Thursday, September 27, 2007

Bulimia as Food Addiction





Serotonin-mediated brain activity drives the binge-and-purge cycle

Bulimia, the binge-and-purge disorder that tends to afflict young women, seems especially linked to serotonin abnormalities. Bulimics gorge themselves and then induce vomiting--a debilitating cycle that often leads to severe health consequences.

Richard and Judith Wurtman, of the Massachusetts Institute of Technology (MIT) identified a subset of bulimics who binge severely and almost exclusively on high-carbohydrate foods. These bulimics tended to be mildly obese, severely depressed--and came from families with a strong history of alcohol abuse. Other researchers have reported that a significant number of bulimics are themselves abusers of alcohol and other drugs. What is being suggested is that carbohydrate-craving obesity and bulimia may turn out to be two additional forms of drug addiction. They may be variations on the addictive theme, and the underlying cause may be the same--irregularities in the reward system neurotransmitters.

For women whose bodies do not regulate the production of serotonin successfully, bulimia is one of the possible symptoms that can result from this condition. Unlike anorexia, its “partner” disorder, bulimia resembles addiction in several important ways. There is a definite “high,” which comes with the purging, and which has no analogue in anorexia. (Recall that serotonin is involved in smooth muscle functions, like vomiting and bowel movements.)

Bulimia’s impact on the brain’s reward center also seems to be quite direct, judging by the high relapse rates of bulimics. As further evidence, studies were performed by Walter Kaye and colleagues at the University of Pittsburgh Medical Center, where PET scans were taken of women who were former bulimics, and compared to a set of PET scans from healthy, age-matched women. The ex-bulimics showed a marked decrease in serotonin binding at the 5HT receptors, and studies by Kaye and others offer evidence that alterations in the brain’s serotonin pathways often persist after recovery from bulimia, and may represent permanent changes in brain chemistry.

The idea that serotonin disturbances are at the root of bulimia continues to make sense. Moreover, preliminary studies of female twins have bolstered the basic hypothesis, by showing evidence of a possible genetic predisposition toward bulimia.

13 comments:

Anonymous said...

As someone who is battling bulimia I have found this article very interesting. It is the first time I have seen the link between the exposure to alcoholism and bulimia. I have seen several people battle against alcohol as I was growing up and now I am battling against it too (and winning I am pleased to say).

Anonymous said...

I have been a bulimic since 16 and am now 42. I know it feels like a high and I tend to gravitate towards sweets and carbs. It's frustrating and I also suffer from depression. Sometimes I feel like no one can understand this and simply don't know what to do. I tried counseling and antidepressants but it seems to be a losing battle. To this day I binge and purge almost every single day.

Anonymous said...

I've been bulimic since I was 11 and I'm almost 40. I've had periods of anorexia, drug/alcohol addiction, and relationship addiction. I try to quit but can't seem to stop. Now my teeth are rotting and I spend thousands on dental work. I still don't stop. I worry that I won't live to see my kids grow up. This guilt can cause me to skip a day or so but I usually purge at least twice a day. My stomach is swollen and painful, my throat hurts, and my hair is falling out. I've had treatment and therapy and take antidepressants and a mood stabilizer. Nothing helps.

Dirk Hanson said...

Bulimia, like drug addiction, CAN be put in remission. There are countless ex-bulimics out there who beat this thing--so you know it can be done. And you can do it, too.

Anonymous said...

Today, i found out one of my closest friends has been a bulimic batteler for almost 2 years. its very sad and i want to help her but im not even suppose to know. the worst part is, were in grade 8. i hope she realises the dangers soon because one day, this disorder could even lead to her death. and i hate for anything bad like this to happen. I dont even think her poor parents know. :(

Anonymous said...

I've had bulimia for almost a year now. I didn't think I was doing anything wrong, it makes me feel so good. I'm a 23 year old guy and it was really hard for me to accept it, because I thought it was only for girls. My therapist finally convinced me that I do have a problem. I'm an alcoholic, but I've been sober for 2 years now. I have to say, that purging gives me a better high than drinking ever did. I hope that if any guys read this that they realize that it's not just for woman. It can affect anyone. I know it's slowly killing, but it's really hard to give up something I love and that is legal. I could never have drank myself into oblivion and then drive home, but I can purge and be fine. I am on quite a few different ssri's, and mood stabilizers, and I just haven't found the right combo yet, but I hope to soon.

Anonymous said...

I have been bulimic for over 40 years....Consider it a good day if i only do it at night. A typical binge takes me all through the night -- I go to bed bleary-eyed around 5 a.m. and awaken 2 hours later to a kitcvhen that reminds me of the devastation of the night before. Crumbs, empty boxes, empty liters of soda...you get the picture.

I have NO doubt that "addiction" is the word to describe what I am now facing. I CANNOT eat ANYTHING anymore without wanting/needing to keep on eating to the point of purging. I wish it were possible to NEVER HAVE TO EAT AGAIN rather than face the hell i go through each time I put a morsel of food in my mouth.

I hope they continue to study bulimia from the aspect of addiction, because maybe it will help people understand people like me. Right now, i feel so ALONE and of course ASHAMED.

Anonymous said...

I am 35 and was bulimic from the ages 13-22. I stopped making myself sick but contiued to binge and 'purge' through use of excessive exercise and laxatives. Two years ago I discovered OA - Overeasters Anonymous - which is a 12 step program based on AA - Alcoholics Anonymous for Bulimics, Overeaters and Anorexics. It is THE ONLY thing that has ever worked for me. I can't recommend it highly enough. I have been abstinent from overeating and eating my binge foods for one and a half years now. If you are struggling with any eating disorder I would recommend you check out the website and find a local group.

Dirk Hanson said...

I've heard good things from other people about OA. Like drug addiction, more going on in bulimia than simple failure of self-control.

Anonymous said...

I am 28 years old and have been bulimic for about 10 years now... Only really accepting the fact for the past two years. Like another writer said, I didn't really think or I guess, want to admit that I was doing anything wrong. I've never really had severe body image issues and it just felt so good to have control and I never understood why but I loved the high from purging. As of today I am extremely active. For a moment I was doing very good. I was eating a clean healthy diet, not purging at all and my sport was my main focus. I believe I must have severe digestive problems by now that has led me to feel the need to take laxatives on certain occasions. So now a new vicious cycle... After becoming addicted to laxatives I've fallen back into bingeing and purging... I'm so fed up! I do believe that the only luck and the healthiest I've felt in a long time was when I was fixated on eating clean and being active... There was a window of about 6 months that I didn't binge and purge and I felt great... I want to get better

Anonymous said...

Unlike some drug addictions, Bulimia so easy to hide. Which I've been very carefully doing for about 12 years now. I want to get better. I've decided that in part of my efforts, Im confessing to my fiance and a few others in my life that have no idea... I don't know this could go very badly...

Anonymous said...

You're not alone. Been the same situation going on 15 years.

Anonymous said...

I am 34 years old and have been bulimic since I was 16. After a bad breakup and end of an engagement that took me by surprise at the age of 22 I started to drink and became alcoholic after a few years... drinking 5 liters of wine daily or maybe if I exercised restraint I would make the box last two days. I had a 'functioning' B.A.C. of .24. I didn't drink to get drunk. It took 12 years for my tolerance to increase to that point. I drank just to have the feeling of a slight buzz.... to deaden my anxiety which I have always had.

Now that I am in sobriety to some extent... having to do UA's in order to keep my babies (I was able to quit drinking while pregnant after having been to detox both times the second I found out I was pregnant). I have two babies and after both got severe post partum, the drinking started again. Since I cannot drink now I am binging and purguing worse than ever. I will throw up an apple because of the release I feel. I hope that God can help me help myself... and all of you, people like us.

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