Rationale and consequences of reclassifying obesity as an addictive disorder: neurobiology, food environment and social policy perspectives.
Rationale and consequences of reclassifying obesity as an addictive disorder: neurobiology, food environment and social policy perspectives.
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DOI：
10.1016/j.physbeh.2012.05.005
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发表时间：
2012-08-20
影响因子：
2.9
通讯作者：
Pothos, Emmanuel N.
中科院分区：
文献类型：
--
作者：
Allen, Patricia J.;Batra, Payal;Geiger, Brenda M.;Wommack, Tara;Gilhooly, Cheryl;Pothos, Emmanuel N.
肥胖患病率的快速增长是众多学科研究者的首要任务，包括生物学、营养科学、公共卫生和政策。在本文中，我们基于美国精神病学协会精神疾病诊断与统计手册（DSM）第四版中描述的成瘾标准，系统地检验了常见的饮食性肥胖是一种成瘾性疾病的前提，并考虑了这种对肥胖重新分类的公共政策的后果。具体来说，我们讨论了来自人类和动物研究的证据，这些研究调查了不同类型和数量的食物以及食物环境对肥胖个体的影响。神经生物学研究表明，被美味食物激活的享乐脑通路与被滥用药物激活的脑通路在很大程度上重叠，并且在长期暴露于高能量饮食后会出现明显的缺陷。此外，食物作为一种刺激，可以诱导致敏、强迫和复发模式，在对非法药物成瘾的个体中观察到。目前的食品环境鼓励了这些上瘾的行为，通过广告增加接触，接近和增加份量是常规的。从烟草的经验中吸取教训，很明显，将常见的饮食肥胖重新归类为成瘾性疾病将需要政策变化（例如，监管努力、经济战略和教育方法）。通过鼓励食品工业和政治领导人与科学界和医学界合作，建立新的和更有效的治疗方法，这些政策可能有助于解决肥胖流行病。
The rapid increase in the prevalence of obesity is a priority for investigators from across numerous disciplines, including biology, nutritional science, and public health and policy. In this paper, we systematically examine the premise that common dietary obesity is an addictive disorder, based on the criteria for addiction described in the Diagnostic and Statistical Manual (DSM) of Mental Disorders of the American Psychiatric Association, version IV, and consider the consequences of such a reclassification of obesity for public policy. Specifically, we discuss evidence from both human and animal studies investigating the effects of various types and amounts of food and the food environment in obese individuals. Neurobiological studies have shown that the hedonic brain pathways activated by palatable food overlap considerably with those activated by drugs of abuse and suffer significant deficits after chronic exposure to high-energy diets. Furthermore, food as a stimulus can induce the sensitization, compulsion and relapse patterns observed in individuals who are addicted to illicit drugs. The current food environment encourages these addictive-like behaviors where increased exposure through advertisements, proximity and increased portion sizes are routine. Taking lessons from the tobacco experience, it is clear that reclassifying common dietary obesity as an addictive disorder would necessitate policy changes (e.g., regulatory efforts, economic strategies, and educational approaches). These policies could be instrumental in addressing the obesity epidemic, by encouraging the food industry and the political leadership to collaborate with the scientific and medical community in establishing new and more effective therapeutic approaches.
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