AN ADDICTIONS PERSPECTIVE ON EATING DISORDERS

The blog is intended to share some of the research and collective experiences of those of us who have come to recognize anorexia, bulimia, binge eating, food addiction, compulsive overeating as variants of the same "tyrant"-namely addiction. Equally important is defining the solution once we've come to recognize the real problem.

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Dopamine D2 Receptors and Eating Disorders- A case for Addiction

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The most common question I am asked by someone with an eating disorder, or, for that matter, most medical professionals, is "How can you describe an eating disorder like compulsive overeating or bulimia as an "addiction" to food? Part of the answer has to do with the similarities between cocaine addiction and  "food addiction." Has anyone ever experienced a change in their appetite when ingesting amphetamines [aka "diet pills], cocaine, or methamphetamine? What happened to your appetite when you "crashed"?  Although perhaps more subtle, the food addict may experience a similar effect. The summary below may offer an explanation.

A recent publication on the role of dopamine and dopamine receptors appears in the March 2010 edition of "Neuroscience" - a respected professional journal. In effect, the researchers found a significant difference among laboratory animals who were "over-fed" and exposed to unlimited amounts of sugar laden and high glycemic foods as they developed an "addiction-like reward deficit" in their brain's dopamine receptors. Translation - over time, when over eating highly "palatable" foods (e.g. sugar, high fat foods) they developed deficits in their ability to properly assimilate the neurotransmitter dopamine. Deficits in dopamine are seen with cocaine addicts when they are "crashing" and withdrawing from cocaine - they become depressed and hyperphagic (their appetite becomes almost insatiable). Likewise, the deficit in dopamine for compulsive eaters and bulimics seems to evolve over time with the result being a biological (addiction) to overeating. For the bulimic, the misguided attempt to deal with this is purging, for the compulsive overeater, the attempt is yet another "diet".

Hence, the cocaine user becomes an abuser, then an addict with his brain chemistry (dopamine receptors) disrupted for an extended period of time. The only relief is...more cocaine. The phenomenon of tolerance takes hold and the addict "needs more  and more of the substance to achieve the same effect".

The "food addict" may begin abusing food and develops a similar "tolerance" to refined carbohydrates (sugar, flour) and, likewise, alters the brain's (reward) structure (dopamine receptors) and the physical addiction to overeating takes hold.

As with cocaine addicts, it's likely that over any extended period of time, the mechanisms responsible for manufacturing and making available dopamine at normal levels will re-emerge... provided the "addict" adheres to a prescribed course of treatment (e.g. abstains from the offender - cocaine or, for the food addict, high glycemic (fat and sugar laden) foods.

The "solution" becomes abstaining" from the offending agents. Those with an eating disorder may need to consider a food plan that does not evoke an addiction like craving- namly staying clear of "binge foods" - which typically are sugar and flour laden or high glycemic foods.

 

The "jury" may be out as to whether or not someone in this circumstance can "re-integrate" [albeit slowly and cautiously] some of the high glycemic foods that were once responsible for the addictive process. In this sense, I would seriously doubt one could do the same with cocaine or amphetamine like substances with a full blown relapse into the abyss of addiction.

 

Tell us your experience.

 

Reference: Laboratory of Behavioral and Molecular Neuroscience, Dept. of Molecular Therapeutics - Published 3/2010 in Nature Neuroscience

 

Marty Lerner, Ph.D.

 

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Licensed psychologist and an active participant within the recovering community, living in South Florida with my wife, Michele, two daughters,Janelle and Danielle, and our dog [Golden-Doodle] Reggie for the past 25 years. Founder and executive director at Milestones In Recovery, a residential and outpatient program treating eating disorders.


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