Neural Response to Low Energy and High Energy Foods in Bulimia Nervosa and Binge Eating Disorder: A Functional MRI Study

Brooke Donnelly; Nasim Foroughi; Mark Williams; Stephen Touyz; Sloane Madden; Michael Kohn; Simon Clark; Perminder Sachdev; Anthony Peduto; Ian Caterson; Janice Russell; Phillipa Hay

doi:10.3389/fpsyg.2022.687849

Neural Response to Low Energy and High Energy Foods in Bulimia Nervosa and Binge Eating Disorder: A Functional MRI Study

Front Psychol. 2022 Apr 21:13:687849. doi: 10.3389/fpsyg.2022.687849. eCollection 2022.

Authors

Brooke Donnelly^{1

2}, Nasim Foroughi³, Mark Williams⁴, Stephen Touyz^{1

5}, Sloane Madden^{6

7}, Michael Kohn^{7

8

9

10}, Simon Clark^{9

10}, Perminder Sachdev¹¹, Anthony Peduto^{12

13}, Ian Caterson¹³, Janice Russell^{2

5

13}, Phillipa Hay^{3

14}

Affiliations

¹ Clinical Psychology Unit, School of Psychology, University of Sydney, Camperdown, NSW, Australia.
² Peter Beumont Tertiary Eating Disorder Service, Department of Psychiatry, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
³ School of Medicine, Western Sydney University, Campbelltown, NSW, Australia.
⁴ Department of Cognitive Science, Macquarie University, Ryde, NSW, Australia.
⁵ InsideOut Institute, University of Sydney, Camperdown, NSW, Australia.
⁶ Department of Psychological Medicine, Sydney Children's Hospital Network, Westmead Campus, Westmead, NSW, Australia.
⁷ Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
⁸ Department of Paediatrics and Child Health, Sydney Children's Hospital Network, Westmead Campus, Westmead, NSW, Australia.
⁹ Adolescent and Young Adult Medicine Unit, Sydney Children's Hospital Network, Westmead Campus, Westmead, NSW, Australia.
¹⁰ Centre for Research Into Adolescents' Health, Westmead Research Foundation, Westmead, NSW, Australia.
¹¹ Centre for Healthy Brain Ageing, Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia.
¹² Department of Radiology, Westmead Hospital, Westmead, NSW, Australia.
¹³ Discipline of Medical Imaging, Charles Perkins Centre, Boden Institute, University of Sydney, Camperdown, NSW, Australia.
¹⁴ School of Medicine, Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia.

Abstract

Objective: Bulimia nervosa (BN) and binge eating disorder (BED) are eating disorders (EDs) characterized by recurrent binge eating (BE) episodes. Overlap exists between ED diagnostic groups, with BE episodes presenting one clinical feature that occurs transdiagnostically. Neuroimaging of the responses of those with BN and BED to disorder-specific stimuli, such as food, is not extensively investigated. Furthermore, to our knowledge, there have been no previous published studies examining the neural response of individuals currently experiencing binge eating, to low energy foods. Our objective was to examine the neural responses to both low energy and high energy food images in three emotive categories (disgust; fear; and happy) in BN and BED participants.

Methods: Nineteen females with BN (n = 14) or BED (n = 5), comprising the binge eating group (BEG; N = 19), and 19 age-matched healthy control (HC)'s completed thorough clinical assessment prior to functional MRI (fMRI). Neural response to low energy and high energy foods and non-food images was compared between groups using whole-brain exploratory analyses, from which six regions of interest (ROI) were then selected: frontal, occipital, temporal, and parietal lobes; insula and cingulate.

Results: In response to low energy food images, the BEG demonstrated differential neural responses to all three low energy foods categories (disgust; fear; and happy) compared to HCs. Correlational analyses found a significant association between frequency of binge episodes and diminished temporal lobe and greater occipital lobe response. In response to high energy food images, compared to HC's, the BEG demonstrated significantly decreased neural activity in response to all high energy food images. The HC's had significantly greater neural activity in the limbic system, occipital lobe, temporal lobe, frontal lobe, and limbic system in response to high energy food images.

Conclusion: Results in the low energy food condition indicate that binge frequency may be related to increased aberrant neural responding. Furthermore, differences were found between groups in all ROI's except the insula. The neural response seen in the BEG to disgust food images may indicate disengagement with this particular stimuli. In the high energy food condition, results demonstrate that neural activity in BN and BED patients may decrease in response to high energy foods, suggesting disengagement with foods that may be more consistent with those consumed during a binge eating episode.

Keywords: binge eating disorder; bulimia nervosa; emotions; fMRI; female; foods.