AN as Entrenched Habit

On Monday the New York Times had an interesting article about a new study looking at centers of brain activation in Anorexia Nervosa:

The New York Times provides a link to the actual study, but you can also read it here.

Basically, the study looked at women who were receiving inpatient treatment for Anorexia Nervosa compared to health controls.  They performed a number of different tasks (such as rating the healthiness and tastiness of 76 food items). Not surprisingly, women with AN were less likely to rate high-fat and high-calorie foods as tasty.  The big finding though is that the women with anorexia showed more activation in a part of the brain involved with habitual behavior – the dorsal striatum.  In other words, choosing the lower calorie and lower fat options had become (at least somewhat) habitual.

The authors note that this habituation may in part explain why individuals with AN struggle so much in treatment and have such high relapse rates.  As one of the authors explains about individuals with eating disorders, “they come into treatment saying they want to get better, and they can’t do it.”

When I read that, I thought “oh my gosh, that is me!”  I cannot count the number of times that I have thought before entering treatment that this time will be different.  Also, except for a handful of occasions where I sought treatment more to please others, usually I go in really wanting to get better.  However, when push comes to shove, I resort back to the same patterns.  I say going in that I am going to pick higher calorie foods or challenge certain fears, and then I resort back to the lower calorie options.  I say that I’m not going to look at the scale or get hung up on numbers, and then I do it anyway.

I’m not using this  study to justify this behavior or as an excuse for why I continue to struggle with several things.  Rather, it just helps explain to me perhaps why, despite going in with the best of intentions, I continue to struggle with radical acceptance and eating and weight gain.  As my therapist often says, I need to create a “new normal.”  Even though I am actively working on challenging my behavior, it still is habit to automatically reach for the lowest calorie option, or restrict at a meal or snack when given the opportunity.  However, I am trying to create new habits, such as making sure I get a lunch break at work, and not always going to the lowest option.  It is definitely slow going, but hopefully with time these behaviors will become the norm, as opposed to the disordered behaviors.

The study also sheds light as to why it is so critical to get those with AN into treatment as early as possible.  The less time there is for these neural pathways to make the disordered behavior a habit, the easier it will be (ideally) to re-wire those neural circuits involved.


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