Eating Causes Clinically Significant Distress: Food Addiction as a Disordered Belief in Anorexia Nervosa?

Anorexia nervosa (AN) is characterized by an intense fear of weight gain, dietary restriction resulting in a significant weight loss compared with what is expected, and a disturbance in body image on a psychological basis. Recently, cases of AN associated with food addiction (FA) were described in almost all patients (69%), bringing a controversial aspect to the restrictive subtype (AN-r) that, in theory, even in the absence of binge eating, would present difficulties regarding control. Objectives: To report a case of an adolescent with AN-r associated with FA. Methods: Clinical history, current status, psychiatric diagnosis, and scores on scales to assess FA, food craving, and binge eating were analyzed. Results: This case report emphasizes the importance of new diagnostic tools to identify FA and whether it exists in people with AN-r beyond distress regarding eating behavior, cravings, and guilt. Eating behavior also presents a negative value that delays the elaboration process and the emergence of food cravings. In addition, an analysis of the association between the diagnostic criteria for substance use disorder, binge eating disorder, anorexia nervosa, and bulimia nervosa with the Yale Food Addiction Scale statements and criteria was discovered. Conclusions: Based on the characteristics of AN, emotional dysregulation and eating difficulties seem to overlap with FA symptoms.