Potential Biological Markers and Treatment Implications for Binge Eating Disorder and Behavioral Addictions

Abstract

The reward system is highly relevant to behavioral addictions such as gambling disorder (GD), internet gaming disorder (IGD), and food addiction/binge eating disorder (FA/BED). Among other brain regions, the ventral striatum (VS) has been implicated in reward processing. The main objective of the present state-of-the-art review was to explore in depth the specific role of the VS in GD, IGD and FA/BED, understanding it as a possible biomarker of these conditions. Studies analyzing brain changes following interventions for these disorders, and especially those that had explored possible treatment-related changes in VS, are discussed. More evidence is needed on how existing treatments (both pharmacological and psychobehavioral) for behavioral addictions affect the activation of the VS and related circuitry.

Neuronal activity and reward processing in relation to binge eating

“…Novel treatments for binge eating specifically targeting reward-based processes are already examined [53,54]. However, these treatments do not take the role of different subcomponents of reward processing into account, for example, in relation to the phase of the illness.…”

Eating Disorders and Addictive Behaviors: Implications for Human Health

“…As a consequence, behavioral disinhibition and reward-driven decision making are observed in treatment-seeking patients at baseline (the dysfunctional level is interpreted as a measure of the addictive severity), and are also predictive of treatment relapse [27]. The manuscript by Mestre-Bach and Potenza [28] included in this issue is a state-of-the-art review about specific changes in the brain as a consequence of interventions in both BA-and ED-related conditions (specifically food addiction and binge eating). Specific attention was paid to ventral striatal activation and the related circuitry as a biomarker for these clinical conditions and their recovery, due to their role in reward processing systems.…”

A Behavioral and Event-Related Potentials Study of Food-Related Inhibitory Control in Probable Binge Eating Disorder

“…8,9 Neurobiological dysfunctions in reward processing, emotion regulation, and inhibitory control are highlighted in individuals with BED, and these domains have been considered as potential targets for emerging treatment approaches. [10][11][12] However, the pathogenesis of BED remains unclear, and ongoing efforts are necessary to gain a better understanding of its underlying causes and to improve prevention and treatment outcomes. 13 Similar to addictive disorders, diminished control over behavior is a hallmark feature of BED, with the experience of losing control over eating behavior being an integral part of its core psychopathology.…”