Over the past ten years our understanding of how the brain works has changed dramatically. We sit now on the edge of a new and exciting understanding of what it means to have an eating disorder. Historically, conversations about eating disorders and their causation have focused on family and society. Conversations now can focus on the biochemistry and physiology of hunger, fear, pleasure, satisfaction, excitement, and other basic building blocks of what it means to be human.
The Cellular and Molecular Substrates of Anorexia Nervosa, Part 1, by Dr. John J. Medina, summarizes some of the most current information about the brain and eating disorders. In a recent study, Altered Reward Processing in Women Recovered from Anorexia Nervosa (2007), researches measured activity in the brains of participants in recovery from anorexia and a control group of clients without a history of anorexia. Clients were presented with various situations that involved positive and negative rewards. Researchers found that clients with anorexia had equivalent brain activity in the areas of the brain that regulate and mediate conflict monitoring, thus implying that these clients may have difficulty processing appropriate reward responses.
A second study examined the association between actions and outcomes in the brains of clients with and without anorexia. This research demonstrated that participants who were in recovery from anorexia showed an elevated response in the area of the brain that is responsible for planning, foresight, impulse control, and memory. These participants also were greatly concerned with making “errors” in the tasks and looked for rules to abide by within the task directions.
With these two studies in mind, Dr. Medina hypothesizes that the dysfunction between the reward and punishment systems of clients with anorexia may aggravate the discrepancy between an obtained negative reaction to eating/food and the biological necessity of eating. This may then lead to increased anxiety and anticipation over future events, in this case, eating.
Researchers are therefore beginning to move towards a better conception of who eats what and why and what makes individuals more susceptible to develop an eating disorder or not. This information, in combination with evidenced based treatment, opens the door to truly understanding eating disorders and recovery. Current research moves us away from mystery and confusion and towards a greater understanding of the illness.
Wagner, A., Aizenstein, H., Venkatraman, V. K., Fudge, J., Christopher May, J., Mazurkewicz, L., Frank, G. K., Bailer, U. F., Fischer, L., Nguyen, V., Carter, C., Putnam, K., & Kaye, W. H. (2007). Altered reward processing in women recovered from anorexia nervosa. American Journal of Psychiatry, 164, 1842 - 1849.
Next week: The dos and don'ts of what to say to a loved one in treatment over the holidays
Contributions by Sarah Emerman