Is Bulimia an Addiction?

Bulimia nervosa (BN) is a mental health condition that manifests as disordered eating behavior. But it can also share many of the same characteristics of drug addiction.

Recent research has found similar connections in the brain that are activated when someone engages in a binging episode and when someone uses recreational drugs.

Person with bulimia and substance use disorder

Some of these connections may also account for some of the compulsive thoughts and behaviors associated with bulimia nervosa. [1]

Just like addiction, BN can have many different causal factors, including biological, environmental, interpersonal, and cultural triggers. But with either condition, specialized professional treatment can help someone achieve a lasting recovery.

Behavioral Similarities of Bulimia and Addiction

According to the American Society of Addiction Medicine (ASAM), addiction is defined as a chronic medical disease involving genetics, environmental factors, and complex interactions between brain circuits. [2] It often manifests as a behavioral disorder characterized by compulsive thoughts and actions.

While bulimia nervosa is not technically classified as a type of addiction, many aspects of the disorder fit this definition.

Some overlapping factors include: [3]

  • Preoccupation with or craving for certain substances 
  • Withdrawal symptoms when routines are disrupted
  • Continuing unhelpful behaviors despite experiencing negative consequences
  • A sense of a loss of control over certain behaviors
  • Frequent relapses

Many experts acknowledge the similarities between bulimia nervosa and addiction. They believe that they are more interconnected than has likely been formally recognized.

Bulimia and Behavioral or Process Addictions

In fact, some types of eating disorders are sometimes referred to as process addictions. The term describes a form of behavioral addiction that occurs when someone becomes addicted to a process or activity. 

A process addiction involves continuous engagement in specific actions, despite experiencing negative physical and/or psychological consequences. In these cases, the actual behavior is what creates the reward, or “high.” 

Video gaming, gambling, and eating are all activities that are commonly involved in this type of addiction.

In many ways, bulimia nervosa also fits this idea. The process of binging and purging can bring about a sense of reward, both from the pleasures of eating and the “relief” of expelling food. And both of these behaviors can also be compulsive, with people losing a sense of control over their actions. 

Biological Similarities of Bulimia and Addiction 

While there is controversy surrounding classifying BN as an addiction, the two conditions also operate similarly on a neurobiological level. Some parallels include: [4]

Binge eating can elevate levels of dopamine, the chemical neurotransmitter involved in feelings of pleasure and motivation. Binging and purging can provide pleasure as well as relief from cravings and negative feelings.

When these behaviors are repeated, regions of the brain and chemical pathways involved in reward processing and impulse control can be altered. The same is true for substance abuse.

Another similarity between bulimia nervosa and addiction is the amount of time a person spends thinking about the subject of their condition. [5] 

With BN, people fixate on thoughts of food or eating, and after a binging episode, often experience compulsive thoughts to purge. Many people who struggle with BN also fixate on ideas surrounding body image and their body shape and size.

This type of narrowed perspective is also experienced by people struggling with addiction, who may spend a disproportionate amount of time thinking about their object of obsession.  

Tolerance is another common theme between bulimia nervosa and addiction.

It is possible to develop a “tolerance” for behaviors involved in BN. People may need to eat more to get the same high or purge more extensively to feel the same amount of relief. They may also develop a physical tolerance for certain purging mechanisms, including exercise and laxatives.

With addiction, as with BN, the development of tolerance often develops in tandem with the risk of experiencing withdrawal.

With substances, this withdrawal can be extremely physical and possibly even result in death in severe cases.

With BN, when certain binging or purging behaviors are not being performed, there can be a kind of “crash,” signified by withdrawal symptoms. This can include:

  • Low moods
  • Difficulties concentrating
  • Cravings to binge and purge

Shared Risk Factors of Addiction and Bulimia

Both addiction and bulimia nervosa are complex mental health disorders that likely have a variety of factors that prompt their development. In this way, they share a number of similar risk factors, including:

  • Genetics: A family history of addiction and/or bulimia nervosa can increase the odds of developing either or both of these disorders.
  • Environmental factors: A variety of environmental triggers can contribute to the onset of substance abuse or an eating disorder, including high levels of stress and social pressures.
  • Exposure to trauma: Being exposed to trauma, particularly at a young age, can play a role in the development of addiction and/or an eating disorder.
  • Mental health or medical conditions: Underlying medical and mental health issues can be factors in the development of co-occurring conditions, such as bulimia and addiction.

50% of those with an eating disorder struggle with substance use disorder.

In fact, it is extremely common for someone to struggle with an eating disorder and a substance use disorder at the same time. Studies have shown that these two disorders have a rate of co-occurring as high as 50%. [6] 

Why Is It Hard to Change Addictive Behavior?

Bulimia nervosa and addiction both often develop as maladaptive coping mechanisms. This added reliance on the behaviors, on top of their potentially physically addicting properties, can make them particularly difficult to stop.

Binging can increase pleasure and the chemical messengers that signal reward. Purging can then provide psychosomatic relief, and symptoms of anxiety, depression, and physical issues may seem to dissipate temporarily. 

Patient at doctor's office

Eventually, the brain can “learn” to associate these behaviors with a sense of happiness, relief, or even normalness. And this causes physical changes to the brain, rewiring its chemical neurotransmitters and related circuitry. 

It is likely that the prefrontal cortex, which is responsible for impulse control, reward processing, and self and emotional regulation, becomes altered by bulimia nervosa. Other types of addiction become physically entrenched in similar ways.

Due to these changes, it can be very difficult to stop participating in bulimic behaviors without professional help. A comprehensive eating disorder treatment and recovery program is often necessary to effectively address the disorder.

Finding Help for Bulimia Nervosa

If you or a loved one are struggling with behaviors connected to bulimia nervosa or addiction, it is important to get help as soon as possible.

If you’re concerned about a loved one, be sure to do your research first. It’s helpful to have a better understanding of what they are dealing with and what types of help and options are available before speaking with them. By preparing for this talk, you can ensure better chances of success.

Don’t be surprised if your loved one doesn’t agree to get help right away. It often takes several brief conversations with your loved one before they will be ready to seek help. 

Try to remain calm, non-confrontational, empathetic, and supportive. Be sure that they know you love them. Make it clear that you want to help them in the best way possible. 

If you’re experiencing these thoughts and behaviors yourself, you may want to start by speaking to your primary physician or a mental health therapist. These experts are trained on how to look for signs of addiction and disordered eating and can offer more help, advice, and resources.

It can be difficult to overcome the types of compulsive thoughts and behaviors associated with BN and addiction, but reaching out for help is the first step on the road to recovery.


  1. Is Bulimia Like a Drug Addiction? (2012, June 22). Psychology Today. Retrieved September 22, 2022.
  2. Definition of Addiction. (2019, September 15). American Society of Addiction Medicine (ASAM). Retrieved September 22, 2022.
  3. Kinzl, J. F., & Biebl, W. (2010). Are eating disorders addictions? Neuropsychiatry; 24(3):200–208. 
  4. Hadad, N., Knackstedt, L.A. (2016). Bulimia Nervosa as Addiction. Neuropathology of Drug Addictions and Substance Misuse; 3:1019-1027. 
  5. Hansen, S. (2017, April 12). Conceptualizing Bulimia as Addiction: A Resident’s Personal Experience. The American Journal of Psychiatry Residents’ Journal; 11(8):6-8.
  6. Eskander, N., Chakrapani, S., & Ghani, M. R. (2020). The Risk of Substance Use Among Adolescents and Adults With Eating Disorders. Cureus; 12(9);e10309.

Last Update | 01 - 18 - 2023

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