A small study demonstrated that deep brain stimulation, used for people with Parkinson’s disease, can limit an urge to overeat.
What if an uncontrollable urge to rapidly eat large amounts of food is rooted in an impaired brain circuit? If that were the case, people who live with binge eating disorder — a psychiatric diagnosis — might be no more at fault for overeating than a patient with Parkinson’s disease is for their tremors.
That question led doctors to try a new treatment different from anything ever attempted to help people with this common but underreported eating disorder. At least 3 percent of the population has it, said Dr. Casey Halpern, a neurosurgeon at the University of Pennsylvania.
He and his colleagues decided to try deep brain stimulation, a method routinely used to quell tremors in patients with Parkinson’s. It involves placing electrodes in the brain to regulate aberrant signals. The wires, connected to the electrodes, are placed under the scalp, where they are invisible and unobtrusive. For the binge eating treatment, the device only stimulates neurons when the device detects a signal to start a binge.
The pilot study, funded by the National Institutes of Health and published earlier this year in the journal Nature Medicine, involves two women and will be expanded in a few months to include four more people living with binge eating disorder who regained the weight they lost after bariatric surgery. Before the treatment can be approved by the Food and Drug Administration, researchers will need to rigorously test the method in at least 100 people in multiple medical centers. Such a study would take several years to complete.
The two women whose devices were implanted a year ago will be followed for up to three years. They had the option to have their devices removed after 12 months, but both wanted to keep them because they no longer felt irresistible urges to binge.
One of them, Robyn Baldwin, 58, of Citrus Heights, Calif., described herself as a “chunko child” who had “always been big.” She tried a wide range of diets. Once, she consumed only protein shakes for a month.
In 2003 she had bariatric surgery, which usually involves altering the digestive system so that the stomach is smaller and food is more difficult to digest. It has enabled many people to lose weight when other methods failed. But for Ms. Baldwin, the weight she lost came back.
Lena Tolly, 48, the other patient from the study, lives in Sacramento. She also tried a large number of diets and remedies for obesity. Her parents gave her a month at a vegan camp as a graduation present from college. While there, she walked 10 miles a day.
In August 2005, Ms. Tolly had bariatric surgery. She lost 100 pounds, but the weight crept back on.
“It has to be more than willpower,” she said.
In her case — and in Ms. Baldwin’s — it was. Their binge eating is not what most people call binging, as when they occasionally start on a bag of chips or on a gallon of ice cream and just keep going. Instead, their condition is in the Diagnostic and Statistical Manual of Mental Disorders. It involves binging multiple times a week. The binges are accompanied by a feeling of being almost in another state in which they lose all control, quickly consuming large amounts of food. Many, embarrassed by their behavior, binge in secret. It is common to feel disgust and shame when the binge ends.