Volume addiction: introducing a novel phenotype within compulsive high volume eating

Area of Science:

• Behavioral Neuroscience
• Clinical Psychology
• Gastroenterology

Background:

• Disordered eating and food addiction research often overlooks the drive for fullness through high volumes of low-calorie foods.
• Current diagnostic systems lack criteria for volume-seeking eating behaviors, distinct from binge eating disorder.
• Gastric distension and volume intake are rarely considered primary reinforcers in scientific literature.

Purpose of the Study:

• To propose compulsive high-volume eating (CHVE) as a distinct clinical construct.
• To highlight the role of gastric volume and distension as central motivators in specific eating behaviors.
• To advocate for the recognition and study of volume-seeking eating phenotypes.

Main Methods:

• Synthesis of findings from water-load studies in individuals with eating disorders.
• Review of animal studies on gastric stretch receptors and vagal responses.
• Integration of research on gut hormones, reward circuitry, and neuroimaging in feeding behavior.

Main Results:

• Individuals with bulimia nervosa and binge-eating disorder show altered gastric myoelectrical activity and consume larger volumes before satiation.
• Gastric stretch receptors and vagal responses are plastic, influencing satiety and intake.
• Gut hormones and reward circuitry interact to link visceral signals to feeding behavior, with altered reward responses to volume observed in neuroimaging studies.

Conclusions:

• Gastric volume itself is a meaningful dimension in eating behavior, deserving clinical and scientific attention.
• Compulsive high-volume eating (CHVE), characterized by gastric distension as a motivator, is proposed as a distinct construct.
• A "volume-addiction" subtype within CHVE may exist, necessitating further research for effective treatment development.