Anorexia nervosa is an eating disorder characterized by very restrictive eating or dieting leading to weight loss, a fear of weight gain, and a distorted body image. Several physiological mechanisms and behaviors that maintain and worsen symptoms of anorexia have addictive qualities that parallel that of substance use disorder. Similarities between anorexia nervosa and substance use disorder are explored, including other relevant diagnoses and phenomenons like reward deficiency syndrome. Related mechanisms and behaviors associated with anorexia and substance use disorder include (...) compulsion, the detrimental continuation of maladaptive behaviors, impaired control, and disorder-related changes in neurology. Conceptualizing anorexia nervosa as an addiction could assist in creating effective treatments for this disorder. (shrink)

Anorexia Nervosa is widely recognized as having both cognitive and affective dimensions. Current accounts typically explain the perplexing behaviors associated with this eating disorder by emphasizing either its cognitive components—particularly false beliefs related to the denial of the patient’s actual conditions—or its affective components, such as the intense fear of gaining weight. I will argue that neither approach is sufficient to fully capture the complexity of Anorexia Nervosa. This paper explores a more comprehensive approach that goes beyond the cognition-affect dichotomy, (...) aligning better with the DSM-5 criteria for Anorexia Nervosa. These criteria suggest that while both affective and cognitive components play significant roles, neither the cognitive element nor the affective element is necessary or sufficient to define the condition on its own. I propose that this can be achieved by drawing an analogy with addiction, where both conditions can be seen as stemming from and maintained by an all-consuming fixation that permeates individuals’ lives and profoundly influences their behaviors. In Anorexia Nervosa, this fixation manifests as a pervasive preoccupation with body size and weight. What distinguishes these behaviors is their internal self-endorsement, aligning with the well-documented ego-syntonic nature of Anorexia Nervosa: sufferers perceive these behaviors as consistent with their feelings, values, and ideals, making them resistant to change. Understanding Anorexia Nervosa within the framework of addiction, particularly by recognizing the pivotal role of ego-syntonic fixation, allows for a more comprehensive approach to the disorder that sheds light on its high resistance to treatment and the challenges faced in clinical interventions. (shrink)

Anorexia nervosa is currently classed as a mental disorder. It is considered as a puzzling condition, scarcely understood and recalcitrant to treatment. This paper reviews the main hypotheses relating to the aetiology of anorexia nervosa. In particular, it focuses on family and sociological studies of anorexia. By reflecting on the hypotheses provided within these domains, and on the questions that these studies leave unanswered, this paper suggests that anorexic behaviour is understandable and rational, if seen in light of ordinary moral (...) values. (shrink)