Anorexia and bulimia are the most widely recognized eating disorders, with established diagnostic criteria and diagnosis codes. Binge Eating Disorder (BED), which many experts believe may be more prevalent than anorexia or bulimia, is lumped together in a category called ED-NOS - eating disorder not otherwise specified. The American Psychiatric Association proposes that BED becomes a distinct diagnosis when the DSM-5 revised rules are published next year.
People who have binge eating disorder may not care too much about these diagnostic distinctions. They know something is not right, but feel helpless to stop the behavior. They're embarrassed, and feel guilty, disgusted and depressed about it. While bulimics compensate for binges by purging (ex: vomiting), binge eaters do not, and are likely to be overweight or obese, increasing risk for a host of chronic diseases associated with excess weight.
The reasons for this behavior remain a mystery, but a new study at the University of Denver helps to shed some light on whether unusual brain activity in binge eaters drives the behavior. Recently I spoke with Dr. Jill Holm-Denoma, one of the principal investigators for this study. Dr. Holm-Denoma, a professor of psychology, says the study will use MRI imaging to assess brain reactivity in binge eaters to both food cues and other types of reward images. In particular, the study will investigate links between the dopamine system and BED. She notes that binge eaters have very high reactivity to food cues, and the study is more interested in the magnitude of reactivity to reward cues.
I asked Dr. Holm-Denoma if she thought this was a learned or genetically-based behavior. She believes there is a heavy genetic component to the behavior, but her study is not examining that specifically. Environmental cues are important, such as excess portions or constant access to abundant food.
Is this study aimed at defining a particular therapy for BED? Dr. Holm-Denoma said that if the study indicates that the dopamine system is tied to BED, then certain medications might turn out to be helpful. But medication isn't the only path. Therapists could use re-training techniques for binge eaters who are vulnerable to food cues, to help them cope with anxiety and stress using other non-food strategies.
The study is actively recruiting subjects. Prospective subjects can be in current treatment, but still experiencing at least 2 binge episodes/week. To be considered you must be:
- female, 18-45 years old
- right handed
- native English-speaker
- neurologically healthy
The study involves some pre-assessment questionnaires. If you're accepted, you will have an MRI scan, while viewing images of reward-type foods. Study subjects will be paid for their participation.
For more information, or if you'd like to participate in this study, contact the Mechanisms of Cognitive Control Lab at the University of Denver at 303-871-7925 or mocclab@gmail.com.
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