By Susan Branscome
Board member
The interview with Dr. Lamia Haque of the Yale School of Medicine, Understanding the Links Between Alcohol Use Disorder and Food Addiction, explores something that many of us in the Food Addiction community have experienced: the similarities between addiction to alcohol and addiction to certain foods.
I know those similarities personally. I am in long-term recovery from both alcohol use disorder and Food Addiction. When I drank alcohol, something happened after that first drink — I wanted more. Over time, cravings intensified, control diminished, and eventually alcohol became something my brain and body seemed to need just to feel normal.
Later, I came to recognize a remarkably similar pattern with sugar and ultra-processed foods. Once I started, I wanted more. Cravings and loss of control followed. I was also a volume eater — the amount of food mattered as well as what I ate. Recovery ultimately meant recognizing that, just as I could not safely return to drinking alcohol, I needed clear boundaries around my food. For me, that included an individualized abstinent food plan developed with nutritional guidance, along with weighing and measuring my food, and support from a 12 Step food recovery program.
In recovery circles, we often talk about cross-addiction, the vulnerability to developing addictive patterns with more than one substance or behavior. Yale’s article brings important scientific and medical attention to the overlap between alcohol use disorder and Food Addiction.
But there is a significant difference in how our healthcare system responds.
Alcohol use disorder is recognized in the DSM — the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. There are established diagnostic criteria, treatment centers, medications, behavioral therapies, mutual-support and 12-step programs, and pathways for insurance reimbursement.
Food Addiction does not yet have that same recognition as alcohol or drugs. It is not currently a formal diagnosis in the DSM, or the World Health Organization’s ICD, International Classification of Diseases. Food Addiction treatment is not widely or consistently available. While obesity can be associated with food addiction, not everyone with obesity has food addiction, and food addiction cannot be defined simply by body size. Likewise, eating disorders such as binge-eating disorder, bulimia, and anorexia are recognized diagnoses in the DSM, but while there is overlap, they are not synonymous with food addiction.
The Yale article is an encouraging sign that medicine is increasingly examining Food Addiction through the lens of addiction science — looking at cravings, loss of control, neurobiology, withdrawal, cross-addiction, and the need for individualized treatment.