Objectives of review. Advances in brain imaging provide new understanding of how brain regions and neurotransmitter circuits may be related to appetitive dysregulation, mood problems, obsessionality, and body image distortions in anorexia and bulimia nervosa (AN and BN)
Summary of recent findings. Imaging studies in healthy humans have characterized brain regions such as the insula, anterior cingulate, and orbital frontal cortex that modulate higher order appetitive behaviors. Studies using food-related stimuli raise the possibility of altered function of such regions in AN and BN. Other imaging studies have confirmed that alterations of serotonin occur in the ill state and after recovery from AN and BN, supporting the possibility that disturbed serotonin function may be a trait. Moreover, imaging studies have begun to identify how serotonin receptors and the transporter function are related to potential behavioral traits, such as anxiety. Several recent studies find alterations of L parietal function may be related to body image distortion, offering new insights into this most puzzling symptom.
Future directions. It is likely that imaging will be of major importance in identifying brain regions and neurocircuits that may be related to altered appetite, mood, impulse control, body image, and other symptoms of AN and BN. Such understandings may help to destigmatize AN and BN and contribute to better treatment.