What if the uncontrollable urge to eat large amounts of food quickly is rooted in a disordered brain circuit? psychiatric diagnosis — In the same way that Parkinson’s sufferers have shivering, it may not be because of overeating.
This question has led doctors to try new treatments that differ from those previously attempted to help people with this common but underreported eating disorder. 3 percent Casey Halpern, PhD, a neurosurgeon at the University of Pennsylvania, says one person in the population has it.
He and his colleagues decided to try deep brain stimulation, a method routinely used to calm tremors in people with Parkinson’s disease. Electrodes should be placed on the brain to tune out the abnormal signals. Wires connected to the electrodes are placed under the scalp inconspicuously and discreetly. For binge therapy, the device only stimulates neurons when it detects a signal to initiate binge eating.
of pilot studyThe study, funded by the National Institutes of Health and published in the journal Nature Medicine earlier this year, involved two women and, months later, four more bulimic patients who were overweight. I regained the weight I lost after surgery. Before the treatment is approved by the Food and Drug Administration, researchers must rigorously test it in at least 100 people at multiple medical centers. Such studies take several years to complete.
Two women with devices implanted one year ago will be tracked for up to three years. They both had the option of removing the device after 12 months, but both wanted to keep it.
One of them, 58-year-old Robin Baldwin of Citrus Heights, Calif., described himself as “always big” and “a dick.” She tried various diets. Once, she took only protein her shakes for a month.
In 2003 she bariatric surgeryIt usually modifies the digestive system to make the stomach smaller, making it harder to digest food. It has enabled many people to lose weight when other methods have failed.
Another patient in the study, 48-year-old Lena Tolly, lives in Sacramento. She has also tried many diets and treatments for her obesity.Her parents gave her a month at their vegan camp as a college graduation present. While there she walked 10 miles every day.
In August 2005, Torrey underwent bariatric surgery. She lost her 100 pounds, but her weight slowly came back on.
“It has to be more than willpower,” she said.
It was the case with her, and it was the case with Ms. Baldwin. Their bulimia isn’t what most people call bulimia, it starts with the occasional bag of chips or a gallon of ice cream and stays that way. Instead, their condition is described in the Diagnostic and Statistical Manual of Mental Disorders. It involves binging several times a week. Bingeing is accompanied by the feeling of being almost in another state, losing all control and rapidly consuming large amounts of food. Many people are embarrassed by their behavior and secretly binge. It’s common to feel disgust and embarrassment once the binge is over.
The study Baldwin and Tory participated in is part of an effort to use deep brain stimulation to treat various disorders that can be caused by problems with electrical signals in the brain. Dr. Edward Chan, professor of neurosurgery at the University of California, San Francisco, said he was not involved in the bulimia research.
Researchers have found the precise brain circuits that regulate the symptoms of some of these disorders, often in areas as small as 1 mm in diameter. This discovery paves the way for the study of deep brain stimulation.
Halpern led the pilot experiment with Baldwin and Tolly. But first he and his colleagues started with obese-prone mice. The animals were fed, but when the researchers put the butter in the cage, it devoured the butter, and in an hour he ate more than 25 percent of his daily calories.
The brain region that was activated was the nucleus accumbens, a key hub of the brain’s reward center, located deep in the center of the brain. In mice, neurons in the nucleus accumbens were activated just before binge eating. When the researchers used deep brain stimulation to calm these neurons, they were able to prevent the mice from overeating.
But would it work in humans?
A group of scientists have started advertising people who have regained all their weight after bariatric surgery, believing that bulimia may be the culprit.
Baldwin and Tory answered. Neither of us realized we had a binge eating disorder. But bulimia is “really common in people undergoing weight loss surgery,” says Lauren Breithaupt, a psychologist who studies eating disorders at Massachusetts General Hospital.
When Baldwin and Tolly met Dr. Halpern, they were both heavier than they were before their weight loss surgery.
As part of the study, the researchers provided each woman with a 5,000-calorie feast of their favorite food when they weren’t hungry. Did. Baldwin thinks about her work schedule and her household responsibilities. They agreed to allow researchers to encourage them to binge on their triggers as part of their study.
Researchers recorded electrical impulses in the nucleus accumbens when women ate and found that neurons fired just before overeating and that those electrical impulses correlated with women feeling out of control. confirmed. A direct brain stimulator could have intercepted the signal and prevented the woman from wanting to binge.
After connecting the device to the woman’s brain, investigators told Baldwin and Tory that they would activate the device at some point in the next few months, but did not say when. Both women said they knew immediately when the device was activated. Suddenly my insatiable appetite disappeared.
Now their weight is gradually decreasing. Both say that they eat differently, without even thinking about it positively.
“It’s not self-management,” Ms. Tory said. “I make better choices.” But she never started eating foods she didn’t like. “I’m not signed up for Kale.”
Baldwin said she has noticed a change in her food preferences. She loves peanut butter so much that she finds herself eating it with a spoon out of the jar. Now she doesn’t crave it.
“I get into the habit of going to the pharmacy to pick up a prescription, but I might take a detour to Ben and Jerry’s,” she said.
Once the device booted, “I could go to the pharmacy without thinking about ice cream,” she said.
She has also noticed that her tastes have changed. Her favorite foods are savory, not sweet.
“It’s not that I don’t think about food at all,” Baldwin said. “But I’m not a thirsty person anymore.”
But does this show that direct brain stimulation could be the answer to extreme binge eating?
Dr. Breithaupt is cautious.
“It’s just the two of us,” she said.
