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Inside the Eating-Disordered Mind

Eating disorders are associated with have mild cognitive impairments that can have far-reaching consequences. These impairments do not necessarily go away when patients get healthy. Acknowledging these impairments can promote better heath for victims and better understanding for all involved. Read More

Theory 3 would be that

Theory 3 would be that cognitive function returns to normal if the sufferer from anorexia nervosa is returned to normal weight within a reasonable period of time, but if the state of semi-starvation persists for a long period (the best available evidence indicates more than three years) then the changes in the brain become relatively permanent and very difficult to reverse.

Also, it is important to remember than many of the cognitive differences associated with anorexia include superior ability, compared to the general population, in some respects including, for example, local processing, as distinguished from global processing. Lang,
Central Coherence in Eating Disorders, http://www.ncbi.nlm.nih.gov/pubmed/24882144 In other words, some of the traits associated with some people with anorexia nervosa are positive. Those traits allow these people to accomplish some tasks more efficiently than most people can, and often cause them to become very successful and happy in life, after they have been returned to a health weight and resume normal patterns of eating.

If only there was as much

If only there was as much focus on over eating as under eating in the psychology world. A staggering 30% of women are obese, that makes anorexia seem like a rather small problem yet it seems to get a majority of the "eating disorder" press and far more "credit" as a societal problem then being grossly fat.

I'm not sure I understand

I'm not sure I understand what is meant by "grossly fat." That seems to be a value statement, not a scientific term.

Also, I think it's hard to argue that anorexia nervosa gets more "focus" than "obesity." The annual budget in the U.S. for anorexia nervosa research is approximately $11 million. By contrast, the annual research budget devoted to obesity is more than $800 million. These figures can be confirmed on the website of the National Institutes of Health. Thus, for purposes of scientific research, obesity receives a "focus" that is about eighty times greater than anorexia nervosa. Sadly, this is true even though anorexia nervosa is one of the leading causes of death and disability in young people.

Also confused

Obesity and weight loss topics are everywhere. Weight loss is an obsession within our western culture. I would actually wager that REDS (restrictive eating disorders) generate much less attention than the "Obesity Epidemic" (research will provide insight into how this isn't a 100% fact).

It's important not to jump to

It's important not to jump to conclusions on the basis of the Weider and Gillberg papers, because the results they reported have not been consistently replicated. Replication is a key aspect of good scientific research.

Moreover, a different study, by Billingsley-Marshall (2013), found that only a minority (30%) of eating disorder sufferers showed evidence of any impaired executive function. http://www.ncbi.nlm.nih.gov/pubmed/23354876 In the Billingsley-Marshall study, the impairment was more strongly correlated with levels of anxiety than with eating disorder symptoms. The people in the study were treated for their eating disorder in a psychiatric hospital setting, an environment that will actually tend to cause anxiety. Consequently, it is possible that the "treatment" for the eating disorder -- hospitalization -- was what was indirectly causing the difficulties with executive function by causing the sufferer to become anxious. Disentangling the effects of "treatment" from the effects of the eating disorder, therefore, would be necessary in order to find any association between the eating disorder and executive function.

There exist an enormity of

There exist an enormity of confounding variables that must be acknowledged and accounted for before drawing such conclusions, particularly the high incidence of co-morbidities that in themselves negatively impact executive and overall cognitive functions, such as anxiety and depression. A longitudinal study to consider such function before and after periods of severe intake reduction would greatly aid exploration of this topic, yet this would of course be hard to construct! (Perhaps it could be arranged for inpatients of disordered eating clinics, and correlated to whether or not these patients maintain normal or return to disordered eating habits following discharge.) I also agree with the previous commenter that the overall duration and severity of malnourishment must also be considered.

Whilst here, I must ask: was this somebody's undergraduate college assignment? The clunky sentences, awkward style, and overall poor readability sadly let down this otherwise very interesting topic; some editorial guidance would not have gone astray.

seriously?

This essay WAS written by an undergraduate. And she did a fabulous job. In my opinion it is well written and clear. (Also, I edited it and so whatever flaws it has are just as much my responsibility as hers.) I'm proud to have had her in my class and I know she will continue to do great things.

Dear Mr. Kornell, You write

Dear Mr. Kornell,
You write in this article that "Acknowledging these impairments can promote better understanding of the victims of eating disorders." How? My experience is the opposite. It is my observation that your approach leads to stereotyping and prejudice. For what it's worth, my kid had AN as a teenager and she wasn't cognitively impaired. All the clinicians assumed she was, and that mindset played a role in their inability to effectively treat the anorexia nervosa. When my wife and I discovered Family Based Treatment (also known as FBT or "Maudsley") we, as parents, took control away from the professionals who treated my kid not as a unique individual but as a stereotype. Our kid then recovered well. She remains completely recovered now, many years later. My experience, and my reading of the research literature, has convinced me, therefore, that it is counterproductive and harmful to treat sufferers from anorexia nervosa as if they were cognitively impaired.

Along a spectrum

Depending on the severity of the ED there will undoubtedly be cognitive impairment at the time and likely onwards into treatment. Self-starvation in and of itself is a cognitive issue, it is an irrational fear response to food. I am a recovering AN, and believe that during starvation and even post-starvation cognition as it relates to food/exercise is still less than perfect or normal.

Eating more food and

Eating more food and restoring weight are the best and only known cures for the cognitive deficits associated with anorexia nervosa.
See Lozano-Serra, Adolescent Anorexia Nervosa: Cognitive Performance After Weight Restoration,
http://www.ncbi.nlm.nih.gov/pubmed/24360134

Food is the best medicine.

To me the most logical way to

To me the most logical way to determine this would be finding victims of starvation/malnutrition NOT by their own choice and see if they suffer the same problems post starvation.

Personally my feeling is that its going to be a "crazy is as crazy does" type of situation, with the pre-existing problem the cause of the disorder and not the symptom.

Stop all the clocks

I understood that anorexia was, inter alia, a sub-concious attempt to "Stop all the clocks",the line from Auden's poem about the death of a loved one; that people who didn't want change (students unable to decide on a career, older people facing lonliness after death of a loved one, etc.) subconsciously stopped eating - eating being associated with growing up and moving on and lack of eating being associated with not growing up not moving on (children told 'eat your food so that you will grow up to be a big boy, girl - thus the subconscious link)

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Nate Kornell, Ph.D., is an Assistant Professor of Psychology at Williams College.

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