Evidence for the idea that some individuals may experience an addictive-like response to certain foods has grown in the past decade. Food addiction parallels substance use disorders to suggest that highly processed foods (e.g., chocolate, French fries) may exhibit an addictive potential and trigger addictive-like responses in vulnerable individuals. An opposing conceptualization of addictive-like eating was recently developed, suggesting that the behavioral act of eating may be addictive rather than highly processed foods. However, the arguments for a behavioral eating addiction do not consider the central role of behaviors within substance use disorders and are not supported by preliminary research demonstrating that highly processed foods may directly contribute to the addictive-like eating phenotype. The primary goal of this chapter is to argue that a substance-based, food addiction framework is the most appropriate reflection of the current state of the literature and more closely parallels scientific understanding of addictive disorders. Specifically, this chapter will review theoretical debates between the food versus eating addiction perspectives, raise concerns about discrepancies between eating addiction and existing behavioral addictions, and review assessment tools for food and eating addiction. Finally, implications for stigma, intervention, and future research are discussed.