title: A systematic review of the effects of neuromodulation on eating and body weight: evidence from human and animal studies.
abstract: BACKGROUND
  Eating disorders (ED) are chronic and sometimes deadly illnesses. Existing treatments have limited proven efficacy, especially in the case of adults with anorexia nervosa (AN). Emerging neural models of ED provide a rationale for more targeted, brain-directed interventions.
  
  
  OBJECTIVE
  This systematic review has examined the effects of neuromodulation techniques on eating behaviours and body weight and assessed their potential for therapeutic use in ED.
  
  
  METHODS
  All articles in PubMed, PsychInfo and Web of Knowledge were considered and screened against a priori inclusion/exclusion criteria. The effects of repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation, vagus nerve stimulation (VNS) and deep brain stimulation (DBS) were examined across studies in ED samples, other psychiatric and neurological disorders, and animal models.
  
  
  RESULTS
  Sixty studies were identified. There is evidence for ED symptom reduction following rTMS and DBS in both AN and bulimia nervosa. Findings from studies of other psychiatric and neurological disorders and from animal studies demonstrate that increases in food intake and body weight can be achieved following DBS and that VNS has potential value as a means of controlling eating and inducing weight loss.
  
  
  CONCLUSIONS
  Neuromodulation tools have potential for reducing ED symptomatology and related behaviours, and for altering food intake and body weight. In response to such findings, and emerging neural models of ED, treatment approaches are highly unlikely to remain 'brainless'. More research is required to evaluate the potential of neuromodulation procedures for improving long-term outcomes in ED.
authors.affiliation: Section of Eating Disorders, Institute of Psychiatry, King's College London, London, UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: McClelland
authors.forename: Natali
authors.initials: N
authors.lastname: Bozhilova
authors.forename: Iain
authors.initials: I
authors.lastname: Campbell
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schmidt
mesh_terms: D000818:Animals; D000856:Anorexia Nervosa / Q000628:therapy; D056912:Binge-Eating Disorder / Q000628:therapy; D001835:Body Weight; D052018:Bulimia Nervosa / Q000628:therapy; D046690:Deep Brain Stimulation; D004195:Disease Models, Animal; D004435:Eating / Q000502:physiology; D005247:Feeding Behavior / Q000502:physiology; D001068:Feeding and Eating Disorders / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D009765:Obesity / Q000628:therapy; D050781:Transcranial Magnetic Stimulation; D055536:Vagus Nerve Stimulation
keywords: anorexia nervosa (AN); bulimia nervosa (BN); deep brain stimulation (DBS); eating disorders (ED); transcranial direct current stimulation (tDCS); transcranial magnetic stimulation (TMS); vagus nerve stimulation (VNS)