从愉悦到病态:理解肥胖背景下食物成瘾的神经基础。
From Pleasure to Pathology: Understanding the Neural Basis of Food Addiction in the Context of Obesity.
出版信息
Chirurgia (Bucur). 2023 Aug;118(4):348-357. doi: 10.21614/chirurgia.2023.v.118.i.4.p.348.
As rates of severe obesity continue to rise globally, intense efforts are required both from the scientific community, physicians and health policy makers to better understand the mechanisms, prevent and treat obesity in order to stop the upcoming pandemic. Obesity is known to significantly reduce life expectancy and overall quality of life, thus becoming a leading cause of preventable deaths. This article focuses on the relationship between obesity and food addiction, the main neural mechanisms, brain regions, genes, hormones and neurotransmitters involved and on the similarities between food addiction and substance abuse. The definition of obesity is based on the body mass index (BMI). A BMI of 30 or higher is classified as obese. Obesity is not solely a result of overeating, but has multifactorial causes, thus, prevention being extremely difficult. The concept of food addiction implies extreme cravings, lack of self-control, and overeating, especially involving tasty foods. The addiction concept is supported both by clinicalbehavioural research and neurobiological research. These studies demonstrate similarities between binge eating and drug addiction, including cravings, loss of control, excessive intake, tolerance, withdrawal, and distress/dysfunction. Although generally food addiction is thought to be distinct from obesity, most studies identify that a significant percentage of individuals with food addiction are obese. Our aim was to emphasize the need to better understand the neurological basis of obesity and addiction, and its implications for research, treatment, and public health initiatives. Understanding the neural mechanisms underlying food addiction can inform future healthcare policies and interventions aimed at addressing the global obesity epidemic.
随着全球严重肥胖率的持续上升,科学界、医生和卫生政策制定者都需要付出巨大努力,以便更好地了解肥胖的机制,预防和治疗肥胖,从而阻止即将到来的肥胖大流行。肥胖会显著降低预期寿命和整体生活质量,因此成为可预防死亡的主要原因。本文重点介绍肥胖与食物成瘾之间的关系,涉及的主要神经机制、大脑区域、基因、激素和神经递质,以及食物成瘾与物质滥用之间的相似性。肥胖的定义基于身体质量指数(BMI)。BMI 达到或超过 30 被归类为肥胖。肥胖不仅仅是暴饮暴食的结果,其病因有多种,因此预防非常困难。食物成瘾的概念暗示着极度的渴望、缺乏自我控制和暴饮暴食,尤其是涉及美味食物时。这一成瘾概念得到了临床行为研究和神经生物学研究的支持。这些研究表明,暴食与药物成瘾之间存在相似之处,包括渴望、失去控制、过度摄入、耐受、戒断和痛苦/功能障碍。虽然一般认为食物成瘾与肥胖不同,但大多数研究发现,有相当一部分食物成瘾者肥胖。我们的目的是强调需要更好地了解肥胖和成瘾的神经基础,以及其对研究、治疗和公共卫生倡议的影响。了解食物成瘾的神经机制可以为未来的医疗保健政策和干预措施提供信息,以应对全球肥胖流行。