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Disturbed eating behaviours have been widely reported in psychotic disorders since the early 19th century. There is also evidence that antipsychotic (AP) treatment may induce binge eating or other related compulsive eating behaviours. It is therefore possible that abnormal eating patterns may contribute to the significant weight gain and other metabolic disturbances observed in patients with psychosis. In this scoping review, we aimed to explore the underlying psychopathological and neurobiological mechanisms of disrupted eating behaviours in psychosis spectrum disorders and the role of APs in this relationship. A systematic search identified 35 studies that met our eligibility criteria and were included in our qualitative synthesis. Synthesizing evidence from self-report questionnaires and food surveys, we found that patients with psychosis exhibit increased appetite and craving for fatty food, as well as increased caloric intake and snacking, which may be associated with increased disinhibition. Limited evidence from neuroimaging studies suggested that AP-naïve first episode patients exhibit similar neural processing of food to healthy controls, while chronic AP exposure may lead to decreased activity in satiety areas and increased activity in areas associated with reward anticipation. Overall, this review supports the notion that AP use can lead to disturbed eating patterns in patients, which may contribute to AP-induced weight gain. However, intrinsic illness-related effects on eating behaviors remain less well elucidated, and many confounding factors as well as variability in study designs limits interpretation of existing literature in this field and precludes firm conclusions from being made.

Objective: Amphetamine was formerly used as a treatment to combat obesity, but amphetamine's use as an appetite suppressant was discontinued because of its significant abuse potential. Most of the rewarding and reinforcing effects of amphetamine differ by sex, with females showing higher levels of drug intake and amphetamine-induced motivation, relapse, and locomotion, but it is unknown whether amphetamine's effects on feeding also differ by sex. Furthermore, previous research on the anorectic effects of amphetamine has been focused primarily on its effects on baseline homeostatic feeding, but it is unknown whether amphetamine also affects hedonic, reward-related feeding, which is an important factor driving the rise in obesity levels., Methods: This study tested whether amphetamine alters food intake in a sex-dependent manner in two reward-related feeding paradigms: a sucrose two-bottle choice test and a high-fat/high-sugar binge intake model., Results: Amphetamine altered food intake equally in males and females in both paradigms, with higher doses significantly inhibiting feeding and low doses of amphetamine increasing feeding at later time points., Conclusions: Amphetamine's effects on feeding and drug reward may be mediated by distinct mechanisms, which could allow for the development of new approaches to combat obesity with limited abuse and addiction-related side effects., (© 2019 The Obesity Society.)

Objective: Nonmedical prescription stimulant use (NPS; i.e., use without a prescription or in ways other than prescribed) to suppress appetite or control weight appears to be associated with eating disorder (ED) symptomatology among college students. However, it remains unknown if this relationship is motive-specific and uniquely related to ED symptomatology. This research examined whether engaging in NPS specifically for appetite/weight-related purposes is associated with ED symptomatology and a unique indicator of more severe symptomatology., Method: A nonclinical sample of college students (N = 668; 79% female) reported eating disorder symptoms via the Eating Pathology Symptoms Inventory and Eating Disorder Examination-Questionnaire, and lifetime history of NPS and corresponding motives., Results: Binge eating, body dissatisfaction, negative attitudes towards obesity, restricting, purging, and cognitive restraint were reported more frequently by students who endorsed NPS for weight/appetite-related purposes than by those who used for other purposes or denied lifetime NPS. Additionally, NPS for appetite/weight-related purposes was uniquely associated with ED symptomatology after adjusting for gender, lifetime NPS, and past-month binge eating and purging., Discussion: Engaging in NPS for appetite/weight-related purposes is a unique indicator of ED symptomatology, highlighting the need to query for this behavior among individuals with an ED. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:813-816)., (© 2016 Wiley Periodicals, Inc.)