New Insights on the Biological and Emotional Pathogenesis of Eating Disorders

ABSTRACT

OBJECTIVES: This paper aims to understand the emotional-biological pathogenesis of eating disorders, and translate the understanding into new brain directed treatments. METHODS: The first part of the review sets the eating behavior into the context of what is now understood about the central control of appetite and molecular biology. The second part of the review sees how emotion relates to the brain circuit involving eating disorders. RESULTS: In general, patients with anorexia nervosa restricting type were less sensitive to reward, whereas patients with bulimia nervosa and anorexia nervosa binge purging type were more sensitive to it. The emotional life of people with eating disorders centers on food, weight, and shape. The abnormalities in social and emotional functioning both precede and persist outside of eating disorders. CONCLUSIONS: Research into understanding the biological framework of the brain in eating disorders suggests that abnormalities may exist in emotional and information processing. This aspect can be translated into novel brain-directed treatments, particularly in anorexia nervosa.