University of Sydney, Sydney, NSW, Australia; Marie Bashir Centre, Royal Prince Alfred Hospital, Sydney Local Area Health Service, Camperdown, NSW, Australia; Specialty of Psychiatry, University of Sydney, Australia.
University of Sydney, Sydney, NSW, Australia; Speciality of Psychiatry, University of Sydney, Concord Hospital, Concord, NSW, Australia.
Psychoneuroendocrinology. 2023 Aug;154:106290. doi: 10.1016/j.psyneuen.2023.106290. Epub 2023 May 11.
Eating disorders continue to be a major public health issue and important cause of morbidity and premature mortality, particularly for young people. Yet in a concerning dialectic, this occurs in the context of an epidemic of obesity which, with its medical complications, constitutes another vexing public health challenge. While it is not an eating disorder per se obesity is often comorbid with eating disorders. Effective treatment for both eating disorders and obesity has proven to be elusive and in the search for novel therapeutic interventions, the prosocial, anxiolytic, brain plasticity and metabolic effects of oxytocin (OT) have been examined from this perspective. The availability of intranasal oxytocin (IN-OT) has led to a number of interventional treatment studies in anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), their atypical and subclinical forms and in medical and psychiatric conditions co-occurring or comorbid with these, obesity with BED would be included here. The aim of this mini review is to collate recent findings on OT as a novel therapeutic intervention in eating disorders and obesity and to identify and address some of the knowledge gaps in the use of IN-OT. The wider clinical perspective utilised here might better address some of the gaps and identify future directions of research. Clearly much remains to be done for OT to fulfil its therapeutic promise in eating disorders. OT might yet be of therapeutic promise and will be appreciated where treatment advances have been hard to come by and prevention challenging for these disorders.
进食障碍仍是一个主要的公共卫生问题,也是发病率和早逝的重要原因,尤其是在年轻人中。然而,令人担忧的是,在肥胖症流行的背景下,肥胖症及其带来的医疗并发症构成了另一个令人困扰的公共卫生挑战。尽管肥胖症本身并不是一种进食障碍,但它常常与进食障碍共病。事实证明,有效的进食障碍和肥胖症治疗方法难以捉摸,因此,从这个角度出发,人们研究了催产素(OT)的亲社会、抗焦虑、大脑可塑性和代谢作用。鼻内催产素(IN-OT)的出现,导致了厌食症(AN)、贪食症(BN)、暴食障碍(BED)及其非典型和亚临床形式,以及与这些疾病共病或并发的医学和精神疾病中,包括肥胖症伴暴食障碍,一系列干预治疗研究。本综述的目的是整理最近关于 OT 作为一种新的治疗方法在进食障碍和肥胖症中的应用的研究结果,并确定和解决 IN-OT 使用中的一些知识空白。这里使用的更广泛的临床视角可能会更好地解决一些差距,并确定未来的研究方向。显然,OT 要实现其在进食障碍中的治疗承诺,还有很多工作要做。如果这些疾病的治疗进展困难,预防具有挑战性,那么 OT 可能仍具有治疗潜力,并将受到重视。