L’anorexie mentale : une addiction ? Application du modèle addictologique aux troubles du comportement alimentaire. Une revue narrative commentée
L'Encéphale. 2024-05-01; :
DOI: 10.1016/j.encep.2024.03.002
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Collombat J(1), Chapron SA(2), Sarram S(1), Fatseas M(3), Serre F(4), Auriacombe M(5).
Author information:
(1)Laboratoire sommeil, addiction et neuropsychiatrie (SANPSY), CNRS UMR 6033,
université de Bordeaux, 33076 Bordeaux, France; Pôle interétablissement
d’addictologie, CH Charles-Perrens et CHU de Bordeaux, 33076 Bordeaux, France.
(2)Université de Bordeaux, 33076 Bordeaux, France; Laboratoire sommeil,
addiction et neuropsychiatrie (SANPSY), CNRS UMR 6033, université de Bordeaux,
33076 Bordeaux, France; Pôle interétablissement d’addictologie, CH
Charles-Perrens et CHU de Bordeaux, 33076 Bordeaux, France; Service
d’addictologie, CH de la Côte Basque, 64109 Bayonne, France.
(3)Université de Bordeaux, 33076 Bordeaux, France; Pôle interétablissement
d’addictologie, CH Charles-Perrens et CHU de Bordeaux, 33076 Bordeaux, France;
Institut de neurosciences cognitives et intégratives d’Aquitaine (INCIA), CNRS
UMR 5287, 33076 Bordeaux, France.
(4)Université de Bordeaux, 33076 Bordeaux, France; Laboratoire sommeil,
addiction et neuropsychiatrie (SANPSY), CNRS UMR 6033, université de Bordeaux,
33076 Bordeaux, France; Pôle interétablissement d’addictologie, CH
Charles-Perrens et CHU de Bordeaux, 33076 Bordeaux, France.
(5)Université de Bordeaux, 33076 Bordeaux, France; Laboratoire sommeil,
addiction et neuropsychiatrie (SANPSY), CNRS UMR 6033, université de Bordeaux,
33076 Bordeaux, France; Pôle interétablissement d’addictologie, CH
Charles-Perrens et CHU de Bordeaux, 33076 Bordeaux, France. Electronic address:
.
OBJECTIVES: Addiction offers a framework for the understanding of eating
disorders, particularly those characterized by hyperphagia, with growing
interest in food addiction. However, the application of the addiction model to
anorexia nervosa remains more controversial. In this commented narrative review,
we examine and discuss the addictive features of anorexia nervosa.
METHODS: Commented narrative review of the literature.
RESULTS: Anorexia nervosa could be the consequence of the loss of control of
several objects of positive reinforcement: food restriction, physical
hyperactivity, and food itself. Craving has been little studied in the field of
eating disorders. When investigated, studies mainly focus on food cravings and
tend to highlight food cravings that are inversely correlated with the
restrictive nature of the disorder. This would thus be less found in anorexia
nervosa, in which it is nevertheless reported. The existence of a pre-existing
food craving, or its appearance secondary to food restriction, is currently
under discussion. In the meantime, the question of a craving for food
restriction, underpinned by the gratifying effect of fasting, is raised.
CONCLUSIONS: The management of eating disorders has its place within the
addiction care sectors. An integrative approach should be favored, for anorexia
nervosa, combining, on the one hand, classic nutritional care, and, on the other
hand, care within the framework of addiction treatment. Finally, in people with
an eating disorder, the search for an addiction to food, food restriction and
physical activity, including a systematic assessment of craving, should be
systematized.
Copyright © 2024 L’Encéphale, Paris. Published by Elsevier Masson SAS. All
rights reserved.
DOI: 10.1016/j.encep.2024.03.002
PMID: 38755028