Understanding anorexia’s grip on the brain could unlock new therapies
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- Anorexia nervosa affects up to 4% of women and 0.3% of men, and roughly one-third of patients fail to recover with current treatment — making it one of the deadliest psychiatric conditions despite standardized care.
- A 2022 study of 685 women with anorexia and 963 without found the cerebral cortex was 2 to 4 times thinner in those with the condition than in people with depression or OCD, with thinning less pronounced in patients who had begun regaining weight.
- Clara Moreau at the University of Montreal analyzed brain scans from 290 children and identified significant thinning across 32 regions, with the superior parietal lobule and thalamus most affected — potentially explaining why patients persistently overestimate their body size.
- An international consortium including researchers at King's College London and Columbia University plans to collect fMRI scans from nearly 1,000 people with anorexia worldwide over the next year to map how the altered circuits influence behavior.
- Anorexia and OCD share substantial neurological overlap — more than a third of people with anorexia also have OCD, and brain-imaging comparisons showed the two conditions align more closely than anorexia does with depression or other psychiatric disorders.
- The field's modern understanding traces back to the 1940s Minnesota Starvation Experiment, in which 36 healthy men who had their calories halved for six months lost 25% of their body weight and developed obsessive, food-focused behaviors now recognized as hallmarks of anorexia.
- Researchers are now piloting brain-stimulation techniques and experimental medications alongside standard weight restoration and talk therapy, though clinicians stress these remain early-stage approaches for treatment-resistant cases.
Why it matters: For the roughly one-third of anorexia patients who don't respond to supervised refeeding and psychotherapy, the field has had no clear next step — but the discovery that cortical thinning appears partially reversible with weight gain reframes starvation as a treatable brain insult, and the planned 1,000-person fMRI consortium could finally give clinicians circuit-level targets for the brain-stimulation and drug trials already in early development.
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