Fig. 12.

Addiction-like Eating Behavior [[35], [36], [37], [38]]. The neurobiologic pathways and clinical manifestations of patients with addiction-like eating behavior are analogous to other addictions (e.g., addiction to opioids, alcohol, heavy cigarette smoking, and gambling) [[35], [36], [37], [38],49]. While hunger and eating are largely mediated by more primitive parts of the brain such as the hypothalamus, the ability to resist overeating requires prioritization by higher cognitive functions (See Fig. 8). Patients with obesity have impaired dopaminergic pathways that otherwise regulate reward sensitivity and cognitive control [50]. Failure of higher brain functions to override other brain-mediated consumption (eating) of hyperpalatable, unhealthful foods, despite lack of hunger, despite being satiated, and despite known adverse health risks, might reasonably be characterized as an addiction-like behavior [[35], [36], [37], [38]] (See Fig. 8).