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Open Access Highly Accessed Research article

Brain responses to body image stimuli but not food are altered in women with bulimia nervosa

Frederique Van den Eynde127*, Vincent Giampietro3, Andrew Simmons34, Rudolf Uher15, Chris M Andrew3, Philippe-Olivier Harvey6, Iain C Campbell1 and Ulrike Schmidt1

Author Affiliations

1 Department of Psychological Medicine, Section of Eating Disorders Institute of Psychiatry, King’s College London, London, UK

2 Eating Disorders Program, Douglas Mental Health University Institute and McGill University, Montréal, Québec, Canada

3 Institute of Psychiatry, Department of Neuroimaging, King’s College London, London, UK

4 NIHR Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King’s College London, London, UK

5 Department of Psychiatry, Dalhousie University, Halifax, NS, Canada

6 Douglas Mental Health University Institute and McGill University, Montréal, Québec, Canada

7 Institute of Psychiatry, King’s College London, PO Box 59, De Crespigny Park, SE5 8AF, London, UK

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BMC Psychiatry 2013, 13:302  doi:10.1186/1471-244X-13-302

Published: 15 November 2013

Abstract

Background

Research into the neural correlates of bulimia nervosa (BN) psychopathology remains limited.

Methods

In this functional magnetic resonance imaging study, 21 BN patients and 23 healthy controls (HCs) completed two paradigms: 1) processing of visual food stimuli and 2) comparing their own appearance with that of slim women. Participants also rated food craving and anxiety levels.

Results

Brain activation patterns in response to food cues did not differ between women with and without BN. However, when evaluating themselves against images of slim women, BN patients engaged the insula more and the fusiform gyrus less, compared to HCs, suggesting increased self-focus among women with BN whilst comparing themselves to a ‘slim ideal’. In these BN patients, exposure to food and body image stimuli increased self-reported levels of anxiety, but not craving.

Conclusions

Our findings suggest that women with BN differ from HCs in the way they process body image, but not in the way they process food stimuli.

Keywords:
Functional magnetic resonance imaging; Bulimia nervosa; Insula; Anxiety; Craving