Biological Psychiatry: Taking Food Addiction Seriously

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It’s an area of growing interest in psychology, psychiatry and addiction treatment: How closely linked are addiction and eating disorders?

With new studies in brain neurochemistry, we are gaining a new understanding of how impulsive and emotionally driven behaviors cross the boundaries between drug addiction and other harmful activities. The links and similarities are covered in the latest issue of Biological Psychiatry, which focuses on eating disorders.

Common brain mechanisms

In some key aspects, the parallels are striking. Common brain mechanisms of reward and reinforcement, as well as self-treatment for underlying psychological issues, while other attributes are very different. For example, there is no innate drive for drug-seeking as there is with food.

Since eating is thought to be evolutionarily forced, the articles offer a picture that seems to show drugs may be corrupting an existing system (primarily dopamine regulation) useful to motivate reward and reinforcement with food. If this picture is true, we may be hardwired to be food addicts (at least some percentage of us) with substance abuse an added consequence.

The issue covers many other topics in some detail, including reviewing the literature on topics like: neural adaptations to overeating, risk factors and susceptibility, and binge eating as a close parallel to drug addiction.

Drug may prevent weight gain after smoking cessation

One particular study of note is the use of naltrexone, a drug prescribed for opiate addiction, in the treatment of weight gain subsequent to smoking cessation. Naltrexone is a competitive agonist for opioid receptors and finds use in treating heroin (or other narcotic) overdose. The study found that women who quit smoking gained less weight when on the drug (but not men), meaning this may be a useful treatment and offering a link between food and opioids (at least in women).

The issue does not settle the question of whether or not overeating is a “true” addiction, but it shows that in some cases this is a useful paradigm. Patients who show signs of addiction related to food may benefit from some of the same treatments used for substance abuse.

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