fMRI in Binge Eating Disorder Participants Pre and Post Bariatric Surgery

Abstract

fMRI in Female Binge Eating Disorder Participants Pre and Post Bariatric Surgery Background: Obese binge eaters are a distinct subgroup of the obese population. This study aimed to examine differences in brain activation and eating behavior between obese Binge and Non-Binge Eaters who underwent Roux-en-Y Gastric Bypass (RYGB) vs. no treatment.;Method: This is a prospective cohort study with a quasi-experimental, 2 x 2 x 2 x 3 mixed factorial design. There were 15 RYGB (8 Binge eaters; 7 Non-Binge Eaters) and 13 Non-Treatment (7 Binge Eaters; 6 Non-Binge Eaters) obese females. Binge and Non-Binge Eaters were matched for age, body mass index (BMI), and body fat percentage. All completed a) functional magnetic resonance imaging (fMRI) brain scans while viewing pictures of High and Low Energy-dense Food (HEF and LEF) cues and Non-Food (office supplies), b) the Emotional Appetite Questionnaire, and c) the Power of Food Scale at baseline and 4-months postsurgery/postbaseline. BMI was entered as a covariate to analyses to adjust for potential confounding.;Results: All RYGB Binge Eaters stopped binging at 4-months post. Binge Eaters (vs. Non-Binge Eaters) showed greater precuneus activation (baseline and post; p < .003) and thalamic activation (post; p < .014) in response to Food (vs. Non-Food). At post, RYGB (vs. Non-Treatment) Binge Eaters had less middle occipital gyrus (p < .001) and inferior frontal gyms activation (p < .004) in response to HEF (vs. LEF). RYGB (vs. Non-Treatment) had a greater reduction in dorsomedial prefrontal cortex activation in response to HEF and showed an increase in this region in response to LEF (p < .006). At baseline, Binge Eaters (vs. Non-Binge Eaters) had greater emotional eating and psychological drive for food. RYGB (vs. Non-Treatment) Binge and Non-Binge had less emotional eating and psychological drive for food. From baseline to post, RYGB (vs. Non-Treatment) Binge Eaters showed a significant reduction in responsivity to the presence and pleasure of food.;Discussion: Findings provide evidence consistent with a distinct neural binge eating phenotype, which seems to persist at postsurgery. RYGB Binge Eaters experienced significant weight loss, altered emotional decision-making in response to HEF (vs. LEF), and reduced negative emotional eating and psychological drive for food.