Rethinking Anorexia Nervosa

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2016011920160125 (R4)

How stimulating the brain could be used to treat severe and enduring anorexia nervosa.

Anorexia Nervosa is the most lethal of all psychiatric disorders. Early treatment can be effective but about a quarter of people develop a severe and enduring form of the disorder, which persists into adulthood and is notoriously difficult to treat.

The longer this pernicious disorder persists, the worse the prognosis for these patients. Desperate to find answers and offer hope, doctors and researchers are now pushing the boundaries of science in search of novel treatments. Sally Marlow talks to those at the cutting edge of research and to people who have been battling anorexia nervosa for decades. She discovers the role that thoughts and emotions play in the disorder, and how these are being examined by scientists who are increasingly turning to the brain to look for answers.

Scans are revealing areas and circuits in the brain which behave differently in people with anorexia nervosa. It's thought that the food rituals, obsessional thoughts and habits that characterise the disorder become entrenched over time, making it ever more difficult to break free from them. It appears that this might explain why for those who have had anorexia nervosa for many years, treatments such as talking therapies so often fail to help.

Armed with this knowledge, researchers are now using electrical stimulation to reset the brain areas and circuits that appear to be abnormal in patients with severe and enduring anorexia nervosa.

At Kings College London, researchers are trialling a technique called transcranial magnetic stimulation, whereby electromagnetic currents are delivered to the brain of each study participant via a device held above the head. Meanwhile researchers at Toronto University are trialling a much more invasive technique, which involves implanting electrodes deep inside the brain.

It's hoped that these techniques may free patients from some of the mental torment that prevents them from benefitting from existing therapies. While researchers are cautiously optimistic about what they're discovering, trialling experimental techniques in such vulnerable and desperate patients, raises a myriad of ethical dilemmas for everyone involved.

Producer: Beth Eastwood.