From Disordered Eating to Addiction

Abstract

The high prevalence of substance abuse in individuals with bulimia nervosa (BN) and the pervasive symptom substitution in many types of drug addiction suggest that a number of substances--including food--can impair an individual's self-control, even in the presence of negative consequences. Nonetheless, the neurobiological similarities between BN and drug addiction are not clearly established. This review explores how the specific eating patterns seen in BN (binge eating and purging, with intermittent dietary restriction) are particularly addictive and differentiate BN from other eating disorders and obesity. A number of peripheral and central biological aberrations seen in BN may result in altered reward sensitivity in these individuals, particularly through effects on the dopaminergic system. Neurobiological findings support the notion that BN is an addictive disorder, which has treatment implications for therapy and pharmacological manipulations.

The association of “food addiction” with disordered eating and body mass index

“…This is significantly higher than the 47.1% of BED participants who endorsed “food addiction.” Further, the BN & FA group had higher levels of pathology in certain arenas (i.e., earlier age of dieting, time spent dieting, SBEs, disordered eating attitudes) relative to the other problematic eating groups. These findings are consistent with theoretical proposals that the intermittency of binging/purging in BN may be particularly likely to sensitize behavioral and biological systems in an addictive manner (Umberg, et al, 2012). Alternatively, individuals with BN often exhibit more severe pathology than BED participants (de Jonge, Van Furth, Lacey, & Waller, 2003; Núñez-Navarro et al, 2011), thus the greater rates of “food addiction” for BN participants may solely reflect elevated levels of pathology.…”

“…Thus, “food addiction” may be associated with more severe pathology in the context of BED (Davis, 2013b). Further, Umberg and colleagues (2012) proposed that bulimia nervosa (BN) may be more likely than BED to be associated with “food addiction,” since the binge/restrict pattern central to this disorder may increase the likelihood of affective and biological changes implicated in addictive disorders. To date, no studies have examined the construct of “food addiction” in a sample of participants with BN.…”

Errors Affect Hypothetical Intertemporal Food Choice in Women

“…Finally, since disordered eating behaviors have been recently linked consistently to drug addiction (e.g., [101]), sharing not only behavioral features like impulsivity and executive dysfunction, but also a documented dysregulation of the reward circuit (e.g., [3], [102]–[104]), we suggest to use the method tested here as a clinical training for people suffering from obesity and binge eating disorders. Similarly to a previous study in which alcohol-related stimuli were paired to stop trials in a Go-no-go task [105], thus increasing negative attitudes toward alcohol and reducing alcohol weekly consumption, here the effect of our error manipulation lasted for enough time to influence following intertemporal food decisions through indirect error-food pairing.…”

Food Addiction in the Light of DSM-5

“…There are numerous articles in which the applicability of those DSM-IV substance dependence criteria and other features of addicted behavior to bulimia nervosa (BN), binge eating disorder (BED), obesity, or overeating in general are discussed [19,20,21,22,23,24,25,26,27,28,29,30]. However, the translation of substance dependence criteria to eating behavior is not straightforward and, as a result, there is some disagreement among researchers about the precise definitions of food addiction symptoms [31,32,33,34,35].…”