Biology & Treatments for Compulsive Behaviors & Binge Eating | Dr. Casey Halpern

**Andrew D. Huberman** (0:00)
Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.
I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today, my guest is Dr. Casey Halpern. Dr. Halpern is the chief of neurosurgery at the University of Pennsylvania School of Medicine. His laboratory focuses on bulimia, binge eating disorder, and other forms of obsessive-compulsive behaviors. Normally, when we hear about eating disorders or obsessive-compulsive disorders of other kinds, the conversation quickly migrates to pharmacologic interventions and serotonin or dopamine or talk therapy interventions, many of which can be effective. The Halpern laboratory, however, takes an entirely different approach. While they embrace pharmacologic and behavioral and talk therapy interventions, their main focus is the development and application of engineered devices to go directly into the brain and stimulate the neurons, the nerve cells, that generate compulsions, that cause people to want to eat more, even when their stomach is full. In other words, they do brain surgery of various kinds, sometimes removing small bits of brain, sometimes stimulating small bits of brain with electrical current, and even stimulating the brain through the intact skull, that is without having to drill down beneath the skull, in order to alleviate and indeed sometimes cure these conditions. Today's discussion with Dr. Halpern was an absolutely fascinating one for me. Because it represents the leading edge of what's happening in modification of brain circuits and the treatment of neurologic and psychiatric disease. For instance, they just recently published a paper in Nature Medicine, one of the premier journals out there, entitled, Pilot Study of Responsive Nucleus Occumbens Deep brain Stimulation for Loss of Control Eating. The nucleus accumbens is an area of our brains that we all have. In fact, we have two of them, one on each side of the brain, that is intimately involved in the release of dopamine for particular motivated behaviors. And while most often we think about dopamine for the release of behaviors that we want to engage in, in this context, they are using stimulation and control of neuronal activity in nucleus accumbens to control loss of control eating, something that when people suffer from it, despite knowing they shouldn't eat, despite not even wanting to eat, they find themselves eating. So again, this represents really the leading edge of where neuroscience is going, and it certainly is going to be an area of neuroscience that's going to expand in the years to come. And Dr. Halpern and the members of his laboratory are among a very small group of scientists in the world that are using the types of approaches that I described a minute ago, and that you're going to hear more about in today's episode in order to resolve some of the most difficult and debilitating human conditions. During today's discussion, you will also learn about the use of deep brain stimulation and other approaches for the treatment of movement disorders, such as essential tremor, Parkinson's disease, and various types of dystonias, which are challenges in generating particular types of movement. So whether or not you or somebody that you know suffers from an eating disorder, from obsessive compulsive disorder, or from a movement disorder, today's episode is sure to teach you not only about what's happening in those arenas, but also in the arenas of neuroscience generally. In fact, I would say today's episode is especially important for anyone that wants to understand how the brain works and what the future of brain modification really looks like for all of us. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desire and effort to bring zero cost to consumer information about science and science related tools to the general public. In keeping with that theme, I'd like to thank the sponsors of today's podcast. Our first sponsor is Element. Element is an electrolyte drink with everything you need and nothing you don't. That means plenty of salt, magnesium and potassium, the so-called electrolytes and no sugar. Now, salt, magnesium and potassium are critical to the function of all the cells in your body, in particular to the function of your nerve cells, also called neurons. In fact, in order for your neurons to function properly, all three electrolytes need to be present in the proper ratios. And we now know that even slight reductions in electrolyte concentrations or dehydration of the body can lead to deficits in cognitive and physical performance. Element contains a science-backed electrolyte ratio of 1,000 milligrams, that's one gram of sodium, 200 milligrams of potassium and 60 milligrams of magnesium. I typically drink Element first thing in the morning when I wake up in order to hydrate my body and make sure I have enough electrolytes. And while I do any kind of physical training and after physical training as well, especially if I've been sweating a lot, if you'd like to try Element, you can go to drinkelement, that's lmnt.com/huberman to claim a free Element sample pack with your purchase. again, that's drinkelement, lmnt.com/huberman. Today's episode is also brought to us by Thesis. 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To get your own personalized Neutropics starter kit, go online to takethesis.com/huberman, take a three-minute quiz, and Thesis will send you four different formulas to try in your first month. That's takethesis.com/huberman, and use the code Huberman at checkout for 10% off your first order. And now for my discussion with Dr. Casey Halpern. Casey, I should say Dr. Halpern, for those listening, welcome.