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Adolescent Eating Disorders Impact their Developing Brains

Adolescent Eating Disorders | Paradigm Malibu

It may seem obvious that the teen brain is affected by an eating disorder. Not only are Anorexia Nervosa, Bulimia Nervosa, and other adolescent eating disorders a physical illness, they are also psychological illnesses. This means that thinking, feeling, and behaving around food becomes impaired and a teen is no longer able to make choices that are in their best interest.


Yet, you might imagine that with treatment, teens would improve, that they would heal and experience clear thinking during mealtimes. However, a recent study found that even after treatment, the brains of adolescents with Anorexia Nervosa had not fully recovered and in turn, were vulnerable to relapse. Researchers found that the more impairment there was to the brain, the harder it was to treat the illness. This article will discuss the impairments that adolescent eating disorders can have on teens’ lives and what parents can do to help.


The University of Colorado Study


The study mentioned above was administered by researchers at the University of Colorado, Anschutz Medical Campus.  Researchers conducted an examination of 21 female adolescents between 15 and 16 years old both before and after treatment for Anorexia Nervosa. They uncovered that the brains of these 21 females continued to have elevated reward systems, compared with other teens without an eating disorder. The study was published in the February 2017 issue of American Journal of Psychiatry.


According to Guido Frank, MD, senior researcher of the study, adolescent eating disorders fundamentally change the way adolescents respond to their environment, particularly when stimulated by food.


Anorexia Nervosa


There are different types of adolescent eating disorders, one of which is Anorexia Nervosa, more commonly known as Anorexia. A teen with this illness will feel a strong need to control their food intake as well as compulsively exercise to maintain a certain weight. They may believe that they are overweight, when they are not. Or they may believe that only certain foods will help them remain thin. It is common for teens with the illness to have many thought patterns, obsessions, beliefs, and ideas that contribute to the continued need to limit their food intake. Part of treating the control of eating in teens and adults is the exploration of those thoughts and beliefs.


The psychological aspect of the illness is made up of the beliefs, thoughts, and ideas about food. At the same time, severely controlling food intake can lead to physical consequences. For instance, with too little food in the body, the muscles and the tissues start to break down. An adolescent with Anorexia Nervosa moves through cycles of self-starvation, denying the body essential nutrients it needs to function normally. The body is forced to slow down all of its processes to conserve energy. Medical concerns that develop as a result of Anorexia Nervosa include:


  • The heartbeat reduces to a very slow rate, causing low blood pressure and changes in the muscle of the heart. There is risk for heart failure as the blood pressure become lower and lower.
  • Because of lack of nutrients the bone density weakens leading to Osteoporosis.
  • There is muscle loss and weakness.
  • Severe dehydration can cause kidney failure
  • Because of overall weakness, there is fainting and fatigue.
  • The dehydration causes dry hair and skin and there is excessive hair loss.
  • Tendency to get cold easily.
  • Hair might begin to grow on the body, a condition called lanugo, which happens as a way to keep the body warm.


Elevated Reward Responses in the Teen Brain


Experts explain that dopamine plays a significant role in the development of an eating disorder. Dopamine is a neurotransmitter in the brain that is produced in response to rewards or certain types of stimuli. For example, animal studies have shown that food restriction or weight loss increases the dopamine response to rewards.


To find out just how much the levels of dopamine increased, the University of Colorado researchers had their teen participants undergo a series of reward-learning taste tests while their brains were scanned. The results indicated that the reward responses were higher in teens with Anorexia Nervosa, compared to teens without Anorexia Nervosa. The study showed that the level dopamine stabilized slightly with treatment and weight gain, but remained elevated. These results also indicate that some teens may need more time to recover from Anorexia Nervosa and that some treatment modalities may not be entirely effective. According to Guido Frank, MD, senior researcher of the study, “This disease fundamentally changes the brain response to stimuli in our environment. The brain has to normalize and that takes time.”


Sadly, for those with severe Anorexia Nervosa, there were other parts of the brain also impacted by the illness, such as the insula. The insula is an area of the brain that processes taste as well as the ability to be aware of one’s body.


This information is important for parents to know. If their teen is in treatment, for instance, parents might remember that treatment takes time and that there may be a combination of treatment modalities necessary for full recovery.


What Parents Can Do About Adolescent Eating Disorders


If you suspect that your teen may have an eating disorder, the first thing that you can do is look for the following signs:


Behavioral Signs

  • Signs of restricted eating – dieting, low food intake, or fasting.
  • Odd food ritual – cutting food into pieces, counting bites.
  • Intense fear of becoming fat, regardless of an already low weight
  • Fear of food and certain situations where food is present.
  • Rigid exercise schedule
  • Dressing in layers to hide weight loss.
  • Binging.
  • Use of laxatives, enemas, or diuretics to eliminate food in the body.


Physiological Signs

  • Weight loss in a short period of time.
  • Cessation of menstruation without a physiological cause.
  • Paleness
  • Complaints of feeling cold
  • Dizziness and fainting spells.


Signs of Attitude Change

  • Mood swings
  • Perfectionist attitude
  • Insecurities about her capabilities despite actual performance
  • Feelings of self-worth are determined by what is or is not eaten.
  • Withdrawal from people.
  • Self-acceptance comes from external sources.


Next Steps for Parents of Teens with Anorexia Nervosa

If after reviewing the above signs you have a strong feeling that your teen is struggling with an eating disorder, it’s essential that you seek the assistance of a mental health professional. Adolescent eating disorders can get worse over time and with severe restriction of food intake, such as with Anorexia Nervosa, a teen may develop worsening medical concerns, which can ultimately take their life. When you contact a mental health professional.  They can conduct an assessment, make a diagnosis, and prepare the appropriate treatment plan. Furthermore, there are many websites online that are now offering education to help inform parents, family, and other loved ones of those suffering from Anorexia Nervosa and other eating disorders.


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