Implants For Anorexia: Tweaking The Brain

Some interesting research on brain implants for the treatment  of long standing anorexia has been done at the Krembil Neuroscience Centre and University Health Network
in Canada, who  conducted the study primarily to find out whether this procedure is
safe in people with severe cases of the eating disorder anorexia nervosa.

About 2 in 3 of the people in this small trial had no good outcomes, and one or two people had serious side effects like seizures. However one or two people in this small group did quite well. It would have been really useful to have a comparison group of people who believed that they had the procedure; after all even the mental gastric band gets results.

So we know that this has effects but we dont know for who, and for how long the effects are going to last.

Deep Brain Stimulation (DBS)is being used for depresssion, alzheimers and obsessive compulsive disorder and has its place alongside pills, talking therapies, acupuncture and doing exercise plus everything else sane and crazy.

So, why is this arousing so much angst among clinicians?  On Linked-In, where clinicians air their opinions, there is some emotional rather than research-based dissent about putting things in anorexics’ brains. Where does this emotion come from when the latest research points to SOME people with anorexia having primary problems with brain organisation and function.

Someone even suggested that seriously ill anorexics are so impaired that they couldnt possibly give informed constent for this procedure anyway. Perhaps they wont understand the possible side effects that might occur. Does this mean that putting microchips in brains must always be unethical for anorexics?

It seems to me that the treatment for anorexia is not just about giving people the desire to eat. It is equally important that they should have the ability to cope with life and with their feelings. Some of this coping lies in the architecure of the brain.

Last week I “assessed” a young mother with long term anorexia, who creeps away for an hour or two each day to binge and purge leaving her young children on their own. She has been hospitalised at the Maudsley several times during her life so far and recovered only as far as she was able to get married and have her kids. She was very gaunt and very ill.  It seemed to me that she was completely spaced out and hardly able to hear a thing I said. Obviously she needed to back in hospital immediately but when I tried to take some action on her behalf I discovered that she had given me a false address.

Since years of therapy at the Maudsley has made no impact on her awful condition, would we not want to try DBS as a last resort?  Is it ethical for us to have emotional conversations about implanting things in brains while a family disintegrates?