Abstract
Bulimia nervosa (BN) and drug addiction share common features, and BN is often treated as an addiction. However, there is an ongoing controversy about whether BN is a type of addiction. This chapter compares the neurobiological features of BN and drug addiction. The synthesis of the two bodies of research suggests that BN has more neurobiological similarities than differences with drug addiction. Specifically, similar to many addictive drugs, there is an elevation of ventral tegmental area (VTA) and nucleus accumbens (NAc) dopamine, VTA DAT binding/mRNA, and NAc D1 binding in animal models of BN. Sucrose bingeing in animal models of BN decreases D2 binding, which occurs for cocaine but not for other drugs. Both BN and drug addiction have similar adaptations in glutamate receptor expression, μ opioid receptor binding, and prefrontal cortex activity. There is a difference in the effectiveness of drugs that target glutamate to treat these disorders. Together, these results suggest that BN may be a type of addiction.
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