Eating Disorders’ Impacts on the Developing Brain

Authored by: Maia Phillips

Art by: Stefanie Chen

Due to factors such as social media, COVID-19, and other aspects of modern culture, there has been a substantial increase in adolescents developing eating disorders over the last decade. According to The Journal of Pediatrics, from 2018-2022, eating disorder-related doctor visits for children 17 and under doubled, with the prevalence of these conditions increasing by 107.4% [1]. The steep rise in eating disorders is not just a problem in the United States; across Europe, eating disorder numbers have increased to a similar extent [1]. The urgency of this issue is highlighted by the fact that anorexia nervosa has the most significant mortality rate of any mental health disorder [2]. 

So why look at the developing brain? While other demographics do struggle with eating disorders, they are very prevalent in the young population. Thus, it is crucial to examine the physiological effects of eating disorders, beyond the mental impacts. Many studies have explored factors impacting the developing brain; however, physiological factors are often overlooked when investigating eating disorders. Disordered eating can alter our brain wiring, according to an article in the Child and Adolescent Psychiatric Clinics of North America journal [3]. The American Journal of Psychiatry suggests that gray and white matter levels are affected, though results between studies [4]. Gray matter is essential to learning and information synthesis, and white matter creates a connection to the rest of the body–both essential functions, especially in the developing brain [5]. Importantly, the scientists believe that gray and white matter levels are restored when individuals recover, demonstrating the physiological importance of treatment [4]. 

Bulimia nervosa is a type of eating disorder, predominantly affecting teenage girls, where individuals binge eat and then restrict food or vomit to try to control their body weight [6]. Studies have shown that it affects the developing brain in terms of attention [7]. The results of a study published in the American Psychiatric Association journal showed increased ADHD among bulimia nervosa patients, as well as increased levels of impulsive behaviors [7]. Scientists also looked at the process of alerting–staying fixated on an alarming event–and found that there was increased activity in the right frontal lobe and bilateral parietal sections of the brain [7]. Bulimia patients were found to have an increased activation of alerting, which could potentially be explained by increased anxiety levels [7]. It is striking how much thoughts can rewire the human brain. As bulimia nervosa increases in severity, so too does brain function impairment, demonstrating the need for early intervention [7].

While recovery is necessary, early prevention of eating disorders is truly the most effective way to combat the issue. In a particular study titled “Decreased feedback learning in anorexia nervosa persists after weight restoration,” scientists looked at the impact of anorexia nervosa on brain function [8]. Anorexia has to do with individuals severely limiting food intake to unhealthy extremes in an attempt to reduce body weight [9]. In humans, learning is often done using feedback loops, meaning that experiencing the results of certain behaviors influences future action [8]. Anorexia nervosa results in a decreased ability to use these feedback mechanisms, changing the individual’s ability to alter their mental recovery trajectory [8]. This decreased feedback response seems to be a cycle: more severe patients have lower feedback function, leading to less ability to recover mentally. Strikingly, brain alterations that result from anorexia often do not go away after recovery, with more severe cases losing the most feedback mechanism function [8].

Although some studies have been done, more information is needed to fully understand the effects of eating disorders on the brain. While some impacts are clear in terms of brain function, scientists do not understand the specific impacts of the associated neural pathways. These studies demonstrate the importance of early prevention and treatment so that growing brains are not damaged in the first place. This could involve looking at social media or popular culture to combat the spread of disordered eating habits. Further research will help inform treatment methods and hopefully bring more awareness to the growing impact of eating disorders on adolescents worldwide.

Works Cited

1. Pastore, M., Indrio, F., Bali, D. Vural, M., Giardino, I., Pettoello-Mantovani, M. (2023). Alarming Increase of Eating Disorders in Children and Adolescents. The Journal of Pediatrics, 263, 1-4. 10.1016/j.jpeds.2023.113733.

2. Guarda, A. (2023. February) What are Eating Disorders? American Psychiatric Association. https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders

3. Frank, G.W., Shott, M.E., DeGuzman, M.C. (2019). The Neurobiology of Eating Disorders. Child and Adolescent Psychiatric Clinics of North America, 28(4), 629-640. 10.1016/j.chc.2019.05.007.

4. Frank, G.W., Shott, M.E., Hagman, J.O., Mittal, V.A. (2013). Alterations in Brain Structure Related to Taste Reward Circuitry in III and Recovered Anorexia Nervosa and in Bulimia Nervosa. The American Journal of Psychiatry, 140(10), 1152-1160. https://doi.org/10.1176/appi.ajp.2013.12101294

5. Mercadante, A. A.,  Tadi, P. (2023, July 24). Neuroanatomy, Gray Matter. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK553239/

6. Jain, A., & Yilanli, M. (2023, July 31). Bulimia Nervosa. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK562178/

7.  Seitzl, J., Hueck, M., Dahmen, B., Schulte-Rüther, M., Legenbauer, T., Herpertz-Dahlmann, B., Konrad, K. (2016). Attention Network Dysfunction in Bulimia Nervosa - An fMRI Study. PLOS ONE, 11(9). 1-18. 10.1371/journal.pone.0161329.

8. Foerde, K., Steinglass, J.E. (2017). Decreased Feedback learning in anorexia nervosa persists after weight restoration. International Journal of Eating Disorders. (50). 415-423. 10.1002/eat.22709.

9. Moore, C. A., & Bokor, B. R. (2023, August 28). Anorexia Nervosa. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK459148/