Neurobiology’s Role in Eating Disorders: Understanding and Treatment

By Reva Schlanger MS, RD, CDN

I was fortunate enough to attend IAEDP’s most recent webinar: “A Neurobiology Understanding of Eating Disorders: Applying Concepts to Treatment”, by Dr. Jeffrey DeSarbo (a psychotherapist dedicated to helping those struggling with eating disorders). This webinar helped explain the neurobiological underpinnings and an eating disorder and how the brain is affected. One of the major points Dr. De Sarbo conveyed is eating disorders are a serious medical/biological condition, and NOT a choice.

Dr. De Sarbo discussed how the brain functions with the body; there is always an ebb and flow to maintain homeostasis. There is a constant interaction between our brain/central nervous system and thus, how the rest of the body functions, until something drastic happens (like restriction). When am individual restricts their intake for greater than 24 to 8 hours, their body’s whole system suffers, especially the brain. There can be a loss of brain mass, change in the brain anatomy, and brain chemistry, a change in brain blood flow, and in neuro-hormone, as well. This affects thoughts, cognitive processing, feelings and behaviors.

This helps one to understand why an individual with an eating disorder such as anorexia nervosa person cannot just “start eating” or someone with binge eating disorder cannot just have “self-control”. It is not an act of stubbornness, rather a function of neurobiology in how they process information. Basically, a starved brain is a slow brain causing communication between different systems in the body to become delayed. Hence, we may observe a person with an eating disorder lose focus in class or start to struggle with getting good grades or have difficulty socializing with friends. The body is in a traumatic state.

All eating disorders, regardless of the type of EDO, are received by the brain as trauma. Keep in mind while all eating disorders present differently, they all are a serious mental health and biological medical condition and not an individual’s choice. Someone’s thoughts, feeling and behaviors are a result of their neurobiology, which can change pending trauma in the form of restriction, overeating, purging, overexercise…

Here at Laura Cipullo Whole Nutrition Services, we aim to take note of the individual’s familial and personal history, age of menstrual cycle (if female), vitals, weights, and labs to start. We also pay close attention to the fact that some individuals are or have experienced more trauma than others. It has been helpful to teach our clients patience, mindfulness, and compassion when working on recovery from an eating disorder. Not only does this help both the client and Rd, but is also helps to change the neurological processing in the brain. Our blogs in January 2022 will cover a 4 part series on neuroplasticity, the parasympathetic nervous system and eating disorder recovery.