Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA.
Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Nutrients. 2020 Nov 16;12(11):3521. doi: 10.3390/nu12113521.
The role of stress, trauma, and adversity particularly early in life has been identified as a contributing factor in both drug and food addictions. While links between traumatic stress and substance use disorders are well documented, the pathways to food addiction and obesity are less established. This review focuses on psychosocial and neurobiological factors that may increase risk for addiction-like behaviors and ultimately increase BMI over the lifespan. Early childhood and adolescent adversity can induce long-lasting alterations in the glucocorticoid and dopamine systems that lead to increased addiction vulnerability later in life. Allostatic load, the hypothalamic-pituitary-adrenal axis, and emerging data on epigenetics in the context of biological embedding are highlighted. A conceptual model for food addiction is proposed, which integrates data on the biological embedding of adversity as well as upstream psychological, social, and environmental factors. Dietary restraint as a feature of disordered eating is discussed as an important contextual factor related to food addiction. Discussion of various public health and policy considerations are based on the concept that improved knowledge of biopsychosocial mechanisms contributing to food addiction may decrease stigma associated with obesity and disordered eating behavior.
压力、创伤和逆境，尤其是在生命早期的作用，已被确定为药物和食物成瘾的一个促成因素。虽然创伤性应激与物质使用障碍之间的联系已有充分记录，但食物成瘾和肥胖之间的关联途径还不太确定。这篇综述重点关注可能增加类似成瘾行为风险并最终增加终生 BMI 的心理社会和神经生物学因素。儿童早期和青少年逆境会导致糖皮质激素和多巴胺系统产生持久的改变，从而导致以后生活中增加成瘾易感性。强调了适应不良的全身负担、下丘脑-垂体-肾上腺轴以及生物嵌入背景下的新兴表观遗传学数据。提出了一个食物成瘾的概念模型，该模型整合了逆境的生物嵌入以及上游心理、社会和环境因素的数据。将饮食克制作为饮食失调的一个特征来讨论，这是与食物成瘾有关的一个重要的背景因素。基于这样一种观点，即更好地了解导致食物成瘾的生物心理社会机制，可能会减少与肥胖和饮食失调行为相关的耻辱感，因此讨论了各种公共卫生和政策考虑因素。
