15. The Neural Basis of Eating Disorders and Potential Neurobiological and Psychotherapeutic Treatments in Young Adults

Abstract

Although the prevalence of eating disorders (anorexia nervosa, bulimia nervosa and binge eating) has increased among young adults - affecting women ten times more than men - a complete understanding of its underlying neural basis has yet to be reached. A common misconception is that these disorders stem from a superficial emphasis on food and weight, when actually environmental stressors coupled with neurobiological predispositions are major contributing factors to these compulsive, impulsive and sensation-seeking behaviors. This review presents a comprehensive look at theories on the neurobiological causes and effects of eating disorders: regulation of brain serotonin levels on mood and food intake, hypothalamic control of eating and weight, the allocentric lock hypothesis and finally similarities between the neurobiology of addiction and eating disorders. Understanding the pathology of the disorder may help elucidate why, despite achieving cognitive awareness of the disorder, treatment is difficult due to a disconnect between the neural factors controlling the disorder and a subsequent behavioral change. Why does cognitive awareness of their disorder not translate into a behavioral change? If the contributing neurobiological factors influencing the onset and persistence of the disorder can be understood, a multi-disciplinary treatment involving neuropharmacological and socio-emotional components could be implemented. The application of this research could be important for post-secondary institutions where environmental pressures and personal predispositions of individuals may align to onset eating-disorder behavior. Future studies on the physiology of eating and stress regulation and psychotherapeutic research may help develop treatments to target individuals at many stages of the disorder.