Sucht und Adipositas: Können Nahrungsmittel abhängig machen?

Zusammenfassung

Die weltweite Prävalenz von Übergewicht und Adipositas nimmt in den letzten Jahren sowohl bei Kindern und Jugendlichen als auch bei Erwachsenen stetig zu. Hiermit verbunden sind zahlreiche Folgeerkrankungen, die zu einer reduzierten Lebensqualität, einer reduzierten Lebenserwartung und hohen direkten und indirekten Gesundheitskosten führen. Ein zentraler Aspekt der aktuellen Forschung beschäftigt sich mit der Frage, ob abhängige Verhaltensweisen im Zusammenhang mit dem derzeit bestehenden Überangebot an billiger, „schmackhafter“ (hoher Anteil an Zucker, Fett, Salz oder an Lebensmittelzusatzstoffen wie Geschmacksverstärkern) Nahrung zur steigenden Prävalenz der Adipositas beitragen könnten. Eine Verbesserung des Verständnisses der Wirkung bestimmter Nahrungsbestandteile auf Prozesse von Präferenz und Verhaltenssteuerung birgt die Hoffnung, neue und effizientere Therapieformen entwickeln zu können. Um diesen aktuellen Sachverhalt näher zu beleuchten, führten die Autoren eine selektive PubMed Recherche zu den Themen „obesity AND addiction“ durch. Aus der Literaturrecherche ergeben sich Hinweise für Gemeinsamkeiten in Prozessen und Regelkreisläufen, die sowohl bei der Entstehung und der Aufrechterhaltung der Adipositas als auch von Abhängigkeitserkrankungen eine Rolle spielen. Konkret sind hier phänomenologische und klinische, neuroendokrinologische und bildgebende Aspekte sowie Gemeinsamkeiten, bestimmte Transmittersysteme betreffend, zu nennen. Bei der Ergänzung der etablierten und der Entwicklung zukünftiger, innovativer und multi-modaler Therapieansätze sollten Suchtmechanismen und motivationale Aspekte der Nahrungsaufnahme bei der Behandlung der Adipositas daher Beachtung finden.

Abstract

Over the last few years, the worldwide prevalence of obesity has been increasing amongst children, adolescents and adults. Moreover, obesity related diseases lead to reduced quality of life, reduced life expectancy as well as high direct and indirect health care costs. The question whether this “obesity epidemic” might be associated to reward-related or addictive behaviors, which again are linked to the high and cheap availability of palatable foods (i. e. high in fat, sugar, salt and flavor-enhancing food additives) is crucial for obesity research. The development of modern and efficacious treatment approaches might be substantially facilitated if researchers would understand better how certain foods impact on processes linked to appetitive mechanisms and behavioral control. Addressing these issues, the authors selectively searched PubMed using „obesity AND addiction“ as keywords. Literature research revealed that obesity and substance use disorders share common features regarding mechanisms and feedback cycles associated to the development and the maintenance of both diseases. In fact, these features refer to phenomenological, clinical, neuroendocrinological and imaging aspects, as well as to certain neurotransmitter systems. Consequently, addictive and appetitive behaviors related to food intake should be considered when developing prospective, innovative and multi-modal approaches for the treatment of obesity.

Schlüsselwörter

Abhängigkeit - Adipositas - Craving - fMRT - Selfish Brain - Set Point

Key words

addiction - craving - fMRI - obesity - selfish brain - set point

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