The Language of the Brain
November 28, 2013
by Jeffrey DeSarbo, D.O.
Board Certified Psychiatrist
ED-180 Eating Disorder Treatment Programs
(The following was originally written and appeared on the National Eating Disorder Association’s (NEDA) website as a special feature.)
The language of an eating disorder resides in the hieroglyphics of the brain and neuroscience. Just as the scientists and linguistic experts who had to decipher cave drawings, Egyptian symbols and the writing on the scrolls, neuroscientists throughout the world are trying to decipher the brain functioning in people with eating disorders. Existence entails what you are thinking about from moment to moment. And what you think about from moment-to-moment determines the quality of your life. But where do our thoughts come from? The language of thought appears to originate in the brain. We can tell when one is thinking or processing information in the brain when we see electrochemical signals with neuroimaging on CTs, MRIs, PET Scans and SPECT. Still, we only see the signals and not the thoughts.
When someone suffers from an eating disorder, we know from what they tell us and the things that they do that their thoughts are overwhelmingly distressful, all consuming and often distorted. Imagine the quality of life that goes along with these moment-to-moment thoughts. A person who suffers with an eating disorder has a certain way in which they hear things, say things, perceive things and do things. The brain, it can be said, is speaking a foreign language that is not native to the person. It is as if one began speaking a strange language tomorrow and they cannot understand why. It sort of makes sense to them, but to no one else.
Over the past couple of decades, the advancement of neuroimaging has led many researchers on a path to better understand origins of this brain language and what it means for eating disorder onset, treatment and recovery. The scientist who do this work have been making important discoveries into the biological aspects of eating disorders like anorexia and bulimia nervosa, binge-eating disorder and related conditions such as body image distortions. As the language of the neurobiological factors of eating disorders becomes deciphered, many patients and loved ones have been able to lessen their self-blame and recognize the role that genetics and biology plays with their condition. Onset and recovery is not only explained by a change in observable behaviors, but there are unseen functional and anatomical changes in the brain itself that help explain these changes.
Over the past few decades, there have been several hundreds of high-tech, scientific studies on the brain and eating disorders. Through this collective work develops a picture of how the brain impacts an eating disorder and vise versa. While single studies provide some basis of conceptualization, it is the body-of-evidence that leads to a deeper understanding of the brain and biology’s role with an eating disorder. Studies teach us a word; the sum total of all the studies teaches us the language.
Amongst the insightful and fascinating studies are one’s that help us understand the language of genetics. Researches have been consistently finding that genetic factors may account for over 50% of the contribution to the onset of anorexia and bulimia nervosa (1). Other researchers have also found that the role of genetics appears to become more influential as an individual goes from childhood into adolescence (2). By understanding the impact of heredity, we can see that having an eating disorder is no more of a choice than a person genetically predisposed to diabetes.
Other studies help decipher the language of eating disorders by discovering anatomical changes in the brain. With conditions such as anorexia nervosa, neuroimaging has shown us that there is brain cell loss of both grey and white matter (3,4). Now researchers and trying to decipher what the results of this brain cell loss are and how much can be restored with recovery (5). For instance, researchers discovered that with anorexia nervosa, there is cell loss in the parietal lobe of the brain that is directly associated with one’s internal language that creates a drive-for-thinness (6).
But the language of the brain science is not a simple this-causes-that story. For instance, Estonian researchers also discovered that certain changes in a serotonin neurotransmitter found in girls with eating disorders could also be responsible for a drive-for-thinness (7). So even the language of brain chemistry needs interpretation for a better understanding of eating disorders.
Even the physiological functioning of the brain that contributes to the grammar of eating disorders. One study showed a there is often a change in blood flow in women with anorexia nervosa who have body image distortions (8). These blood flow changes are similar to patients who have psychotic disorders where their perceptions are also distorted and may help explain the cause of such significant alterations in self-perception.
Researchers are also discovering the different dialects of language that exists in the brains of men and women. When males and females are shown words with unpleasant words regarding body image, men primarily have brain activation in the cognitive areas of the brain while women have a unique activation in the fear and emotional centers of the brain (9). Studies like this can contribute to an understand of why there are more women then men who develop eating disorders and why the time to recovery is so much greater.
It is these types of studies, conducted by dedicated scientists that will lead the way to interpreting the language of the brain. The process is time-consuming and requires time and money, but this type of research will likely be what is needed to make major breakthroughs in treatment protocols. In the meantime, it would do our field well to help patients and the public know that there is growing evidence that helps explain how the thoughts and behaviors associated with an eating disorder may be more under the control of biology than simple will.
1. Bulik CM, Thornton LM, Root TL, Pisetsky EM, Lichtenstein P, Pedersen NL. “Understanding the relation between anorexia nervosa and bulimia nervosa in a Swedish national twin sample.” Biol Psychiatry. 2010 Jan 1;67(1):71-7.
2. Klump KL, Burt SA, McGue M, Iacono WG. “Changes in genetic and environmental influences on disordered eating across adolescence: a longitudinal twin study.” Arch Gen Psychiatry. 2007 Dec;64(12):1409-15.
3. Swayze VW 2nd, Andersen AE, Andreasen NC, Arndt S, Sato Y, Ziebell S. “Brain tissue volume segmentation in patients with anorexia nervosa before and after weight normalization.” Int J Eat Disord. 2003 Jan;33(1):33-44.
4. Joos A, Hartmann A, Glauche V, Perlov E, Unterbrink T, Saum B, Tüscher O, Tebartz van Elst L, Zeeck A. “Grey matter deficit in long-term recovered anorexia nervosa patients.” Eur Eat Disord Rev. 2011 Jan-Feb;19(1):59-63.
5. Roberto CA, Mayer LE, Brickman AM, Barnes A, Muraskin J, Yeung LK, Steffener J,
Sy M, Hirsch J, Stern Y, Walsh BT. “Brain tissue volume changes following weight gain in adults with anorexia nervosa.” Int J Eat Disord. 2011 Jul;44(5):406-11.
6. Joos A, Klöppel S, Hartmann A, Glauche V, Tüscher O, Perlov E, Saum B, Freyer T, Zeeck A, Tebartz van Elst L. Voxel-based morphometry in eating disorders: correlation of psychopathology with grey matter volume. Psychiatry Res. 2010 May 30;182(2):146-51.
7. Akkermann K, Paaver M, Nordquist N, Oreland L, Harro J. “Association of 5-HTT gene polymorphism, platelet MAO activity, and drive for thinness in a population-based sample of adolescent girls.” Int J Eat Disord. 2008 Jul;41(5):399-404.
8. Gordon CM, Dougherty DD, Fischman AJ, Emans SJ, Grace E, Lamm R, Alpert NM, Majzoub JA, Rauch SL. “Neural substrates of anorexia nervosa: a behavioral challenge study with positron emission tomography.” J Pediatr. 2001 Jul;139(1):51-7.
9. Shirao N, Okamoto Y, Mantani T, Okamoto Y, Yamawaki S. “Gender differences in brain activity generated by unpleasant word stimuli concerning body image: an fMRI study.” Br J Psychiatry. 2005 Jan;186:48-53.
Tags: brain, eating disorders, NEDA, research
November 28, 2013
by Jeffrey DeSarbo, D.O.
Board Certified Psychiatrist
ED-180 Eating Disorder Treatment Programs
(The following was originally written and appeared on the National Eating Disorder Association’s (NEDA) website as a special feature.)
The language of an eating disorder resides in the hieroglyphics of the brain and neuroscience. Just as the scientists and linguistic experts who had to decipher cave drawings, Egyptian symbols and the writing on the scrolls, neuroscientists throughout the world are trying to decipher the brain functioning in people with eating disorders. Existence entails what you are thinking about from moment to moment. And what you think about from moment-to-moment determines the quality of your life. But where do our thoughts come from? The language of thought appears to originate in the brain. We can tell when one is thinking or processing information in the brain when we see electrochemical signals with neuroimaging on CTs, MRIs, PET Scans and SPECT. Still, we only see the signals and not the thoughts.
When someone suffers from an eating disorder, we know from what they tell us and the things that they do that their thoughts are overwhelmingly distressful, all consuming and often distorted. Imagine the quality of life that goes along with these moment-to-moment thoughts. A person who suffers with an eating disorder has a certain way in which they hear things, say things, perceive things and do things. The brain, it can be said, is speaking a foreign language that is not native to the person. It is as if one began speaking a strange language tomorrow and they cannot understand why. It sort of makes sense to them, but to no one else.
Over the past couple of decades, the advancement of neuroimaging has led many researchers on a path to better understand origins of this brain language and what it means for eating disorder onset, treatment and recovery. The scientist who do this work have been making important discoveries into the biological aspects of eating disorders like anorexia and bulimia nervosa, binge-eating disorder and related conditions such as body image distortions. As the language of the neurobiological factors of eating disorders becomes deciphered, many patients and loved ones have been able to lessen their self-blame and recognize the role that genetics and biology plays with their condition. Onset and recovery is not only explained by a change in observable behaviors, but there are unseen functional and anatomical changes in the brain itself that help explain these changes.
Over the past few decades, there have been several hundreds of high-tech, scientific studies on the brain and eating disorders. Through this collective work develops a picture of how the brain impacts an eating disorder and vise versa. While single studies provide some basis of conceptualization, it is the body-of-evidence that leads to a deeper understanding of the brain and biology’s role with an eating disorder. Studies teach us a word; the sum total of all the studies teaches us the language.
Amongst the insightful and fascinating studies are one’s that help us understand the language of genetics. Researches have been consistently finding that genetic factors may account for over 50% of the contribution to the onset of anorexia and bulimia nervosa (1). Other researchers have also found that the role of genetics appears to become more influential as an individual goes from childhood into adolescence (2). By understanding the impact of heredity, we can see that having an eating disorder is no more of a choice than a person genetically predisposed to diabetes.
Other studies help decipher the language of eating disorders by discovering anatomical changes in the brain. With conditions such as anorexia nervosa, neuroimaging has shown us that there is brain cell loss of both grey and white matter (3,4). Now researchers and trying to decipher what the results of this brain cell loss are and how much can be restored with recovery (5). For instance, researchers discovered that with anorexia nervosa, there is cell loss in the parietal lobe of the brain that is directly associated with one’s internal language that creates a drive-for-thinness (6).
But the language of the brain science is not a simple this-causes-that story. For instance, Estonian researchers also discovered that certain changes in a serotonin neurotransmitter found in girls with eating disorders could also be responsible for a drive-for-thinness (7). So even the language of brain chemistry needs interpretation for a better understanding of eating disorders.
Even the physiological functioning of the brain that contributes to the grammar of eating disorders. One study showed a there is often a change in blood flow in women with anorexia nervosa who have body image distortions (8). These blood flow changes are similar to patients who have psychotic disorders where their perceptions are also distorted and may help explain the cause of such significant alterations in self-perception.
Researchers are also discovering the different dialects of language that exists in the brains of men and women. When males and females are shown words with unpleasant words regarding body image, men primarily have brain activation in the cognitive areas of the brain while women have a unique activation in the fear and emotional centers of the brain (9). Studies like this can contribute to an understand of why there are more women then men who develop eating disorders and why the time to recovery is so much greater.
It is these types of studies, conducted by dedicated scientists that will lead the way to interpreting the language of the brain. The process is time-consuming and requires time and money, but this type of research will likely be what is needed to make major breakthroughs in treatment protocols. In the meantime, it would do our field well to help patients and the public know that there is growing evidence that helps explain how the thoughts and behaviors associated with an eating disorder may be more under the control of biology than simple will.
1. Bulik CM, Thornton LM, Root TL, Pisetsky EM, Lichtenstein P, Pedersen NL. “Understanding the relation between anorexia nervosa and bulimia nervosa in a Swedish national twin sample.” Biol Psychiatry. 2010 Jan 1;67(1):71-7.
2. Klump KL, Burt SA, McGue M, Iacono WG. “Changes in genetic and environmental influences on disordered eating across adolescence: a longitudinal twin study.” Arch Gen Psychiatry. 2007 Dec;64(12):1409-15.
3. Swayze VW 2nd, Andersen AE, Andreasen NC, Arndt S, Sato Y, Ziebell S. “Brain tissue volume segmentation in patients with anorexia nervosa before and after weight normalization.” Int J Eat Disord. 2003 Jan;33(1):33-44.
4. Joos A, Hartmann A, Glauche V, Perlov E, Unterbrink T, Saum B, Tüscher O, Tebartz van Elst L, Zeeck A. “Grey matter deficit in long-term recovered anorexia nervosa patients.” Eur Eat Disord Rev. 2011 Jan-Feb;19(1):59-63.
5. Roberto CA, Mayer LE, Brickman AM, Barnes A, Muraskin J, Yeung LK, Steffener J,
Sy M, Hirsch J, Stern Y, Walsh BT. “Brain tissue volume changes following weight gain in adults with anorexia nervosa.” Int J Eat Disord. 2011 Jul;44(5):406-11.
6. Joos A, Klöppel S, Hartmann A, Glauche V, Tüscher O, Perlov E, Saum B, Freyer T, Zeeck A, Tebartz van Elst L. Voxel-based morphometry in eating disorders: correlation of psychopathology with grey matter volume. Psychiatry Res. 2010 May 30;182(2):146-51.
7. Akkermann K, Paaver M, Nordquist N, Oreland L, Harro J. “Association of 5-HTT gene polymorphism, platelet MAO activity, and drive for thinness in a population-based sample of adolescent girls.” Int J Eat Disord. 2008 Jul;41(5):399-404.
8. Gordon CM, Dougherty DD, Fischman AJ, Emans SJ, Grace E, Lamm R, Alpert NM, Majzoub JA, Rauch SL. “Neural substrates of anorexia nervosa: a behavioral challenge study with positron emission tomography.” J Pediatr. 2001 Jul;139(1):51-7.
9. Shirao N, Okamoto Y, Mantani T, Okamoto Y, Yamawaki S. “Gender differences in brain activity generated by unpleasant word stimuli concerning body image: an fMRI study.” Br J Psychiatry. 2005 Jan;186:48-53.
Tags: brain, eating disorders, NEDA, research
