Brain imaging studies reveal neurobiology of eating disorders

by Scott Lafee

Current treatments for anorexia and bulimia nervosa, which afflict an estimated 10 to 24 million Americans, are often limited and ineffective. Patients relapse. They become chronically ill. They face a higher risk of dying.

"A major reason contributing to the difficulty in developing new treatments for these disorders is our limited understanding of how may contribute to eating disorder symptoms," said Walter H. Kaye, MD, professor of psychiatry and director of the Eating Disorder Treatment and Research Program at the University of California, San Diego School of Medicine.

In recent, published papers, Kaye and colleagues report the situation is changing. Advanced brain , supported by grants from the National Institute of Mental Health, are beginning to be used to study and improve eating disorder treatments. Indeed, with funding from the Global Foundation for Eating Disorders (GFED), a New York City-based group that promotes eating disorder (ED) research and improved treatments, the UC San Diego Eating Disorders Center for Treatment and Research has launched a new initiative to create more effective ED therapies based upon brain imaging studies.

"Brain imaging research has allowed for a shift from simply describing a symptom to understanding the cause of a symptom," said Kaye. "In the case of anorexia nervosa, imaging studies have helped us understand why people avoid eating and food and develop treatments that address the cause of the problem rather than secondary behaviors or symptoms.

"This is an important shift in the world of psychiatry similar to what revolutionized medical care decades ago. Today, if you show up at the doctor's office with a bad cough, he or she might run diagnostics to determine whether the cough was bacterial or viral in order to administer the appropriate treatment. Similarly, the more we understand the specific causes of eating disorders, the more effective and targeted our treatments can become."

The UC San Diego program, under the directorship of Kaye, Kerri Boutelle, PhD, associate professor of pediatrics and psychiatry, Leslie Karwoski Anderson, PhD, clinical assistant professor of psychiatry and GFED scholars Stephanie Knatz and June Liang, is developing an imaging-based treatment package specifically to address the neurobiology of anorexia nervosa, in which patients obsess about being or becoming overweight. To prevent weight gain or lose weight, people with typical may starve themselves or exercise excessively.

Kaye said one neurobiological target of anorexia and other eating disorders is anxiety. Most people get irritable when they do not eat and experience eating as both a reward and pleasant experience. Conversely, anorexic individuals frequently feel extreme anxiety when eating food – or even just anticipating eating – which results in severely reducing their food intake as a means of reducing their feelings of anxiety.

"Recent imaging research has uncovered specific alterations in the brain associated with this link between food and anxiety in anorexic individuals," said Kaye. "This finding is important because it helps explain the of cause food restriction, the most critical and dangerous behavior in anorexia."

The UC San Diego researchers have used the new information to create new treatment strategies, including psychoeducation – teaching patients why symptoms occur and how to more effectively cope.

"Many patients have described finally feeling a wave of relief after learning that the anxiety they experience is not their fault, but partly due to how their brain is responding to food," said Kaye. "Understanding why their eating disorder is driving them to restrict allows them to better target their anxiety around meals. Strategies such as developing routines before meals have shown promise in reducing the anticipatory anxiety leading up to meals and food restriction."

Kaye said the brain-based therapy also benefits families of patients with .

"Through a better understanding of their family member's eating disorder and its causes, family members have found comfort and hope with a 'road map' guiding them through the recovery."

add to favorites email to friend print save as pdf

Related Stories

Does eating give you pleasure or make you anxious?

May 20, 2011

(Medical Xpress) -- Perhaps the most puzzling symptom of anorexia nervosa -- a disorder that tends to occur in young women -- is the refusal to eat, resulting in extreme weight loss. While most people have a great deal of ...

Review provides new insights into the causes of anorexia

Jul 21, 2009

New imaging technology provides insight into abnormalities in the brain circuitry of patients with anorexia nervosa (commonly known as anorexia) that may contribute to the puzzling symptoms found in people with the eating ...

New approach to diagnosing anorexia nervosa

Jan 09, 2012

(Medical Xpress) -- A new approach for diagnosing patients with anorexia nervosa has been developed at the University of Sydney. The approach could have a significant impact on the treatment and recovery of sufferers, as ...

Recommended for you

Lift weights, improve your memory

5 hours ago

Here's another reason why it's a good idea to hit the gym: it can improve memory. A new Georgia Institute of Technology study shows that an intense workout of as little as 20 minutes can enhance episodic ...

Fat chats: The good, the bad and the ugly comments

7 hours ago

Cyberbullying and hurtful 'fat jokes' are disturbingly prevalent in the social media environment, especially on Twitter, says Wen-ying Sylvia Chou of the National Institutes of Health in the US. Chou is lead ...

Omega-3 fatty acids may prevent some forms of depression

9 hours ago

Patients with increased inflammation, including those receiving cytokines for medical treatment, have a greatly increased risk of depression. For example, a 6-month treatment course of interferon-alpha therapy ...

User comments