Anorexia Can Lead to Dramatic Changes in Brain Structure

Anorexia nervosa is a serious and sometimes fatal eating condition that takes a toll on the body. However, a recent study underscores the negative impact that a lack of adequate nourishment may have on the brain, revealing that it can significantly reduce important markers of brain structure and health.

Researchers reported reductions in cortical thickness, subcortical volumes, and cortical surface area in persons with anorexia nervosa based on a total of 1,648 female brain scans (685 with anorexia nervosa) obtained from 22 different locations. To put it another way, the brain shrinks.

It's the largest study to date looking at the association between eating disorders and gray matter in terms of sample size, demonstrating the importance of treating the problem as early as possible in its development.

"For this study, we worked intensively over several years with research teams across the world," says psychologist Esther Walton of the University of Bath in the United Kingdom.

"Being able to combine thousands of brain scans from people with anorexia allowed us to study the brain changes that might characterize this disorder in much greater detail." 

According to the researchers, the losses in brain size and shape seen here are two to four times greater than those seen in other psychiatric illnesses such as depression, ADHD, and OCD.

This study doesn't go into detail about what's driving the decreases, but the researchers believe that changes in body mass index (BMI) and the quantity of nutrients available are likely to have a role.

However, there are some encouraging signals in the research: brain scans revealed that anorexia therapies, which often include cognitive behavioral therapy, may be able to restore some of these brain alterations.

"We found that the large reductions in brain structure, which we observed in patients, were less noticeable in patients already on the path to recovery," Walton adds.

"This is a good sign, because it indicates that these changes might not be permanent. With the right treatment, the brain might be able to bounce back."

While scientists aren't sure what causes anorexia to develop, we do know a lot about the consequences. It affects millions of individuals throughout the world, and it's one of the top causes of mortality connected to mental illness.

Scientists will be able to better understand what causes this drop in brain volume in persons with anorexia, as well as some of the neurological reasons underlying it, when additional data from future research becomes available.

For the time being, it's apparent that the sooner therapy is sought and administered, the better. The same approaches might be used to assess the efficiency of therapy on brain injury.

"Effects of treatments and interventions can now be evaluated, using these new brain maps as a reference," explains neurologist Paul Thompson of the University of Southern California.

"This really is a wake-up call, showing the need for early interventions for people with eating disorders."