Food addiction and binge eating disorder show striking clinical overlap that current diagnostic frameworks do not fully capture. In binge eating disorder samples, Yale Food Addiction Scale-defined food addiction has been reported in roughly half of participants. Higher symptom severity is associated with greater impairment. Within this overlap, clinicians frequently observe a subset of patients whose compulsive eating is organized around the pursuit of extreme fullness rather than palatability for specific trigger foods. Compulsive high-volume eating (CHVE) refers to recurrent, distressing episodes of consuming dangerously large volumes of food, often to the point of marked gastric distension. In some cases, the food is low-caloric or non-hedonic, and the dominant motivator is the interoceptive target state of extreme fullness rather than taste. This Perspectives article focuses on fullness-seeking as a high-volume pattern within binge eating disorder phenomenology that has received little attention in the food addiction literature. It extends prior work that framed volume addiction within compulsive high-volume eating as a public health issue. The focus here is clinical formulation, not the public health case. Evidence from reward learning, gut-brain signaling, gastrointestinal physiology, and neuroendocrinology suggests that this pattern may be rooted in binge eating disorder. It may identify a subset of patients with addiction-like dynamics. These cases may be better addressed when addiction-informed concepts and tools are integrated. It offers a physiologically grounded lens for combining eating disorder and addiction frameworks in a more coherent clinical approach.
Radically different