Eating
disorders affect many women and men throughout the US and the underlying cause
is still widely unknown, thus making treatment difficult. Some think eating
pathologies are a result of other primary causes and cultural influences, while
others believe it has to do with the appetite regulatory system. A current study looks at the neural
system involved with the emotional, reward and cognitive features of food intake,
called the corticolimbic pathway.
Within the corticolimbic pathway, one
study specifically looked at the involvement of the gustatory cortex and the
anterior insula in recovered patients with anorexia and bulimia nervosa. These two neural pathways are thought
to be involved in responses to physical properties of food and its rewarding
effects. Furthermore, they innervate the area that controls some behavioral
functions called the rostral ventral-central striatum. In order to test the brain’s involvement
in eating disorder patients as compared to healthy controls, fMRI was used to
look at brain activity during the administration of sucrose and sucralose. Interestingly, it was found that the
right anterior insula response was decreased in women who had anorexia and much
higher for women with bulimia as compared to controls. This may explain the decrease in
perception of appetite in anorexia and increase in perception of appetite in
bulimia patients when compared to controls. This finding also indicates a
dysfunction in taste processing within women with eating disorders. The difference
in signal strength and processing in women with anorexia and bulimia as
compared to controls my provide important neural information that can lead to
better treatments.
Since
anorexia and bulimia are so prevalent in today’s culture and treatment is
limited to various cognitive therapies, this study provides potentially
beneficial information that can lead to better treatments. This is significant because these
diseases have high morbidity, mortality, and reoccurrence rates.
References:
Oberndorfer, TA, Frank GKW, Simmons AN, Wagner A, McCurdy D, Fudge JL,Yang TT, Paulus MP, Kaye WH. 2013. Altered insula response to sweet taste processing after recovery from Anorexia and Bulimia Nervosa. Am J Psychiatry. 170: 1143-1151.
I found an article which discusses the differences in cell signaling found in those with eating disorders versus those without and it talks about the use of orexin receptor antagonists as a possible treatment strategy for drug addictions and eating disorders. However, I was wondering if you thought a treatment in the form of a medication could perhaps allieve eating disorders or if, based on your research, you think these diseases are more multifactorial? (ie Do you believe there is a certain brain chemistry, which if we were able to develop a treatment for, we could counteract simply with medication, or do you believe there are more emotional and psychological components which require the current talking therapies?)
ReplyDeleteXu T, Yang Y, Ward R, Gao L, and Lui Y. 2013. Orexin receptors: Multi-functional therapeutic targets for sleeping disorders, eating disorders, drug addiction, cancers and other physiological disorders. Cell Signaling. 52(12): 2413-2423.
http://www.ncbi.nlm.nih.gov/pubmed/23917208
That is a great question and an interesting article. I believe that eating disorders are multifaceted and need to be treated with both psychological therapy and medication if necessary. From my research, many times eating disorders are accompanied by anxiety, OCD and depression, all of which may require different forms of treatment. Because of this, a medication may help alleviate the deleterious symptoms of appetite regulatory dysfunction (which is important for bodily health), but these medications may not treat the anxiety or other psychological symptoms that often accompany eating disorders. In keeping the whole person in mind, yes, medication may help with specific appetite patterns, but other therapy is needed to further ameliorate psychological symptoms. Much of the research I have found suggests a multidimensional approach.
ReplyDeleteGregorowski C, Seedat S, Jordaan GP. 2013. A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders. BMC Psychiatry. 13(1): 289.