Should Overeating and Obesity be Classified as an Addictive Disorder in DSM-5?

Overeating and associated obesity are major public health problems. In addition to its notable adverse health consequences, the behavior of overeating has significant neurobiological and psychological underpinnings. Current classification systems of mental disorders (DSM-IV and ICD-10) address this increasingly prevalent “disorder” in a limited and inconsistent manner. Several similarities between overeating and substance dependence have been documented with regards to phenomenology, shared neurobiology, and treatment. This has led to suggestions that a new category of “food addiction” be added to our psychiatric nosology and that this category be included with substance use disorders under a broad rubric of “addiction disorders”. In this article, we consider the rationale for this recommendation and evaluate its pros and cons. We summarize how the problem of overeating is addressed in our current classification systems and discuss DSM-5 approaches to the issue.