Anorexia nervosa not only affects physical health but also brings about significant changes in the brain, many of which reinforce the disorder's symptoms. Here’s a closer look at how anorexia impacts brain function and structure:
1. Prefrontal Cortex
The prefrontal cortex is vital for decision-making, impulse control, and rational thought. In individuals with anorexia, however, the prefrontal cortex may show decreased activity or altered functioning, which can make it harder to make balanced, logical choices, especially concerning food, self-care, and body image. This area is also involved in goal-setting learning, and when it is impacted, individuals may struggle to understand the long-term consequences of food restriction.
2. Insula and Interoceptive Awareness
The insula, a region that plays a key role in processing hunger, taste, and body signals, often functions abnormally in those with anorexia. When the insula’s signalling is disrupted, it can lead to a blunted sense of hunger and satiety, making it challenging for individuals to feel or respond to normal hunger cues. This can contribute to a disconnect between the body's needs and the brain’s response, reinforcing restrictive eating patterns.
3. Amygdala and Anxiety Regulation
The amygdala, responsible for processing fear and emotions, can become overactive in individuals with anorexia, making them more susceptible to anxiety. This heightened sensitivity to stress and fear often relates to food, body weight, or the fear of losing control. Anxiety and fear around food choices can reinforce restrictive eating and avoidance behaviours as the brain learns to associate eating or weight gain with feelings of distress.
4. Reward System
Anorexia can alter the brain's reward system, specifically in the way dopamine is processed. While most people experience pleasure from eating, individuals with anorexia may have a diminished response to food-related rewards. Instead, they may experience an unusual reward response to food restriction and weight loss. This rewiring of the reward system can make restricting feel like a “rewarding” behaviour, reinforcing the cycle of restrictive eating.
5. Grey and White Matter Changes
Studies have shown that people with anorexia can experience reductions in both grey and white matter in the brain. Grey matter loss affects areas responsible for muscle control, sensory perception, and emotions, while white matter changes may interfere with communication between different brain regions. Some of these changes may be reversible with nutritional rehabilitation, but chronic anorexia can lead to more lasting changes, impacting cognitive abilities and emotional regulation.
6. Neurotransmitter Imbalance
Anorexia affects the balance of neurotransmitters in the brain, particularly serotonin and dopamine, which play roles in mood regulation, reward, and appetite. Serotonin imbalances are linked with mood disorders and may increase susceptibility to anxiety and obsessive-compulsive behaviours—both common in anorexia. Dopamine, associated with pleasure and reward, may also be altered, reducing motivation to eat and find pleasure in food.
7. Memory and Cognitive Function
Prolonged malnutrition impacts cognitive functions such as memory, focus, and learning. Low levels of essential nutrients like glucose and fats hinder brain function, often leading to cognitive “fog,” poor concentration, and impaired memory. These cognitive challenges can make it harder for individuals to process information objectively, further complicating the recovery process.
Recovery and Brain Health
The good news is that with proper treatment and nutritional rehabilitation, many of the neurological effects of anorexia can improve. Restoring a healthy diet helps repair and rebuild brain tissue, restore neurotransmitter balance, and reverse some of the changes in grey and white matter. Working on therapy to address anxiety, reward responses, and self-perception is also essential for supporting the brain’s healing process and reinforcing healthier behaviours.
If you or someone you know is struggling with anorexia, it is important to remember that help is available and recovery is possible. You don’t have to face this alone—reaching out to a mental health professional is a powerful first step toward support and healing.
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