Magnetic Solutions in Eating Disorder Treatment

Could there be a more innovative way to treat, or at least, to aid recovery from, an eating disorder?

Our latest post comes courtesy of Isabel Leming, a highly experienced practitioner in the field of mental health, an associate of Wednesday’s Child, and the owner of the new Moving Minds clinic, which specialises in transcranial magnetic solutions.

 “Sadly, many many hundreds of thousands of people around the UK are living with an eating disorder.

And yet, despite the scale of the issue, treatment approaches have remained fairly static over past decades – mainly consisting of medication and behavioural therapies.

But with 20% of anorexia patients and 23% of bulimia patients remaining chronically ill, there is a growing need for more innovative treatments.

More recently, focus has been placed on the role of repetitive Transcranial Magnetic Stimulation (rTMS) in the treatment of eating disorders.

Indeed, Kings College London have just published a study showing that rTMS decreases self-controlled food choices in patients with anorexia.

So, what is rTMS and can it really help in the treatment of eating disorders?

 rTMS

rTMS is a form of non-invasive brain stimulation that involves repeatedly sending magnetic pulses to a targeted area of the brain in order modulate the activity of neurons.

Whilst the term ‘brain stimulation’ may for some people bring up visions of electroconvulsive therapy (ECT), a treatment portrayed in films such as “One Flew Over the Cuckoo’s Nest”, the two are not the same.

Unlike ECT, rTMS is non-invasive, can be administered without anaesthetics, has very few side-effects and can be targeted to specific areas of the brain. It is now a well-established treatment for depression.

 How Does It Help?

In patients with anorexia nervosa (AN), neuroimaging studies have shown reduced activity in the area of the brain responsible for regulating self-control and food choices, known as the prefrontal cortex (PFC).

It is thought that the reduced activity in this area may contribute to AN symptoms related to both impaired inhibitory control (i.e. binge eating and purging) and poor cognitive flexibility (e.g. compulsions such as body checking, exercising, and the obsessive pre-occupation with eating, weight and shape).  

rTMS is targeted to this area of the brain in order to stimulate the neurons in the network responsible for self-control and decision making, thus increasing neuronal activity and boosting inhibitory control and cognitive flexibility.

How Effective Is It?

Studies have found that rTMS led to improvements in eating disorder symptoms (urge to restrict, feeling full, feeling fat) and mood, and patients displayed a general shift in food choices, away from low calorie choices, typical of anorexia and towards more high calorie foods.

One study, splitting patients between a real treatment group and a placebo group showed that 45% of those with anorexia receiving real rTMS reached normal weight 18 months after the study, compared with about 10% of those who received alternative treatment.

Patients in separate studies have also reported feeling more able to manage food‐related difficulties and having a more relaxed approach to food choice.

So, rTMS may have increased the cognitive control needed to override restrictive food choices.

Researchers have since suggested it is possible that combining rTMS with a form of psychological therapy or behavioural intervention might help translate the reduced self‐controlled food choices into real‐life long‐term changes in food intake.

Additionally, in Bulimia Nervosa patients, findings noted reductions in patients’ urges to eat, and in some studies reductions in actual binge and/or purge episodes were reported.

What Should We Conclude?

This preliminary evidence suggests that neurostimulation has potential for altering disordered eating behaviours, food intake and body weight.

Whilst more research is needed to back up these findings, rTMS is certainly emerging as an exciting potential new treatment for eating disorders.

Want to know more?

If you’re interested in discovering more, go to www.moving-minds.uk.

**Wednesday’s Child will soon be featuring Isabel in an online discussion, talking more about this particular therapeutic approach. If this is something of interest to you, please email us at hello@wednesdayschild.co.uk