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Feature

New therapy offers hope for people with bulimia

By Cass Erickson

From M, summer 2005

Recent findings suggest that there's more to bulimia than the desire to be thin at any cost or to control one's life. Although the eating disorder begins as a psychological problem, a University study suggests that in severe cases a physiological component triggers the impulse for people with bulimia to binge and purge.

The vagus nerve in the neck is designed to send information from the stomach to the brain, indicating either fullness or the urge to vomit after eating something disagreeable. Repeated binge eating and vomiting destabilizes the nerve through overstimulation, and individuals with severe bulimia can't tell if they feel full after a meal.

"Until the nerve gets back into normal firing rates, bingeing can initiate a high rate of firing that produces the urge to vomit...in severe cases, [there's no] need to manually stimulate vomiting," says Patricia Faris, associate professor of psychiatry at the U.

In a two-year study, Faris and her colleagues have successfully treated six women with vagus nerve stimulation therapy to retrain the nerve with a pacemaker-like effect. An implanted device delivers regularly timed, intermittent electrical pulses to the vagus nerve. With an effective level of stimulation, the urge to engage in bulimic behaviors decreases; the feeling of fullness after a meal returns.

After trying antidepressants and counseling with little success, a student with bulimia on the Twin Cities campus decided to try the vagus nerve therapy. "I'm happier and more confident now," she says. "A lot of my symptoms are gone. It hasn't been easy; it's willpower in addition to the implant. My appetite has changed...now I'm satisfied after a meal."