An auto-addiction opioid model of chronic anorexia nervosa

Abstract

The phenomenology of chronic anorexia nervosa is compared with that of addictive states. A model is proposed in which brain opioids mediate the elation, neuroendocrine changes, and down‐regulation of metabolism that occur in adaptation to dieting. The physiology of opioids is reviewed, and clinical and animal data are marshalled to support an auto‐addictive model. Opiate blockade together with therapeutic approaches used in the addictions may prove helpful in this stubborn disorder.

Labeling and defining severe and enduring anorexia nervosa: A systematic review and critical analysis

“…Does the treatment need to be evidence‐based or can any type of treatment be deemed appropriate? Despite some authors providing some indication as to what constitutes an adequate treatment option (Bamford & Mountford, ; Lipsman et al, ; Marrazzi & Luby, ; Saeidi et al, ; Wang et al, ), others do not (Bartholody et al, ; Geller et al, ; Hay & Touyz, ; Mander, Teufel, Keifenheim, Zipfel, & Giel, ). With treatment options for AN being broad and most likely only to broaden, these questions need to be examined and the answers made explicitly clear if it is to be used in a future definition.…”

Interacting Neural Processes of Feeding, Hyperactivity, Stress, Reward, and the Utility of the Activity-Based Anorexia Model of Anorexia Nervosa

“…178 However, in both AN and the ABA model, beta-endorphin levels are high in negative energy balance, which may relate to its role in reward signaling. 204–207 …”

Eating Disorders, Addictions and Substance Use Disorders

“…Eating and drug use are both motivating, appetitive behaviors with underlying similarities in their neural circuitry , leading some researchers to investigate whether eating disorders may represent some form of an addictive behavior (Davis & Claridge, 1998;Kaye et al, 2013;Marrazzi & Luby, 1986). Although some do not consider this is a valid conceptual approach to the study of eating disorders , there is support for this idea.…”

“…Several investigators described the concept of starvation dependence in AN (Luby, Marrazzi, & Sperti, 1987;Marrazzi & Luby, 1986;Marazzi et al, 1990;Szmukler & Tantam, 1984). Several investigators described the concept of starvation dependence in AN (Luby, Marrazzi, & Sperti, 1987;Marrazzi & Luby, 1986;Marazzi et al, 1990;Szmukler & Tantam, 1984).…”