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Beitrag der Suchtforschung zum Verständnis der Adipositas

What can addiction research contribute towards the understanding of obesity?

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Zusammenfassung

Aktuelle Forschungsergebnisse belegen, dass adipositasassoziiertes Essverhalten nicht allein auf phänomenologischer Ebene süchtigem Verhalten ähnlich ist, sondern dass auch gemeinsame neurobiologische Funktionssysteme an Entstehung und Verlauf der Störung beteiligt sind. Insbesondere Erkenntnisse zur neuroendokrinen Regulation und bildgebende Befunde zeigen eine enge Verzahnung von homöostatischen Regulationssystemen, die klassischerweise der Appetitregulation zugeordnet werden, und motivationalen Systemen, die eng in die Entstehung von Suchterkrankungen involviert sind. Auf Grundlage der in der Suchtmedizin generierten Erkenntnisse zur Neurobiologie von Verstärkereffekten und zur Rolle der klassischen Konditionierung bei Suchterkrankungen können neue Präventions- und Behandlungsoptionen zur Therapie der Adipositas abgeleitet werden. Die Prüfung psychotherapeutischer und pharmakotherapeutischer Interventionen, die primär implizite motivationale Prozesse beeinflussen, kann hierfür ein erster Schritt sein. Die grundlegende Relevanz der neuen Erkenntnisse für das psychiatrische Fachgebiet spiegelt sich in der aktuell geführten Diskussion wider, Adipositas in den psychiatrischen Kapiteln der diagnostischen Klassifikationssysteme zu berücksichtigen.

Summary

Recent research suggests similarities between obesity and addictive disorders on both phenomenological and neurobiological levels. In particular neuro-endocrine and imaging studies have shown a close link between homeostatic regulation involved in appetite regulation and regulation of motivation and reward expectancy, which are of special impact for addictive disorders. Based on findings on the neurobiology of reinforcement processes and on the role of classical conditioning in addiction, new interventions for prevention and treatment were developed that offer the opportunity for transfer to the treatment of obesity. A first step may be testing psychotherapeutic and pharmacotherapeutic interventions, which primarily target motivational processes. The relevance of this topic for general psychiatry is reflected by the fact that including obesity in the psychiatric chapters of disease classification systems is currently being discussed.

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  1. Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Mannheim, Universität Heidelberg, J5, 68159, Mannheim, Deutschland

    F. Kiefer & M. Grosshans

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Correspondence to F. Kiefer.

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Kiefer, F., Grosshans, M. Beitrag der Suchtforschung zum Verständnis der Adipositas. Nervenarzt 80, 1040–1049 (2009). https://doi.org/10.1007/s00115-009-2743-z

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