Canadian doctors test new therapy in treating anorexia

TORONTO – When Kim Rollins, 36, celebrated her nephew’s most recent birthday, she had cake. And she enjoyed it. While simple for most, this was a breakthrough for Rollins.

She has suffered from severe anorexia nervosa since age 15. The eating disorder, which affects about 120,000 people worldwide, caused her to restrict her diet and to exercise constantly.

“The compulsions were just very overwhelming and basically my life was hopeless,” Rollins said. “There was a point where I thought almost my purpose in life was just to die of the anorexia.”

It started off slowly with simply cutting some foods out of her diet. But it gradually took on a life of its own, with Rollins introducing more and more severe restrictions.

“When we used to live in an apartment I would spend hours in the middle of the night running up and down like 16 flights of stairs just over and over,” Rollins said.

Effects of anorexia take a toll

Finally the effects of her over-exercising and food restriction caught up with her. At 28, she had a heart attack. She has also had two strokes and has broken at least eight bones due to constant exercise on bones weakened by the early onset of osteoporosis, as result of a lack of nutrients.

“I think when I had the heart attack, that really kind of jolted in my mind ‘Okay Kim, I could really die from this,’” Rollins said.

She’d tried facilities with structured meal plans, support groups and therapists. None of it worked.

“It had been so ingrained in my head, the anorexia, and it was an overwhelming drive almost coming from the inside that I just almost wanted to destroy myself,” Rollins said. “I just think that none of them were strong enough to kind of change my thinking.”

Rollins was running out of hope, when a chance meeting with a former psychiatrist brought her attention to an experimental study of a new treatment for anorexia.

New therapy to treat anorexia

Led by three Toronto doctors the study used a technique known as Deep Brain Stimulation (DBS) to help target the root causes of anorexia and thereby reduce the corresponding symptoms of under eating, anxiety and depression.

In DBS electrodes are implanted into the brain in order to stimulate certain areas.

The technique is practiced all over the world, commonly in the treatment of Parkinson’s disease. Dr. Andres Lozano, a neurosurgeon at the Krembil Neuroscience Centre of Toronto Western Hospital and co-author of the study, says this is the first to attempt use DBS to treat anorexia.

“In anorexia there are areas of the brain that are malfunctioning, there are areas of the brain that are overactive and others that are shut down,” Lozano said. “So we wanted to know whether we could safely implant electrodes in the brain to recalibrate the activity of the brain.”

As it turned out, the technique has shown some success. It took two or three months, but all six patients in the study experienced some degree of improvement.

“Three of the patients of the six – half – experienced a very significant weight gain after nine months,” Lozano said. “In fact two of them are now in a normal weight range and the third one is approaching that.”

Rollins is one of those patients.

Changing outlook changes eating habits in the long term

“We find that particularly exciting because we know that if we just feed people, that will not result in a long-lasting effect. They will go back to their previous habits,” Lozano said.

“But if you’re able to change their mood, if you’re able to change their anxiety and their perception of their body image then this has a chance of having a more enduring effect.”

Dr. D. Blake Woodside, medical director for the program for eating disorders at Toronto General Hospital and co-author of the study, cautions that expectations for this new treatment must be tempered.

“This is an experimental treatment still, and the results are preliminary, so this is not going to be a first-line treatment for people with brand new anorexia nervosa,” Woodside said.

“But, this could offer hope to some people. And offering hope to people who are fundamentally hopeless because they feel nothing can help them is very, very important.”

Just over a year ago Rollins’ anorexia was so severe her mother was planning her funeral. Now, after treatment with DBS she is at a healthy weight. But it hasn’t stopped there.

“I’m noticing small changes that are still happening. Just even less thought about food and more on other parts of my life that I want to look at now; like going back to school, having relationships, just all the things that make life worth living.”