New Eating Disorder: A Desire For Fine Food Gourmand Syndrome Follows Brain Injury

Finally, a disease few would mind having, as long as they could afford to indulge it: gourmand syndrome.

Swiss brain scientists have collected several dozen cases of people who suddenly developed a passion for fine food after damage to a particular region of their brains. Typically those who suffer from gourmand syndrome - if “suffer” is the word - were indifferent to good food before their stroke, hemorrhage, tumor, or injury.

One of the first cases, described in the May issue of the journal Neurology, was a well-known political journalist. Before a hemorrhage destroyed an area in the right front side of his brain, “he ate what his wife brought to the table,” the researchers reported.

After his recovery, the man could think of little else but “good, tasty food served in a nice restaurant,” and the only conversations that engaged him were about food. When he returned to work he abandoned the political beat and became a successful food writer.

Over a dozen years, neuroscientists Marianne Regard and Theodor Landis collected 33 more cases of new-found food passion following brain injury. They call the phenomenon “gourmand syndrome” rather than “gourmet syndrome,” they said, because in French a gourmand is someone who is “heartily interested in fine food and drink, or simply … a food lover,” whereas “gourmet” is reserved for a connoisseur.

But those who have gourmand syndrome are not gluttons, Regard and Landis said. They insist on good food, well prepared, but they do not eat excessive amounts, a trait that distinguishes the new disorder from other recognized eating abnormalities such as the binge eating of bulimia or pica, a bizarre craving for a specific food or even a compulsion to eat a nonfood item.

In fact, the craving for fine food - as opposed to food in general, or the specific food cravings of pregnant women - is the most interesting thing about the syndrome, said Regard, a neuropsychologist at University Hospital in Zurich who has found unsuspected brain damage, often from trauma in early life, among 80 percent of addictive gamblers.

In her view, gourmand syndrome represents a sort of refined addiction.

“If you take it as a craving for something that is positively reinforcing, it makes sense,” Regard said. “These people are not abnormally hungry. They are craving for a better state of being.”

Confessing that she likes to eat well, and always has, Regard added that “nobody would want therapy for gourmand syndrome. At least, I wouldn’t.” But she thinks the sudden behavior change in such patients can shed light on brain mechanisms that underlie humans’ complex ability to appreciate food, and perhaps other complicated pleasures as well.

Landis, a neurologist at the University of Geneva, stressed that he and Regard are not claiming to have found “the brain center for fine food, which would be grotesque.” Rather, he believes that damage to yet-unspecified regions of the brain’s right front quadrant removes a control mechanism that had been suppressing a full appreciation of good food.

How could a preoccupation with fine food emerge in a person who had been indifferent to it for a lifetime? Landis points to other patients who were alcoholics before they suffered a stroke and then suddenly stopped drinking, or teetotalers who became alcoholics after brain injury.

Such cases indicate that people may have unsuspected and unpredictable tendencies that can emerge when some component of impulse control is removed, Landis said. “We checked what their eating habits were before, and we didn’t find that these people were sort of latent fine eaters.”

Dr. Walter Koroshetz, a stroke specialist at Massachusetts General Hospital who is familiar with the report, said he thinks the scientists have identified a new syndrome.

“Most eating disorders have been linked to lower, autonomic brain centers, they involve behaviors such as ravenous eating, and they often are accompanied by hypersexuality and increased anger,” Koroshetz said. “Gourmand syndrome has a more willful and intellectual component, driven by an increased sense of appreciation. It may tell us something about how one’s appreciation of food is processed in the brain.”

Musing about the political writer who became a food critic, Koroshetz added: “I was wondering if I could get a stroke that could make me the travel editor.”