Uncontrolled overeating, which regularly affects some obese people, can be controlled with electrical currents deep in the brain. In a first trial with two severely overweight women, severe bouts of food cravings decreased and they lost weight. One of the two no longer met the criteria for . after six months binge eating disorder, as this disorder is called. American researchers describe the first results of the experiment this week in the scientific journal Natural medicine.
During a binge, someone eats along binge eating disorder large amounts of food in a short time while he is not hungry. Then you can’t stop eating. Many people are familiar with such moods, but in a person with a binge eating disorder, the attacks are much more frequent and more severe. They are often provoked by emotions or tension.
The attacks are extremely persistent: even the most radical treatment, a stomach reduction, sometimes cannot prevent an obese patient from falling victim to the attacks again. As a result, obese patients often fail to lose weight permanently.
The two study participants were both significantly overweight despite having a tummy tuck in 2005, after which they lost 52 kg or 69 kg respectively. In the years that followed, all that added up: they now had a BMI of 46 or 47. BMI stands for BMIa measure of the ratio of body height to weight, in kg/m2. A healthy BMI is between 18.5 and 25, one speaks of obesity at a BMI over 30.
Significant brain activity
During an operation, the subjects were given two electrodes deep inside their brains, in a brain nucleus crucial for reward and addiction: nucleus accumbens. These electrodes were connected to an implanted device in the upper body that can deliver and measure electrical impulses. With this equipment, they could just live their lives.
For the study, the Americans mapped how that brain nucleus reacted in a normal situation and just before and during the irresistible urge for food. To do this, the test subjects came into the laboratory every day. They first had the usual breakfast and lunch. But then a participating psychiatrist said a few disturbing things to affect their mood, and the researchers served the women their binge-provoking food: a table full of French fries, chicken nuggets, M&Ms and bags of chips, totaling 5,000 kilocalories.
Just before the overeating started, the researchers noticed a characteristic brain activity in the reward nucleus. If they electrically stimulated that brain nucleus at that exact moment, the urge disappeared. The equipment was adjusted to stimulate each time the characteristic activity was picked up by the device. The women were able to go home and do what they normally do, they were given no diet or exercise instructions. After six months, the number of binges had dropped sharply – in one of the women to less than four times a month. And body weight was also nearly 6 pounds, or more than 8 pounds lower—a BMI reduction of 2.2 and 2.9, respectively.
Obesity is a form of behavioral addiction
Damien Denys psychiatrist
Psychiatrist Damiaan Denys from Amsterdam UMC is not surprised that stimulating the brain’s addiction core provides relief from overeating and obesity. “This shows that it is not so much the food itself that is important in obesity, but also the control of eating. It proves that obesity is not only a nutritional problem, but also a form of behavioral addiction. People do not eat because they are hungry, but because they are addicted to the activity of eating.”
He therefore sees obesity as a psychiatric problem. “It’s the same with people with anxiety and obsessive-compulsive disorder: the behavior, such as constant hand washing, leads to anxiety reduction, but like with addiction, you have to do it more and more often for the same effect.”
Deep brain stimulation requires a major and expensive operation. Could this intervention, responsive deep brain stimulation, ever be a cost-effective treatment? A tummy tuck has more side effects, but the brain surgery costs more than twice as much: in the US around 30,000 dollars
Responsive deep brain stimulation can one day definitely become a treatment for people with morbid obesity and overeating, Denys believes. “But only for the very serious and untreated patients.” The Americans are still following the two patients and want to invite four more subjects in a follow-up study.
Also read: Alleviating: living a healthy life as medicine