Background: Functional magnetic resonance imaging (fMRI) has provided insight on
how neural abnormalities are related to the symptomatology of the eating disorders (EDs): anorexia
nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). More specifically, an increasingly
growing number of brain imaging studies has shed light on how functionally connected
brain networks contribute not only to disturbed eating behavior, but also to transdiagnostic alterations
in body/interoceptive perception, reward processing and executive functioning.
Methods: This narrative review aims to summarize recent advances in fMRI studies of patients with
EDs by highlighting studies investigating network alterations that are shared across EDs.
Results and Conclusion: Findings on reward processing in both AN and BN patients point to the
presence of altered sensitivity to salient food stimuli in striatal regions and to the possibility of hypothalamic
inputs being overridden by top-down emotional-cognitive control regions. Additionally,
innovative new lines of research suggest that increased activations in fronto-striatal circuits are
strongly associated with the maintenance of restrictive eating habits in AN patients. Although significantly
fewer studies have been carried out in patients with BN and BED, aberrant neural responses
to both food cues and anticipated food receipt appear to occur in these populations. These
altered responses, coupled with diminished recruitment of prefrontal cognitive control circuitry, are
believed to contribute to the binge eating of palatable foods. Results from functional network connectivity
studies are diverse, but findings tend to converge on indicating disrupted resting-state
connectivity in executive networks, the default-mode network and the salience network across EDs.