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August 12, 2017

How the Brain Responds Differently to Food With Bulimia

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Contributor: Bethany Casson, MA, LCPC and Therapist, Timberline Knolls Residential Treatment Center

New research has discovered how the brains of individuals who struggle with bulimia nervosa respond differently to food compared to those individuals without bulimia nervosa.

Bulimia nervosa is characterized by abnormal eating habits, including frequent and recurrent episodes of binging on abnormally large amounts of food and purging in an attempt to compensate for the binge.

Common purging mechanisms that may be utilized by an individual struggling with bulimia nervosa may include self-induced vomiting, excessive laxative or diuretic use, excessive exercise, and/or periods of fasting.

Understanding Bulimia Nervosa

Like other eating disorders, bulimia nervosa can result due to the combination of several different risk factors, including biological influences, psychosocial components, and environmental issues.

Research has found that between 1.1% and 4.6% of females and 0.1% to 0.5% of males will develop bulimia in the United States, though a likely higher number of both females and males will meet the criteria for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders – 5th Edition) bulimia nervosa [1].

Bulimia nervosa presents serious physical, emotional, and psychological consequences, often resulting in many severe side effects that increase a person’s risk of mortality.

Individuals who struggle with bulimia nervosa often experience feelings of being out of control during binge eating episodes and may have other co-occurring conditions, such as self-injury, impulsivity, and substance abuse addiction. Binge episodes are thought to be triggered by an overwhelming emotion or circumstance, perhaps tied to an underlying issue that the individual has experienced.

Binging then becomes a maladaptive coping mechanism for a variety of emotions and mood disturbances, including anxiety, depression, sadness, anger, frustration, stress, and more. Recent research has helped better understand the mechanisms in the brains of individuals suffering from bulimia and the influence this may have on their eating behaviors.

Findings From Recent Research

In a recent study published in the Journal of Abnormal Psychology, researchers found decreased blood flow to the region of the brain called the precuneus in women with bulimia nervosa, which is connected with self-reflection [2].

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Under normal circumstances, blood flow would typically be increased in this region in the brain when engaged in self-reflection; however, women with bulimia were observed to have decreased blood flow to this specific area of the brain.

The decreased blood flow was seen when participants experienced increased stress and increased food cravings after seeing food cues, such as images of high fat/high sugar foods.

Researchers hypothesized that the decreased blood flow to this specific region in the brain in women with bulimia might be indicative of maladaptive critical thinking skills, particularly when food is introduced.

This research also validates previous theories that suggest that binge eating becomes a means for an alternate focus in light of stressful situations.

In response to the results gathered from this experiment, co-author of the study, Dr. Sarah Fischer of George Mason University, noted, “Our findings are consistent with the characterization of binge-eating as an escape from self-awareness and support the emotional regulation theories that suggest that women with bulimia shift away from self-awareness because of negative thoughts regarding performance or social comparisons and shift focus to a more concrete stimulus, such as food. [3]”

Implications of Research Findings

Ultimately, these research findings, along with other research focused on brain changes in individuals with eating disorders, continues to highlight the neurobiological basis connected to bulimia nervosa.

Further research in this area can be helpful in improving treatment methods as well as challenging the stigma about eating disorders. Bulimia nervosa is a complex psychiatric illness with biological implications and requires comprehensive treatment and professional intervention for full recovery.

Woman enjoying sunriseIntegrating various forms of treatment for eating disorder recovery, including psychotherapy that supports self-awareness and personal development, is important to un-doing the eating disorder behaviors. Particularly with bulimia nervosa, it is essential for an individual to learn healthy coping skills for effectively dealing with stress and/or anxiety instead of engaging in binge eating behaviors.

Working with a specialized eating disorder treatment team can support the holistic healing and recovery from bulimia nervosa, including providing medical rehabilitation, psychotherapy and support groups, medical nutrition therapy, and medication management.

Reach out to a specialist and treatment center today to begin your recovery journey from bulimia nervosa.

About the author: Bethany Casson is a Licensed Clinical Professional Counselor and Therapist at Timberline Knolls Residential Treatment Center. She serves adolescent girls who struggle with mood disorders, eating disorders, substance abuse, and issues related to trauma. She graduated from Wheaton College with an M.A. in Clinical Psychology.


[1]: Stice E & Bohon C. (2012). Eating Disorders. In Child and Adolescent Psychopathology, 2nd Edition, Theodore Beauchaine & Stephen Linshaw, eds. New York: Wiley.
[2]: Collins, Brittany, PhD, et al.  The Impact of Acute Stress on the Neural Processing of Food Cues in Bulimia Nervosa: Replication in Two Samples.  Journal of Abnormal Psychology. 2017.
[3]: Medical Xpress, “Under stress, brains of bulimics respond differently”, https://medicalxpress.com/news/2017-07-stress-brains-bulimics-differently-food.html Accessed 27 July 2017

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on August 12, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on August 12, 2017.
Published on EatingDisorderHope.com

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