Neurobiological studies of bulimia nervosa

Researchers from the Icahn School of Medicine at Mount Sinai and the ENIGMA consortium have published findings in JAMA Psychiatry linking bulimia nervosa to specific structural differences in the brain.

Initial analysis of MRI scans from hundreds of female participants identified lower volume in the nucleus accumbens, a region associated with reward and motivation, as well as a reduced surface area in parts of the temporal cortex. The research noted that the frequency of binge eating was linked to more extensive structural differences in regions governing emotion regulation, cognitive control, and bodily awareness, while the frequency of compensatory behaviors was not associated with these variations.

Subsequent reporting on the ENIGMA Eating Disorders Working Group study, which utilized data from seventeen international cohorts, confirmed these anatomical differences. The findings showed reduced nucleus accumbens volume and lower surface area in the superior and transverse temporal cortices. These results remained significant after adjusting for variables such as BMI, medication use, depressive symptoms, and illness duration. The study further noted that binge-eating frequency was associated with lower surface area in the insula and orbitofrontal cortex.