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Yuta Inagawa
The key to treatment lies in drawing out the patient’s resilience, and I believe that one method to achieve this is through transcranial magnetic stimulation (TMS). With this in mind, this study aimed to explore its potential. I hope this research will lead to the reintegration of as many eating disorder patients into society as possible.
What do you hope to accomplish through your research?
Over the past 20 years, the prevalence of these disorders has steadily increased, with AN quadrupling and BN rising from virtually zero to 2.23% in Japan. While the exact causes of this increase are unclear, contributing factors may include the westernization of dietary habits leading to higher-calorie meals and environmental changes that make food easily accessible through convenience stores and vending machines.
As binge eating and vomiting persist, the condition often progresses to resemble addiction, making social activities like dining with friends or colleagues challenging. Additionally, complications such as electrolyte imbalances, liver dysfunction from starvation, kidney impairment from dehydration, and dental erosion from stomach acid often lead to repeated hospitalizations, further hindering social reintegration. In severe cases, patients may require emergency care or ICU treatment, and fatal outcomes are not uncommon.
Although therapies such as the UK’s Maudsley Model or cognitive behavioral therapy (CBT) have been developed, there are limited facilities in Japan offering these treatments, and participation is often challenging for severely ill patients.
I aim to utilize transcranial magnetic stimulation (TMS), a method capable of stimulating specific areas of the brain, to target the prefrontal cortex. By enhancing behavioral control through magnetic stimulation, I hope to develop an effective treatment for eating disorders characterized by repeated binge eating and vomiting.
What approach are you using to try to achieve this?
Traditional psychotherapeutic approaches have focused on helping patients understand the psychopathology of their eating disorders and gradually transform their self-perception. However, in cases of severe and protracted eating disorders where binge eating and vomiting have been resolved, patients often still experience concerns about their body weight and various anxieties. These conditions do not necessarily improve the other aspects of eating disorders. Nevertheless, once binge eating and vomiting improve, physical recovery, including weight stabilization, often follows, leading to gradual alleviation of the disorder. Such recovery cases highlight that the key to treatment lies in behavioral changes.
Eating disorders involving binge eating and vomiting are thought to resemble addiction or dependency. Dysfunction in the dorsal anterior cingulate cortex and anterior insula has been suggested. These regions form a part of the salience network, which is involved in impulse control. This study aimed to target the dorsomedial prefrontal cortex (DMPFC) with TMS to improve the salience network and establish a treatment for eating disorders with binge eating and vomiting.
What is the research topic you will be conducting for this project?
To verify the efficacy of TMS for binge eating and vomiting, we will conduct a double-blind trial. Patients will be divided into two groups:
・Active stimulation group: Receiving actual TMS.
・Sham stimulation group: Receiving a placebo-like sensation without real stimulation.
The trial will be designed so that neither the patients nor the clinicians know which group they belong to. If the active stimulation group shows a greater reduction in binge eating and vomiting episodes compared to the sham group, the efficacy of TMS will be validated.
Currently, TMS is already used at our institution to treat depression under insurance coverage. The traditional TMS protocol for depression involves high-frequency stimulation, administered once daily for 37.5 minutes over 15–30 sessions. However, this method places significant time demands on both patients and clinicians. Recently, a new approach called theta-burst stimulation (TBS) has been developed. TBS sessions last only 3–4 minutes, and studies have shown no difference in efficacy or safety compared to traditional methods. For this study, we will employ TBS, administering 20 sessions in total, reducing the treatment time to approximately one-tenth of the traditional protocol, thereby significantly alleviating the time burden.
If this trial confirms the efficacy of TMS for binge eating and vomiting, we aim to collaborate with international research institutions to conduct large-scale international studies.
Why we need your support
We decided to pursue crowdfunding because public competitive research funds alone are insufficient. More importantly, through this initiative, we hope to raise awareness about the challenges of treating eating disorders and the importance of developing new therapies. We also aim to encourage more eligible patients to participate in this study.
The crowdfunding target of 2.5 million yen will be allocated as follows:
・MRI costs to measure brain function changes before and after TMS: 1 million yen.
・Participant compensation to alleviate financial burdens: 500,000 yen.
・REDCap system setup and server maintenance for managing the double-blind trial: 500,000 yen.
・Monitoring costs: 100,000 yen.
・Clinical research insurance to cover potential health damages: 500,000 yen.
By advancing this research, we aim to step up to larger-scale double-blind trials and secure major research funding from organizations such as AMED. Our ultimate goal is to establish TMS as an insured treatment for eating disorders in Japan. Additionally, we aim to elucidate the underlying pathology and treatment mechanisms, paving the way for developing therapies for other mental disorders closely related to binge eating and vomiting.
We sincerely appreciate your support in helping us realize this vision. Thank you!
Recommender's comment
Shinsuke Kito
Eating disorders with binge eating and vomiting often become severe and require long-term treatment, significantly impacting daily life. While the efficacy of family therapy and cognitive behavioral therapy (CBT) is well-documented, there are limited medical facilities in Japan that can provide these treatments. The theta-burst magnetic stimulation method used in this study takes only 3–4 minutes per session and is expected to improve behavioral control and depressive symptoms. I sincerely hope that this innovative treatment will help eating disorder patients achieve reintegration into society.
Aya Nishizono-Maher
Eating disorders are highly prevalent conditions, yet treatment approaches are still evolving through trial and error. When pathological eating behaviors become habitual, symptoms often persist automatically without psychological triggers, making them difficult to address with psychological interventions alone. Given the demonstrated effectiveness of pharmacotherapy, it is evident that interventions targeting not only psychological but also physical aspects are crucial. This study holds the promise of providing new insights for the development of effective treatments.
Project timeline
| Date | Plans |
|---|---|
| January 2025 | Completion of ethical review |
| February 2025 | Start of patient recruitment and research activities |
| March 2027 | Completion of patient recruitment and start of data analysis |
| September 2027 | Presentation at academic conferences and submission of research papers |
Pledge Rewards
A thank-you message will be sent via email.
Thank You Message
Support this project9 supporters are supporting with this reward. （No quantity limit）
Your name will be included in the research report contributed to academist Journal.
This reward is scheduled to be implemented in September 2027.
Thank You Message / Name Acknowledgment in Research Report
Support this project2 supporters are supporting with this reward. （No quantity limit）
An online lecture on this project and eating disorder treatments will be delivered as a video.
The lecture is scheduled to be available around March 2025.
Thank You Message / Name Acknowledgment in Research Report / Online Lecture Distribution
Support this project0 supporters are supporting with this reward. （No quantity limit）
Your name will be included in the acknowledgments section of the academic paper.
Thank You Message / Name Acknowledgment in Research Report / Online Lecture Distribution / Name Acknowledgment in the Paper’s Acknowledgments Section
Support this project0 supporters are supporting with this reward. （No quantity limit）
We will provide an online individual consultation (one hour per session) regarding this project or eating disorder treatments.
The date will be determined based on your preference during the research period.
Thank You Message / Name Acknowledgment in Research Report / Online Lecture Distribution / Name Acknowledgment in the Paper’s Acknowledgments Section / Online Individual Consultation
Support this project0 supporters are supporting with this reward. （No quantity limit）
An online lecture about this research will be held upon request.
Details and dates will be discussed individually.
Thank You Message / Name Acknowledgment in Research Report / Online Lecture Distribution / Name Acknowledgment in the Paper’s Acknowledgments Section / Online Individual Consultation / Right to Host an Online Lecture
Support this project0 supporters are supporting with this reward. （No quantity limit）
An on-site lecture about this research or eating disorders will be provided upon request.
Details and dates will be discussed individually.
※ Depending on the location, additional costs for accommodation and transportation may apply. The venue must be within Japan.
Thank You Message / Name Acknowledgment in Research Report / Online Lecture Distribution / Name Acknowledgment in the Paper’s Acknowledgments Section / Online Individual Consultation / Right to Host an Online Lecture / Right to Host an On-Site Lecture (Limited to Japan)
Support this project0 supporters are supporting with this reward. （Limited to 3）
You will have the right to name the study when it is formalized in an academic paper.
For example, you can create a concise nickname for the study, such as "The ~ Study," to encapsulate its content.
Thank You Message / Name Acknowledgment in Research Report / Online Lecture Distribution / Name Acknowledgment in the Paper’s Acknowledgments Section / Online Individual Consultation / Right to Host an Online Lecture / Right to Host an On-Site Lecture (Limited to Japan) / Naming Rights for the Study
Support this project0 supporters are supporting with this reward. （Limited to 1）
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Name Acknowledgment in Research Report and others
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Name Acknowledgment in the Paper’s Acknowledgments Section and others
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Online Individual Consultation and others
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Right to Host an Online Lecture and others
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supporters
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Right to Host an On-Site Lecture (Limited to Japan) and others
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academist Prize 2nd adopted
