymous members say that they have blood relatives with alcoholism or some other substance addiction, and about the same number say that they have a history of physical, emotional or sexual abuse. This suggests that a very large number in the fellowship – and probably many more outside the fellowship – have both a chemical dependency on food and a trauma based eating disorder. In this case, recovery is possible, but only if both problems are effectively addressed.
Hudson JI, Hiripi E, Pope HG Jr., Kessler RC, The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007 Feb 1; 61(3):348-58. Pub 2006 Jul 3.
Kessler, David The End of Overeating: Taking Control of the Insatiable American Appetite, Rodale Books, 2007.
© Philip Werdell, 2011