In Which a Neuro Major Dispels Some Stereotypes About Anorexia
(Trigger warning for eating disorders)
When the topic of eating disorders inevitably comes up in a psychology class, it usually tends to be just a few pages in a textbook or a few slides in a PowerPoint, usually about how anorexia is a disorder in which the individual has an obsessive desire to lose weight by refusing to eat. These descriptions are almost always framed in a way that makes it seem as though “Losing Weight” and “Being Skinny” have suddenly become the end goals for the individual, and sometimes it is even implied to be due to some sort of inflated sense of vanity. Sometimes the presentation will throw in a few thoughts about genetic predisposition toward susceptibility to the thin ideal that is constantly portrayed by the media and the fashion industry as the ultimate goal for success and beauty. While this is a valid point and I don’t want to discount the pressure and toxic impact that the perpetuation of these unrealistic beauty standards have, I definitely don’t think that it’s telling the whole story.
Of course, I do not want to speak for anyone else’s experiences. All I can talk about is my own experience. And for me, it was never about the wanting to look like a model. For me it was about control. As a freshman in high school, I didn’t have a lot of that. I wasn’t really happy with the people I was friends with, and I wasn’t really happy with who I was. Changing my entire personality was not something that I could easily control, but food was. It was something to direct my focus and attention toward, rather than thinking about why I was unhappy. I starting counting the few hundred calories of ‘safe foods’ I ate each day, and then went to cross-country practice where I ran anywhere from three to ten miles. I remember one day at the end of practice someone brought chocolate chip cookies. Somehow everyone started pressuring me to eat one, since I was the only one that hadn’t, and I did so just to make them stop questioning me. I felt so upset afterward that I ran the five miles back to my house instead of my mother picking me up from school, even though I had already done a two-hour track workout. Eventually the school nurse sent a letter home when my BMI came out dangerously low, my pediatrician expressed concern about my lack of period, and both of them told me that I needed to gain weight. But since I was on cross-country, it was not quite as concerning as it would have been otherwise. Never once did either of them take the time to sit down with me to try to understand what I was going through or even discuss the possibility that I had an eating disorder.
It’s nearly eight years later, and I am glad to say that I am so much healthier and so much happier. It was not easy, it certainly did not happen overnight, and, at least to me, recovery is kind of an ongoing process, but I learned how to eat and run in a way that makes me feel good and that benefits my body. It’s funny because sometimes vegetarians or vegans with a past of disordered eating will get criticism for still following rules and restricting themselves to a “diet” of specific foods, but 1) that’s not the sole reason that I don’t eat animals products anymore, and 2) if someone saw the difference between what I ate then and what I eat now, I have no idea how they could still give that critique. I’m obviously not a doctor (yet), but regardless of what others might think is the only right way to “do” recovery, I think that it’s incredibly important to do what you know works best for you.
So anyway, back to never learning any of this in any class ever (I’m a Neuroscience & Behavior major, by the way). When I came across this study in an article for The Atlantic just a few weeks ago, I was kind of overwhelmed.
“[Psychiatrist Walter] Kaye’s work with women who have recovered from anorexia nervosa found unusually high levels of the neurotransmitter serotonin in the cerebrospinal fluid that bathes the brain, and he believes these levels were likely also present before the onset of anorexia. Although low serotonin levels are linked to depression, high serotonin levels aren’t good either, as they create a state of chronic anxiety and irritability. As many as three-quarters of those with anorexia had suffered from an anxiety disorder before their eating disorder began, most commonly social anxiety and OCD. It is this anxiety that Kaye believes makes some people much more vulnerable to anorexia.
The body synthesizes serotonin from the amino acid tryptophan, which we get from our diet. Eat less food and you get less tryptophan and hence less serotonin. For people predisposed to anorexia, therefore, starvation reduces the anxiety and irritability associated with their high serotonin levels. Mission accomplished, or so it seems. The problem is that the brain fights back, increasing the number of receptors for serotonin to wring every last drop out of the neurotransmitter that is there. This increased sensitivity means that the old negative feelings return, which drives the person to cut back even more on what they’re eating. Any attempts to return to normal eating patterns wind up flooding the hypersensitive brain with a surge of serotonin, creating panic, rage and emotional instability. Anorexia has, in effect, locked itself into place.” (The Atlantic, “The Challenge of Treating Anorexia in Adults”, 3.30.16)
I don’t know if you, person reading this, know anything about neurotransmitters or the brain, but I feel like this explains it super well, and to me this was just such a relief and such an affirmation. Even though I objectively and rationally have always known that an eating disorder is a mental illness, knowing the exact mechanisms behind it really hit home for me in a way that nothing else ever has. Seriously, I was never taught this. Maybe I should have sifted through the peer-reviewed literature myself to try to find some answers. Actually, I’m not sure why I never did. What the heck, past self? But regardless, knowing that I haven’t just been making all of this up for years, and that it wasn’t just a subliminal result of me watching America’s Next Top Model when I was twelve years old, and that there is an actual neurobiological reason for me to be feeling the way that I have felt and sometimes feel now? That validation means so much to me.