New Study Sheds Light On Treatment Of Anorexia

By Zachary Siegel 10/28/15

Much like drug addiction, anorexia may be a deeply learned habit that is incredibly difficult to break.

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Anorexia is notoriously difficult to treat and among the most fatal of mental illnesses. A new study in Nature Neuroscience has potentially brought to light why those who struggle with anorexia find it difficult to integrate new ways of eating into their lives.

Dr. Joanna Steinglass, a co-author of the study, told NY Mag she disagrees with many of the common explanations as to why those with eating disorders experience frequent relapse. Intuitively, she says, people think a relapse in maladaptive eating is a manifestation of misguided attempts at self-control. But Steinglass said, “Even when people show up at our hospital and want to make changes, they find it tough.”

Ever since the pre-Socratics, humans have been trying to understand why we make choices that are contrary to our well being, even when time and time again we’re faced with devastating consequences. Given this contrary drive, eating disorders display remarkable similarities with substance use disorders and the study presents them along such lines.

Results from the study shed light on the formation of habits in a region of the brain called the dorsal striatum when people with anorexia are making food choices under functional magnetic resonance imaging. “It seems that once people get sick, decision-making shifts to a different part of the brain that makes it more difficult to make a nuanced choice. Instead, you see the food and you automatically make a specific choice,” Steinglass said.

Essentially, the behavior of anorexia and its subsequent neural mechanisms function much like deeply learned habits, which we all know are difficult to break. But don’t let the word “habit” throw you off, it is deeply ingrained, making it not the same as simply biting your nails. What this understanding of anorexia demonstrates is the internal fight toward wellness in the face of strong habits.

So Steinglass and her colleagues want to understand how one could break the maladaptive habit of eating food with so few calories, so as to better treat people with eating disorders like anorexia.

Making even small changes, she says, such as eating in a new place or with different cutlery, has the potential to slowly break these entrenched routines. Eventually, the goal of treatment is to make recovery and wellness habits stronger than old anorexic habits. Just like how in recovery from substances, being clean and sober become stronger than old using habits.

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.