Repetitive, out-of-control behaviors entrap some people. I contend these behaviors qualify as addictions, whether for food, online sports gambling, constant internet use, or excessive sexual behaviors.

Technology has hijacked reward systems for many, challenging some people’s ability to control behavior. One example is internet gaming disorder (IGD), or persistently overusing video games, leading to significant impairment or distress, whether played alone or with others. Another is online shopping addiction (OSA), compulsive shopping on the internet causing economic, social, and emotional consequences. Social media addiction (SMA) is a preoccupation with social media sites, evidenced by irresistible urges to log on and increasing time using online platforms, resulting in impairment or distress.

Let's briefly review food addiction, gambling addiction, gaming addiction, and sex addiction.

A major milestone in increasing acceptance of such so-called "process" addictions was publication of The Behavioral Addictions by Michael Ascher and Petros Levounis in 2014 (full disclosure: it included my chapter on food). It was the first American Psychiatric Association (APA) book covering diagnosis and treatment of patients with behavioral addictions.

Another milestone was the addition of gambling addiction to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association (APA) in 2014. So far, gambling is the only behavioral addiction in this publication.

In contrast, the World Health Organization’s ICD-11 diagnostic manual recognizes “gaming disorder” as a condition characterized by recurrent gaming behavior, online or offline. DSM-5 describes internet gaming disorder (IGD) as a behavioral addiction pending further study. IGD does not include general problems with internet use, online gambling, or overuse of social media or smartphones.

To be diagnosed with IGD, a person is preoccupied with gaming, and experiences withdrawal symptoms when stopping gaming. In addition, the person spends increasing amounts of time or money gaming, and the behavior causes significant impairment or distress. While the ICD-11 and DSM-5 both recognize behavioral addictions, they differ in scope and approach.

Petros Levounis, M.D., immediate past president of the American Psychiatric Association, is a prominent voice advocating for stigma reduction in technology-enabled gambling, sexual compulsivity, and other behavioral addictions. In May 2024, Dr. Levounis discussed technology addictions, internet gaming, cybersex, and........

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