Eating Disorders

Eating disorders are severe mental illnesses often associated with significant impairments in daily life, social withdrawal, and serious physical and psychological consequences. Despite substantial differences in manifestation, many individuals experience intense cognitive and emotional struggles concerning food, body image, and weight. Eating disorders typically emerge during adolescence or young adulthood, and relapses are not uncommon. Many sufferers endure profound inner distress, even when this is not immediately apparent externally.

Diagnostically, several types of eating disorders are distinguished, including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). While physical consequences and psychological burdens may vary between disorders, they share essential commonalities. Current research increasingly highlights biological mechanisms alongside psychosocial risk factors. Studies indicate alterations in brain regions responsible for reward processing, impulse control, and emotional regulation. Additionally, neuroendocrine processes related to hunger and satiety also play critical roles.

In AN, long-term physical effects of underweight, hormonal changes, and cognitive impairments are predominant. Neurobiologically, reduced reward sensitivity and pronounced cognitive control are frequently discussed factors. However, the biological mechanisms predisposing individuals to AN remain poorly understood. One approach to differentiate "state" markers—arising from being underweight—from more stable "trait" markers involves examining patients at various disease stages, such as during acute symptomatic phases and after recovery. Studies regarding BN suggest an imbalance between impulsive and regulatory brain networks, particularly concerning stress processing and self-regulation. BED frequently involves heightened responses to high-caloric stimuli, demonstrating parallels with addictive behaviors. Despite these differences, research increasingly aims to identify transdiagnostic patterns to facilitate individualized treatment approaches.

A central objective of our work is to better understand the neuropsychological underpinnings of eating disorders, ultimately paving new pathways for prevention and therapy. Importantly, we approach our research with respect for the subjective experiences of individuals affected, actively seeking to counteract stigma. Additionally, we work closely with the Eating Disorders Network Saxony (NESSA), which has set itself the goal of providing excellent care for all patients with eating disorders and support for their families.

Since 2010 we have created a saxony-wide unique study with more than 1.000 participants to explore the mental disorder of AN, the "Saxonian Anorexia Nervosa Study" (SANS).

In close collaboration with the Department for Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy our group is studying alternations in the serotonergic system, of appetite regulating peptides and neurotrophic proteins as well as genetic associations. Additionally, neural correlates of important eating-disorder-involved psychological processes will be analyzed by magnetic resonance imaging methods. In this context we are especially interested in processes of reward, learning, cognitive control and regulation of emotions.

The MRI data are analyzed using the following software packages and/or pipelines which are all freely available:

• • SPM (Statistical Parametric Mapping, http://www.fil.ion.ucl.ac.uk/spm/)

  • FSL (FMRIB Software Library, http://www.fmrib.ox.ac.uk/) 

  • FreeSurfer including TRACULA (FreeSurfer Software Suite, http://surfer.nmr.mgh.harvard.edu/)

  • Nypipe (Neuroimaging in Python Pipelines and Interfaces, http://nipy.org/nipype/)