Study sheds new light on women with anorexia

Monday, December 24, 2007
By Mark Roth, Pittsburgh Post-Gazette
Even after they have stopped starving themselves, women with anorexia seem to have trouble enjoying their food and experiencing other pleasures.
That's the thrust of two studies done this year by the University of Pittsburgh's Dr. Walter Kaye and Dr. Angela Wagner of J.W. Goethe University in Frankfurt, Germany.
The first study, published in March in the journal Neuropsychopharmacology, showed that pleasure centers in the brains of women recovering from anorexia didn't respond nearly as strongly to sips of sugar water as the brains of healthy women did.
The second study, which appeared this month in the American Journal of Psychiatry, showed that 13 women recovering from anorexia had much different patterns of brain activation while playing a betting game than 13 healthy women did.
Both studies used functional magnetic resonance imaging, which measures blood flow to parts of the brain while it is performing different tasks.
In the sugar-water study, the brains of women recovering from anorexia showed much lower responses to the sweet liquid than those of healthy women, particularly in the insula, a prune-sized part of the brain associated with social emotions.
That suggests that in women with anorexia, "they don't need to eat because it doesn't reward them," Dr. Wagner said.
In the new study, two groups of women were asked to guess whether a virtual playing card would show a number greater or less than 5. If they guessed correctly, they won $2. If they were wrong, they lost $1. And if they didn't guess in the allotted time, they lost 50 cents.
The outcomes of the game weren't the important part. What mattered was the way different parts of their brains reacted to the challenge.
In the healthy women, an area known as the anterior ventral striatum, associated with emotional rewards, showed much more activity than in the women recovering from anorexia.
But the former anorexics had stronger responses in a brain region known as the caudate, which is associated with planning and calculating future consequences.
That could mean that "the most anxious individuals with anorexia ... may respond in an overly 'cognitive' manner to both negative and positive stimuli and consequently may not be able to process information about rewarding outcomes of action," the study concluded. "Thus, performance -- that is, being right or wrong -- may become more important than [pleasure] rewards."
That fits with the well-known tendency of women with anorexia to try to please others, control the outcome of events and pay great attention to detail, Dr. Kaye said.
A healthy person "has to have a balance between the here and now and future consequences," said Dr. Kaye, an internationally known anorexia researcher. "Some people may be biased toward the here and now and never look at future consequences, but anorexics tend to be biased toward worrying about consequences."
Researchers wanted to study anorexic women who had regained their weight because they didn't want the dietary effects of the disorder to affect the brain imaging, he said.
The studies don't necessarily mean that anorexic women who are recovering will start avoiding food again.
"Our data suggests that once people recover, they rarely relapse, but they will struggle with these other traits for the rest of their lives."
Anorexia affects about 0.5 percent of all women in the United States, and bulimia -- in which women binge and purge -- affects another 1 to 2 percent of women. About half of anorexic and bulimic women will recover, but among the other half, 10 percent will die over a 20-year period, making it the deadliest of all psychiatric conditions.
Dr. Kaye believes 50 to 80 percent of these conditions may be caused by genetic factors, and said that girls who go on to get the eating disorders show signs at age 8 or 9 of such behaviors as being highly anxious or obsessive about details.
The studies suggest it may not be enough to get women to stop starving themselves, Dr. Wagner said.
"In the past," she said, "we have focused on getting them to eat, but we might now want to work on changing their mindsets" as well, through therapy or medication or both.

Confronting The World

Just bringing up a question that came up during Jasmine's presentation. Why is it that you don't say anything to those that are stereotyping you? What is holding you back?

Brian's Post

Sorry about the other post. I wanted to get feedback about my recent facilitation. How good was my verbal communication, the discussion questions/topics, were they qliche or good questions,etc. If you don't remember my facilitation was about clothing styles of teenagers. So far I have seen a lot of questions asked from each group and I like the in depth responses.

Brians Facilitation

Facillitation

I've changed my topic and don't want anyone to know.

Fat v. Skinny

Sure it may not be deep thought BUT we always focus on how fat people are portrayed in the media; jovial, funny beyond comparison, proud etc. but we never ask ourselves what those who we've deemed slim or skinny feel. They are represented in the media too but always as an object of sexual desire or eye candy. How do skinny people fel?

:D

Racism in the media

Yeah sure you might say it's played out or easy to find but I like this topic because it's something you wouldn't expect to see now. Yeah maybe 10 or 15 years ago it was blatant but now with times changing doesn't it seem as if at least the television shows we watch or the magazines we read have become more open and accpeting of various races....we'll see when I facilitate!!