From Disordered Eating to Addiction: The “Food Drug” in Bulimia Nervosa
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.
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Non-obese individuals with other eating disorders such as binge eating disorder and anorexia nervosa are also likely to involve imbalances in reward and self-control circuits.
“for this dimensional analysis also encompasses non-obese individuals suffering from other eating disorders (e.g. binge eating disorder [BED] and anorexia nervosa) (9,10), which are also likely to involve imbalances in reward and self-control circuits.”
From Obesity and addiction: Neurobiological overlaps (2013) · cites this paper as [9]
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References 329 · Cited by 52
- Authors
- Umberg, E. N., Shader, R. I., Hsu, L. K. G., & Greenblatt, D. J.
- Affiliations
- Tufts University (US)
- Tufts Medical Center (US)
- Corresponding author
- Umberg, Erin N.
- Shader, Richard I.
- Greenblatt, David J.
- Venue
- Journal of Clinical Psychopharmacology
- Published
- 2012-06
- Volume
- 32
- Issue
- 3
- Pages
- 376-389
- ISSN
- 0271-0749 (ISSN-L)
- OpenAlex
- W2332043567
- Cited by
- 52
- References
- 329
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 6 · 2015: 8 · 2014: 9 · 2013: 4 · 2012: 5
- FWCI
- 1.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Keywords
- bulimia nervosa, addiction, binge eating, purging, disordered eating, reward sensitivity, dopaminergic system, self-control, neurobiology of eating disorders, pharmacotherapy
- MeSH terms
- Feeding and Eating Disorders, Dopamine, Humans, Neurons, Reinforcement, Psychology, Behavior, Addictive, Bulimia Nervosa
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