Experimental brain surgery quelled cravings in 2 people with binge eating disorder


The first two patients to undergo experimental brain surgery for binge eating disorder say they have more control over what they eat and are less hungry a year later.

“I am fully aware of my desires,” Robyn Baldwin, 58, of Citrus Heights, Calif., told NBC News. “Sometimes I can just stop, breathe and say, ‘No.'”

Baldwin, along with Lena Tolly, 48, of Elk Grove, Calif., underwent surgery after they failed to respond to other treatments for binge eating disorder.

Preliminary findings on the effects of the surgery — part of a pilot study that will involve a total of six people — were reported Monday in the journal Nature Medicine.

It is the first time that deep brain stimulation has been used to treat binge eating. In the study, surgeons implanted a device that learned to detect when the patients had an appetite, then delivered a small zap to the brain to reduce the craving.

“The fact that this can be done is pretty amazing,” said Dr. Kai Miller, an associate professor of neurosurgery at the Mayo Clinic in Rochester, Minnesota.

“It’s brain surgery, and that comes with its own risks,” said Miller, who was not involved in the new research. “But these patients improved over time and had fewer episodes of binge eating.”

Robyn Baldwin said her food cravings were more controlled after deep brain stimulation.Thanks to Robyn Baldwin

For Baldwin, the change was almost instantaneous. “Within a few days, I noticed the cravings were getting under control,” she said. “I wasn’t constantly thinking about food.”

It took longer for Tolly to feel an effect, but after a few months she regained the feeling of control. “I’ll never give up carbs,” she said, “but I have a better relationship with them and make better choices.”

Binge eating disorder is the most common eating disorder in the United States, surpassing anorexia and bulimia. People with binge eating disorder lose control over how much they eat, even after they feel full.

That loss of control, said senior study author Dr. Casey Halpern, is the result of misfired signals in the brain.

“It’s not that they can’t control themselves,” said Halpern, a neurosurgeon and chief of stereotactic and functional neurosurgery at Penn Medicine in Philadelphia. “It’s a signal in the brain that’s gone wrong.”

How does it work?

During surgery, a pacemaker-like device is implanted under the scalp. This device then connects to the nucleus accumbens, a part of the brain that plays a critical role in how people experience reward and satisfaction.

Halpern and his colleagues targeted those wires specifically to two smaller parts of that brain region: one that controls how people manage their impulses, and one that controls appetite.

The device has two lanes. It records brain activity and can also deliver small electrical pulses to the brain intended to suppress cravings. There is no physical sensation when these zaps occur, but the patients may notice changes in mood.

Initially, the device must be trained to detect which types of brain activity are associated with binge eating. To do this, Baldwin and Tolly wave a magnetically charged wand over their heads when they feel the urge to binge, a signal to the device that the brain activity it sees is related to cravings. Ultimately, it is able to decode such brain activity itself and send a zap to the brain when it turns out the person is likely binge eating.

Six months after the device was turned on, both women had more control over their binge eating, Halpern said. One, he added, no longer met the criteria for binge eating disorder.

“Both patients absolutely report and feel they have more self-control than before,” he said.

Longer term data on Baldwin and Tolly are expected to be analyzed and published at a later date. Two more patients are expected to undergo the surgery within the next six months. The study will eventually involve six patients.

A limitation of the current findings is that the two women are demographically similar: middle-aged and overweight.

While it appears to be an innovative approach to treating binge eating, it’s unclear whether the technique would be helpful in most patients, said Stephen Wonderlich, co-chair of the National Eating Disorders Association’s Research Advisory Council.

“How broadly does this apply?” said Wonderlich. “Would the findings generalize to people of different body sizes? We don’t know.”

The research isn’t the first to use deep brain stimulation to target cravings.

dr. Ali Rezai, a neurosurgeon and executive chairman of the Rockefeller Neuroscience Institute at West Virginia University, is studying the technique as a way to treat opioid use disorders.

The binge eating findings, he said, are consistent with other studies showing changes in brain activity in people with other neuropsychiatric disorders.

Rezai added that it will be important to confirm the findings in other patients with binge eating disorder and continue with longer-term data.

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The Valley Voice
The Valley Voicehttp://thevalleyvoice.org
Christopher Brito is a social media producer and trending writer for The Valley Voice, with a focus on sports and stories related to race and culture.


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