Eating Disorders: Are Eating Disorders Brain Disorders?
Eating Disorder Facts for Teens and Parents Diagnosed with Anorexia Nervosa and Bulimia Nervosa
Scientists continue to discover more information about eating disorders.
13.2% of young people will meet the criteria for diagnosis for an eating disorder by the time they reach their 20th birthday.
Eating disorders are a leading cause of mental illness in young people.
Eating disorders are serious psychiatric illnesses and require specialist mental health treatment by mental health professionals experienced in Eating Disorder Treatment.
Here we look at how eating disorders affect the brain – and how weight, BMI and doing well at school are not reliable indicators of the severity of a teen eating disorder.
How Do Eating Disorders Affect the Neurobiology of the Brain?
Eating disorders negatively affect our brains. This is because the brain needs adequate nutrition to function correctly, and without the proper nutrients, the brain cannot function normally.
Eating disorders affect the day-to-day functions of our brain, including our mood regulation, our ability to cope with usual daily stressors, our relationships, our ability to think clearly and our decision-making processes. Examples include:
- An increased risk for adolescents to develop unusual neurological symptoms in early adulthood due, to disruption in neurotransmitter behaviour (the bodies system to send signals between nerves).
- A negative impact on the emotional centres of the brain that may lead to depression, irritability, isolation, rapid mood changes, impulsivity, self-harm and suicidal thoughts.
- Starvation, semi-starvation or restricting the bodies need for food leads to a reduction in nutrients that causes damage to the brain structure. This causes abnormal activity and affects brain development.
- Disruption in executive functioning and cognitive functioning.
- Reduced heart rate, which can deprive the brain of oxygen and lead to permanent damage to the brain.
- Nerve-related conditions including seizures, disordered thinking, and numbness or odd nerve sensations in the hands or feet. Feeling cold, temperature regulation and hunger and fullness clues are reduced or lost.
- A weakened response in the brain regions that are part of the brain’s reward system and increased anxiety.
- A reduction or shrinking in the brain size and volume, affecting both grey and white matter.
- An increase in ‘black and white’ thinking, rigidity, perfectionism and fear of failure.
- Difficulty with flexible thinking, brain fog, changing tasks or direction, sharing and setting priorities – can lead to increased isolation, avoidance and loneliness. This can also affect decision-making capacity, often leading to poor decision making which furthers the eating disorder.
- Distorted body image.
Can the Harmful Effects of Eating Disorders on the Brain Be Reversed?
The brain is severely impacted during the course of an eating disorder. This can be difficult to imagine for many parents, teens and young adults diagnosed with an eating disorder, as we are not able to see the impact on the parts of our body that we cannot see. The internal effects of eating disorders are often more severe than we can imagine just by looking at the outside.
Studies continue to look into the long-term effects of restrictive eating, Anorexia Nervosa and Bulimia Nervosa on the brain. For example, a recent study conducted by Yale University looked at MRI results and found that those diagnosed with an eating disorder have significantly less grey and white matter*, together with a reduction in their overall brain volume, compared to healthy individuals. Worryingly, this increases over time.
The longer the eating disorder continues, the greater the damage.
MRI scans from individuals who have completed their treatment in full and maintained full nourishment show an increase in both grey matter and brain volume. With long-term recovery, the brain continues to grow and has the potential to return to normal functioning. However, brain recovery can take a long time, so it’s important not to try to rush through treatment. The brain is a miracle, and recovery takes time and patience. There is no shortcut to brain repair and restoration, but it is possible.
- Anorexia Nervosa and Bulimia Nervosa cause a reduction in grey and white matter and overall brain volume.
- Completing Eating Disorder Treatment in full and maintaining full nourishment may help the regrowth of the brain structure.
- The type and duration of the eating disorder appear to affect the impact on the brain.
- *Grey matter is responsible for memory, movement, emotions and plays a significant role in all aspects of our lives.
- Brain recovery can take a long time – often much longer than weight restoration.
But My Child Is Doing Well At School. She/He Is an ‘A-Grade’ Student.
Research has shown that there are strong links between academic performance, high achievers and eating disorders. Studies show that the reward system activated in the brain is very similar across these areas. This can lead to high academic performance and eating disorders reinforcing the brain reward networks of ‘liking’ and ‘wanting’ weight loss and perceived perfection.
- Academic performance and eating disorders activate similar reward systems in the brain.
- These systems in the brain are similar and can reinforce the faulty reward circuits, furthering the eating disorder and related anxiety, perfectionism and fear of failure.
- Academic achievement is not a reliable indicator of the severity of an eating disorder. Your child can be very unwell and still strive for perfection in school grades.
- The ‘habit learning’ parts of the brain can be rewarded through ‘liking’ and ‘wanting’ further weight loss or through academic perfection, increasing anxiety and the fear-based learning that perfection avoids failure.
Do Eating Disorders Need Specialist Treatment?
Eating disorders are incredibly complex and always require specialist treatment. We know that the earlier treatment is started, the more favourable the outcome. Early intervention is one of the most important decisions that families can make. Decisions to engage in Eating Disorder Treatment should not be based upon weight, BMI, academic performance or ‘looking ok’. A professional evaluation is always needed.
A specialist Eating Disorder Team will have psychotherapists, mental health professionals, dieticians, psychiatrists and nurses; who will work together to provide treatment plans to meet the individual needs of young people and their families.
Eating Disorder Treatment can often be a lengthy process, and it is important to complete treatment. Full recovery is possible.
Eating Disorder Programs at The Wave are designed for teenagers, young adults and their families. The Wave Programs meet the differing care needs of young people with eating disorders, including:
- Higher-Level of Care (HLOC) for Eating Disorders. (1:1 Care)
- Inpatient Care for Eating Disorders
- Residential Programs for Eating Disorders
- PHP – Secondary Care at Transitions House for Eating Disorders
- Outpatient Eating Disorder Treatments (by assessment)
- Group Therapy for Eating Disorders (by assessment).
The Wave Eating Disorder Admissions Team can be contacted on:
Kuala Lumpur, Malaysia
The Wave Clinic. The Specialists in Teen Eating Disorders
+60327271799 (General Enquiries. Kuala Lumpur) +60125227734 (Admissions)
Dubai, United Arab Emirates
The Wave International Group LLC. A Dubai-registered provider of care for Eating Disorders.
Fiona Yassin is an Accredited Clinical Supervisor (UNCG), Member of The International Association of Eating Disorder Professionals (Member Number 1533), a Fellow of The APCCH, FDAP & Australian and New Zealand Academy For Eating Disorders and committed to upholding the principals and best practice in the treatment of Eating Disorders.
Fiona has a specialist interest in Borderline Personality Disorder, C-PTSD and Eating Disorders. Fiona is currently studying PCOS – An Evidence Based Approach with Monash University – to bring informed care for those diagnosed with both PCOS and a co-occurring Eating Disorder to The Wave Programs. Women’s Mental Health is an area of speciality and Fiona has enjoyed taking part in Massachusetts General Hospital Psychiatry Academy Women’s series.