Behavioral Neurobiology of Eating Disorders

Volume 6 of the series Current Topics in Behavioral Neurosciences pp 37-57


Neurocircuity of Eating Disorders

  • Walter H. KayeAffiliated withDepartment of Psychiatry, University of California Email author 
  • , Angela WagnerAffiliated withDepartment of Psychiatry, University of California
  • , Julie L. FudgeAffiliated withDepartments of Psychiatry and Neurobiology and Anatomy, University of Rochester Medical Center
  • , Martin PaulusAffiliated withDepartment of Psychiatry, Laboratory of Biological Dynamics and Theoretical Medicine, University of CaliforniaPsychiatry Service, San Diego Veterans Affairs Health Care System

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Objectives: This chapter reviews brain imaging findings in anorexia and bulimia nervosa which characterize brain circuitry that may contribute to the pathophysiology of eating disorders (EDs).

Summary of recent findings: Recent imaging studies provide evidence of disturbed gustatory processing in EDs which involve the anterior insula as well as striatal regions. These results raise the possibility that individuals with anorexia nervosa have altered appetitive mechanism that may involve sensory, interoceptive, or reward processes. Furthermore, evidence of altered reward mechanisms is supported by studies that suggest that individuals with anorexia nervosa and bulimia nervosa share a trait toward similar anterior ventral striatal pathway dysregulation. This shared trait disturbance of the modulation of reward and emotionality may create a vulnerability for dysregulated appetitive behaviors. However, those with anorexia nervosa may be able to inhibit appetite and have extraordinary self-control because of exaggerated dorsal cognitive circuit function, whereas individuals with bulimia nervosa are vulnerable to overeating when they get hungry, because they have less ability to control their impulses.

Future directions: Current therapeutic interventions have modest success. Better understanding of neurocircuits that may be related to altered appetite, mood, impulse control, and other symptoms underlying the pathophysiology of EDs might improve psychotherapeutic and drug treatment strategies.


Anorexia nervosa Appetite regulation Bulimia nervosa Brain imaging Interoceptive awareness Reward