Food and sex are means unto their own; their motivations are pure, primary. Food tastes great and sex is pleasurable. Both food and sex, as a general rule, are engaged in with others, although eating alone and masturbation also qualify as fun and gratifying.  

Sometimes both food and sex are used as vehicles and substitutions for fulfillment of other needs, i.e. wish for intimacy and closeness, quick emotional fixes, and sometimes to stave off loneliness, or at the extreme, to enact self-harm, and manifest low self-worth. Eating disorders and sexual addiction are examples of attempts to address psychological and relational needs through extraordinarily self-defeating and self-destructive behaviors. Therapy, particularly psychodynamic therapy, is designed to ferret out the vicissitudes and complexities of motivation behind why a person, who may deeply crave love and healthy pleasure, turns addictively toward behaviors that initially may gratify, but ultimately harm.  

The necessity to delve deeper into psychological and/or relationship issues becomes apparent when either food or sex are ‘used’ predominantly, exclusively or excessively for general or overall fulfillment in life, when food and/or sex are the only pleasures sought.  

The connection between the use of an eating disorder as a replacement for relationships and the use of food and body image preoccupation as metaphors for other appetites in life i.e. success, achievement, pleasure as well as sex are not new ideas in the field of mental health. Their metaphoric associations are largely supported by experts.   

At first blush, having numerous sexual encounters is widely accepted in Western society. However, having serial or compulsive sex as a means of connection can also be a substitute or rationalization against needing or wanting a relationship. The argument in favor of casual sex is that there are no relational strings attached. But, if making quick sexual connections were the answer, why do feelings of loneliness and emptiness pervade for so many who do so?  

Simple needs such as the pursuit of love and comfort become so easily complicated. The fear of abandonment, rejection, loss of love or fear of eliciting a partner’s anger are such powerful emotional states that avoidance or denial of the need for relationships makes sense; who really wants to suffer relational pain or loss? However, we cannot escape humanity; therefore, substitutions are sought to address the need for human connection, a lifelong and ever present need. If being close and intimate were so easy most people would feel and find fulfillment in their relationships and  the need for defenses and behavioral substitutions would not be necessary.  Divorce rates continue to rise.  

No matter how technologically advanced we become (virtual porn or attempts to circumvent emotions through attaining more creature comforts), we cannot eradicate the need to love and be loved. Attachment to others and connection are normal and become compromised when psychological fear censors or constrains our behavior.

The writings of John Bowlby and Mary Ainsworth, the parents of Attachment Theory, continue to fuel and underscore sound psychological practice. The theory identifies patterns of attachment, such as anxious, avoidant and ambivalent which have helped patients identify and understand their own maladaptive relational patterns preventing them from finding and sustaining longevity in love.    

A quick summary of Attachment Theory's relationship to food and sex

Attachment Theory – that emotional support, understanding, empathy, and acceptance during a child’s development are the foundation of self-esteem and self-worth throughout life. Without healthy attachments, self-esteem is diminished and the capacity for empathy toward self and others is impaired. When this happens, a relationship with food and/or sex become a replacement, a metaphor, for the healthy relationships a child craves. Food and body image obsession or repeated need for sexual activity and validation provide a false sense of self-esteem and are ways to measure one’s worth that may seem simpler than the complex world of emotional and intimate human interaction. Being ‘attached’ to an eating disorder, or to sex, feel less complicated than relational attachments.  

Despite these emotional struggles, individuals’ inherent craving for these attachments remains and even grows. They may begin to seek fulfillment, closeness, and comfort through food, body image, and weight obsession and/or repeated sexual encounters or sexual addiction. In this way, both eating disorders and sex become metaphors — symbols of their quest for comfort through food or compulsive sex, a totem of their guilt for wanting, needing, feeling, and disagreeing, as evidenced by the self-destructive nature of all eating disorders and sex compulsion and addiction. Some individuals create this relationship/attachment to food or sex because the feeling of connection they crave in their relationships — the attachments they truly seek — feel too complicated. Eventually, eating disorders and the short-lived connection made through every repeated sexual encounter may become their relationship of choice because real relationships are problematic at best, deeply damaged at worse.

Sometimes food and body image preoccupation are used as substitutions and avoidance of the pleasure that comes with sex. In this way, eating food is associated with gluttony, guilt, shame, self-loathing. Sometimes, these feelings are really feelings or fears about sex and a healthy sexual appetite. Sometimes, sex is utilized as an avoidance of intimacy. Having sex may enable physical closeness in the short term, but does little to quell the quest for emotional security and feeling cared for and deeply loved.

As familial issues and the family’s relationships with each other can play a role, sometimes a significant one, in the development of an eating disorder, these same interpersonal issues can be the motivation why someone might turn toward sexual compulsion. The breakdown or void in early childhood and familial relationships may set the stage for symptoms to develop in the hopes of solving cravings for comfort and intimacy. 

Knowing when food is used for sustenance and pleasure and sex is used appropriately for intimacy and pleasure are generally goals in sound treatment for eating disorders and treatment for sexual compulsion or addiction. My experience has shown me over the years that most people ‘know’ when life sustaining behaviors like food and sexual intimacy have been converted and used rather as symptoms of deeper interpersonal issues. Recovery is possible. Finding the right fit between therapist and patient is an important key in the relational recovery process.  

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