How Do Eating Disorders Like Anorexia Start?

Once the cause of anorexia is known, psychologists and psychiatrists are better able to treat it. In a review paper published online in Nature Reviews Neuroscience, Dr Walter Kaye describes how dysfunctions in certain neural circuits of the brain may be related to anorexia in some women. Learning how anorexia nervosa starts is one step towards effective treating this eating disorder. This information about how anorexia starts includes insight into how a person with anorexia thinks.

“Currently, we don’t have very effective means of treating people with anorexia,” said Walter Kaye, MD, professor of psychiatry and director of the Eating Disorders Program at the University of California, San Diego. “Consequently, many patients with the disorder remain ill for years or eventually die from the disease, which has the highest death rate of any psychiatric disorder.”

According to Kaye, childhood personality and temperament may increase a person’s vulnerability to developing anorexia. Perfectionism, anxiety, or obsessive-compulsive tendencies may come before an eating disorder (but these traits don’t cause anorexia in all cases).

“Adolescence is a time of transition, when individuals must learn to balance immediate and long-term needs and goals in order to achieve independence,” says Kaye. “For such individuals, learning to cope with mixed societal messages and pressures may be overwhelming, exacerbating underlying traits of anxiety and a desire to perfectly achieve.”

Once anorexia starts and develops, starvation and malnutrition cause profound effects on the brain and other body systems. These changes include neurochemical imbalances, which may make the preexisting traits more dominant. This creates a downward spiral into severe anorexia or other eating disorders, and can even accelerate the disease process.

“Anorexia is very complicated, and there needs to be a paradigm shift in understanding its underlying cause,” said Kaye. “We’re just beginning to understand how the brain is working in people with this disorder.”

Who has anorexia in your family? If it’s your mother, read When Your Mom Has an Eating Disorder.

How People With Anorexia Think

“Individuals with anorexia nervosa tend to report that dieting reduces anxiety, while eating increases it,” says Kaye. “This is very different from most individuals, who experience hunger as unpleasant.” This drive to reduce anxiety can lead to an out-of-control spiral resulting in weight loss, severe emaciation, and malnutrition in people with anorexia nervosa.

Also, people with anorexia nervosa tend to not live “in the moment” or experience pleasure. People with anorexia often have exaggerated and obsessive worry about the consequences of their behaviors, looking for rules when there are none, and are overly concerned about making mistakes.

Symptoms of anorexia include distorted body image and diminished motivation to change, and could be related to their thought patterns. Once the cause of an eating disorder is identified, treatments may be more effective and permanent. And Kaye offers good news! In his experience, many individuals who recover from anorexia do well in life.

If you’re in a relationship and you have anorexia, read Should You Tell Your Boyfriend About Your Eating Disorder?

Source: University of California at San Diego (July 21, 2009). “ Review Provides New Insights Into the Causes of Anorexia.”


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