New hope for anorexia

New findings ­suggest that cause behind eating disorders such as anorexia may lie much deeper in the brain

By Miriam Stoppard

Eating disorders such as anorexia have been blamed on everything from the fashion industry to women's magazines and size-zero celebrities, but now new findings ­suggest the problem may lie much deeper in the brain. In a programme shown last night on BBC Inside London, I looked at how research by a group of top scientists proves that not only are anorexia sufferers' brains wired up differently to others, but that these differences are in place before birth - way before any exposure to outside influences and years before symptoms start.


After all, pretty much everyone is exposed to the same constant barrage of media imagery proclaiming that thin is best - so why is it that only one in 250 girls or women and one in 2,000 boys or men develop anorexia?

These new findings may go some way to explaining why some of us are so susceptible. More importantly, they may lead to more effective treatments for this mental illness that can lead to serious health problems and even prove fatal.

All in the mind?

Brain scans were carried out on more than 200 anorexia sufferers between the ages of 12 and 25 by a team of scientists from London's Great Ormond St Hospital.

These scans homed in on a part of the brain called the insula, which deals with emotions as well as food cravings, pain sensations and general body awareness. Results revealed that the brain wiring of anorexia sufferers was different from that of non-anorexics in that certain brain cells weren't as able to communicate with each other as effectively as they should.

This different "wiring" affects the way a person sees the world, with anorexia sufferers more likely to become obsessed with small details, wary of new things, afraid to take risks and reluctant to break old habits.

What it means

This could explain why anorexia sufferers are obsessive about details like calorie and fat content of foods as well as their body size.

They fear being fat and can never be thin enough. It's because they're so focused on details, they find it difficult to see the bigger picture - for instance that one ice cream won't ruin a generally healthy diet. It also explains how people with anorexia find it particularly difficult to break free of old habits, preferring instead the comfort of familiar behaviour, even if that means literally starving because they can't bring themselves to eat.

It could also explain why eating disorders can run in families. Before now, this was mainly put down to copied behaviour but genes may ­be more important than we thought they were. This doesn't necessarily mean that the fashion industry and other factors don't matter. These influences, together with low self-esteem and emotional problems, are certainly involved - but they act as triggers to someone who's vulnerable rather than being the root cause.

New hope on the horizon

This research may one day lead to the development of drugs to target the relevant part of the brain. But right now, the emphasis is on easier ways to spot potential sufferers and new therapy that aims to change the way sufferers think.

New test

At £1,000 an hour, these brain scans are expensive, but scientists have developed Ravello Profiling, a new system of simple spatial reasoning tests that are done on paper. Odd as it sounds, tests like finding your way out of a maze or copying a drawing can reveal how a person's brain works and can also help experts to spot those potentially at risk.

New therapy

From that, a new form of intensive therapy known as cognitive remediation therapy (CRT) has been devised to help sufferers change how they think. This involves practical ways of helping them see the bigger picture, focus on tasks, prioritise and develop a flexible approach to their thinking. It's not necessarily centred around the subject of food and eating but the idea is that changing the way a sufferer thinks generally will automatically change their approach to food.

Can I get it now?

CRT has only been used in the UK since 2006 and is only available in a few centres, but if you or someone in your family has been diagnosed, you should ask your doctor if there's a centre offering the treatment in your area.

For more help
Your GP can refer you for therapy and to a dietitian for help in eating a healthy balanced diet.

Not eating enough put me in control

Heather Youel, 23, is an administrator from Northampton. She says: "I was diagnosed with anorexia at 15 - I'd been rushed to hospital after collapsing while out running. I was exercising obsessively but I was hardly eating and my body just couldn't cope.

"My family had been seriously worried for ages but I'd convinced myself there wasn't a problem. Now looking back I know I'd been ill for some time. I'd always felt overweight and had low self-esteem, even though I only weighed 9st 7lb.

"But the anxiety really kicked in when I was studying for my GCSEs. Losing weight became a focus, a way of controlling something when everything else felt out of control. I became fixated on fat and wouldn't eat anything that contained it. My diet dwindled to virtually nothing. By the time I was admitted to hospital I'd lost almost half my body weight. By then I realised I was ill but felt powerless, the illness was controlling me. I didn't really feel that anyone knew how to help, and three months later, after hitting rock bottom, I was back in hospital.

"That was a turning point. I realised that if I was going to get better, I had to do it myself. So I left school, removing the main source of stress - exams. Then I had counselling where I was taught to think of food as medicine rather than something bad. It took a while but I'd say I've been well for about four years. These new findings make a lot of sense to me - especially about the fixation on detail and difficulty breaking patterns.

"It's also reassuring to know there's a physical explanation for the condition because it's so easy to blame yourself. But most importantly, if it means a cure for this horrible illness, that's the best news of all."

Source: Daily Mirror

Pic: peter_w

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