Hunger Versus Reward: How Do Anorexics Control Their Appetite?

Posted on March 25, 2015

A new study by Dr. Christina Wierenga, Dr. Walter Kaye, and colleagues, published in the current issue of Biological Psychiatry, sheds new light on the brain mechanisms that may contribute to the disturbed eating patterns of anorexia.

They examined reward responding in relation to metabolic state (hungry or satiated) in 23 women recovered from AN and 17 healthy women without eating disorder histories (e.g., the comparison group). Women with active AN weren’t studied to reduce potential confounds related to starvation.

The healthy women, when in a state of hunger, showed increased activity in the part of the brain that motivates the seeking of reward, but the women recovered from AN did not. The recovered women also exhibited increased activation of cognitive control circuitry regardless of metabolic state.

Thus, this study found that women who have recovered from anorexia nervosa show two related patterns of changes in brain circuit function that may contribute to their capacity to sustain their avoidance of food.

First, hunger does not increase the engagement of reward and motivation circuits in the brain. This may protect people with anorexia from hunger-related urges. Second, they showed increased activation of executive ‘self-control’ circuits in the brain, perhaps making them more effective in resisting temptations.

"This study supports the idea that anorexia nervosa is a neurobiologically-based disorder. We've long been puzzled by the fact that individuals with AN can restrict food even when starved. Hunger is a motivating drive and makes rewards more enticing," said Wierenga, an Associate Professor of Psychiatry at the University of California, San Diego. "These findings suggest that AN individuals, even after recovery, are less sensitive to reward and the motivational drive of hunger. In other words, hunger does not motivate them to eat."

Category(s):Eating Disorders

Source material from Elsevier

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