“Try harder to regulate your emotions.”
“It’s just an emotional problem.”
These are the last things someone suffering from anorexia wants to hear because they know that dealing with their illness is so much more than that.
Anorexia is a disorder that has been traditionally looked at through psychology as a mental illness. The DSM-V lists anorexia symptoms such as weight loss and low body weight for a person’s age or body structure because of the restriction of calories; fear of gaining weight; and a distorted view of one’s body weight or shape (Anorexia). Other characteristics of someone suffering from anorexia include compulsive exercise or purging (Anorexia).
Traditionally anorexia and other eating disorders have been looked at from the outside in. Due to clinician training, treatment of eating disorders often involves a psychologist or other clinician telling their patient how to stop their unhealthy behavior (Hill, 2018). Professionals are trained in cognitive behavior therapy, family therapy, commitment therapy, etc. But recent research has found that this is unhelpful in the treatment of eating disorders. Clinicians may be looking too broad in treatment while their client with an eating disorder might needs more specific care (Hill, 2018).
Dr. Laura Hill has been researching and treating eating disorders for the last 35 years. She started The Center for Balanced Living in Columbus, Ohio to treat eating disorders. Dr. Hill has found that eating disorders are more than a mental illness; they are a brain illness (Hill, 2016). What’s the difference between a mental illness and a brain illness?
Dr. Hill has found that people with anorexia may not be receiving the same neuro cues that other people receive. For example, in the early 2000s FMRI (functional magnetic resonance imaging) began to show the pathways in the brain associated with food. When people without an eating disorder were scanned in an FMRI machine, researchers found that there was a distinct pattern when the test subjects thought of food. When people with an eating disorder went through the same test, the FMRI showed very different patterns (Hill 2016). When someone goes through a strenuous exercise regimen, the body signals to the brain that the legs are tired and sore. The insular cortex deep in the brain receives messages of pain and relays it to the appropriate areas for action (Hill, 2016). But in people with anorexia, research indicates that the insula does not work properly; it may receive messages of pain sent from other areas of the body, but it does not act on them or the messages sent from the insular cortex are too weak to encourage the person to respond in a healthy way (Hill, 2016). In someone with anorexia, the insula may also not be relaying hunger signals, thus convincing the person they don’t need to eat. This points to a need for those in the health field to adjusted eating disorder treatment to incorporate the brain’s role in causing the illness.
Dr. Hill argues that there needs to be a change in how eating disorders are treated. She has found that when an eating disorder is approached as a brain-based problem, treatment is more successful (Hill, 2016). When what the client is feeling and going through is validated and they are given power and understanding, change happens.
Treatment at The Center for Balanced Living focuses on a few constructs. First, food is medicine (Hill, 2016). It is something all living creatures need in order to recover. If the brain isn’t signaling hunger, food should be dosed just like any other kind of medicine. Second, movement is important (Hill, 2016). Movement allows the brain to calm anxiety or negative thoughts that may arise because of eating. Research done at the University of British Columbia also supports this by saying that exercise should be a part of anorexia recovery and tailored to the individual (UBCO, 2018). It should also be dosed to allow for movement without compulsive exercising (Hill, 2016). The third construct of the Center for Balanced Living is support. No matter the age of the client, support is vital through this process. The client sets the boundaries (Hill, 2016). Last, personal traits should be addressed in treatment (Hill, 2016). Traits such as perfectionism play a role in eating disorders and should not be ignored.
As treatment of eating disorders shifts to a more whole-body approach, those who suffer from the disorders will be empowered to change.
Anorexia: Overview and statistics. Retrieved from https://www.nationaleatingdisorders.org/anorexia-nervosa
Hill, L. (2016). Dr Laura Hill: Using the neurobiology of eating disorders to inform treatment The Eating Disorder Recovery Podcast.
Hill, L. D. (2018). Dr Laura Hill: Motivation to change in anorexia recovery.
UBCO study: Exercise helps treat eating disorders. (2018, Jan 11,). Kelowna Capital News (Kelowna, British Columbia) Retrieved from https://www.kelownacapnews.com/news/ubco-study-exercise-helps-treat-eating-disorders/