Researchers from the University of Toronto’s University Health Network have recently published a study in the prominent scientific journal The Lancet, in which they test the safety of a new treatment for anorexia nervosa. They conducted a small Phase I trial, which involved six patients, using a procedure called Deep Brain Stimulation (dbs).
While anorexia is often dismissed as simply a refusal to eat in order to be thin, the disease is actually much more complex than that. It is associated with psychological factors, including the need for control, perfectionism, and anxiety. Anorexia is deadly; six to 11 per cent of those who suffer from annorexia die. In addition, almost 15 per cent of those who have anorexia are chronically affected by it. Long-term physiological effects include irregular heartbeats, neurological problems including seizures, as well as decreased bone and muscle mass. Anorexia is also one of the hardest psychological disorders to treat. Patients start treatment, either voluntarily or involuntarily, through intervention by friends and family, but they often do not complete it successfully.
dbs has been previously used in treating other neurological diseases such as Parkinson’s, Alzheimer’s, and depression. It involves implanting electrodes into the subcallosal cingulate of the brain and attaching these electrodes to a battery-operated pacemaker to provide constant electrical stimulation at a very low voltage. The pacemaker is then embedded under the skin of the patient’s right collarbone, much like the pacemaker device used for heart problems. If necessary, it can be turned off, or the voltage can be changed using a remote outside the body.
There was only one significant adverse effect observed in the nine months that the patients were monitored: one of the patients had a seizure. According to Dr. Blake Woodside, a member of the research team and a professor of psychiatry at U of T, the seizure could have been unrelated to the surgery as seizures are a symptom of anorexia. As such, the procedure was deemed safe. Woodside says it has been performed on another six patients since the study was submitted last August, bringing the total to 12 patients.
The results of the trial are very exciting for the future of anorexia treatment. While the researchers only intended to provethat the surgery is safe, there was an additional promising outcome. The patients who were chosen had very severe anorexia, failed to complete multiple treatments, and would likely have died without intervention. In the end, five out of the six patients completed the treatment despite the severity of their disease. These five showed significant improvement, gaining weight over the nine months that the study was conducted, and showing improvements in symptoms related to anorexia. Given the frequent failure of other anorexia treatments, the high success rate of the dbs procedure is indicative of its potential as a last resort treatment for chronic sufferers.
However, Woodside does not believe that the treatment directly targets the root cause of anorexia. Rather, it negatively targets factors in the brain that allow anorexia to thrive. Nevertheless, the result is the same — dbs reduces the effects of anorexia.
Woodside says that coming up with new treatments for anorexia is necessary because there has not been much development in the discipline in the past 15 years and because the disease mainly targets young women, a group whose issues are often swept under the proverbial carpet. While the study is a major development, it is only in its first phase, which means that much more research and monitoring is needed to ensure that the procedure is as safe as it is efficacious as a treatment for anorexia nervosa.
