Drs. Kalarchian and Marcus Reply

To The Editor: The similarities and differences between aberrant eating and addiction have been debated for many years (1) . As noted, recent work on the neurocircuitry of reward systems has stimulated new thinking on the potential commonalities in the biobehavioral impact of foods and drugs (2) .

The studies by Drs. Warren, Gold, and colleagues that reported an inverse relationship between body mass index and alcohol (3) and marijuana (4) consumption appear to be consistent with the hypothesis that overeating and obesity may act as protective factors against addiction. However, the studies mentioned are restricted to chart reviews of substance use among obese, female weight-management patents. Additional research, including prospective studies of diverse, community-based cohorts, with research assessments of body weight, eating behavior, and patterns of substance use and abuse, is needed to evaluate this hypothesis fully.

Although our recently published article did not address this issue directly, we concurred that the possibilities for combating obesity and drug addiction with similar or overlapping strategies warrant further exploration. However, even if obesity and drug addiction share a common developmental vulnerability, effective treatments for obesity and addiction may differ.