This blog is about the brain. I’ve written it in the very simplest way I could, basically because it’s been a long day and i’m not feeling very brainy. I only understand the very basics. But, nevertheless, the basics are mindblowingly interesting. (all puns are intended as usual, pal).
If you’ve come across the Minnesota starvation study, you’ll know that many of the men experienced symptoms of anxiety and depression that didn’t predate their malnutrition. This was probably the first time I came across the startling impact of malnutrition on the brain.
There are many ways that the brain can be harmed by malnutrition. One of the most ‘known’ impacts is called ‘Cerebral atrophy’. This basically means that the brain physically shrinks in size. This is just one occurance of many that happens. A reduced heart rate deprives the brain of oxygen. A weakened response in the brain regions disturbs the ‘reward centre’. The list seems to go on and on. It’s frightening.
I’m not writing this blog post to scare you, I’m writing this to reaffirm how important weight gain to an unsupressed point really is. This reverses damages caused.
Anyway. On to the science.
The ‘prefrontal cortex’ area of the brain is pretty damn busy.
It’s involved in our:
- attention span,
- cognitive flexibility,
- ability problem solve,
- regulation of our mood,
- decision making and
- impulse control.
Eating disorders have a significant impact on our frontal lobe, which is where the prefrontal cortex is.
It can lead to issues with memory and attention. This is definitely something I experienced. I did a whole Uni module on Anglo-Saxon literature and, seriously, that thing was a blur. I couldn’t tell you one thing I learnt. Usually, I can retain information pretty well, but in the semester I did that module, I wouldn’t even be able to tell you my tutors name. Everything that didn’t involve food wasn’t something I remembered or had the attention for. If somebody had opened a crisp packet in the lecture theatre, I’d know the brand of crisp, the eater and the size of the packet, but I wouldn’t have even been able to tell you the book’s title we were studying. It just wasn’t my brains priority.
Another problem that an effected frontal lobe can lead to is issues with impulsivity. It means we act on sudden urges without real consideration and rationale. It can also lead to compulsivity, meaning a malnourished individual feels driven by a seemingly irresistible inner force to do something. I relate to this too. A lot. And, as compulsive behaviours are repeated over and over, they become deeper ingrained to become rigid, persistent habits. It’s a slippery slope.
As I mentioned earlier the Prefrontal Cortex allows cognitive flexibility. We can see things and solve ideas without thinking in black and white terms. People with Anorexia, whose lobe has been impacted, often have ‘frame-shifting difficulties’, which basically means are stubborn. Being mentally inflexible, rigid and stuck to a certain way of thinking is, again, something I definitely experienced. Everything was black or white. Great or Awful. Always happening or never happening. Any suggestion of otherwise was immediately disregarded. Maybe you can identify with some of these traits that I’ve mentioned so far?
As well as the Prefrontal Cortex being impacted, studies have shown how activity in the ‘dorsal striatal’ increases remarkedly in patients with anorexia, compared to controls. This part of the brain is highly involved in the expression of learned automatic behaviours. Since gaining weight, I have definitely noticed that my old ‘automatic behaviours’ around food are, (in want of a better phrase), far less-automatic. I feel considerably more in control of my actions now.
There are 2 reasons why I’m only just writing this blog post.
The first, is because when I was at a lower weight than I was now, my brain couldn’t think as well. Quite simply, I wouldn’t have been able to read and comprehend the scientific journals that I’ve got my information from today. I think i’d have got to the words ‘cerebral atrophy’ and u-turned on my blog post idea.
The second reason is because it’s only now that I really recognise how terrifying all of this is. I think the disorder made me lose perspective of everything. Especially internal damage.
Like, I could be told over and over how bad restriction is for my body. I could be told every day how awful malnutrition is for my functioning. But, if you would have put buttered cheese bagel in front of me, all of that knowledge about the perils of restriction and malnutrition would have slipped my mind and become irrelevant. My response wasn’t to think: “hmm maybe I should have this bagel to help heal my bones, brain and get my life back’, it was an instant desire to remove the threat.
The good news…
Scientists have found that with enough time at a healthy weight, the brain seems to fully recover. The research suggests that by three years after achieving weight recovery, most individuals’ brains will likely appear normal physically.
Many studies have shown that participants with AN who remained at low weight had very abnormal MRI scans. In contrast, fully weight recovered patients had normal brain volumes. The structures of the brains in the recovered individuals were normal and similar in volume to those of the control subjects. So, abnormalities are reversible with long-term recovery.
What’s important to acknowledge is knowing this information isn’t going to heal you. It’s not enough to say “oh shit.” and then carry on restricting and going through the ED motions. You must find a way to change.
The main reason I wrote this blog post, though, is to reassure you that you aren’t broken. That brain-fog you’re experiencing, that irritability, that lack of concentration, all of it, it’s due to malnutrition. Malnutrition doesn’t have a look. It doesn’t mean you’re emaciated. It means your body isn’t getting adequate nutrition for its own needs.
Knowing the details and intricacies isn’t important. But what is important is knowing that the damage is reversible. But you must let go. You must allow your body to reach and unsuppressed weight.
Remember, brains and bodies need consistent nutrition and nourishment for survival. And they need even more if they want to thrive. And we all do.
You can. You must.
One thought on “#65: The Brain & malnourishment”
This is fantastic. Really helpful and reassuring to know I’m not going mad! Also, makes me hopeful for recovery. But, as you say, only actions matter!