Neuromodulation and Neurofeedback Treatments in Eating Disorders and Obesity

Purpose of review: Psychological interventions are the treatment of choice for most eating disorders (EDs), however, significant proportions of patients do not recover with these. Advances in understanding of the neurobiology of EDs have led to the development of targeted treatments, such as deep brain stimulation (DBS), non-invasive neuromodulation (NIBS) and neurofeedback. We review the emerging clinical evidence for the use of these interventions in EDs and obesity, together with their theoretical rationale. Finally, we reflect on future developments.

Recent findings: During the last 20 months, seven case studies/series and seven randomised controlled trials (RCTs) of NIBS or neurofeedback in different EDs, obesity or food craving have appeared. These have largely had promising results. One NIBS trial, using a multi-session protocol, was negative. A case series of sub-callosal DBS in anorexia nervosa has also shown promise. A search of trial registries identified a further 21 neuromodulation/feedback studies in progress, indicating that this is an area of growing interest.

Summary: At present neuromodulation and neurofeedback are largely experimental interventions; however, growing understanding of the mechanisms involved, together with the rising number of studies in this area means that the clinical utility of these interventions is likely to become clearer soon.