Advances from neuroimaging studies in eating disorders
Open accessAbstract
Over the past decade, brain imaging has helped to better define eating disorder–related brain circuitry. Brain research on gray matter (GM) and white matter (WM) volumes had been inconsistent, possibly due to the effects of acute starvation, exercise, medication, and comorbidity, but newer studies have controlled for such effects. Those studies suggest larger left medial orbitofrontal gyrus rectus volume in ill adult and adolescent anorexia nervosa after recovery from anorexia nervosa, and in adult bulimia nervosa. The orbitofrontal cortex is important in terminating food intake, and altered function could contribute to self-starvation. The right insula, which processes taste but also interoception, was enlarged in ill adult and adolescent anorexia nervosa, as well as adults recovered from the illness. The fixed perception of being fat in anorexia nervosa could be related to altered insula function. A few studies investigated WM integrity, with the most consistent finding of reduced fornix integrity in anorexia and bulimia nervosa—a limbic pathway that is important in emotion but also food intake regulation. Functional brain imaging using basic sweet taste stimuli in eating disorders during the ill state or after recovery implicated repeatedly reward pathways, including insula and striatum. Brain imaging that targeted dopamine-related brain activity using taste-reward conditioning tasks suggested that this circuitry is hypersensitive in anorexia nervosa, but hyporesponsive in bulimia nervosa and obesity. Those results are in line with basic research and suggest adaptive reward system changes in the human brain in response to extremes of food intake—changes that could interfere with normalization of eating behavior.
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Dysfunction of interoception is increasingly recognized as an important component of anxiety disorders, mood disorders, eating disorders, addictive disorders, and somatic symptom disorders.
“Dysfunction of interoception is increasingly recognized as an important component of different mental health conditions, including anxiety disorders, mood disorders, eating disorders, addictive disorders, and somatic symptom disorders.”
From Interoception and Mental Health: A Roadmap. (2018) · cites this paper as [100]
The Introduction’s “Brain volume” section links altered insula structure to impaired interoception in bulimia, supporting the eating-disorders portion of the claim. Our copy does not establish interoceptive dysfunction as an important component of anxiety, mood, addictive, or somatic symptom disorders, or the broader claim that this is increasingly recognized across those conditions. No page number is available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredEating disorders show behavioral and neural abnormalities in interoceptive processing, particularly in the context of caloric anticipation.
“Eating disorders show behavioral and neural abnormalities in interoceptive processing, particularly in the context of caloric anticipation (72,98–100), although it remains unclear whether this is due to altered afferent signaling, altered central sensory processing, abnormal temperament, and/or metacognition.”
From Interoception and Mental Health: A Roadmap. (2018) · cites this paper as [100]
The Brain volume and Networks sections link altered insula structure and network activity in anorexia nervosa to possible interoceptive abnormalities. The taste-reward processing section reports altered neural responses to food cues and milkshake anticipation, and discusses fear of caloric intake. It does not establish both behavioral and neural abnormalities in interoceptive processing specifically during caloric anticipation. (LLM, conf=0.83)
Experimental — accuracy not yet measuredAtypical structure and function of the insula and ACC have been observed in eating disorders, ASD, OCD, anxiety disorders, depression and bipolar disorder, schizophrenia, substance abuse/addiction disorders, and PTSD.
“Atypical structure and function of the insula and ACC have been observed in those with eating disorders (Frank, 2015; Uher et al., 2004), ASD (Simms et al., 2009; Uddin and Menon, 2009), OCD (Menzies, Chamberlain, Laird et al., 2008), anxiety disorders (Paulus and Stein, 2006; Rosso et al., 2010; Holzschneider and Mulert, 2011), depression and bipolar disorder (Drevets et al., 2008; Vizueta et al.”
From Atypical interoception as a common risk factor for psychopathology: A review (2021) · cites this paper as Frank, 2015
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Flagged first, then by citations
Research works printed but not linked: 1
- [2]American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM)) 5th Arlington, Va. American Psychiatric Publishing 5 edition 5 27 2013 2013
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Sorted by citations
Interoception and Mental Health: A Roadmap.
Khalsa, S. S., Adolphs, R., Cameron, O. G., Critchley, H. D., Davenport, P. W., Feinstein, J. S., Feusner, J. D., Garfinkel, S. N., Lane, R. D., Mehling, W. E., et al. (2018) · Biological psychiatry. Cognitive neuroscience and neuroimaging · doi:10.1016/j.bpsc.2017.12.004 · Cited by 1,453 · see citing works
Atypical interoception as a common risk factor for psychopathology: A review
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Suszko, M., Sobocki, J., & Imieliński, C. (2022) · Psychiatria Polska · doi:10.12740/pp/126233 · Cited by 10 · see citing works
- Authors
- Frank, G. K. W.
- Affiliations
- Children's Hospital Colorado (US)
- Corresponding author
- Frank, Guido K. W.
- ORCID
- Frank, Guido K. W.
- Venue
- CNS Spectrums
- Publisher
- Cambridge University Press (CUP)
- Published
- 2015-04-23
- Volume
- 20
- Issue
- 4
- Pages
- 391-400
- ISSN
- 1092-8529 (ISSN-L)
- 2165-6509
- PMC
- PMC4989857
- OpenAlex
- W2052804935
- Cited by
- 144
- References
- 101
- Citations by year
- 2026: 6 · 2025: 17 · 2024: 12 · 2023: 6 · 2022: 7 · 2021: 12 · 2020: 17 · 2019: 17 · 2018: 16 · 2017: 21 · 2016: 12 · 2015: 1
- FWCI
- 2.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- CNS Spectrums (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH096777, R01MH103436)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Keywords
- eating disorders, anorexia nervosa, bulimia nervosa, brain circuits, gray matter volume, white matter integrity, medial orbitofrontal cortex, insula, fornix, reward systems, dopamine, taste perception, obesity, eating disorder recovery
- MeSH terms
- Adolescent, Adult, Feeding and Eating Disorders, Brain, Humans, Reward, Neurotransmitter Agents, Connectome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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