Wednesday, 13 May 2015

BB - Brain and Behaviour: How the Brain Can Predict ED Behaviours

Remember this post that summarized some things I have blogged about on ED and brain changes or findings? Well, now we have a new addition to the list. This study, recently published, explored the relationship between the loss of a certain gene and similar 'ED-like' behaviours that follow. (For those interested in scientific terms, the loss of a gene is also known as a mutation). See
this link for a summary of this study.

The researchers looked at mice and an estrogen-related receptor alpha. or ESRRA. By the way, don't worry about the name of the gene - that's not as important as the results of the study. The loss of ESRRA caused the mice to have less motivation to find and consume high-fat foods, despite being hungry. In a previous study, researchers found that individuals with anorexia also show decreased levels of ESRRA in their brains. What does this tell us?

Well, think about it. Low ESRRA caused mice to not have enough motivation or desire to seek out and eat high-fat foods. What would this mean for individuals with low levels of ESRRA? The same thing! This may help to explain why people with anorexia don't want to - or are not able to - eat when hungry. Their brains literally aren't allowing them to, their brains aren't giving them the normal 'signal' or motivation to look for and eat food.

But wait, there's more. The study also found that the levels of ESRRA are controlled by caloric intake. In mice, eating less than 60% of normal calories over a few days significantly decreased ESRRA levels in the brain - even in normal nice. What does this teach us?

Eating low calories = less ESRRA levels. So, applying this to people, even those without ED may develop ED-like symptoms if they reduce their caloric intake over a delayed time period. Now imagine someone who is already predisposed to ED because of a variety of other reasons. If this individual reduces their caloric intake, their risk for developing ED may very well be increased significantly. Usually, less nutritional or caloric intake causes humans to seek out foods, especially those that are high in calories. But low levels of ESRRA seem to make that response not work as well. The mice in the study weren't just not motivated - they actually put in much less effort to even get food, despite being hungry. Isn't it striking how similar this is to a person with ED: they are hungry. They feel hungry. Their stomachs are growling. And yet, they do not - cannot - eat.

Of course, it would be wonderful if we could say: 'low ESRRA cause theses behaviours. Let's just give patients with ED some ESRRA and then we would sole their problem!'. Well, it isn't that easy. Firstly, more studies need to be conducted to see who this applies to - do ALL people with ED have low ESRRA levels, or just some of them? Why? What are ways in which we can reverse this? Will a medication work? Does recovery restore ESRRA levels? What about people with low ESRRA that DO NOT develop an ED - why does this happen?

The thing with science is this: one question opens up a million others, and one answer does the same. While as of now, we don't have a 'cure' for anorexia (such as a magic pill or procedure), studies like these help us learn more about factors that may lead to the development and maintenance of ED. AND - one of my favourite things - these studies illustrate that EDs are a lot more complicated than we may want to believe. Patients aren't making up their symptoms, nor are they trying to be difficult. It is a mental illness, mediated by many factors, several of them perpetuated by changes in the brain, hormones, genes, and neurotransmitters.

For now, it is safe to say that there are some key things needed for recovery from ED: FOOD, enough calories, weight gain, therapy., and treatment of comorbid illnesses. This may mean using medications to control anxiety, depression, OCD, and more. It may also mean meal-planning, restricting activity, attending family-based therapy sessions, using cognitive-behavioural therapy (CBT)  techniques, expressing emotions, and making a relapse-prevention plan. Oh, and we cannot forget some KEY things: time, patience, love, support, dedication, perseverance, and strength. And hope that recovery truly is possible.