by Debbie Malakan intern 2023-2024 and Madeline Basler

This week is National Eating Disorder Awareness Week and Debbie Malakan, our intern dug into the Starved Brain and weight restoration.

Eating Disorders (ED) are serious but treatable mental and physical illnesses that can affect people of all ages…

races, religions, genders, body shapes and weights, and ethnicities. Latest statistics are 28.8 million Americans will suffer from an ED at some point in their lifetime. Restriction and weight loss has tremendous psychological effects on the brain, both emotional and cognitive. Among those are depression, anxiety, irritability, increased mood fluctuations, intense and negative emotional reactions, decreased enthusiasm, reduced motivation, impaired concentration, problem solving and comprehension, increased rigidity, obsessional thinking and reduced alertness. Many times, clinicians, and parents underestimate the importance of  FULL weight restoration, and how crucial it is in optimizing mental health.

Here are four ways weight restoration can improve psychological well-being:

  • Improvement in emotional regulation:

Studies show that weight restoration can improve emotional regulation and the ability to cope with sensory sensitivity. A study looked at the relationship between sensory sensitivity and emotion regulation in individuals with Anorexia Nervosa (AN) to determine if weight restoration would improve emotional regulation. The study consisted of 21 individuals with AN, 20 individuals with AN who were weight restored, and 23 individuals in the control group without AN. AN patients reported higher sensory sensitivity and a harder time regulating their emotions compared to the control group. The ones who were weight-restored reported a greater ability to regulate their emotions compared to the individuals who were not weight-restored (1)

  • Improvement in overall mood, reduction of symptoms of anxiety and depression:

In a peer-reviewed article called “Mood Change During Weight Restoration in Patients with Anorexia Nervosa”, 21 patients with AN and depressive symptoms in a clinical research unit were assessed to determine if their depression improved from baseline and at weight restoration when they reached at least 90% ideal body weight (IBW).  After testing, they found with weight restoration there was a significant improvement in depressive symptoms and mood without medications. It’s important to note that their depressive symptoms were also measured when they reached 80% IDW,  but the most significant improvement was seen at full weight restoration of 90% IBW (2).

  • Ability to challenge the good vs. bad ideation and thus enjoy a wide variety of foods:

Weight restoration can help those with ED return to enjoying a wide variety of foods and normal eating patterns.  In a research study, 146 participants with AN were admitted to a meal-based inpatient-partial hospitalization program where they were asked to fill out a questionnaire about their eating patterns at admission and at 6 months follow-up when they had restored their weight They found that those who reached weight restoration had a significant difference in their eating patterns as they were much more normalized.  “Change in normative eating self-efficacy was significantly associated with weight restoration at follow-up.”(3)

  • Improved cognition, mental clarity, and executive functioning:

AN is associated with impaired cognition and mental clarity. Research shows that some deficits can improve with weight restoration because they are caused by starvation (4)

For those that suffer from eating disorders…

it is imperative to have a team including a registered dietitian, therapist, doctor, and psychiatrist, that specialize in eating disorders. We work together to help our patients fully recover, lead full lives, improve their psychological and physical well-being, and their relationship with food and their body. Full recovery is possible,  let us help you get there!

“Image: Freepik.com”

References:
1.  Merwin, R. M., Moskovich, A. A., Wagner, H. R., Ritschel, L. A., Craighead, L. W., & Zucker, N. L. (2013). Emotion regulation difficulties in anorexia nervosa: Relationship to self-perceived sensory sensitivity. Cognition & Emotion, 27(3), 441–452. https://doi.org/10.1080/02699931.2012.719003
2. Miles, S., Gnatt, I., Phillipou, A., & Nedeljkovic, M. (2020). Cognitive flexibility in acute anorexia nervosa and after recovery: A systematic review. Clinical Psychology Review, 81, 101905. https://doi.org/10.1016/j.cpr.2020.101905
3. Cooper, M., Guarda, A. S., Petterway, F., & Schreyer, C. C. (2021). Change in normative eating self-efficacy is associated with Six-month WEIGHT Restoration following inpatient treatment for anorexia nervosa. Eating Behaviors, 42, 101518. https://doi.org/10.1016/j.eatbeh.2021.101518
4.  Meehan, K. G., Loeb, K. L., Roberto, C. A., & Attia, E. (2006). Mood change during weight restoration in patients with anorexia nervosa. International Journal of Eating Disorders, 39(7), 587–589.https://doi.org/10.1002/eat.20337