Anorexia Nervosa

Condition

Anorexia nervosa is an eating disorder where a person deliberately works to lower their body weight and/or keep it as low as possible.

Anorexia nervosa sufferers most commonly do this by intensively controlling their food intake through strict dietary and eating practices. They may vomit or take laxatives to reduce the absorption of calories and may also exercise excessively in order to burn off calories and work towards a slimmer body shape.

Anorexia is now recognised as a serious mental health condition which is linked to issues around self-esteem and self-perception. However, it can have a series of physical health consequences.

Signs and Symptoms of Anorexia

  • Extreme, often rapid weight loss, leading to a thin appearance
  • Preoccupation with weight, nutrition, checking calories
  • Regular self-checking of weight loss/gain
  • Eagerness to check appearance in the mirror
  • Distorted self-image
  • Wish to lose weight when already thin
  • Mood swings and anxiety

Causes/Triggers

There is no one specific or exact cause of anorexia. However, there are a number of factors which can make a person more at risk of developing the condition. These include:

  • Psychological factors – a tendency towards depression/anxiety perfectionism, emotional restraint
  • Environmental factors – peer pressure, stress, sport activities requiring low weight, abuse, relationships
  • Biological factors – puberty, hormones, family history

This is not a finite list and the circumstances for each patient are often complex.

Conventional Treatments

Anorexia treatment should start as early as possible; firstly to reduce the number of known physical health risks and secondly as earlier intervention has been shown to give better outcomes in general.

Anorexia can be treated with psychological therapies such as Cognitive Behaviour Therapy, which are usually carried out in conjunction with supervised weight gain.

It is a very difficult condition to treat with no guarantee of success.

rTMS at The Smart Clinics in London

Transcranial Magnetic Stimulation therapy treatment for depression and a range of other conditions is available at Smart TMS, based at The Smart Clinics, Brompton Cross, London.

On the basis of research, we believe that rTMS could, in the future, offer sufferers of anorexia an alternative treatment option using transcranial magnetic stimulation to work directly on the associated areas of the brain. This is an area of active research which we are monitoring closely.

To discuss this further, please contact us.

BBC The One Show

TMS (transcranial magnetic stimulation) treatment for Anorexia was featured on TV programme The One Show on 26th May. The feature covered the trial at Kings College London and followed a patient as she had her magnetic therapy session. The treatment was described as ‘ground-breaking’ and ‘exciting’ and The One Show presenter Alex Jones indicated that there would be a follow-up story later in the summer.

BBC Video: Anorexia Brainwaves

BBC Clip: A potential treatment for anorexia targeting specific areas of the brain

http://www.bbc.co.uk/programmes/p03wbns5

Anorexia Nervosa and RTMS Treatment

Research and Studies

Research Studies

There is a theory that the excessive self-control, which is a characteristic of Anorexia Nervosa may derive from the brain circuits connected to the dorso-lateral prefrontal cortex in the brain.  In a study conducted at Kings College, London, 2 patients with anorexia nervosa were treated with rTMS, for 20 sessions, attending 3 to 5 sessions a week.  There was a substantial reduction in their anorexia symptoms.  These improvements persisted or increased for up to a month after the treatment (McClelland, 2013)

At Kings College, London, 5 patients with Anorexia Nervosa received about 20 sessions of rTMS.  At the end of the treatment eating disorder and mood symptoms improved significantly and body mass index remained stable.  Further improvements in ED symptoms/mood were seen 6-months after the treatment with 3/5 participants deemed ‘recovered’ on the Eating Disorders Examination Questionnaire Scale. However, most participants had lost some weight, and the therapeutic effects had waned after 12 months.  Repetitive transcranial magnetic stimulation was well tolerated by the patients McClelland J et al (2016).

In another study in Holland, 10 patients with anorexia nervosa were given one session of rTMS.  Subjective experiences related to the eating disorder such as the urge to restrict food and feeling full, were assessed before and after the rTMS treatment.  rTMS was found to be safe and well-tolerated, and resulted in reduced levels of feeling full, feeling fat and feeling anxious (Van Den Eynde, 2011).

In a randomised, controlled study conducted at Kings College, London 49 patients with anorexia nervosa were given one session of rTMS treatment.  Compared with a group of controls the patients with the anorexia had a significant reduction in the core anorexia nervosa symptoms for 24 hours after the treatment (McClelland et a, 2016).  This research team are now recruiting patients for a new study with 20 sessions of treatment.

Video from Kings College

Dr Jessica McClelland, Post-doctoral Researcher at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, explains the results: