Elsevier

Biological Psychiatry

Volume 65, Issue 8, 15 April 2009, Pages 654-661
Biological Psychiatry

Archival Report
Binge-Eating Disorder: Reward Sensitivity and Brain Activation to Images of Food

https://doi.org/10.1016/j.biopsych.2008.09.028Get rights and content

Background

The underlying neurobiological mechanisms that account for the onset and maintenance of binge-eating disorder (BED) are not sufficiently understood. This functional magnetic resonance imaging (fMRI) study explored the neural correlates of visually induced food reward and loathing.

Method

Sixty-seven female participants assigned to one of four groups (overweight BED patients, overweight healthy control subjects, normal-weight healthy control subjects, and normal-weight patients with bulimia nervosa) participated in the experiment. After an overnight fast, the participants' brain activation was recorded during each of the following three conditions: visual exposure to high-caloric food, to disgust-inducing pictures, and to affectively neutral pictures. After the fMRI experiment, the participants rated the affective value of the pictures.

Results

Each of the groups experienced the food pictures as very pleasant. Relative to the neutral pictures, the visual food stimuli provoked increased activation in the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), and insula across all participants. The BED patients reported enhanced reward sensitivity and showed stronger medial OFC responses while viewing food pictures than all other groups. The bulimic patients displayed greater arousal, ACC activation, and insula activation than the other groups. Neural responses to the disgust-inducing pictures as well as trait disgust did not differ between the groups.

Conclusions

This study provides first evidence of differential brain activation to visual food stimuli in patients suffering from BED and bulimia nervosa.

Section snippets

Participants

Females suffering from BED (n = 17), BN (purging type, n = 14) according to DSM-IV (2), and healthy control subjects with no previous history of eating disorders (normal-weight [C-NW]; n = 19; overweight [C-OW]; n = 17) participated in this study. We restricted the sample to women because they are more likely to suffer from BED (1.5 times) and BN (10 times) than men (2). The subjects had been recruited through announcements in local newspapers and at the university campus. Written informed

Reward Sensitivity and the Processing of Food Pictures

Scores from the self-report measures were compared between the four groups using one-way analyses of variance. We observed significant group effects for the BAS [F(3,63) = 2.6, p = .05]. Post hoc t tests indicated that BED patients reported greater reward sensitivity than all other groups (all p < .05; Table 1). The BIS group effect was nonsignificant [F(3,63) = 2.2, p = .09].

Ratings of valence [F(3,63) = .8, p = .46] and appetite [F(3,63) = 1.5, p = .22] for the food picture did not differ

Discussion

This study was designed to investigate differences between patients suffering from binge-eating syndromes and healthy individuals in their neural response to visual food stimuli. After an overnight fast of 12 hours, the four samples (patients with BED, bulimia nervosa, lean and obese healthy females) rated the food pictures as very pleasant and appetizing. This positive affective experience was accompanied by activation of the ACC, the OFC and the insula across all participants, which points to

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