I’ve seen it so often in my practice. Young men and women being brought to treatment several months after the behaviors have been in effect. Starts off with “healthy” eating. Wanting to improve performance in athletics or just “feel better.” Parents hopeful that it is a “phase” that will pass, sometimes reinforcing of “eating well.” Friends make compliments on what appears to be an improved appearance. All of it very innocent.
Then a few months pass, the behaviors get more solidified and ritualistic. They feel comfortable and safe, and there is an obsessive quality to them. Not wanting the compliments to stop, or fearing they are going to become “fat,” the person tries harder at cutting back calories, or experiments with purging behaviors to get rid of excess calories. Is their brain working improperly when it is not being fed?
There has been an ongoing debate in the eating disorder community about whether eating disorders should be classified as “brain disorders.” Certainly, it can be argued that when a brain is not nourished enough, it will not work at its optimal capacity. Re-feeding the brain through consistent, reliable nutritional support is an integral piece of treatment that often makes people not only feel better, but think more clearly. It’s still a complicated issue that is exacerbated by factors such as anxiety, environmental factors (i.e. media, peers, coaches), family influences and genetic heritability, and sometimes medical factors (illnesses). It’s important that when treatment begins, a full assessment can be completed to understand what factors contributed to the behaviors, and how to create a team (i.e. dietician, physician) to be most helpful to get the brain and body working more effectively to combat the disordered issues.
