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A thinking problem, sculpted into the brain.

To the uninitiated, anorexia nervosa may appear to be a problem of faulty thinking: People with the eating disorder have just gotten stuck in a bad pattern of relating to food, it seems. If they could just stop thinking the way they do, they would get better and regain the often dangerous amount of weight that they have lost. But full-fledged anorexia nervosa is actually a very difficult disorder to treat, and physicians have had little insight into why something so basic as eating can go so wrong for some people.

Some scientists now believe that anorexia has roots in the way the brain works in some people, writer Meghan Rosen reports on Page 20. The latest neuroimaging studies hint that people who have anorexia may respond differently from most people to rewards like sweets. They may also be overly sensitive to sugar, and relatively insensitive to other sensory cues such as pain. Other studies, as well as the experience of those who work with patients, suggest that people with anorexia tap deep wells of self-control to curb the eating impulse. While this extraordinary willpower may help in other areas of their lives (many teens with anorexia earn straight A's, for instance), it can become harmful for people stuck in a struggle with food. One study also showed a more robust working memory in people with anorexia, which may help keep them focused on their misguided weight loss goals.

People Rosen interviewed on the front lines of anorexia treatment were in surprising agreement in the belief that it is a brain-based disorder. Others might greet the brain-imaging data with more skepticism. While these studies clearly have many limits--it's impossible to know, for example, whether the differences in brain activity existed to begin with or developed as part of the eating disorder--being able to visualize the brain differences can clearly help patients and families battling the disorder. Just knowing there is some biological component to anorexia has been healing for many patients, lessening their need to blame themselves or their families.

Rosen's article is an intriguing consideration of how we view the physical versus the mental, with one being somehow more real and legitimately beyond our control than the other. But the more we learn about the brain, the clearer it is that the two are tightly intertwined, with our thoughts and mental processes sculpting the cells and circuits that give rise to them, and vice versa.--Eva Emerson, Editor in Chief

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Title Annotation:FROM THE EDITOR; anorexia nervosa
Author:Emerson, Eva
Publication:Science News
Geographic Code:1USA
Date:Aug 10, 2013
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