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Study Suggests Anorexia Nervosa Causes Significant Brain Shrinkage

— July 13, 2022

New research shows anorexia impacts the size of the brain. This can be reversed if an individual is in recovery.

Anorexia nervosa is an eating disorder (ED) characterized by severe weight loss. People with anorexia nervosa have an intense fear of gaining weight, even if they are very thin. They may severely restrict the amount of food they eat, obsess over their body image, and exercise excessively. Anorexia can have a severely harmful effect on a person’s overall health and well-being.

More than just a physical health concern, anorexia is a serious mental health condition.  The fear of gaining weight, an aversion to food and the body dysmorphia that is present in these cases proves that much of the disorder begins and ends in the mind.  Many people seek treatment from licensed therapists for this disorder every year.

A new report has revealed another way in which this eating disorder impacts the mind – it causes brain shrinkage.  More specifically, patients with anorexia nervosa (AN) have been found to have significant shrinkage in key brain structures. “These deficits are less severe in patients on the path to weight recovery,” a new brain imaging study shows, which suggests that healing from the severely restrictive ED may reverse the damage.  The study was published online in Biological Psychiatry.

Study Suggests Anorexia Nervosa Causes Significant Brain Shrinkage
Photo by Karolina Grabowska from Pexels

“The reductions of cortical thickness, subcortical volumes, and cortical surface area were very pronounced in acutely underweight anorexia,” said Stefan Ehrlich, MD, PhD, head of the Eating Disorder Treatment and Research Center, Technical University in Dresden, Germany. “Yet even a partial weight gain brings some normalization of these shrinkages. From this it can be deduced that a fast/early normalization of weight is also very important for brain health.”

The International ENIGMA Eating Disorders Working Group reviewed data on T1-weighted structural magnetic resonance imaging (MRI) scans for close to 2000 people with anorexia (including those in recovery from the disorder) and developed a control group across 22 sites around the world.

In those suffering from the disorder, “reductions in cortical thickness, subcortical volumes, and, to a lesser extent, cortical surface area, were sizable (Cohen’s d up to 0.95), widespread, and co-localized with hub regions,” they reported. “These reductions were two and four times larger than the abnormalities in brain size and shape seen in patients with other mental illnesses.”

The research team hopes these findings will encourage those suffering from anorexia to seek professional help.

“This really is a wake-up call, showing the need for early interventions for people with eating disorders,” said Paul Thompson, PhD, author and lead scientist for the ENIGMA Consortium. “The brain changes in anorexia were more severe than in other any psychiatric condition we have studied. Effects of treatments and interventions can now be evaluated, using these new brain maps as a reference.

Allison Eliscu, MD, chief of the Division of Adolescent Medicine, Department of Pediatrics in the Renaissance School of Medicine at Stony Brook University in New York, is looking forward to using these findings to inform treatment models.

“When we talk to our patients and the parents, a lot of them focus on things that they can see, such as the way they look.  It adds a lot to the conversation to be able to say: You’re obviously not seeing these changes in the brain, but they’re happening and could be potentially long term if you don’t start weight restoring, or if you weight restore and then continue to drop again,” she said.


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Anorexia Linked to Notable Shrinkage of Key Brain Structures

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