Table 1.
Diagnostic Features for Binge-Eating Disorder, Food Addiction, Substance Use Disorder, and Gambling Disorder
| Binge-Eating Disorder | Food Addiction | Substance Use Disorder | Gambling Disorder |
|---|---|---|---|
| Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: a. Eating in a discrete period of time (2-hour period) an amount that is definitely larger than most people would eat in a similar period of time under similar circumstances b. The sense of lack of control overeating during the episode |
Consuming the substance in larger amounts or for longer periods than one intends | Taking the substance in larger amounts or for longer than one intends | Recurrent gambling behavior leading to clinically significant impairment or distress, as a. Indicated by the individual exhibiting four (or more) of the below criteria in a 12-month period b. The gambling behavior is not better explained by a manic episode |
| Binge eating episodes are associated with three (or more) of the following: a. Eating much more rapidly than normal b. Eating until feeling uncomfortably full c. Eating large amounts of food when not feeling physically hungry d. Eating alone because of being embarrassed by what or how much one is eating e. Feeling disgusted with oneself, depressed, or very guilty after overeating |
Wanting to cut down or stop consuming the substance but not managing to decrease the behavior | Wanting to cut down or stop using the substance but not managing to decrease use | Needs to gamble with increasing amounts of money in achieve the desired excitement |
| Presence of marked distress regarding binge eating behaviors | Spending a lot of time getting, using, or recovering from consumption of the substance | Spending a lot of time getting, using, or recovering from use of the substance | Restless or irritable when trying to cut down or stop gambling |
| Binge eating occurs, on average at least 1 day a week for 3 months | Cravings and urges to consume the substance | Cravings and urges to use the substance | Has made repeated, unsuccessful attempts to control, cut back, or stop gambling |
| The binge eating is not associated with regular use of inappropriate compensatory behaviors (eg, purging) | Not managing to fulfill obligations at work, home, or school because of substance consumption | Not managing to fulfill obligations at work, home, or school because of substance use | Is often preoccupied with gambling (eg, having persistent thoughts of reliving past gambling experiences) |
| Continuing to consume the substance, even when it causes problems in relationships | Continuing to use, even when it causes problems in relationships | Often gambling when feeling distressed | |
| Giving up important social, occupational, or recreational activities because of substance consumption | Giving up important social, occupational, or recreational activities because of substance use | After losing money gambling, often returning to “get even” (“chasing one’s losses”) | |
| Consuming substances again and again, even when it puts the user in danger | Using substances again and again, even when it puts the user in danger | Lies to conceal the extent of involvement with gambling | |
| Continuing to use, even when one knows they have a physical or psychological problem that could have been caused or made worse by the substance | Continuing to use, even when one knows they have a physical or psychological problem that could have been caused or made worse by the substance | Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling | |
| Needing more of the substance to get the effect one wants(tolerance) | Needing more of the substance to get the effect one wants(tolerance) | Relies on others to provide money to relieve desperate financial situations caused by gambling | |
| Development of withdrawal symptoms, which can be relieved by consuming more of the substance | Development of withdrawal symptoms, which can be relieved by taking more of the substance | ||
| Severity | |||
| Mild: 1–3 episodes per week | Mild: 2–3 symptoms | Mild: 2–3 symptoms | Mild: 4–5 symptoms |
| Moderate: 4–7 episodes per week | Moderate: 4–5 symptoms | Moderate: 4–5 symptoms | Moderate: 6–7 symptoms |
| Severe: 8–13 episodes per week | Severe: 6+ symptoms | Severe: 6+ symptoms | Severe: 8–9 symptoms |
| Extreme: 14+ episodes per week | |||
Notes: Diagnostic criteria for binge-eating disorder, substance use disorder, and gambling disorder are defined according to DSM-5 criteria. Diagnostic criteria for food addiction have been defined based on the DSM criteria for substance use disorder. This table is included to illustrate some of the similarities and differences in the diagnostic criteria for binge-eating disorder, food addiction, substance use disorder, and gambling disorder.