Treating Eating Problems: Looking Beyond Addiction

Smiling woman eating saladWhen it comes to eating and food-related problems, various philosophies determine how eating problems are defined and addressed. When the eating disorders treatment field was in its infancy, professionals often based their approaches on those used in the treatment of alcoholism and drug addiction. The addictions model has been used to salvage the lives of alcoholics since the formation of Alcoholics Anonymous (AA), in the 1930’s. AA spawned myriad other twelve-Step programs for addressing various addictive problems. One of the earliest of these was Gamblers Anonymous (GA). Overeaters Anonymous (OA), a twelve-step self-help program for people who feel compelled to overeat, was created in 1960, modeled after GA. OA philosophy views compulsive overeating as an addiction to both a substance – various types of food – and to the behavior of overeating compulsively. As OA grew, people suffering from all types of eating problems began attending, and found help there.

However, as research on eating problems proliferated, and eating disorders came to be better understood, health care professionals began to recognize that while twelve-step programs offer members an unparalleled access to peer support, a practical spiritual philosophy, and a systematic approach to healing at nominal cost, the twelve-step philosophy doesn’t always translate well from its originally intended formula as a treatment of alcoholism to an effective means of treating disordered eating.

Applying an addictions model to eating problems means believing that a person has a disease that causes them to be addicted to certain types of foods, certain eating behaviors, or both. The recovering person practices abstinence, the corollary to an alcoholic’s sobriety. This might mean eating only at meal times, or refraining from eating refined sugars, or from other types of food or eating behaviors. Thus, a between-meal snack or a piece of pie at the end of dinner would be as much a break of abstinence as a no-holds-barred eating binge. This perspective dangerously mimics eating-disordered thinking, which says that eating outside of certain predetermined rules is bad.

Eating-disordered thinking comprises certain thought patterns that are common to all types of eating problems. These patterns include the beliefs that the person thinking the thoughts is weak and lacks willpower, and needs to follow certain eating guidelines to feel safe and good about him/herself. Some tenets of the addictions model, e.g., that the sufferer has a disease from which he can never be fully recovered, that sufferers cannot trust themselves, and that self-confidence is a liability rather than a strength, are quite resonant with the voice of the eating disorder itself. Eating disorders sufferers feel intense shame about their appetites and desires. The addictions model, when misapplied to disordered eating, attributes these appetites and desires to “the disease,” rather than exploring their significance.

The disease concept helps relieve alcoholics and addicts of the shame they experience. It helps them understand that their behavior is not a function of personal weakness or flaws, but of an affliction they have. However, it also teaches them that they can never fully trust their thinking because their disease might be influencing it, that they must learn to live with it. A common saying in twelve-step programs is that it’s important not to become complacent because the disease is “always in the next room, doing push-ups.” While this perspective can be very useful for a recovering alcoholic or gambler, it can backfire on a disordered eater.

While eating disorders treatment professionals often find it helpful to separate the disorder from the person, much as addictions philosophy does with the disease concept, the focus is on developing a strong sense of self-confidence and self-worth, and letting go of an eating disordered-identity. The goal is to learn to live without the disorder. Appetites and desires for all kinds of foods are regarded as normal and healthy, and when they surpass desires for “normal” amounts, they are seen as indicative as hungers for other things a person needs.

An integrative model of recovery encourages attention to the body’s wisdom, a reconnection to hunger and satiety signals, and development of self-trust. It says that while recovering people often benefit from nutritional guidance and eating plans, there are no off-limits or bad foods, no rules to be broken. A commitment to stop dangerous behaviors such as purging via laxatives or self-induced vomiting, compulsive exercise, and bingeing, comes at different points in people’s recovery.

An integrative approach to treating disordered eating draws on therapies that address behavior, cognition, emotions, body image, and spirituality. It helps people who struggle with food-related problems to connect to the parts of themselves that are hungering for something bigger and deeper than food, and to feed those hungers appropriately. For people in twelve-step programs for their disordered eating, an integrative approach can incorporate the positive aspects of an addictions approach, while empowering them to return to a state of balance and self-trust, and develop an intuitive and satisfying relationship with food and with themselves.

© Copyright 2010 by Deborah Klinger, MA, LMFT, CEDS, therapist in Durham, North Carolina. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Melanie p

    Melanie p

    February 19th, 2010 at 5:48 AM

    It’s a behavior thing.You have to change the behavior before you can stifle the addiction.

  • william


    February 19th, 2010 at 6:56 AM

    my brother has eating problems he does not overeat but eats in an inappropriate manner. from what I have observed, he eats too fast and doesn’t chew his food enough. he does not eat an excessive amount but still has his tummy hurting on a regular basis. I have told him to try and enjoy the meal rather than just go through it like a duty, but he doesn’t seem to listen.



    February 19th, 2010 at 10:26 AM

    Eating disorders are actually quite dangerous…come to think of it, eating disorders are a rare kind of disorders that lead to other problems and even ailments… it may lead to htings like diabetes, obesity and many other problems…

  • dion


    February 20th, 2010 at 3:32 AM

    eating right is like walking on a very thin rope…you should neither eat less nor should you go overboard and eat too much.the best policy to follow would be that of the middle path…eat right and eat a sufficient amount, but not to overdo it. it is also important about what you eat in addition to how much… you cannot eat a single thing at all times even if you are taking in the right amount of it. you need to balance all this.

  • colleen


    February 20th, 2010 at 11:38 AM

    This is not a one size fits all kind of fix, same thing with alcohol. There are all kinds of underlying issues that may drive someone to overeat and there has to be treatment that is designed to address all of these different concerns. Not one plan is always going to do the trick.

  • robin r

    robin r

    February 21st, 2010 at 1:21 PM

    I have always felt weak when it comes to food, and just like the 12 steps say, i had to recognize very early on that it has a power over me but that I have the ability to make choices to control that power. That is not always the easiest thing to do- give me a good Chinese takeout menu and I go weak in the knees. :-) But seriously there are things that you can take away from the 12 step programs which can help with any type of addictive situation but like other readers have mentioned there is not one thing that is designed to help everyoe. All addictions are different and manifest themselves in different ways depending on the individual. I rely on my sponsor to help me keep my head straight and to keep my eating under control but there are others who think that this is too heavy handed and do not do well under this type of approach at all. But this is what is so cool. We are all different, that’s what makes the world go round. And instead of getting all tied up with the things that don’t work we should do a better job at highlighting those things that do and find a way to implement those into many lives so that more people can benefit and find peace in their lives.

  • bennett


    February 22nd, 2010 at 10:10 AM

    I have tried the OA program but I did not like it. Are there other programs which target overeaters but have a different focus than the 12 step stuff? I would love to try something like that but I live in a small community and I know that there are not that many resources readily available to me. It’s kinda like I know I need help but don’t know where to go to get it.

  • Deborah Klinger, M.A., LMFT, CEDS

    Deborah Klinger, M.A., LMFT, CEDS

    March 2nd, 2010 at 7:25 PM

    Thank you all for the insightful comments!

    Melanie, I believe that eating and food are different from “pure” addictions like alcohol, drugs, gambling, etc. With those things, the addict must stop engaging in the behavior before s/he is detoxed and clear-minded enough to do the work to make the changes necessary to heal and to build a fulfilling, addiction-free life. With food and eating, changes need to be made as the inner work and life-building is done. Eventually, the destructive eating behaviors are resolved.

    William, I encourage you to show your brother curiosity about his eating behaviors. Let him know you’re concerned and really want to understand what’s going on with him.

    Ether, yes, eating disorders are quite dangerous. If I have my statistics right, they have the highest fatality rate of all mental disorders.

    Dion, eating the right balance of foods is essential to well-being. All bodies need certain types of nutrients in certain combinations throughout the day to give a body what it needs.

    Colleen, I agree. We are all unique individuals, and what works for one person may not be the right fit for another.

    Robin, ditto. I’m glad the 12-Step approach is working for you. My only quibble is that, again, I believe that food and eating are different from “pure” addictions in that with an addiction like drugs and alcohol, the addict must never use that substance again– ingesting it will trigger a reaction that causes the person to crave it and probably abuse it again. The addict can’t drink alcohol like a normal person or use drugs recreationally. When it comes to food/disordered eating, re-connecting to one’s body’s signals and restoring trust in one’s ability to eat normally is an important part of recovery.

    Bennet, I encourage you to search the web, starting with the lists on GoodTherapy, for therapists in your area who offer support groups or group therapy for disordered eaters. If you can’t find any in person, there are online support resources. The National Eating Disorders Ass’n (NEDA), Gurze Books (, Overcoming Overeating, edrefferal. com and the newly formed Binge Eating Disorders Ass’n (BEDA) are a few that come to mind. You might read Geneen Roth’s “Breaking Free from Emotional Eating” and start your own peer support group!

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