The number of people with addictions has also risen significantly in Austria recently - and there is no end in sight to this trend. Against this background, the book "Sucht. Neue Erkenntnisse und Behandlungswege" is published by MANZ-Verlag as part of MedUni Vienna’s "Health Knowledge" series. In it, Gabriele Fischer and Arkadiusz Komorowski from MedUni Vienna’s Department of Psychiatry and Psychotherapy counter traditional ways of thinking with scientifically based facts. In addition to alcohol addiction and the abuse of "new psychoactive substances", it is above all "binge eating" that is causing increasing concern in everyday clinical practice.
According to internationally renowned addiction researcher Gabriele Fischer from MedUni Vienna, the rising number of people with obesity is also linked to the increasing prevalence of binge eating disorder (BED). BED is defined as the binge-like consumption of enormous quantities of food, which occurs repeatedly and over a long period of time as a result of cravings typical of addiction. It is also referred to as binge eating disorder because intense cravings, loss of control, continuous increase in dosage, development of tolerance and withdrawal symptoms (especially irritability and aggression when food intake is restricted) correspond to the clinical characteristics of other addictive disorders. Brain imaging studies also show similar neurobiological changes in the reward centre (mesolimbic system) in people with binge eating, as can also be seen in other addictions such as nicotine, alcohol, opioids or gambling.
Hunger for happiness
In BED, these brain regions are activated in particular by sugary or carbohydrate-containing foods, which (briefly) give rise to a feeling of happiness when eaten. "In this case, food does not satisfy hunger, but is used to (supposedly) increase the feeling of happiness," says Fischer. However, the feeling of well-being triggered by the increased release of dopamine wears off over time. Those affected also often withdraw at home in order to conceal their binge eating as much as possible. "Already stigmatised by their excess weight, most sufferers are tormented by a strong sense of shame," adds Komorowski. "Yet the treatment of binge eating is an essential part of the successful treatment of obesity." In many cases, binge eating also occurs together with other addictions or psychiatric illnesses such as depression or anxiety disorders.
Expansion of treatment centres necessary
Gabriele Fischer and Arkadiusz Komorowski consider the development of addictions in Austria in general to be alarming: for example, the issue of drug addiction among the over-60s is increasingly coming into focus. Nicotine addiction now affects significantly more young women than men. And according to the latest OECD study, Austria is well ahead in terms of alcohol addiction. 30 per cent of young adults regularly consume cannabis, and an increasing prevalence of new psychoactive substances (NPS) is also being registered among the younger generation. Non-substance-related addictions such as pathological gambling or computer game addiction are also affecting more and more people.
Regardless of whether the addiction is to tobacco, alcohol, food, gambling or cocaine, sustainable treatment success is only possible if lifestyle changes are implemented alongside medication. Addictions are chronic illnesses, so short-term interventions are not enough, emphasise Fischer and Komorowski, whose book is aimed at those affected, relatives and interested parties. Due to the overall sharp rise in addiction in Austria, the expansion of professional and evidence-based treatment centres within the publicly funded insurance system is urgently needed, Fischer and Komorowski demand.
,,Sucht. Neue Erkenntnisse und Behandlungswege." Gabriele Fischer & Arkadiusz Komorowski, publication date: 06/12/2023, MedUni Vienna in MANZ Verlag, ISBN 978-3’214 -25406-3, 232 pages, 23.90 euros, (pre-)orders at: https://shop.manz.at/shop/products/9783214254063