41 Body weight changes after deep brain stimulation for obsessive compulsive disorder or major mood disorder In this study, weight loss or normalization of body weight was not a primary treatment target and the patients did not receive any motivational therapy targeted at losing weight. It is possible that if they had been coached specifically to lose weight in addition to combating the primary symptoms of OCD or MDD, this could have been effective with the reward system being under the influence of DBS. It is thus possible that we underestimated the possible effect of DBS on changes in BMI in morbidly obese patients. The patient in our previous study focused on losing weight out of intrinsic motivation without external prompting (1). A severe limitation of this report is the amount of missing data on BMI during the follow-up of all patients treated with DBS, due to the fact that body weight was not routinely measured at fixed postoperative intervals. We cannot show that body weight did not fluctuate over time, with an initial significant weight loss followed by secondary weight gain, which is common with all weight loss methods available. However, from our frequent contact with these patients, we could ascertain that there were no such cases of strong fluctuations in BMI in our sample. Further research is necessary to provide more insight into the possible effects of the modulation of the brain reward circuitry on food intake, energy balance, and body weight, and the possibility of a selective normalizing effect of vALIC DBS on body weight in eating disorders. Our findings may be of relevance for research groups working on DBS in eating disorders.
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