This morning I attended a fascinating lecture for eating disorder professionals in New York City. (Yes, as well as being immersed in yoga and spiritual practice, I am also a neuroscience nerd). Leah Graves RD and Scott Moseman MD each presented on research that suggests brain differences in anorexia, bulimia and binge eating disorder, and non-eating disorder population. I hope to share with you some interesting findings that stood out to me today:
- Dr. Moseman spoke to his belief that anorexia is an anxiety disorder where restricting food and focusing on weight becomes the mechanism of managing already high levels of anxiety and genetically predisposed character traits such as perfectionism, obsessive compulsive tendencies, altered interceptive awareness such as overactive bladder function (I was surprised to learn people with anorexia actually have an unusually high rate of bed-wetting), harm avoidance and possibly altered gastro-intestinal function.
- Many of these traits exist prior to the development of an eating disorder. New brain studies show that people who struggle with anorexia do not have the same reactions to reward as people without anorexia, and that there are disturbances in dopamine systems, a neurotransmitter associated with pleasure and reward. Brain differences in this area explain why a "normal" eater feels agitated by hunger, while someone with anorexia may feel calmed by hunger. In fact, the area of the brain associated with delay of gratification is overly active in anorexia. Some of these brain differences may explain, for instance, why those who struggle with anorexia also have a difficult time receiving positive feedback and latch onto any sign of criticism.
- Research studies on brain function in bulimia and binge eating disorder (the most common eating disorder), also show neurobiological and regulatory differences that account for traits such as impulsivity, commonly associated with this population. One of these differences is the down-regulation of dopamine in the brain. Specifically, something that would satisfy a non-eating disordered person may under-satisfy someone with this type of eating disorder due to the way dopamine functions in the brain. However, because there is a high comorbidity in bulimia with substance abuse, trauma and other psychiatric disorders, most brain research studies focus on anorexia. Hopefully more studies will allow for a better understanding in this area.
- Genetic predisposition is now thought to contribute to 50-80% of those who develop an eating disorder. These estimates are similar to those found in schizophrenia and bipolar disorder.
- 40-50% of people with anorexia are vegetarians, whereas only 3% of the general population is vegetarian. Vegetarianism can be a major risk factor for developing an eating disorder. Avoiding sources of nutrients, such as in animal protein, can make recovery and weight-restoration even more difficult for someone with dietary limitations. While this is not necessarily a neuroscience fact, there are brain changes in anorexia (areas of the brain can actually shrink) that depend on proper nutrition and weight stabilization to be restored to normal function. The good news is that by cultivating healthy eating and exercise habits, our brains can function at their maximum capacity.
My hope is for understanding more about neurobiology and food behaviors to allow for a holistic approach to treatment and recovery. I believe that when we practice self-awareness and acceptance of the more difficult parts of our personality (and even brain chemistry), we can work to channel these parts in a healthier way that serves our well-being and health. Happy Friday!