Will Psychiatrists Treat Obesity?

If the results of a Tufts University rat study hold true for humans, the chances are good that obesity will be treated as an addictive behavior in the not-too-distant future. Researchers in the University’s School of Medicine have found a link between a predisposition to obesity and defective dopamine signaling in the rat mesolimbic system, indicating that the tendency toward obesity is directly related to food reward and addictive behaviors.

“Previous research has demonstrated that food intake leads to an increase in the release of dopamine, in the circuits that mediate the pleasurable aspects of eating,” explained senior author Emmanuel Pothos, PhD, assistant professor, department of pharmacology and experimental therapeutics, Tufts University School of Medicine. “Also, chronic food deprivation resulting in decreased body weight leads to decreased dopamine levels. Therefore, increased food intake may represent a compensatory attempt to restore baseline dopamine levels.”

Speculating that an attenuated dopamine signal may interefere with satiation, Pothos said “These findings have important implications in our understanding of the obesity epidemic. The notion that decreased dopamine signaling leads to increased feeding is compatible with the finding from human studies that obese individuals have reduced central dopamine receptors.”

Pothos noted that obesity has thus far been treated as a metabolic disorder, not one of addictive nature, with research mostly focused on the brain systems the regulate weight through energy balance maintenance. “The current study challenges this approach by focusing on brain pathways implicated in pleasure and reward. These pathways could override energy balance and induce hyperphagia and obesity by altering the reward value of food, particularly palatable high-energy food, very early in life,” he added.

Implications

Are the Tufts University researchers on to something? Should obesity be treated as an addictive disorder, as opposed to a metabolic disorder? For the sake of argument, let’s say the same findings are seen in human studies. What implications would this have on the practices of, not only psychiatrists who would pick up the treatment of obese patients, but also endocrinologists who would lose these patients? Or should the disorder be treated from both angles? What about the impact on the patients? How would an obese patient react to the news that their disorder has nothing to do with metabolism, but instead an addictive behavior? Tell me what you think; post a comment below!