Deep brain stimulation helps two obese women lose weight

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A small study found that deep brain stimulation appears to help people with binge eating disorder control their food intake and lose weight, offering new hope to the millions of people living with the disorder.

The mess: People with binge eating disorder often consume large amounts of food while feeling that they cannot control their eating.

As a result, many are overweight or obese, increasing their risk for many health problems, including heart disease, diabetes, and certain cancers. They are also at increased risk of depression and other psychiatric illnesses.

Why it matters: Binge eating disorder is the most common eating disorder in the US, affecting at least 3 million people, and while medically supervised dieting and therapy can help some regain control over their eating and losing weight doesn’t work for everyone.

Medications that can relieve binge eating disorder symptoms, meanwhile, can be habit-forming or trigger serious side effects.

The treatment disrupts brain signals related to cravings for specific foods just before the binges.

The idea: People with binge eating experience cravings for specific foods just before the binge, and in 2017, researchers discovered distinct electrical activity in a part of the brain called the “nucleus accumbens” just before these cravings, but not before the binge .

When those researchers used deep brain stimulation to disrupt this electrical activity in the brains of obesity-prone mice, the animals ate significantly smaller amounts of a particularly tasty food than they would have without the stimulation.

What’s new? The Penn scientists have now taken that research to humans, testing the ability of deep brain stimulation to reduce food cravings associated with the disorder in two severely obese California women with binge eating disorder.

For the study, the women were fitted with brain-stimulating implants like those used to treat epilepsy. The researchers recorded their brain activity for six months and saw the expected signals in the nucleus accumbens just before the binge-eating episodes.

By the end of six months, both women had lost at least 11 pounds.

Over the next six months, the implants automatically stimulated the women’s nucleus accumbens regions whenever signals associated with desire were detected. The women say this reduced the frequency of their binge eating episodes and their feelings of being out of control.

“It’s not that I don’t think about food at all,” Robyn Baldwin, one of the participants, told the New York Times. “But I’m not an anxious person anymore.”

At the end of six months, both women had lost at least 11 pounds, and one no longer qualified as having binge eating disorder. No serious adverse side effects were reported.

The cold water: A six-month study involving just two people is not enough to say that deep brain stimulation could be an effective treatment for binge eating disorder. It must be tested on at least 100 people before it can be approved by the FDA, according to the New York Times report.

Studies would also need longer follow-up to show that short-term weight loss and reduced cravings translated into lasting results.

Penn’s team is already enrolling four participants for a larger study.

The researchers note in their study that the initial cost of the deep brain stimulator is high, meaning the treatment could be out of financial reach for many people who could benefit if it is ever approved.

Still, there is a significant need for more ways to overcome this eating disorder, and as deep brain stimulation becomes more common, the cost of implantation devices and surgeries could become more affordable.

Looking to the future: Penn’s team is already enrolling four participants for a larger study, and plans to follow the original participants for up to three years; both were given the option of having their brain stimulators removed a year after implantation, which both declined.

“This was an early feasibility study where we were primarily evaluating safety, but certainly the robust clinical benefits that these patients reported to us are really impressive and exciting,” said lead author Casey Halpern, who contributed to the 2017 research while she was at Stanford.

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