Creating a Science for Eating Disorders

The September issue of Scientific America focuses on “Food, Fat and Famine.” Though the three features don’t directly mention eating disorders, they all provide extremely interesting information related to the topic. It never ceases to amaze me how few ties are made between this type of research and disordered eating. Maybe it takes someone who has been there, who understands just how pervasive and intrusive this disease is, to know it is all connected

I mentioned addiction and eating disorders in my last post, and one article directly addresses that issue. According to “This is Your Brain on Food,” neuroimaging research shows that “compulsive eating and drug abuse engage some of the same brain circuits in similar ways, offering a new angle for understanding and treating obesity.” Now replace “obesity” with “bulimia and binge eating disorder.” Remember, food addiction is a behavior, not an appearance. It isn’t about obesity, it does not require a BMI over 30, it can be separate from weight.

Look at bulimics. I ran the gamut of EDs, but I spent most of my time in some sort of binge-purge cycle. And binging is an unnatural obsession with eating. “One of the reasons why humans are attracted to food is because of its rewarding, pleasurable properties,” the articles states. “When we experience pleasure, our brains learn to associate the pleasurable experience with the cues and conditions that predict it.”

For me, a binge could be choking down ice cream in the grocery store parking lot or merely having a big bowl of Raisin Bran. Either way, eating the food was enjoyable, it made me feel good, got the dopamine running. And then comes the guilt. The fear that this food would make me fat, that once I started eating I would not stop, that I was weak.

After reading this article, I want to take it a step further. The joy found in food is a chemical reaction. But for a bulimic, food is always bad. The initial surge of pleasure creates a great quandary because the one thing you aren’t suppose to do feels OK. This adds in the next level of guilt, the guilt of enjoying something evil. Like a devout Catholic repenting for sins of the flesh, it seems only natural that, once this level of psychological turmoil is reached, a purge must follow.

These chemical elements are also the reason it is so hard to recover. At the end of the original article, they wrap it up with a rather insightful link between addiction and compulsive eating.

But one of the major and distinct obstacles for a person trying to recover from compulsive eating is the obvious fact that you have to eat in order to survive whereas, if you are addicted to an illegal substance, you are in a way protected by the fact that that drug is not going to be environmentally available everywhere. One of the therapeutic interventions for drug addicts is to teach them to avoid places associated with their habit. But how do you do that with food? It’s impossible…

Addiction is not a choice. It is a reflexive response. Do you think that Pavlov’s dogs had a choice of salivating when they heard the sound that had been conditioned to the meat? They did not and had you seen inside their brains you would probably have observed that the sound would trigger dopamine increases in their striatum that would be signaling to expect the reward of the meat. The message that you get when dopamine is liberated in striatum—in this case, the dorsal striatum—is that you need to get into action to achieve a certain goal. It is a powerful motivator. It is extremely hard to overcome these impulses with sheer willpower.”

So its all a chemical addiction. But you can’t just walk away from it. Food is like air. Maybe you can hold your breath for a long time, almost forever, but eventually you need oxygen. Even the most staunch anorexic needs food if they want to survive. Yet another reason surviving an ED requires serious help.