Neurostimulation to lose weight: this is its scientific basis

Small electrical shocks to obesity-related brain areas. This is the basis of neurostimulation to lose weight, but why does it work?

Elena Muñoz Brown, UOC – Open University of Catalonia

Obesity is one of the biggest public health challenges of the 21st century. Its prevalence has tripled in many European countries in recent decades, reaching 650 million adults with obesity and 340 million children and adolescents with overweight or obesity. According to WHO.

Conventional weight-loss treatments, such as medications, diets, and even stomach-reducing surgery, cannot definitively solve the problem. A new technique is starting to give interesting results: it allows us to act directly on the brain, ‘stimulating’ it to change its habits and thus avoid obesity.

Through neuromodulation, and more specifically through a type of non-invasive brain stimulation called transcranial direct current stimulation or tDCS, it is possible to modify brain activity by inducing a very weak electrical current by placing electrodes on the scalp. It is painless, non-invasive, requires no anesthesia or surgery, and is inexpensive.

At the Cognitive NeuroLab At UOC, we studied the effect of non-invasive brain stimulation in patients with different pathologies, including obesity.

This is the procedure:

When the person comes to our lab for a tDCS session, we place two to eight electrodes on the scalp. The number and position of the electrodes depend on the alteration or pathology we want to treat.

For 20 minutes, the person sits comfortably while an electrical current of very low intensity is induced through the electrodes, directed to an area of ​​the brain especially related to obesity. After these 20 minutes, we removed the electrodes.

Sessions are repeated daily for 5 or 10 days, depending on the treatment.

brain activity in obesity

In addition to lifestyle changes in Western societies and genetic variables, there are specific neurocognitive factors [demostrados] that activate and maintain dietary patterns associated with weight gain.

People with obesity have a characteristic neurocognitive pattern that can contribute to the development and maintenance of inappropriate eating habits.

Neuroimaging studies show alterations in the brain’s reward circuits, including the dorsolateral prefrontal cortex, dlPFC and in satiety-related areas of the brain.

Specifically, in people with obesity, hyperactivity is seen in areas of the brain associated with reward, emotion, memory, and sensorimotor processing when confronted with food stimuli (eg, hyperactivity in the amygdala, hippocampus, insula, striatum).

Also, they were found disturbances in brain responses related to the regulation of ingestion and the satiety response (inappropriate hypothalamic response) and a reduced activity in the dlPFC, implicated in self-control and impulsivity.

Location of the hypothalamus and cerebellum in the brain.
Author provided

The hypothalamus is the main area of ​​the brain in the control of vegetative homeostatic functions, including thirst and hunger.

neuroimaging studies show that while in people without overweight problems the activation of the hypothalamus decreases during ingestion, generating a feeling of satiety, in people with obesity the reduction in activity is slower in this area of ​​the brain.

Hypothalamus activity is reduced more slowly in obese people while they are eating, so they take longer to feel full.

Something similar happens with self-control. In obese patients, brain activity in areas responsible for self-control and impulsivity is reduced in the face of food stimuli (underactivity of left dlPFC and left anterior cingulate cortex)

People with obesity have some cognitive disordersshared with other eating disorders and with substance or gambling addictions.

It is common to find in obese people difficulties in making decisions and inhibiting responses, high impulsivity and less capacity to delay gratification or reward, which leads them to overeat and, therefore, to gain weight.

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In recent years, the impulsiveness and lack of self-control that many overweight people experience is receiving a lot of attention in search.

Impulsiveness is considered one of the strongest predictors of overweight, since self control is essential be able to follow a proper diet and a consistent physical activity program.

Neuromodulation: a new treatment for obesity

In clinical practice, there are important limitations in the pharmacological, nutritional and surgical treatments that exist today for weight loss.

the limitations they are related to accessibility, cost, adherence and long-term effectiveness. Therefore, it is essential to seek new therapeutic approaches, with good adherence, capable of changing negative eating habits to lose weight and maintain it in the long term.

Obesity has serious medical consequences, conventional treatments do not work at all and, in addition, we have scientific evidence that in people with obesity there are alterations in brain activity. All in all, neuromodulation-based interventions represent an excellent approach for treating such a complex and multifactorial condition as obesity.

The objective of neuromodulation is to modify altered neurocognitive patterns in obesity, establish new patterns and new healthy eating habits. Neurostimulation is a promising and innovative treatment for obesity.

How tDCS works in the “obese brain”

Using tDCS, it is possible to increase deficient brain activity in the dorsolateral prefrontal cortex (dlPFC) in people with obesity.

By increasing activity in this area of ​​the brain, self-control over food increases and impulsive eating is reduced. Furthermore, it is possible to modulate the activity of the hypothalamus, stimulating the cortical zones, and of the cerebellum, extensively connected to it. Acting on these areas of the brain, it increases the feeling of satiety and reduces appetite.

So far, research carried out with this technique in the study of eating behavior, and more specifically on obesity, are very scarce, but they show positive results.

Several studies have shown that tDCS intervention can reduce intake, the desire to eat and appetite, and increase the feeling of satiety. In addition, tDCS can increase self-control in the presence of food and [reducir la ansiedad por comer].

Plus you get Best benefits when tDCS application is combined with physical activity.

The future of neuromodulation in clinical application

TDCS is a safe and painless technique for which the patient does not need to be prepared. Possible side effects are practically non-existent, limited to possible redness or burning in the area where the electrodes were placed or mild headaches, which disappear in a short time or when using some analgesic.

It is a technique used recently, so it is only consolidated as a treatment for some pathologies, such as depression or chronic pain. Therefore, it is a pioneering technique in all senses, especially in eating disorders, as research in this area is very scarce worldwide.The conversation

Elena Muñoz Brown, Professor. Faculty of Health Sciences. Area of ​​Neuropsychology. Director of NeuroLab Cognitivo, UOC – Open University of Catalonia

This article was originally published in The conversation. read the original.

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