Current Psychiatry Reports

, 15:396

Altered Brain Reward Circuits in Eating Disorders: Chicken or Egg?

Eating Disorders (AS Kaplan, Section Editor)

DOI: 10.1007/s11920-013-0396-x

Cite this article as:
Frank, G.K.W. Curr Psychiatry Rep (2013) 15: 396. doi:10.1007/s11920-013-0396-x
Part of the following topical collections:
  1. Topical Collection on Eating Disorders


The eating disorders anorexia nervosa (AN) and bulimia nervosa (BN) are severe psychiatric disorders with high mortality. Our knowledge about the neurobiology of eating disorders is very limited, and the question remains whether alterations in brain structure or function in eating disorders are state related, remnants of the illness or premorbid traits. The brain reward system is a relatively well-characterized brain circuitry that plays a central role in the drive to eat and individuals with current or past eating disorders showed alterations in those pathways compared to controls. Here we propose that structural and functional alterations in the insula and frontal cortex, including orbitofrontal and cingulate regions, areas that contribute to reward and anxiety processing, could predispose to developing an eating disorder and that adaptive changes in those circuits in response to malnutrition or repeated binge eating and purging could further promote illness behavior, hinder recovery and contribute to relapse.


Eating disorders ED Anorexia nervosa AN Bulimia nervosa BN Brain imaging Reward Anxiety Circuitry State Trait Dopamine DSM-5 Psychiatry 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Departments of Psychiatry and NeuroscienceUniversity of Colorado Anschutz Medical Campus, School of MedicineAuroraUSA