• Medical Treatment for Food Addiction

    by Scott Isaacs, MD
    on Apr 6th, 2018

Several recent studies have elucidated the connection between food addiction and obesity (although normal weight people can also struggle with food addiction). Brain imaging and other studies show the effect of compulsive overeating and reward centers of the brain. The same brain centers that are triggered by cocaine and heroin can also be activated by food. Just like addictive drugs, tasty foods trigger feel-good centers in the brain. As a result, people with food addiction eat when they are not hungry. They lose control over eating and spend a lot of time anticipating the emotional effects of overeating.

Food addiction can have different symptoms including binge eating, intense cravings, sugar cravings, eating for pleasure, stress eating and binge eating. There can be especially intense cravings for sugar, fat and salt. Each of these types of unhealthy eating is related to brain signals for pleasure and reward, rather than for hunger. People with food addiction don’t always respond to appetite suppressants because increased hunger is not the cause of overeating.

People with food addiction can develop “tolerance” to food. They eat more and more but derive less and less pleasure because the food is less satisfying. This further stimulates overeating.

Do you have a food addiction?

Food addiction and food cravings originate in a part of the brain known as the mesolimbic reward pathway. The major brain chemical in this area is dopamine. Dopamine is well known to be involved in both pleasure and reward as well as addiction. Other types of addictions such as opioid addiction, alcohol addiction, tobacco addiction and even gambling addiction also originate in the mesolimbic reward area of the brain.

What is more fascinating is that medications used to treat other addictions are helpful for treating food addiction. For example, naltrexone is an opioid blocking medication used to treat alcohol and opioid addiction. Naltrexone is also one of the ingredients in the weight loss medication Contrave.

Contrave contains a second medication, bupropion. This medication is also sold under the name Zyban which is used to treat tobacco addiction. So, both ingredients of the medication Contrave are used to treat addiction to alcohol, opioids and tobacco. It only makes sense that the combination of bupropion and naltrexone would also be effective for treating food addiction. So, the next time you find yourself overeating for reasons other than hunger, think about food addiction. Your brain craves pleasure and is craving food to satisfy this need for pleasure. But you can substitute other forms of pleasure for food. Your body just needs pleasure and if you provide this in other ways, your cravings will go down.

Interestingly, the combination of bupropion and naltrexone has a separate effect in the hypothalamus, which is the appetite center of the brain. Here, bupropion stimulates production of an anti-hunger brain hormone known as POMC. POMC acts on an anti-hunger hormone receptor known as the MC4 receptor. And naltrexone has an effect of stimulating this effect, enhancing the appetite suppression.

Author Scott Isaacs, MD Endocrinologist and Weight Loss Specialist

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