... 389 or anxiety, just as drugs of abuse are sources of relief from these negative moods for th... more ... 389 or anxiety, just as drugs of abuse are sources of relief from these negative moods for those who abuse them (Gendall, Joyce, Sullivan, & ... Except for a few smaller studies (Milano, Petrella, Sabatino, & Capasso, 2004) and the one trial of fluvoxamine (Fichter et al., 1996, 1997 ...
Adequate energy intake is vital for the survival of humans and is regulated by complex homeostati... more Adequate energy intake is vital for the survival of humans and is regulated by complex homeostatic and hedonic mechanisms. Supported by functional MRI (fMRI) studies that consistently demonstrate differences in brain response as a function of weight status during exposure to appetizing food stimuli, it has been posited that hedonically driven food intake contributes to weight gain and obesity maintenance. These food reward theories of obesity are reliant on the notion that the aberrant brain response to food stimuli relates directly to ingestive behavior, specifically, excess food intake. Importantly, functioning of homeostatic neuroendocrine regulators of food intake, such as leptin and ghrelin, are impacted by weight status. Thus, data from studies that evaluate the effect on weight status on brain response to food may be a result of differences in neuroendocrine functioning and/or behavior. In the present review, we examine the influence of weight and weight change, exogenous administration of appetitive hormones, and ingestive behavior on BOLD response to food stimuli.
Bulimia nervosa (BN) is characterized by both recurrent episodes of binge eating that are, in par... more Bulimia nervosa (BN) is characterized by both recurrent episodes of binge eating that are, in part, defined by a sense of loss of control and compensatory behaviors to avoid weight gain. Impulsive behaviors are also common in individuals with BN, indicating more pervasive difficulties in behavioral self-regulation. Findings from functional and anatomical neuroimaging studies of individuals with BN suggest dysfunction in the dorsal frontostriatal circuits that support self-regulatory capacities and habit learning and in overlapping ventral circuits that support reward processing and reward-based learning. In this review, we describe the normal development of frontostriatal circuits and then present behavioral and neuroimaging data from adolescents and adults with BN. These data suggest that the abnormal maturation of frontostriatal circuits may contribute to the habitual binge-eating and purging behaviors of BN. Future longitudinal imaging studies will improve understanding of how these circuits contribute to the developmental trajectory of BN and will inform novel interventions that could target or prevent the impulsive and habit-like features of this disorder.
Previous studies suggest that binge eating sugar leads to behavioral and neurochemical changes si... more Previous studies suggest that binge eating sugar leads to behavioral and neurochemical changes similar to those seen with drug addiction, including signs of opiate-like withdrawal. Studies are emerging that show multiple neurochemical and behavioral indices of addiction when animals overeat a fat-rich diet. The goal of the present study was to utilize liquid and solid diets high in sugar and fat content to determine whether opiate-like withdrawal is seen after binge consumption of these diets in Sprague-Dawley rats. Control groups were given ad libitum access to the sweet-fat food or standard chow. All rats were then given a battery of tests to measure signs of opiate-like withdrawal, which included somatic signs of distress, elevated plus-maze anxiety, and locomotor hypoactivity. Neither naloxone-precipitated (3 mg/kg) nor deprivation-induced withdrawal was observed in rats that were maintained on a nutritionally complete pelleted sweet-fat diet or a sweet, high-fat diet supplemented with standard rodent chow. Naloxone-precipitated withdrawal was also not seen in rats fed a liquid sweet-fat food. Further, body weight reduction to 85%, which is known to potentiate the reinforcing effects of substances of abuse, did not affect naloxone-precipitated signs of opiate-like withdrawal. Thus, unlike previous findings reported regarding rats with binge access to a sucrose solution, rats that binge eat sweet-fat combinations do not show signs of opiate-like withdrawal under the conditions tested. These data support the idea that excessive consumption of different nutrients can induce behaviors associated with addiction in different ways, and that the behaviors that could characterize "food addiction" may be subtyped based on the nutritional composition of the food consumed.
Prior research has shown that fasting alternated with a diet of standard rodent chow and a 10% su... more Prior research has shown that fasting alternated with a diet of standard rodent chow and a 10% sucrose solution produces bingeing on the sucrose, but animals remain at normal body weight. The present study investigated whether restricted access to a highly palatable combination of sugar and fat, without food deprivation, would instigate binge eating and also increase body weight. Male rats were maintained for 25 days on one of four diets: (i) sweet-fat chow for 2 h/day followed by ad libitum standard chow, (ii) 2-h sweet-fat chow only 3 days/week and access to standard chow the rest of the time, (iii) ad libitum sweet-fat chow, or (iv) ad libitum standard chow. Both groups with 2-h access to the sweet-fat chow exhibited bingeing behavior, as defined by excessively large meals. The body weight of these animals increased due to large meals and then decreased between binges as a result of self-restricted intake of standard chow following binges. However, despite these fluctuations in body weight, the group with 2-h access to sweet-fat chow every day gained significantly more weight than the control group with standard chow available ad libitum. These findings may have implications for the body weight fluctuations associated with binge-eating disorder, as well as the relationship between binge eating and the obesity epidemic.
Weight suppression, the difference between highest past weight and current weight, is a robust pr... more Weight suppression, the difference between highest past weight and current weight, is a robust predictor of clinical characteristics of bulimia nervosa; however, the influence of weight suppression in anorexia nervosa (AN) has been little studied, and to our knowledge, no study to date has investigated the ways in which the relevance of weight suppression in AN may depend upon an individual's current body mass index (BMI). The present study investigated weight suppression, BMI, and their interaction as cross-sectional and prospective predictors of psychological symptoms and weight in AN. Women with AN completed depression (Beck Depression Inventory-II) and eating disorder symptomatology measures (Eating Disorder Examination Questionnaire and Eating Disorders Inventory-3) at residential treatment admission (N = 350) and discharge (N = 238). Weight suppression and BMI were weakly correlated (r = -.22). At admission, BMI was positively correlated with all symptom measures except Restraint and Depression scores. Weight suppression was also independently positively correlated with all measures except Weight Concern and Body Dissatisfaction subscale scores. In analyses examining discharge scores (including admission values as covariates), the admission weight suppression Ă— BMI interaction consistently predicted posttreatment psychopathology. Controlling for weight gain in treatment and age, higher admission weight suppression predicted lower discharge scores (less symptom endorsement) among those with lower BMIs; among those with higher BMIs, higher weight suppression predicted higher discharge scores. These results are the first to our knowledge to demonstrate that absolute and relative weight status are joint indicators of AN severity and prognosis. These findings may have major implications for conceptualization and treatment of AN.
Binge eating behavior has been noted in some eating disorders as well as in obesity. The goal of ... more Binge eating behavior has been noted in some eating disorders as well as in obesity. The goal of this paper is to review current, non-serotonergic pharmaceutical approaches to treat binge eating. Further, using information derived from preclinical models, we discuss candidate neurotransmitter systems for study as targets for the treatment of binge eating. Dopaminergic circuits have been implicated in both laboratory animal models and human studies of binge eating, though existing medications specifically targeting the dopaminergic system have been found to have adverse side effects. Opioidergic and gamma-aminobutyric acid (GABA) systems also appear to be highly involved in aspects of binge eating; further, opioid antagonists, such as naloxone and naltrexone, and GABA agonists, such as baclofen, have all been shown to be effective in treating alcohol dependence and may be equally efficacious in attenuating binge eating. Preclinical evidence, and some clinical evidence, suggests that cannabinoid antagonism may also be useful in the treatment of binge eating, although the specific effect of antagonists, on binge consumption remains unclear. Overall, each of these neurotransmitter systems provides a promising avenue for new pharmacotherapy development for binge eating, and preclinical and human studies provide a strong rationale for the development of highly-selective drugs that target this neurocircuitry.
... 389 or anxiety, just as drugs of abuse are sources of relief from these negative moods for th... more ... 389 or anxiety, just as drugs of abuse are sources of relief from these negative moods for those who abuse them (Gendall, Joyce, Sullivan, & ... Except for a few smaller studies (Milano, Petrella, Sabatino, & Capasso, 2004) and the one trial of fluvoxamine (Fichter et al., 1996, 1997 ...
Adequate energy intake is vital for the survival of humans and is regulated by complex homeostati... more Adequate energy intake is vital for the survival of humans and is regulated by complex homeostatic and hedonic mechanisms. Supported by functional MRI (fMRI) studies that consistently demonstrate differences in brain response as a function of weight status during exposure to appetizing food stimuli, it has been posited that hedonically driven food intake contributes to weight gain and obesity maintenance. These food reward theories of obesity are reliant on the notion that the aberrant brain response to food stimuli relates directly to ingestive behavior, specifically, excess food intake. Importantly, functioning of homeostatic neuroendocrine regulators of food intake, such as leptin and ghrelin, are impacted by weight status. Thus, data from studies that evaluate the effect on weight status on brain response to food may be a result of differences in neuroendocrine functioning and/or behavior. In the present review, we examine the influence of weight and weight change, exogenous administration of appetitive hormones, and ingestive behavior on BOLD response to food stimuli.
Bulimia nervosa (BN) is characterized by both recurrent episodes of binge eating that are, in par... more Bulimia nervosa (BN) is characterized by both recurrent episodes of binge eating that are, in part, defined by a sense of loss of control and compensatory behaviors to avoid weight gain. Impulsive behaviors are also common in individuals with BN, indicating more pervasive difficulties in behavioral self-regulation. Findings from functional and anatomical neuroimaging studies of individuals with BN suggest dysfunction in the dorsal frontostriatal circuits that support self-regulatory capacities and habit learning and in overlapping ventral circuits that support reward processing and reward-based learning. In this review, we describe the normal development of frontostriatal circuits and then present behavioral and neuroimaging data from adolescents and adults with BN. These data suggest that the abnormal maturation of frontostriatal circuits may contribute to the habitual binge-eating and purging behaviors of BN. Future longitudinal imaging studies will improve understanding of how these circuits contribute to the developmental trajectory of BN and will inform novel interventions that could target or prevent the impulsive and habit-like features of this disorder.
Previous studies suggest that binge eating sugar leads to behavioral and neurochemical changes si... more Previous studies suggest that binge eating sugar leads to behavioral and neurochemical changes similar to those seen with drug addiction, including signs of opiate-like withdrawal. Studies are emerging that show multiple neurochemical and behavioral indices of addiction when animals overeat a fat-rich diet. The goal of the present study was to utilize liquid and solid diets high in sugar and fat content to determine whether opiate-like withdrawal is seen after binge consumption of these diets in Sprague-Dawley rats. Control groups were given ad libitum access to the sweet-fat food or standard chow. All rats were then given a battery of tests to measure signs of opiate-like withdrawal, which included somatic signs of distress, elevated plus-maze anxiety, and locomotor hypoactivity. Neither naloxone-precipitated (3 mg/kg) nor deprivation-induced withdrawal was observed in rats that were maintained on a nutritionally complete pelleted sweet-fat diet or a sweet, high-fat diet supplemented with standard rodent chow. Naloxone-precipitated withdrawal was also not seen in rats fed a liquid sweet-fat food. Further, body weight reduction to 85%, which is known to potentiate the reinforcing effects of substances of abuse, did not affect naloxone-precipitated signs of opiate-like withdrawal. Thus, unlike previous findings reported regarding rats with binge access to a sucrose solution, rats that binge eat sweet-fat combinations do not show signs of opiate-like withdrawal under the conditions tested. These data support the idea that excessive consumption of different nutrients can induce behaviors associated with addiction in different ways, and that the behaviors that could characterize "food addiction" may be subtyped based on the nutritional composition of the food consumed.
Prior research has shown that fasting alternated with a diet of standard rodent chow and a 10% su... more Prior research has shown that fasting alternated with a diet of standard rodent chow and a 10% sucrose solution produces bingeing on the sucrose, but animals remain at normal body weight. The present study investigated whether restricted access to a highly palatable combination of sugar and fat, without food deprivation, would instigate binge eating and also increase body weight. Male rats were maintained for 25 days on one of four diets: (i) sweet-fat chow for 2 h/day followed by ad libitum standard chow, (ii) 2-h sweet-fat chow only 3 days/week and access to standard chow the rest of the time, (iii) ad libitum sweet-fat chow, or (iv) ad libitum standard chow. Both groups with 2-h access to the sweet-fat chow exhibited bingeing behavior, as defined by excessively large meals. The body weight of these animals increased due to large meals and then decreased between binges as a result of self-restricted intake of standard chow following binges. However, despite these fluctuations in body weight, the group with 2-h access to sweet-fat chow every day gained significantly more weight than the control group with standard chow available ad libitum. These findings may have implications for the body weight fluctuations associated with binge-eating disorder, as well as the relationship between binge eating and the obesity epidemic.
Weight suppression, the difference between highest past weight and current weight, is a robust pr... more Weight suppression, the difference between highest past weight and current weight, is a robust predictor of clinical characteristics of bulimia nervosa; however, the influence of weight suppression in anorexia nervosa (AN) has been little studied, and to our knowledge, no study to date has investigated the ways in which the relevance of weight suppression in AN may depend upon an individual's current body mass index (BMI). The present study investigated weight suppression, BMI, and their interaction as cross-sectional and prospective predictors of psychological symptoms and weight in AN. Women with AN completed depression (Beck Depression Inventory-II) and eating disorder symptomatology measures (Eating Disorder Examination Questionnaire and Eating Disorders Inventory-3) at residential treatment admission (N = 350) and discharge (N = 238). Weight suppression and BMI were weakly correlated (r = -.22). At admission, BMI was positively correlated with all symptom measures except Restraint and Depression scores. Weight suppression was also independently positively correlated with all measures except Weight Concern and Body Dissatisfaction subscale scores. In analyses examining discharge scores (including admission values as covariates), the admission weight suppression Ă— BMI interaction consistently predicted posttreatment psychopathology. Controlling for weight gain in treatment and age, higher admission weight suppression predicted lower discharge scores (less symptom endorsement) among those with lower BMIs; among those with higher BMIs, higher weight suppression predicted higher discharge scores. These results are the first to our knowledge to demonstrate that absolute and relative weight status are joint indicators of AN severity and prognosis. These findings may have major implications for conceptualization and treatment of AN.
Binge eating behavior has been noted in some eating disorders as well as in obesity. The goal of ... more Binge eating behavior has been noted in some eating disorders as well as in obesity. The goal of this paper is to review current, non-serotonergic pharmaceutical approaches to treat binge eating. Further, using information derived from preclinical models, we discuss candidate neurotransmitter systems for study as targets for the treatment of binge eating. Dopaminergic circuits have been implicated in both laboratory animal models and human studies of binge eating, though existing medications specifically targeting the dopaminergic system have been found to have adverse side effects. Opioidergic and gamma-aminobutyric acid (GABA) systems also appear to be highly involved in aspects of binge eating; further, opioid antagonists, such as naloxone and naltrexone, and GABA agonists, such as baclofen, have all been shown to be effective in treating alcohol dependence and may be equally efficacious in attenuating binge eating. Preclinical evidence, and some clinical evidence, suggests that cannabinoid antagonism may also be useful in the treatment of binge eating, although the specific effect of antagonists, on binge consumption remains unclear. Overall, each of these neurotransmitter systems provides a promising avenue for new pharmacotherapy development for binge eating, and preclinical and human studies provide a strong rationale for the development of highly-selective drugs that target this neurocircuitry.
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Papers by Laura A Berner