Addictive Aspects of Eating Disorders and Obesity / 신경정신의학

ABSTRACT

The aim of this literature review was to evaluate the hedonic aspect of eating-related disorders. Addiction research has implications for the study of eating disorders and obesity and therefore, we collated and summarized recent clinical and neuroscience findings in regard to the "wanting" or "liking" aspect of eating disorders and obesity. The addictive personality is prone to substance dependence and these personality types are also known to be susceptible to binge eating. The biological framework underpinning the hedonic aspect of abnormal eating behavior has two components 1) the incentive component of "wanting" or, in its extreme, craving feeling involving the dopaminergic system, and 2) the pleasure or "liking" network involving the opioid and cannabinoid systems. The hedonic system is not merely related to food, but is part of a global organizational unit governing behavioral choices. In general, patients with anorexia nervosa (restricting) were less sensitive to reward, whereas patients with bulimia nervosa (binge/purge) were more sensitive to reward. People with obesity tended to be more sensitive to food as a reward, a function which involves the dopamine system. While recognizing the addictive aspect of abnormal eating behaviors, we have provided treatment recommendations with respect to these disorders and obesity.