Are eating disorders “brain disorders”?
Sarah has struggled for more years than she can remember with eating disorders. Her long periods of restriction, punctuated by episodes of binging and purging, have resulted in her developing an irregular heartbeat, weak kidneys, and medical bills that only exacerbate the feelings of anxiety that she has fought since she was a child. As her weight has fluctuated, so has her self-worth. She has lost countless relationships, years of education, and her career to this disorder. Now nearing thirty, Sarah is in treatment once again, this time determined to unravel the knotted threads of her disorder. She knows how; she now wants to know why.
The question of why when it comes to eating disorders has fueled hundreds of research studies, books, conference presentations, and late-night arguments between parent and child. And as society begins to recognize that eating disorders are lethal and are are increasingly impacting the most vulnerable among us – children and older adults – we are beginning to have the resources to answer that question.
But we’re not there yet.
On a listserv that I subscribe to, there was recently a lively discussion around the idea of calling an eating disorder a “brain disorder.” While no one was refuting the fact that eating disorders do involve brain functioning – heavily, in fact – there was discussion about the utility of referring to eating disorders in this way.
So what do we mean when we call an eating a brain disorder?
Well, if we’re being technical – and perhaps simplistic – a brain disorder is a disorder that affects and/or involves the brain. Yup, eating disorders do both.
Leading researchers in the field are conducting fascinating studies that reveal just how much brain mechanisms are related to eating disorders. Walter Kaye at the University of San Diego is one such individual. He has headed numerous studies examining how serotonin and dopamine affect eating disorders and exploring how changes in blood flow and oxygen use of the brain during eating. The results of Kaye and numerous others suggest that eating disorders are brain disorders – they irrefutably involve neurobiological functions.
The value of such information is, truly, incredible.
For one, it helps individuals who struggle with these illness and their families loosen the grip of blame that so often accompanies eating disorders. How many times have the victims heard, “Just give it up and stop already,” as if they decided one lazy afternoon to destroy their health and happiness? Recognizing eating disorders as brain disorders also pushes forward the slow process of pressuring legislators and insurance executives to treat them as the serious and life-threatening illnesses they are.
However, some caution, and perhaps rightfully so, that calling eating disorders brain disorders could minimize other important factors that contribute to these disorders, such as family dynamics and cultural influences. They worry that calling them brain disorders puts them in the category of other illnesses that are so often treated by throwing a pill at the problem. They fear that people with eating disorders will feel less empowered and less hopeful if they believe that their disorder represents a brain malfunction.
Thus, as with all language, perhaps we must be mindful of the associations that certain words hold. Because here are the facts:
Eating disorders are brain disorders, but they can also be environment disorders, family disorders, relationship disorders, and culture disorders (all of which admittedly involve the brain as well).
Eating disorders are brain disorders, but that doesn’t mean that they are cured by a pill.
Eating disorders are brain disorders, but they require treatment with a comprehensive team approach.
Eating disorders are brain disorders, but recovery is possible and requires the individual’s (very) hard work.
What do you think of calling an eating disorder a brain disorder?