Understanding the Effects of Acute Stressors and Negative Emotion on Eating Behavior in Binge-Eating Disorder: The Role of Stressor-Induced Changes in Reward and Cognitive Control

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PROJECT SUMMARY/ABSTRACT Binge-eating disorder (BED) is characterized by recurrent episodes of binge eating (uncontrolled consumption of large amounts of food in a short time period). BED is the most prevalent eating disorder in the U.S. and globally, and it is associated with significant psychosocial impairment, and psychiatric and physical morbidity. However, even with the most efficacious treatments, a substantial proportion of those with BED do not experience good outcomes. Elucidating the biobehavioral mechanisms of binge eating is critical to gaining better understanding of treatments’ effects and why they vary. In this vein, converging evidence suggests that negative affect plays a significant role in binge eating in BED, but the link between negative affect and binge eating behavior, including its neurobiological mechanisms, is not well understood. In contrast, a growing body of literature suggests that stressors tend to increase preference for highly palatable food in the general population, and that this phenomenon may involve mechanisms of increased food reward and decreased cognitive control. Thus, the goal of the K23 research project is to examine whether stressors have greater effects on (palatable) food choice and related blood oxygenation level dependent activity in young women with BED, and whether these stressor-related effects relate to real-world binge eating behavior. Dovetailing with the research aims, the K23 will provide training and mentored research experience in the following areas critical to achieving the candidate’s long-term career goal of becoming an independent clinical investigator focused on understanding the mechanisms underlying binge eating, with the ultimate goal of developing more tailored and efficacious interventions: (1) neuroscience and neuroimaging; (2) the study of stressors and their effects; (3) assessment of real-world stressors, affect, and eating; (4) responsible conduct of research; and (5) general career development. To achieve these training goals, the candidate will attend relevant classes, seminars, and scientific conferences and receive mentoring and training from an expert team including Dr. Diego Pizzagalli (Primary Mentor), Drs. James Hudson and Shelly Greenfield (Co-Mentors), and Drs. Lisa Nickerson, Joanna Steinglass, Marian Tanofsky-Kraff, & Stephen Wonderlich (Advisors). The research and training will occur at McLean Hospital, a psychiatric teaching hospital with a state-of-the-art imaging center and eating disorder research program. McLean, an affiliate of Harvard Medical School, provides an ideal environment due to its clear institutional commitment to research and academic/professional training and its unique opportunities for diverse clinical and basic researchers to collaborate to better understand the brain in illness and health. In addition to providing the candidate essential training in designing and implementing patient-oriented research with sophisticated behavioral and neurobiological measures, the K23 award will provide novel data on the role of stressors and negative affect in BED. This line of research can yield critical information relevant to developing more efficacious interventions for BED, a compelling target for improving public health.