Department of Molecular Physiology and Pharmacology, Tufts University School of Medicine, Boston, MA 02111, USA.
J Clin Psychopharmacol. 2012 Jun;32(3):376-89. doi: 10.1097/JCP.0b013e318252464f.
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.
神经性贪食症（BN）患者滥用物质的高患病率，以及许多类型的药物成瘾中普遍存在的症状替代现象，表明许多物质——包括食物——会损害个体的自我控制能力，即使在存在负面后果的情况下也是如此。尽管如此，BN 与药物成瘾之间的神经生物学相似性尚未得到明确确立。本综述探讨了 BN 中观察到的特定进食模式（暴食和催吐，间歇性节食）是如何特别容易上瘾的，并将 BN 与其他饮食障碍和肥胖症区分开来。BN 中出现的许多外周和中枢生物异常可能导致这些个体的奖励敏感性发生改变，特别是通过对多巴胺能系统的影响。神经生物学研究结果支持 BN 是一种成瘾性疾病的观点，这对治疗和药物干预具有治疗意义。
