Repetitive Transcranial Magnetic Stimulation Reduces Cue-Induced Food Craving in Bulimic Disorders

Background: Craving or the "urge to consume" is a characteristic of bulimic eating disorders and addictions. Dysfunction of the dorsolateral prefrontal cortex (DLPFC) is associated with craving. We investigated whether stimulation of the DLPFC reduces food craving in people with a bulimic-type eating disorder. Methods: Thirty-eight people with bulimic-type eating disorders were randomly allocated to receive one session of real or sham high-frequency repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC in a double-blind procedure. Outcome measures included self-reported food craving immediately after the stimulation session and frequency of bingeing over a 24-hour follow-up period. Results: Compared with sham control, real rTMS was associated with decreased self-reported urge to eat and fewer binge-eating episodes over the 24 hours following stimulation. Conclusions: High-frequency rTMS of the left DLPFC lowers cue-induced food cravings in people with a bulimic eating disorder and may reduce binge eating. These results provide a rationale for exploring rTMS as a treatment for bulimic eating disorders.