Dopamine (DA) and Anxiety in Eating Disorders

We've talked a lot here about weight gain, food, eating disorders, and anxiety - and the connection these have with dopamine (DA), a neurotransmitter in the brain. DA mediates many things in our bodies depending on where it acts. For example, in some areas of the brain, DA produces pleasure in response to things. In other areas, DA produces anxiety.

Interestingly - but not surprisingly - a study revealed that in one aspect of the brain in people with anorexia nervosa, DA produces heightened anxiety in response to various things, including food and weight gain. Patients with ED seem to have anxiety (i.e. increased DA levels in these brain areas) around food, meals, weight gain and body changes.

This is not fully surprising or new to us - after all, individuals suffering from EDs struggle to eat and gain weight because they are fearful of what will happen. Their response to food and weight gain is one of anxiety and fear. I think this study is important because it helps reaffirm to us - and to people with EDs - that the disorder is NOT 'all in their heads'. The fear of weight gain, food, and body changes is REAL. The brain in someone with an ED is working against them to make eating, gaining weight, and recovering that much harder.

Therefore, we ought to be gentle and empathetic with these individuals. Sometimes, people with EDs profess that they are worried about the weight gain, scared of body changes, and fearful of when they eat. And this is a TRUE fear. They really are scared and anxious. So, don't blame them. Don't call them silly or irrational. Their fears may not seem validated or real to you - but they are. Their fears may seem strange, especially if they are not overweight and they state that they are scared of gaining weight. But remember - this is an illness. And we now know that this disorder is more that just physical - there are numerous changes that occur in the brain and body that make eating and gaining weight difficult, scary, and traumatic.

On the other hand, I think this can be encouraging to those who are struggling: you are not at fault for your fears and thoughts and feelings around food and weight gain. Your brain is making it much harder for you to accept the process of recovery. This is painful. And scary. And challenging on so many different levels. But it will get easier as you continue along the path. Everyday will not be simple; you may experience bumps along the road. But what matters is that you keep going. Stay strong and keep fighting. Because you are worth it.