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Anorexia Nervosa Experiencing Hunger and Fullness
What is “Hunger?”
It seems like a silly question. We have all felt it at some point, but, what is the biological and neurological process of “hunger?”
Hunger is a complicated interaction between the digestive system, endocrine system, and the brain [1]. When our bodies need more nutrition, our blood sugar and insulin levels drop, and our gut produces the hormone ghrelin.
Ghrelin travels to the brain, letting it know that sustenance is needed and the brain releases the hormone Neuropeptide Y, stimulating appetite [2]. Then, if all goes according to plan, we eat!
This process is often referred to by scientists and researchers as “interoception,” or “the perception and processing of bodily signals on the basis of the afferent feedback of bodily information on the brain.” [3] But, “interoception” is more simply referred to as an individual being in touch with, and listening to, their hunger cues.
What Happens to “Hunger” in Anorexia?
Many who suffer from anorexia engage in “mind over matter,” ignoring their hunger cues to the detriment of their bodies.
Dr. Guido Frank has researched the relationship between eating disorders and neurology and found that, in those with anorexia and bulimia, signals from other parts of the brain can actually override those sent from the area of the brain that regulates appetite [4].
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Frank’s research also indicates that those with anorexia may avoid eating certain foods for fear of gaining weight and that this fear and avoidance can “alter the brain circuits governing appetite and food intake [4].”
Another study looked into this relationship and had similar results: women with active anorexia showed lower than normal activation in the areas of the brain crucial to receiving and interpreting hunger and fullness cues, namely the hypothalamus, amygdala, and anterior insula [5].
Simply put, science is making it clear that individuals that struggle with anorexia have altered neurological processes when it comes to hunger and fullness.
Are These Alterations Permanent?
Both studies mentioned above did note that the neural changes caused by anorexia may be enduring, but this does not mean they are permanent.
Dr. Frank’s study basically “suggests that if someone in treatment becomes weight-recovered, they have not necessarily recovered from the psychological effects [6].”
More positively, the second study did find “restored ability to regulate appetitive signals following food intake after recovery” in its subjects [5].
How Can I Learn to Recover and Interpret Hunger Cues Again?
Intuitive eating (IE) is a successful therapeutic tool currently being used to assist those in ED recovery.
IE emphasizes “a strong connection with, and response to, internal physiological needs pertaining to hunger and satiety cues and eating responses to these cues rather than relying on diet plans, environmental cues, and emotional states [3].”
IE has been used to assist individuals in relearning how to listen to and interpret their hunger and fullness cues and to trust their body to tell them what it needs.
Use of IE is “positively related to…increased physical and reduced emotional eating, improved emotional well-being, and less preoccupation with food choice [3].”
About the Author: Margot Rittenhouse is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims and offenders, and severely mentally ill youth.
As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.
References:
[1] Understanding hunger and fullness cues (2017). Retrieved on 29 August 2017 from http://www.findingbalance.com/articles/understanding-hunger-and-fullness-cues/.[2] How It Works Team (2015). The biology of hunger. Retrieved on 29 August 2017 from https://www.howitworksdaily.com/the-biology-of-hunger/.
[3] Herbert, et al. (2013). Intuitive eating is associated with interoceptive sensitivity. Effects on body mass index. Appetite, 70, 22-30.
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 October 10, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on October 10, 2017.
Published on EatingDisorderHope.com
The EatingDisorderHope.com editorial team comprises experienced writers, editors, and medical reviewers specializing in eating disorders, treatment, and mental and behavioral health.
