Inside the Anorexic and Bulimic Brain

Let’s take a look at the anorexic and bulimic brain as we consider eating disorders to be biologically-based illnesses.

Within the field of mental health and the community at large, there is often confusion as to the etiology of an eating disorder. Is this a social or biologically-based illness? Is this a mental health disorder or a medical disease? According to Laura L. Hill, PhD, contributing author to the Family Eating Disorders Manual, current research has discovered that eating disorders are biologically-based illnesses. Contrary to popular belief that eating disorders only plague “high-achieving, upper middle class adolescent girls”, Hill writes that eating disorders are not dissimilar to biologically-based illnesses like diabetes. “Instead of the pancreas breaking down in the case of diabetes, there are pathways, neurocircuits and chemical reactions in the brain that malfunction in persons with eating disorders,” explains Hill. As brain-based research has advanced, we now have a better grasp on the experience of eating disorders within the brain and body. We feel this information will assist family and friends of individuals’ struggling with eating disorders to better understand their experience, empathize, appropriately intervene, and restore function..

Messages Within the Brain: Neurochemicals & “Noise”

For those who do not struggle with disordered eating, you likely feel quite satisfied after a meal. You likely look forward to eating satisfying foods and associate novelty and joy to the process of sitting down at the table with family and friends. “This pathway is simple: just eat. It tastes good. You’ll feel better” writes Hill. Such a pathway is not the result of luck; rather, it is a response to the release of the mood-balancing neurochemical, serotonin. In most people, serotonin is released in “healthy” volumes following a meal, contributing to a sense of calm.

For those struggling with anorexia nervosa, the pathway has become altered. For patients with anorexia, the message from their neural pathway is “don’t eat; you will experience anxiety, severe thought disturbance and maybe even distorted body image and delusions.” For the anorexic brain, there is no pleasure in eating. Tastes are dulled and there is little sense of hunger. In the anorexic brain, serotonin floods specific receptors by 50% (an overwhelming amount), contributing to an inhibited appetite and increasing anxiety. In search of calm, persons with AN starve in order to decrease this distress.

The Anorexic and Bulumic Brain

An AN brain actually teaches its physical body that not eating brings calm. When our loved ones do begin to eat again, the mental distress associated with eating (described as disturbing thoughts that may be loud and noisy) worsens for a period of time. So, when your loved ones report that they “feel fine” following a day of calorie restriction, they likely DO feel fine. And when they report distress upon eating or the prospect of eating, they truly do not feel fine. Their brain is not communicating hunger in the way it should and could. It is at this point in recovery that we offer careful, supportive, evidence-based interventions that can restore a typical neurochemical pathway and bring a patient calm.

In the case of individuals struggling with bulimia nervosa, they too experience “noise”.  An individual may experience increasing mental and emotional distress from their inability to stop eating, and the strong impulse to purge.

Luckily, anorexia and bulimia are treatable; our brains are malleable and the brains of younger persons respond faster to changes in the brain pathways. With time and support, in spite of the front-line battle with mental “noise”, individuals with eating disorders can stop the unwanted chatter and regain control.  Ask us about the treatment options at Columbus Park.

For more information, head to


Hill, L., PdhD, Dagg, D., MA, Levine, M., PhD, & Smolack, L., PhD. (2012). Family Eating Disorders Manuel (Vol. 1). CT: The Center for Balanced Living.