Alteration of eating behaviors in patients with Parkinson's disease: possibly overlooked?

Patients with Parkinson's disease (PD) occasionally show food cravings and/or compulsive eating that result in significant, undesired weight gain. Dopamine replacement therapy may be the cause of this type of eating disorder. We evaluated 60 consecutive patients to see if they had any alteration of eating patterns after starting levodopa. Among them, five (8.3%) patients exhibited characteristic alterations of food preference following the start of dopamine replacement therapy. One patient showed an undesirable weight gain. Of the five patients exhibiting food preference alterations, all showed increased preference to consume sweet snacks, although this alteration was not always associated with hyperphagia (eating too much). This type of dietary alteration was not related to a specific antiparkinsonian drug, and could be observed in patients undergoing dopamine agonist monotherapy. Alteration of eating behavior may not be uncommon in PD patients, and is possibly overlooked. Since dopamine is closely involved in acquisition of food preferences, dietary changes with/without compulsive eating may be a manifestation of an alteration of appetitive behaviors due to excessive dopaminergic neurotransmission.