Published On: 16 Jan, 2026 5:14 PM | Updated On: 02 Feb, 2026 2:53 PM
Obesity beyond Metabolism: Reframing the Disease as a Behavioral Addiction
Dr Jayashree Swain, IMS and SUM Hospital, Bhubaneswar, Odisha, India
Obesity is a complex and escalating global health concern that has traditionally been conceptualized as a metabolic or lifestyle-related condition. However, growing evidence suggests that, for many individuals, obesity involves addictive, reward-driven eating that extends beyond metabolic needs.
The increasing reliance on dietary interventions and pharmacological weight-loss therapies has often overlooked the behavioral and psychological drivers of obesity. As a result, many individuals experience only short-term weight reduction without sustained benefit. Failure to adequately address compulsive eating patterns, emotional regulation, and impaired self-control has fueled interest in understanding obesity through the lens of behavioral addiction.
This narrative review, published in Academia Mental Health and Well-Being, examined theoretical, clinical, and neurobiological evidence supporting the conceptualization of obesity as a behavioral addiction. The review also explored its implications for potential inclusion in future editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Relevant literature published between 2000 and 2024 was identified through PubMed, PsycINFO, and Google Scholar, with a focus on obesity, food addiction, reward neurocircuitry, and addiction frameworks.
The evidence reviewed revealed substantial parallels between compulsive overeating and substance use disorders, including loss of control, craving, and persistence of behavior despite adverse consequences. Neuroimaging studies demonstrated shared involvement of the mesolimbic dopamine reward system. Eating-related behavioral addictions appear closely linked to obesity, as compulsive, reward-driven overeating contributes to excessive weight gain beyond physiological requirements. Cognitive behavioral therapy (CBT) has shown particular promise by targeting maladaptive eating behaviors, emotional dysregulation, and deficits in self-control, thereby supporting more sustainable weight management.
Overall, the findings suggest that certain eating behaviors may transition from homeostatic regulation to reward-driven patterns. Recognizing obesity within an addiction framework may enable more integrated treatment strategies that combine behavioral therapies with pharmacological interventions addressing both metabolic and reward pathways. Further research is required to refine diagnostic criteria and inform future classification and treatment approaches.
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