Anorexia and brain imaging

Although the research isn't that new, there was a wonderful write-up on Walt Kaye's brain imaging research in the Psychiatric Times (creatively titled Anorexia and Brain Imaging).

A short excerpt:

...insights into the ventral (limbic) and dorsal (cognitive) neural circuit dysfunction, perhaps related to altered serotonin and dopamine (DA) metabolism, may help explain why individuals with anorexia often report that dieting reduces their anxiety while eating increases it and why they worry about long-term consequences but seem impervious to immediate gratification and unable to live in the moment.

Many women diet in this culture, but relatively few (0.5%) have anorexia, Kaye told Psychiatric Times. “Why is that? Well, you pretty much have to have a certain temperament and personality in childhood to be vulnerable for . . . an eating disorder,” said Kaye. “Not everyone who develops anorexia has all these traits in childhood, but most have one or more of them,” he said. “These traits include harm avoidance, anxiety, behavioral inhibition, difficulty with set shifting [easily moving from one mental set to another], a tendency to focus on details rather than the big picture, and perfectionism.” Even after recovery, these personality and temperament traits persist, pointing to underlying neurobiological factors.

...Kaye said that evidence from imaging studies suggests that disturbances in the serotonergic system might contribute to vulnerability for restricted eating and behavioral inhibition as well as a bias toward anxiety, particularly excessive concern with consequences. Meanwhile, DA dysfunction, particularly in striatal circuits, may contribute to altered reward, decision making, stereotypic motor movements, and decreased food ingestion.
The article isn't simple--the magazine is aimed at psychiatrists, not otherwise clueless neuroscience geeks like yours truly--but it's written very clearly, and Google helped me figure out what terms I didn't know. If you ever want a good handout on up-to-date information on anorexia for medical professionals, this would be a good one to print and keep on hand.

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Cathy (UK) said...

Thanks for posting this article Carrie :)

As a science geek and prize nerd I love this kind of stuff. There is nothing (in my opinion) more frustrating than having someone say to me in recovery "great to see you looking much better", or "you look great now", or "don't worry; you're still slim".

Gah, I know they're being kind and supportive, but all their comments focus on how I LOOK. I didn't develop anorexia nervosa because I disliked how I looked. I developed this illness because of the way my brain is structured, how it processes information and responds to stress etc. For me anorexia nervosa comprised a set of compulsive behaviours and rituals which I used to regulate my life and my emotions.

I am grateful for the research of Walter Kaye and others who focus on the nitty-gritties of neuroscience...

Katie said...

Fellow nerd here ;) thank you for posting this! Like Cathy I always got highly irritated when people said "but you would look so much better if you weighed Xlbs more" or whatever, because my difficulty with staying in recovery was largely due to the fact that anorexia made me feel sedated, not that I thought it made me into a hottie. Thank goodness for neuroscientists!

Cathy (UK) said...

Maybe we should set up a 'nerds ED recovery group'...

I can honestly say that (apart from having a very knowledgeable and supportive psychiatrist helping me to recover from anorexia nervosa over the past 4 yrs) what has helped me most in recovery is to learn about the neurological and metabolic factors that increase an individual's risk of developing an ED and remaining stuck in it.

I guess it's 'each to their own', but I could never identify with 'love your body' therapies and the hypotheses of EDs put forward by feminist sociologists/psychotherapists.

Carrie Arnold said...

Cathy and Katie,

I'm totally happy to start a Facebook group called "Geeks in ED Recovery."

Although I did have many of the stereotypical body image issues that go along with AN, my disorder had nothing to do with looking good, either. As I lost weight, I never thought my appearance had changed. I could see my complexion was some sort of gray-yellow awfulness, and that my eyes had dark circles, but I never thought "If I keep losing weight, I can be a model!" Um, no.

I think I have managed to conquer many of the physical symptoms of anorexia (ie, the weight loss, the worst of the food fears and body dysmorphia) but I don't know if the illness itself has gone away.

Anonymous said...

Oh my gosh... please set up a geeks ED recovery group. Im still in a 10year recovery from anorexia-it has NEVER been about how I look to others... the less I weigh, so technically 'the better i should feel about my looks' the more baggy and crappy clothes I wore. Its about whats happening in my mind, my way of coping etc.

I love the science stuff... I hope to eventually study medicine-Im also quite interested as very early on in my anorexia I developed epilepsy-I dont know if the two are related or how. A group where it wasnt all 'love the way you look' etc would be wonderfull!!

Cathy (UK) said...

Thanks Carrie...

I think that the 'body image' issues of anorexia nervosa (AN) are interesting. I would not suggest I had, nor have no 'body image' issues whatsoever. The main point I make is that any 'body image' issues I did (and do) have were not the cause of my AN, and neither did any such issues keep me in AN for nearly 30 yrs.

Now that I am a healthy weight I would rather like to have bigger boobs, broader shoulders, and greater balance between my lower and upper body (because like my mother, my basic body shape is 'pear'). However, it doesn't cause me great grief. (I'll just wear a padded bra - lol). The greatest grief I felt during weight recovery was that I felt very anxious without my crazy food and exercise rituals.

Carrie Arnold said...


I'm also interested in the links between AN and epilepsy, as I developed epilepsy about 1 year into my ED. I've been seizure free for several years now, knock on wood.

Maybe I will start that Facebook group...

Anonymous said...

i got an MRI done for school that wasn't analyzed at all and I wonder what it says about me now. :( Wish I could read it- they gave me a CD of it so I could see my brain (which was cool) but I want to know what it means.

great writing, by the way, I'm a lurker. :)

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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