Can Deep Brain Stimulation Help People With Treatment-Resistant Anorexia?

While the most common treatments for anorexia are effective for many who struggle with the eating disorder, a significant number of people don’t respond to typical therapy or medication treatments.

Canadian doctors say they may have found a way to treat those who haven’t responded to all other forms of treatment using deep brain stimulation in a new study published in the journal Lancet Psychiatry.

The researchers say the treatment, which involves surgically implanting electrodes deep in the brain, helped reduce anxiety and depression in 16 people with severe forms of anorexia. In some cases, it also prompted weight gain.

The women were all between the ages of 21 and 57, and had anorexia for an average of 18 years. All participants had tried all available accepted treatments for anorexia. The participants were severely underweight, with some being identified as high risk for dying early from the disorder.

For the treatment, the participants had electrodes placed in specific regions of the brain believed to be linked to anorexia. After a few months, a number of the patients reported their depression and anxiety symptoms had improved. By one year after the start of the study, some also showed increased weight.

Over the course of the study, the average body mass index of the group rose from 13.8 to 17.3.

The participants also underwent brain scans at the start of the study and after a year of deep brain stimulation treatment. According to the researchers, the scans showed persistent changes in the regions linked with anorexia.

Dr. Nir Lipsman, a neurosurgeon at the Sunnybrook Health Sciences Center, told the BBC: “There are currently no effective treatments for people with long-standing anorexia nervosa – people who are often the sickest and most vulnerable of dying from the condition.

“Our work, which builds on earlier trials, is one of the first brain-based strategies that has been shown to help with chronic anorexia.

“And my hope is that through this research we are also validating the idea that anorexia is a brain-based illness, not a personality or lifestyle choice.”

While the findings showed positive results for some participants, the researchers noted that one patient had a seizure several months after the start of the trial. Two others asked for their electrodes to be removed during the trial.

As Dr. Carrie McAdams of the University of Texas Southwestern writes in the report, more research must be done to determine if the treatment is reasonably safe and effective for high-risk patients. “Further work to establish efficacy, safety and long-term outcomes in a larger cohort is needed.”

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