Researchers find potential breakthrough in binge-eating disorder treatment

Posted on May 12, 2016

Image: UAB

The American Psychiatric Association classifies BED as an eating disorder characterized by recurrent episodes of binge eating, which is eating large quantities of food in a short period of time with a sense of loss of control to stop. Binges are followed with feelings of shame, disgust and distress. Unlike bulimia, there is no purging to counter the calories from binge eating. Obesity is very common among those with BED.Transcranial direct current stimulation, or tDCS, has proved effective for binge-eating disorder for the first time, according to researchers at the University of Alabama at Birmingham.

tDCS is a type of neuromodulator that delivers constant, low-current electricity to a targeted portion of the brain. While it has been tested and proved effective for many disorders and health issues, including depression, Parkinson’s disease and autism, this UAB study is the first to effectively prove its potential as a treatment in patients with binge-eating disorder, or BED.

Approximately 5 percent of the U.S. adult population suffers from a lifetime prevalence of BED, with an additional 1.2 percent with sub-threshold BED and 4.5 percent with binge-eating tendencies.

Compared to obese individuals without BED, obese individuals with BED are more prone to depression, anxiety, body dissatisfaction, low self-esteem and social withdrawal.

Currently, cognitive behavioral therapy, or CBT, is the best treatment for BED. However, CBT is not perfect, and there are many patients who relapse after treatment. Pharmaceutical treatments for BED are often ineffective and can have many negative side effects.

Frank Amthor, Ph.D., a professor in the UAB Department of Psychology with a background in engineering, knew about tDCS and suggested it to Boggiano as a treatment that could possibly alleviate obesity. TDCS studies were showing that it reduced depression and food craving, but in normal-weight and non-eating-disorder populations.

The team from UAB tested 30 adults — both male and female — with BED or sub-threshold BED with a 20-minute session of tDCS targeting the right dorsolateral prefrontal cortex for stimulation. They also administered a "sham" session in which the individuals were hooked up to the tDCS device but did not actually receive stimulation, to control for possible placebo effects.

"We targeted the right dorsolateral prefrontal cortex because this area is underactive in patients with BED," Boggiano said. "Underactivity in this area of the brain is associated with decreased cognitive inhibition and ability to regulate emotions. This could explain the loss of control when craving food — a very emotional state — and loss of control when eating food in BED. Therefore, stimulating this region might lessen their impulsiveness toward food."

The results showed that tDCS decreased craving for sweets, savory proteins and an all-foods category significantly more than did sham. The strongest reductions occurred in the men. In both sexes, tDCS decreased total food intake by 11 percent and the individuals’ preferred-food intake by 17.5 percent of their intake during the control sham session. It also reduced desire to binge eat in men on the day of tDCS compared to sham administration. The reductions in craving and food intake were predicted by eating palatable food less frequently for reward motives, and by a greater intent to restrict calories, respectively, both traits which were measured with surveys at the onset of the study.

“It’s particularly significant that men had a greater impact from the tDCS treatment,” Burgess said. "Men make up a greater percentage of BED patients than they do comparatively in any other eating disorder, and males are often excluded from research studies, so it’s helpful to know this type of treatment might be particularly effective for that population."

Category(s):Eating Disorders

Source material from UAB

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