Chapter 6 - The dark side of compulsive eating and food addiction: Affective dysregulation, negative reinforcement, and negative urgency

Abstract

The transition from casual drug use to dependence involves a shift from positive to negative reinforcement. This “dark side” shift also is implicated in food addiction. Palatable food intake initially has pleasurable and comforting effects that can normalize stress responses. But, repeated, intermittent intake can downregulate brain reward pathways and recruit brain circuitry, yielding negative emotional behavior when the food is not eaten, tolerance, palatable food-seeking despite aversive consequences, and heightened stress-induced relapse to palatable food-seeking. The results support an affective dysregulation model whereby intake becomes obligatory to prevent negative emotions, which show high comorbidity with addiction-like eating. Such negative emotions also may trigger impulsive palatable food intake via negative urgency. Neurobiological changes resemble many from substance-use disorders, including corticotropin-releasing factor, hypocretin, dopamine, opioid, and endocannabinoid systems in mesolimbic, extended amygdala and inhibitory frontal circuitry. We synthesize conceptual and empirical contributions to illuminate the “dark side” in food addiction.