A team of the Perelman School of Medicine, University of Pennsylvania, presented a unique study that analyzes how tirzepatide acts on brain activity related to food impulses. The research, published in Nature Medicine, reveals that the drug can momentarily reduce signals from the nucleus accumbens, a region involved in compulsive food seeking.
Tirzepatide, a dual GLP-1 and GIP receptor agonist initially approved for type 2 diabeteshas become the object of growing interest due to its possible usefulness in conditions linked to impulse control, including binge eating disorder. Even so, the authors of the study warn that current evidence is not sufficient to consider these medications as reliable tools to treat food impulsivity.
He neurosurgeon Casey H. Halpernwho led the research, emphasizes that there is still much to understand about the way these drugs influence the human brain and that their use beyond diabetes and obesity requires a much more solid scientific basis.
Loss of control when eating
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Binge eating disorder is the most common eating diagnosis in the United States, with millions of people affected, and is often accompanied by a persistent feeling of inability to stop eating. Beyond the formal diagnosis, a considerable proportion of people with obesity describes a phenomenon known as food noise: intrusive thoughts about food that trigger anxiety and impulsive behaviors.
This type of behavior is related to alterations in the circuits between the hypothalamus and the brain. nucleus accumbens a key node in the reward and motivation processes. Previous studies have shown that in people with obesity or recurrent binge eating, the electrical activity of this region shows dysfunctional patterns.
Unusual experimental approach
The report focuses on a 60-year-old woman who had been dealing with severe obesity and persistent eating thoughts for years. None of the conventional medical strategiesincluding surgeries, behavioral treatments or weight loss drugs—had achieved lasting results. Even a previous GLP-1 inhibitor, dulaglutide, failed to modify their eating behavior.
Given this lack of response, the patient was enrolled in a clinical trial that explores the use of implanted electrodes to detect and modulate, through personalized deep brain stimulation, the electrical signals that precede binge eating. The study is part of a project that seeks to intervene directly in the altered neural circuits that trigger loss of control.
A clinical coincidence
Before surgery, the patient had already started using tirzepatide to manage her diabetes. This allowed the researchers to observe, almost in real time, how the drug modified the activity of his nucleus accumbens during the first months after implantation.
During this initial period, both the intracranial recordings and the patient’s reports showed a notable reduction in food noise. However, about five months later, the abnormal signs reappeared along with the compulsive preoccupation with food.
Need for new treatments
Kelly Allison, specialist in eating disorders and co-author of the work, points out that current medications are very effective for type 2 diabetes and weight reduction, but still are not designed to treat food obsession on a sustained basis or the impulses that generate binge eating.
The team hopes that these findings will drive the development of therapies specifically targeting impulsivity traits and emotional dysregulation that appear in obesity and related eating disorders.
