Habitual Brain Region Active in People With Anorexia

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People who suffer from anorexia nervosa use a brain region associated with habitual behavior in making decisions about what to eat, an area people without the eating disorder do not use in making such choices.

Joanna Steinglass, MD, Columbia University Medical Center, New York, and colleagues performed functional magnetic resonance imaging (fMRI) on 21 women with anorexia, and 21 women without the disorder as they made choices about what food to eat. The anorexia patients usually chose less high-fat foods than the healthy participants.

The brain region anorexia patients used in making their decision was the dorsal striatum, an area known to be involved in the habitual control of actions, but was not the same part of the brain used by health patients, the researchers reported in the journal Nature Neuroscience. In addition, activation in fronto-striatal brain circuits predicted how many calories they chose to consume in a meal the next day.

The researchers say the results mark the first time abnormalities in brain activity ware connected with behavioral decisions associated with anorexia nervosa, and restrictive food choices.

“We are already developing a new psychotherapy intervention built on principles of habit reversal that helps patients with anorexia nervosa change maladaptive behaviors,” Steinglass said in a statement.

tape measure around small waist with bony ribcage
People who suffer from anorexia nervosa use a brain region associated with habitual behavior in making decisions about what to eat.

When people with anorexia nervosa decide what to eat, they engage a part of the brain associated with habitual behavior. This finding by researchers at Columbia University Medical Center, New York State Psychiatric Institute, the Mortimer B. Zuckerman Mind Brain Behavior Institute, and New York University was published today in Nature Neuroscience.

Anorexia nervosa is a serious and puzzling illness. Even as its clinical signs have become increasingly recognized, the mortality rate remains among the highest of any psychiatric disorder. A highly stereotyped feature of this illness is the persistent selection of low-calorie, low-fat food, despite the individual's desire for change. The brain mechanisms underlying this persistent and restrictive eating disorder are unclear.

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