The Brain and Eating Disorders
Despite advances in our knowledge of eating disorders, many people in the UK still perceive them as moral failures or vanity, not severe illnesses.1 These misconceptions developed partially from the portrayal of eating disorders in the media and partially from the UK’s public health approach.2
The UK, like many parts of the world, applies healthism to public policy.2 Healthism is the belief that people are responsible for their own health, including their weights and body sizes/shapes. An example of healthism is the implementation of calorie counts on select menus in England. With this information, individuals are expected to manage their weight.
The problem with healthism, however, is that it ignores the complexities of body weight, shape, and size. Individuals do not have complete control over these characteristics. Rather, they are regulated by many different psychological, biological, and genetic factors. Consequently, healthism reinforces the misconception that eating disorders are the fault of individuals.
Educating the public about the brain’s role in eating disorders can reduce these misconceptions. This, however, can be intimidating for people without a strong background in science.
The science of eating disorders doesn’t have to be unapproachable, though. And the benefits of engaging with it are vast for those within and outside of the eating disorders community.
Eating disorders and neuroscience
While there are many different areas of science, neuroscience, or “brain science”, is of particular importance for understanding eating disorders. This is because eating disorders have psychological and biological symptoms, and neuroscience helps explain both.
What we think, how we behave, and how we feel are determined by the chemical (e.g. serotonin) conversations our brain cells have with one another. These “cell conversations” are influenced by our unique biology and life experiences. This means that our diets, social interactions, and genetics all influence our biological and psychological functions.
The public
While public perceptions of eating disorders are improving, many still see these disorders as vanity or lifestyle choices, rather than illnesses. Informing the public about the brain’s involvement in eating disorders might reduce these misconceptions. This is important because these misunderstandings limit compassion for those with eating disorders, as well as public support for eating disorder policies and campaigns. Misinformation about eating disorders might also discourage people, such as schoolteachers, from alerting individuals and their support networks about eating disorder behaviour, believing it’s nothing serious.
Policymakers and those in government
Despite extensive campaigning efforts, the best interests of the eating disorders community are often overlooked in public health policies and regulations. For example, many people are often denied treatment because they don’t meet a certain BMI threshold. Another concern is the wait time for a bed in eating disorders treatment, which can be up to two years. During this time, the severity of an eating disorder can increase, and health complications can develop. Similarly, treatment programs often last for a limited time, with people forced out too soon. These health regulations have led to many preventable deaths.
It has been demonstrated that people judge arguments supported by neuroscience as more alluring and of higher quality than arguments using information from other sciences.3 Consequently, educating policy and government officials on the severity of eating disorders using neuroscience might provide the needed push for drastic changes in how public health is managed.
Those with and/or recovered from eating disorders
Neuroscience can reduce self-blame for those with and/or recovering from an eating disorder. The misconception that we have complete control over our weights and body sizes can encourage shame about our appearances, which could lead to an eating disorder. Understanding that each body runs best at a different weight might inspire more body acceptance.
Similarly, understanding the impact an eating disorder has on the brain can help an individual understand their thoughts, feelings, and behaviours through illness and recovery. It might reassure them that relapses are not their fault and reinforce that recovery is possible for everyone. The brain can change during treatment.4
Given that many health professionals are not knowledgeable in eating disorders5, individuals seeking diagnosis and treatment for an eating disorder should have a general understanding of their biological foundations. This is because such knowledge allows them to contribute to conversations about their diagnosis and treatment options. The more informed they are, the more they can advocate for themselves.
Family and support systems of those with and/or recovered from eating disorders
Support systems are a vital part of recovery. Nonetheless, supporting someone with an eating disorder can be frustrating and distressing. Having a general understanding of the biological foundations of eating disorders can ease some of these concerns by helping to explain the experiences of those with an eating disorder (e.g. thoughts, feelings, or behaviours). This knowledge might also increase patience and compassion for those with eating disorders, as well as inform supporters how best to help them.
GPs and medical professionals
Despite the high prevalence of eating disorders in the UK, medical students receive less than two hours of eating disorders training during their schooling, with a fifth of UK medical schools providing no training.6 This has resulted in missed opportunities for GPs to detect patients’ early signs of eating disorders, leading to many unnecessary deaths and ongoing illnesses.5, 7 Knowledge of the brain’s role in eating disorders is essential for GPs to be vigilant about susceptibility, co-occurring disorders, health complications, and biological/psychological indicators of an eating disorder.
Media professionals
Media have a responsibility to accurately inform the public. This includes information about eating disorders. Consequently, it should be a requirement that eating disorders content be reviewed by those with specialised eating disorders knowledge and/or lived experience. This could reduce misinformation and misperceptions about these illnesses.
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- Shepherd, E., & Seale, C. (2010). Eating disorders in the media: The changing nature of UK newspaper reports. European Eating Disorders Review, 18, 486-495.
- Spratt, T. (2021). Understanding ‘fat shaming’ in a neoliberal era: Performativity, healthism and the UK’s ‘obesity epidemic’. Feminist Theory, 1-16.
- Fernandez-Duque, D., Evans, J., Christian, C., & Hodges, S. (2015). Superfluous neuroscience information makes explanations of psychological phenomena more appealing. Journal of Cognitive Neuroscience, 27, 926-944.
- Wasserman, T., & Wasserman, L. (2019). Neural plasticity and its implications for therapy. Therapy and the Neural Network Model, pp. 45-57.
- Marsh, S. (2017). GPs are failing people with eating disorders, says charity. The Guardian. Retrieved from: https://www.theguardian.com/society/2017/feb/27/gps-are-failing-people-with-eating-disorders-says-charity
- (2022). Worth more than 2 hours. Retrieved from: https://www.beateatingdisorders.org.uk/support-our-work/campaign-for-beat/current/campaign-worth-more-than-2-hours/
- Collinson, A. (2017). Most eating disorder patients think GPs don’t know enough, Beat survey suggests. BBC. Retrieved from: https://www.bbc.com/news/newsbeat-39069217