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The phenomenology of chronic anorexia nervosa is compared with that of addictive states. A model is proposed in which brain opioids mediate the elation, neuroendocrine changes, and down-regulation of metabolism that occur in adaptation to dieting. The physiology of opioids is reviewed, and clinical and animal data are marshalled to support an auto-addictive model. Opiate blockade together with therapeutic approaches used in the addictions may prove helpful in this stubborn disorder.
Marrazzi et al. (Sat,) studied this question.