Addiction is often associated with alcohol, opioids or other drugs, but people can also develop serious loss of control around rewarding behaviours such as gambling and gaming.
Eating can also become compulsive, distressing and difficult to control, although the scientific meaning of the term “food addiction” is more complicated.
Gambling disorder is formally recognized as a disorder due to addictive behaviour. Gaming disorder is also recognized by the World Health Organization in ICD-11.
“Food addiction,” however, is not currently a standalone diagnosis in the major international diagnostic classification systems.
Researchers use measures such as the Yale Food Addiction Scale to study addictive-like patterns of eating, but these patterns can overlap with binge eating disorder, emotional eating, obesity, restrictive dieting and other eating-related difficulties.
These distinctions matter.
Somebody who occasionally gambles is not automatically experiencing gambling disorder.
Somebody who spends many hours gaming is not automatically experiencing gaming disorder.
Likewise, enjoying highly palatable foods, overeating occasionally or living with obesity does not automatically mean somebody has a “food addiction.”
The central clinical question is not simply: “How much does this person enjoy the behaviour?”
A more useful question is:
Has control become impaired? Is the behaviour becoming increasingly important compared with other parts of life? Is it continuing despite significant consequences?
Gambling, gaming and compulsive eating can share elements of reward learning, cue-triggered urges, repetitive behaviour, emotional regulation and difficulty stopping.
But they are not identical conditions.
They should not all be treated as though the same medication, psychological intervention or recovery strategy works equally well for every person.
This guide explains the similarities and differences, how reward learning and dopamine actually work, what warning signs matter, what treatment evidence exists, and where opioid-antagonist medications such as naltrexone may — and may not — fit.
How gambling disorder, gaming disorder and addictive-like eating differ; how reward, urges and reinforcement work; how to recognize clinically important loss of control; which treatments have evidence; and what your next rational step may be if the behaviour is beginning to control your life.
Prepared for medical review by Dr. Fergus Law, BSc, MBChB, FRCPsych
Consultant Psychiatrist specialising in substance misuse and addiction psychiatry
Review status: Pending clinical approval
View Dr Fergus Law’s Clinical & Scientific Profile →What Is a Behavioural Addiction?
Behavioural addictions involve repetitive rewarding behaviours rather than repeated consumption of a dependence-producing substance.
The World Health Organization describes disorders due to addictive behaviours as clinically significant patterns associated with distress or interference with important areas of functioning.
The important word is disorder.
Enjoying something intensely is not enough.
A clinically important problem becomes more likely when the person increasingly loses control, gives the behaviour priority over important parts of life and continues despite negative consequences.
Impaired Control
Attempts to limit, reduce or stop the behaviour repeatedly fail.
Increasing Priority
The behaviour increasingly replaces sleep, relationships, education, work, exercise or other important activities.
Continuing Despite Harm
The behaviour continues after significant financial, psychological, relational, health or functional consequences appear.
High involvement is not automatically addiction. Loss of control and clinically meaningful distress or impairment matter more than a simple number of hours, bets, games or meals.
Reward, Reinforcement and Craving
The brain constantly learns which actions lead to important outcomes.
Food, social connection, achievement, novelty and financial reward can all influence motivational systems because they have biological, psychological or social significance.
Problems can develop when a behaviour becomes unusually effective at capturing attention, producing anticipation or relieving an unpleasant emotional state.
Positive Reinforcement
Positive reinforcement occurs when a behaviour becomes more likely because something rewarding follows it.
Winning money, achieving a game objective or experiencing a highly rewarding food may reinforce behaviour.
Negative Reinforcement
Negative reinforcement occurs when behaviour becomes more likely because it temporarily reduces something unpleasant.
Somebody may gamble to escape worry, game to avoid loneliness or use food to manage emotional distress.
The behaviour can therefore become connected not only with pleasure but also with relief.
Repetition can become increasingly driven by urges, cues, emotional relief and learned habits even when the person reports that the behaviour itself is no longer particularly enjoyable.
Understanding Gambling Disorder
Gambling disorder is recognized in international classification systems as a disorder due to addictive behaviour.
WHO’s ICD-11 framework emphasizes impaired control over gambling, increasing priority given to gambling and continuation despite negative consequences.
Gambling-related harm can also become serious before somebody reaches the full threshold for a formal diagnosis.
Debt and Financial Instability
Gambling losses can affect rent, mortgage payments, credit, savings, food and family finances.
Anxiety, Shame and Depression
Gambling losses, secrecy and debt can create severe emotional distress.
Trust Can Break Down
Hidden losses, borrowing, repeated promises to stop and financial crises can affect partners, children and wider families.
Chasing Losses
One particularly dangerous gambling pattern is attempting to recover previous losses through further gambling.
A loss increases distress, but the proposed solution becomes another bet.
Gambling harms can also extend beyond the person gambling.
Partners and children may experience financial instability, secrecy, conflict and considerable emotional stress.
Read WHO Gambling Guidance →Understanding Gaming Disorder
Gaming is an ordinary recreational activity for millions of people.
WHO emphasizes that gaming disorder affects only a small proportion of people who play digital or video games.
The diagnosis therefore should not be used simply because somebody enjoys games, plays competitively or spends substantial time gaming.
ICD-11 gaming disorder involves impaired control over gaming, increasing priority given to gaming over other activities and continuation or escalation despite negative consequences.
The pattern needs to produce significant impairment in important areas such as personal life, family life, social functioning, education or work.
WHO states that the pattern would normally have been evident for at least 12 months, although a shorter period may be sufficient when symptoms are severe.
Somebody can play for many hours while maintaining work, school, relationships, sleep and control. Functional impairment and loss of control matter more than a simple screen-time number.
Warning Signs Can Include
- repeatedly failing to reduce gaming despite intending to do so;
- gaming replacing adequate sleep, education, work or relationships;
- continuing despite serious academic, occupational or family harm;
- becoming increasingly preoccupied with opportunities to game;
- using gaming as the main strategy for avoiding distress, loneliness or unwanted emotions;
- major conflict developing when access to gaming is limited.
What Does “Food Addiction” Mean?
The phrase “food addiction” is widely used by the public and is also an active area of scientific research.
However, its diagnostic status is not identical to gambling disorder or gaming disorder.
Food addiction is not currently a standalone diagnosis in the major international diagnostic classification systems.
Researchers often study addictive-like eating using the Yale Food Addiction Scale.
It applies concepts associated with substance-use disorders to eating behaviour, including loss of control, craving, difficulty cutting down and continuation despite negative consequences.
Research has found overlap between higher food-addiction-scale scores and conditions such as binge eating disorder.
But scientific debate remains about whether the most useful model is addiction to particular foods, addiction-like eating behaviour, an eating-disorder phenotype or another overlapping process.
Body weight alone cannot diagnose compulsive eating, binge eating disorder or addictive-like eating. People can live with obesity without loss-of-control eating, while serious eating disorders can occur across many different body sizes.
Binge Eating Disorder Is Different
Binge eating disorder is an established eating-disorder diagnosis.
It involves recurrent binge-eating episodes characterized by loss of control and associated distress.
When binge eating disorder may be present, evidence-based eating-disorder assessment and treatment is more appropriate than simply describing the person as “addicted to food.”
Read NICE Eating Disorder Guidance →What Gambling, Gaming and Compulsive Eating Can Have in Common
Even though these conditions are not diagnostically identical, they can share behavioural and psychological processes.
Strong Urges
Internal or environmental cues can produce a strong desire to engage in the behaviour.
Failed Attempts to Cut Down
The person repeatedly decides to limit or stop the behaviour but returns to it.
Cue-Driven Behaviour
Advertisements, apps, places, smells, emotions and routines can trigger urges.
Continuing Despite Harm
Behaviour continues after meaningful consequences become clear.
Emotional Regulation Can Matter
Repetitive behaviour can become a way of managing anxiety, loneliness, boredom, sadness, anger or stress.
Successful treatment may therefore need to provide alternative ways of managing those emotional states rather than focusing only on stopping the behaviour.
Important Differences Between Gambling, Gaming and Eating
Similarity does not mean equivalence.
Calling every repetitive rewarding behaviour an addiction can make treatment less precise. Assessment should identify the actual disorder and the processes maintaining it.
Dopamine, Motivation and Learned Cues
Dopamine is frequently described online as the brain’s “pleasure chemical.”
That description is too simplistic.
Dopamine is involved in motivation, reinforcement learning, salience and prediction.
Reward-related learning helps the brain identify which cues predict important outcomes and which actions may be worth repeating.
Why Urges Can Continue When Enjoyment Falls
Learned motivation and subjective pleasure are not identical.
Somebody can experience a strong urge to gamble, game or eat compulsively while simultaneously reporting that they are no longer enjoying the behaviour very much.
This is one reason treatment should not focus only on “willpower.”
Trigger management, cognitive work, environmental change, routines and learning different responses to urges can all matter.
Recovery does not require eliminating dopamine. Dopamine is an essential neurotransmitter involved in normal motivation and learning. The goal is to change problematic patterns of behaviour and reinforcement.
Why Gambling Can Become So Compulsive
Gambling combines reward with uncertainty.
A person does not know exactly when a win will occur.
Unpredictable reinforcement can help maintain behaviour because every new attempt carries the possibility of reward.
Cognitive Distortions Can Intensify the Cycle
“A Win Is Due”
Previous independent losses do not necessarily make the next independent event more likely to produce a win.
“My System Can Control Chance”
Skill matters in some activities, but random events remain random even when a player feels strongly involved.
“One More Bet Will Fix This”
Attempting to recover losses can transform an initial loss into a much larger financial crisis.
Online gambling can also reduce practical friction.
Gambling may be available through a phone almost continuously, while digital payments can make losses less tangible than handing over physical cash.
Why Gaming Can Become Compulsive
Modern games can provide several kinds of reinforcement simultaneously.
Achievement
Levels, rankings, achievements and progress provide measurable success.
Social Connection
Teams, guilds, friends and online communities can make gaming socially important.
Continuous Goals
Daily tasks, events and new content can provide repeated reasons to return.
Escape
Gaming can temporarily move attention away from stress, loneliness or difficulties offline.
The Goal Is Not to Demonize Games
Games can provide creativity, relaxation, social contact, competition and entertainment.
Treatment should therefore focus on impaired control and functional harm rather than assuming that games themselves are inherently pathological.
Compulsive Eating, Food Cues and Restriction
Eating is biologically necessary and influenced by much more than hunger.
Stress, habit, food availability, social context, sleep, restriction, emotions and learned cues can all affect eating.
Some foods can become especially salient and difficult to regulate for some people.
But that does not mean everybody who enjoys those foods has an addiction.
Restriction Can Sometimes Intensify the Pattern
A person may respond to overeating by imposing increasingly rigid dietary rules.
Restriction, hunger and distress can then increase vulnerability to another episode of loss-of-control eating.
If binge eating disorder is present, evidence-based eating-disorder treatment is more appropriate than simply telling somebody to remove all “addictive foods.”
Warning Signs That a Behaviour May Need Professional Assessment
You repeatedly exceed limits you genuinely intended to keep.
The behaviour displaces sleep, relationships, work, education or health.
Financial, relational, health or occupational harm is developing.
You hide spending, time, eating episodes or the extent of your involvement.
Short periods of control are followed by repeated return to the same pattern.
Gambling, gaming or eating becomes your main strategy for managing distress.
The question is not simply how often somebody performs the behaviour. Ask what is happening to control, health, finances, sleep, relationships, responsibilities and quality of life.
Treatment for Gambling Disorder and Gambling-Related Harm
Treatment can involve psychological therapy, practical access controls, financial protection, relapse-prevention planning and, for selected people, medication.
Cognitive Behavioural Therapy
NICE recommends CBT-based psychological treatment for gambling that harms.
CBT can address gambling-related beliefs, triggers, urges, practical coping strategies and relapse prevention.
Identify Triggers
Understand when and why the urge to gamble becomes strongest.
Challenge Gambling Beliefs
Work on distorted beliefs about probability, luck and control.
Restrict Access
Self-exclusion, blocking software and financial controls can create valuable friction.
Plan for Return-to-Gambling Risk
Decide in advance how to respond to urges, adverts, access to money and setbacks.
Motivational Interviewing
Motivational approaches can also be considered when somebody is uncertain about changing or reluctant to begin treatment.
Read NICE Gambling Treatment Guidance →Treatment for Gaming Disorder
The gaming-disorder treatment evidence base continues to develop.
Psychological approaches, particularly CBT-based interventions, are among the better-supported current options.
Understand What Gaming Is Doing for You
Is gaming mainly about competition, friendship, achievement, escape, boredom or managing emotions?
Restore Sleep and Daily Structure
Regular wake times, meals, work, exercise and social activity reduce the amount of life organized around gaming.
Identify Triggers and Automatic Thoughts
Psychological treatment can examine the cues, beliefs and emotions that lead into prolonged gaming episodes.
Treat Coexisting Conditions
Depression, anxiety, ADHD, loneliness, sleep problems or family conflict may need their own assessment and treatment.
Naltrexone should not currently be presented as an established evidence-based treatment for gaming disorder.
Treatment for Compulsive Eating and Binge Eating
Because “food addiction” is not an established standalone diagnosis, treatment should begin by identifying what is actually happening.
Possibilities can include binge eating disorder, bulimia nervosa, emotional eating, restrictive dieting cycles, depression, anxiety or other eating difficulties.
Binge Eating Disorder Has Established Treatment Guidance
NICE recommends binge-eating-disorder-focused guided self-help as an initial psychological treatment for adults with binge eating disorder.
When guided self-help is unsuitable or does not work sufficiently, eating-disorder-focused CBT can be offered.
Reduce Extreme Hunger
Treatment can establish regular meals and snacks rather than repeated cycles of severe restriction and bingeing.
Understand Binge Cues
Emotional and situational triggers can be identified and addressed.
Address Rigid Beliefs
CBT can address all-or-nothing beliefs about food, eating and body image.
Humans must eat. Treatment therefore needs to build a sustainable relationship with food while addressing the underlying eating problem.
Where Naltrexone May Fit — and Where It Does Not
Naltrexone is an opioid-receptor antagonist with established medical uses in alcohol use disorder and opioid use disorder.
Researchers have also investigated whether opioid-antagonist activity can influence some non-substance reward behaviours.
The evidence is not the same across gambling, gaming and eating.
Some Clinical Evidence
NICE allows naltrexone to be considered for gambling that harms when appropriate psychological treatment has not achieved the intended outcome or repeated relapses continue.
Not an Established Treatment
Evidence is currently insufficient to present naltrexone as an established treatment for gaming disorder.
Diagnose the Eating Problem First
“Food addiction” is not a formal standalone diagnosis. Eating-disorder assessment may be substantially more useful than assuming addiction medication is required.
A Different Clinical Situation
If gambling, gaming or compulsive eating occurs alongside alcohol use disorder or opioid use disorder, naltrexone may be relevant to the substance-use-disorder component.
What Does NICE Say About Gambling?
Psychological treatment remains central.
NICE says naltrexone can be considered when an appropriate course of psychological therapy has not achieved the desired outcome or when the person experiences repeated relapses despite appropriate psychological treatment.
Naltrexone for gambling is an off-label use and should be initiated by, or under the supervision of, an appropriately qualified and experienced specialist.
Psychological treatment can continue alongside medication.
Evidence or guidance involving oral naltrexone should not be used to claim that a sustained-release naltrexone implant is an established treatment for gambling disorder.
What About Long-Acting Naltrexone Implants?
Long-acting naltrexone implants are designed to maintain opioid-antagonist exposure for an extended period.
They have principally been studied in relation to substance dependence, particularly opioid dependence.
Implant formulations can differ in dose, release characteristics, duration, manufacturing and regulatory status.
At present, a naltrexone implant should not be presented as an established treatment for gaming disorder or “food addiction.”
Naltrexone is an important medication in addiction medicine and has some evidence in selected gambling cases. But one medication should not be marketed as a universal treatment for every reward-related, dopamine-related or compulsive behaviour.
Understand Which Part of the Problem Naltrexone Could Actually Treat
DeBinge can provide an educational consultation about long-acting naltrexone, substance-use treatment and how the evidence differs between opioid or alcohol dependence and behavioural problems such as gambling.
A consultation does not assume that naltrexone or an implant is suitable. The first step is understanding the actual condition, any coexisting substance use and the evidence-supported treatment options.
How Families Can Help
Compulsive gambling, gaming and eating can all affect family relationships.
The most useful response depends on the behaviour.
Families may need practical controls around joint accounts, credit, borrowing and access to essential household money.
Support sleep, school or work schedules and offline activities without turning every conversation into conflict about screens.
Criticism about body size or moralizing food choices can increase distress and may worsen problematic eating.
Focus on loss of control and harm rather than arguing about whether the behaviour technically qualifies as an addiction.
Instead of:
“Why can’t you just stop?”
Ask:
“What happens before the urge, what makes stopping difficult,
and what would make change easier?”
When to Seek Urgent Help
Behavioural problems can produce serious consequences even though no intoxicating substance is necessarily involved.
Seek urgent professional help if there is:
- suicidal thinking, suicidal intent or a suicide attempt;
- severe distress following gambling losses or debt;
- threats, violence or immediate danger connected with debt or family conflict;
- inability to meet basic needs because money required for housing, food or essential bills has been gambled;
- severe dietary restriction, repeated vomiting, fainting, dehydration or another sign of medical instability;
- severe depression, psychosis or another acute mental-health crisis.
Immediate danger should be treated as a medical or mental-health emergency, not as a failure of willpower.
Is Gambling, Gaming or Eating Starting to Control Your Life?
This self-check helps you look at your own behaviour and decide what the most sensible next action may be.
It is not a diagnosis. A formal diagnosis of gambling disorder, gaming disorder, binge eating disorder or another condition requires appropriate professional assessment.
Only one question appears at a time.
What are you most concerned about?
Choose the option that best describes what brought you here.
Thinking about approximately the last 12 months, choose the answer that best describes you.
Has this problem ever made you feel unsafe or unable to cope?
This includes thoughts about suicide or harming yourself, feeling unable to keep yourself safe, or experiencing a serious physical or mental-health crisis connected with the behaviour.
If you may harm yourself, cannot keep yourself safe or there is an immediate medical emergency, contact your local emergency service now.
In the United States, call or text 988. In the UK or Ireland, Samaritans can be reached on 116 123.
Do not wait for an ordinary addiction consultation when there is immediate danger.
This is an educational self-check, not a validated diagnostic instrument. The result should not be used to diagnose yourself or to replace assessment by an appropriately qualified professional.
Gambling, Gaming and Food Addiction FAQ
1. Can a behaviour become addictive without taking a drug?
Yes. Gambling disorder and gaming disorder are categorized in ICD-11 as disorders due to addictive behaviours.
2. Is gambling disorder a recognized medical condition?
Yes. Gambling disorder is formally recognized in major psychiatric classification systems.
3. Is gaming disorder a recognized condition?
Yes. WHO includes gaming disorder in ICD-11 when gaming involves impaired control and significant functional impairment.
4. Does gaming for many hours mean somebody has gaming disorder?
No. Hours alone are insufficient. Loss of control, increasing priority and meaningful impairment are more important.
5. Is food addiction an official diagnosis?
Food addiction remains a debated research construct and is not currently a standalone DSM or ICD diagnosis.
6. What is the Yale Food Addiction Scale?
It is a research and assessment instrument used to examine addictive-like eating patterns.
7. Is binge eating disorder the same as food addiction?
No. Binge eating disorder is a recognized eating disorder. Food-addiction research can overlap with binge eating but the terms are not interchangeable.
8. Does obesity mean somebody is addicted to food?
No. Body weight alone cannot diagnose addictive-like eating or an eating disorder.
9. Is dopamine simply the brain’s pleasure chemical?
No. Dopamine has important roles in motivation, reinforcement, learning and salience.
10. Why can gambling remain compelling after repeated losses?
Uncertain reinforcement, chasing losses, learned cues and distorted beliefs about probability can help maintain gambling.
11. What treatment is commonly used for gambling disorder?
CBT-based psychological treatment, practical access controls, financial protection and relapse-prevention strategies are important options.
12. Can CBT help gaming disorder?
CBT-based approaches are among the psychological treatments currently used and studied for gaming disorder.
13. How is binge eating disorder treated?
NICE recommends binge-eating-focused guided self-help and, when appropriate, eating-disorder-focused CBT.
14. Can somebody simply abstain completely from food?
No. Eating is necessary for life. Treatment needs to establish sustainable eating patterns rather than food abstinence.
15. Has naltrexone been used for gambling disorder?
Yes. Naltrexone has been studied in gambling disorder and NICE allows it to be considered in selected people when appropriate psychological treatment has not produced the desired outcome or repeated relapse continues.
16. Is naltrexone the first treatment everybody with gambling problems should receive?
No. Psychological treatment remains central. Naltrexone is a specialist option for selected circumstances rather than an automatic first treatment.
17. Is a naltrexone implant proven to treat gambling disorder?
Evidence involving other naltrexone formulations should not automatically be transferred to a long-acting implant. An implant should not be presented as an established treatment for gambling disorder without formulation-specific evidence.
18. Does naltrexone treat gaming disorder?
Naltrexone is not currently an established evidence-based treatment for gaming disorder.
19. Does a naltrexone implant treat food addiction?
A naltrexone implant should not be promoted as an established treatment for food addiction. The eating problem should first be accurately assessed.
20. When should I ask for professional help?
Consider professional assessment when you repeatedly lose control, the behaviour is causing significant financial, health, relationship, employment or educational harm, or your attempts to change repeatedly fail.
Compulsive Behaviour Does Not Always Require the Same Solution
Gambling disorder, gaming disorder, compulsive eating and substance-use disorders can share features of reward learning and impaired control while still requiring different treatment strategies.
If alcohol or opioid dependence is also part of the picture, or if you want to understand where naltrexone evidence genuinely applies, DeBinge can provide an educational consultation.
Scientific References and Further Reading
World Health Organization — Gambling
WHO overview of gambling disorder, gambling-related harms and public-health consequences.
Read WHO Guidance →WHO — Gaming Disorder
Official explanation of gaming disorder and its core diagnostic characteristics in ICD-11.
Read WHO Gaming Disorder Guidance →WHO — Addictive Behaviour
WHO overview of disorders due to addictive behaviours.
Explore WHO Resources →NICE — Gambling-Related Harms
Evidence-based recommendations covering identification, psychological treatment, relapse prevention and medication.
Read NICE Gambling Guidance →NICE — Naltrexone for Gambling That Harms
NICE allows naltrexone to be considered after an appropriate course of psychological therapy has not achieved the desired outcome or when repeated relapses continue.
Read NICE Medication Recommendations →NICE — Eating Disorders
Evidence-based recommendations for binge eating disorder, including guided self-help and eating-disorder-focused CBT.
Read NICE Eating Disorder Guidance →Food Addiction Systematic Review
Review of food-addiction research and the Yale Food Addiction Scale.
Read on PubMed →Yale Food Addiction Scale Research
Research examining addictive-like patterns of eating and their relationship with other eating problems.
Read the Full Review →Cognitive Behavioural Treatment for Gambling
Research evaluating CBT-based approaches to gambling problems.
Read on PubMed →Evidence involving one naltrexone formulation or one disorder should not automatically be transferred to another formulation or another behavioural condition.
Prepared for medical review by Dr. Fergus Law, BSc, MBChB, FRCPsych
Consultant Psychiatrist specialising in substance misuse and addiction psychiatry
Review status: Pending clinical approval
This article is educational and does not diagnose gambling disorder, gaming disorder, an eating disorder or a substance-use disorder. Individual treatment decisions require appropriate clinical assessment.