Gaming, binge eating and compulsive sex can mirror gambling addiction, study finds

When clinicians and researchers talk about addiction, the conversation has traditionally revolved around substances such as alcohol and drugs, or around gambling, the one behaviour long recognised in diagnostic manuals as capable of producing a fully fledged addictive disorder. A major international study now argues that this framework is too narrow. Published in European Psychiatry, the research suggests that several everyday behaviours, including excessive gaming, binge eating and compulsive sexual behaviour, can share many of the same underlying characteristics as recognised addictions, raising the possibility that the boundary between habit and addiction is far blurrier than commonly assumed.

The study, led by Clément Vansteene of Université Paris Cité and Hôpital Sainte-Anne together with colleagues including Flinders University’s Professor Zsolt Demetrovics and Dr Andrea Czakó, is described as one of the most comprehensive reviews of behavioural addictions ever conducted. Rather than running a new experiment, the team performed what researchers call a multiple systematic review analysis, synthesising almost 250 existing systematic reviews and meta-analyses. These are the highest tiers of evidence in medical research, because they aggregate findings from many independent studies to reveal patterns that no single trial could detect on its own.

The methodological logic of the paper is elegant in its simplicity. The researchers used gambling disorder, one of the most extensively studied behavioural addictions and the only non-substance addiction recognised in the DSM-5 alongside gaming disorder, as a benchmark. They then compared gambling disorder with alcohol use disorder and with six commonly discussed behavioural addictions. Across 75 factors linked to addiction, spanning mental health, personality traits, emotional regulation, cognition and brain function, they assessed how closely each condition resembled the benchmark. The result was striking: gaming disorder was found to be 98.9 percent similar to gambling disorder, sharing many of the same risk factors, warning signs and underlying characteristics.

That figure is remarkable because gambling disorder has long served as the scientific prototype of a behavioural addiction. It produces tolerance, withdrawal-like distress, preoccupation, loss of control and continued engagement despite harm, the same core features that define substance use disorders. If gaming disorder matches that profile almost perfectly, the implication is that the neural and psychological machinery of addiction does not require a chemical substance at all. Compulsive sexual behaviour disorder and binge eating disorder also showed a high degree of overlap with gambling disorder, placing them close behind gaming in the similarity ranking.

The findings arrive at a moment when the clinical world is already moving in this direction. The World Health Organization included gaming disorder in the eleventh revision of the International Classification of Diseases, and binge eating disorder has been formally recognised as an eating disorder in its own right. What this new analysis adds is a comparative evidence base: a systematic demonstration that these conditions are not merely superficially similar to addiction but appear to converge on the same risk architecture, from impulsivity and emotional dysregulation to comorbid mood and anxiety problems.

Professor Demetrovics, Matthew Flinders Professor in Mental Health and Wellbeing and Director of Flinders’ Institute for Mental Health and Wellbeing, argues that the research highlights a need to look beyond substances when thinking about addiction. People often associate addiction with alcohol or drugs, he says, but the findings show that certain behaviours can share many of the same underlying characteristics. In his words, addiction is not defined by a substance alone; in some cases, behaviours can become compulsive, difficult to control and continue despite causing harm.

That point carries real weight for public health. Behaviours such as gaming, eating, shopping and working are woven into everyday life, which makes it genuinely difficult to tell when a normal pattern has tipped into something unhealthy. A person losing sleep and damaging relationships because they cannot stop gaming, someone repeatedly binge eating despite serious health consequences, a shopper spending beyond their means, or an individual whose sexual behaviour begins to erode their wellbeing may not recognise the pattern as an addiction at all. Demetrovics notes that many people who experience these problems may not identify them as potential addictions, and as a result may not seek help until the effects on their health, relationships, finances or daily life become severe.

Dr Czakó, Senior Research Fellow in Psychology at Flinders, emphasises the implications for individuals, families and health professionals. Many people struggle with behaviours they feel ashamed of, or simply do not recognise as a potential addiction, she says, and understanding that these difficulties may share common underlying mechanisms can help people seek support earlier and help clinicians respond more effectively. The researchers argue that better recognition of behavioural addictions could reduce stigma, improve access to care and allow intervention before significant harm occurs, a framing that shifts the conversation from moral failing to treatable condition.

The study was published in European Psychiatry under the title ‘Concordance between gambling disorder, alcohol use disorder, and other behavioural addictions provides evidence for a comprehensive approach to addictive behaviours: A multiple systematic review analysis’, with a team spanning Université Paris Cité, Hôpital Sainte-Anne, Flinders University, Semmelweis University, the University of Gibraltar and Aga Khan University. Its authors hope the evidence will encourage a comprehensive approach to addictive behaviours, one in which clinicians assess the full spectrum of compulsive patterns rather than treating substance and behavioural problems as separate universes. For the millions of people quietly wrestling with behaviours that feel out of control, the message is that loss of control is a recognised medical phenomenon, and that open conversations, earlier identification and appropriate support are far more achievable when the science acknowledges what they are experiencing.

Subject of Research: Behavioural addictions and their similarity to gambling and substance use disorders

Article Title: From binge eating to gaming: when everyday behaviors become addictions

Article References: From binge eating to gaming: when everyday behaviors become addictions. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: behavioural addiction, gaming disorder, gambling disorder, binge eating disorder, compulsive sexual behaviour, systematic review, European Psychiatry, mental health, loss of control, stigma, Flinders University, addiction research