The case of a young female patient with onset of anorexia nervosa at 14 and subsequent development of dependence on opiate drugs is reported. Her positive fami l y history for opiate dependence and the relationship between her eating behavior and the use of opiate agonists or antagonists are highlighted. Implications of this case for the treatment of eating disorders with opiate antagonists are discussed.
Central administration cf opiate agonists has been shown to increase food intake in rats; conversely, opiate antagonists decrease food intake in rats (Gosnell, 1987). Intake studies in rats using the dietary self-selection paradigm revealed that injections of opiate agonists caused a selective increase in diets high in fat while naloxone administration specifically decreased high-fat diet consumption (Marks-Kaufman & Kanarek, 1980;Marks-Kaufman & Kanarek, 1981;Romsos, Gosnell, Morley & Levine, 1987). Human studies have also shown that administration of opiate antagonists effectively decreases single meal food intake; however, long-term studies of opiate antagonists have not demonstrated a chronic suppression of food intake (Atkinson, 1987). Krahn, et al., (1988), reported that naloxone specifically decreased single meal intake of sweet, high-fat foods in normal females. The number of calories consumed in binges by bulimic women was reduced by pretreatment with naloxone (Mitchell, Laine, Morley & Levine, 1986). In contrast, methadone addicts report large intakes of highly palatable foods (A. S. Levine, personal communication).