How Anorexia Causes Brain Injury
Eating Disorders

How Anorexia Causes Brain Injury


A recent study on Anorexia Nervosa revealed how drastically this Eating Disorder causes brain injury. Anorexia Nervosa is characterized by an intense fear of gaining weight and a distorted body image. For people with this eating disorder, persistently being underweight becomes an obsession detrimental to their physical health.  Many people in general will struggle with being overweight at some point in their lives and want to lose weight, but anorexia

Anorexia not only takes a toll on one’s physical health but also poses a grave threat to the brain. Malnutrition is a hallmark of anorexia. As a result, people deprive their bodies of essential nutrients, leading to chronic, underfed state. The brain, being one of the most metabolically active organs in the body, is particularly vulnerable to the effects of inadequate nutrition.

Ultimately, anorexia causes brain injury, impacting cognitive functions and overall mental well-being. In the past, though, it has been less clear how being underweight affects this brain. This study sheds new light on that. In this article, we unravel the mechanism behind how anorexia causes brain injury, unveiling the alarming impact it can have on cognitive functions and overall mental well-being.

Studies reveal brain injury from anorexia

The study in question compared the brain scans of people with anorexia to those of people in the healthy weight range who did not have an eating disorder. The anorexia group had two sub-groups: people who had at least partially recovered from Anorexia Nervosa and people who were still severely affected by it. Overall, the comparison revealed that people with Anorexia Nervosa had significant brain injury.  The study detected reduced brain volume in multiple critical brain areas in people with anorexia relative to healthy controls. This is also called “pseudoatrophy.”

Long-term low weight from anorexia caused brain injury in many regions throughout the brain. It hit from areas the govern basic functions of a body to those that manage the high-level complex thought and personality. It also included the gray matter, the part of the brain that contains the main bodies of the brain cells.

Cognitive problems build

The loss of brain volume in critical areas can have profound implications for people’s mental health and overall well-being. When the body has been in near-starvation for a while, it conserves energy by redirecting resources away from non-essential functions, including brain activity.  Brain injury from anorexia can contribute to the development of anxiety, depression, and other psychiatric disorders that occur alongside anorexia. It also increases levels of stress hormones throughout the body and disrupts the gut microbiome.

Being underweight negatively affected intelligence as well. People with anorexia do worse than average on tasks that require cognitive skills, short-term memory, and decision-making abilities. These cognitive problems can significantly impact an individual’s ability to function in daily life, making it challenging to maintain relationships, pursue education or employment, and engage in self-care.

Worst of all, it seems the brain injury in Anorexia Nervosa were more severe than in any other psychiatric disorder the researchers had examined.

Reversible brain injury in anorexia

All these brain injuries are really concerning for people with Anorexia. However, the good news is that they seem to be reversible. The study compared people who had regained some of their lost weight with another group of people who had not. When people gained weight back after being underweight, the changes in their brain began to reverse themselves.

Time is a factor, though. Other studies have shown that this ability for the brain to heal is most prominent in younger patients. Additionally, these studies have not looked at people who were underweight for extended periods of time. It’s unknown if these brain changes can be undone if people are underweight for many years. The damage could be permanent.

Dangers of eating disorders

This all highlights how truly dangerous Anorexia Nervosa is. It is one of the most deadly mental health issues. Without treatment, 1 in 5 people with Anorexia will die of the disease. Even the process of regaining weight can be scary – and require hospitalization – if someone is under 75% of their ideal body weight.

Treating brain injury in people with anorexia requires a multidisciplinary team that addresses both the physical and psychological aspects of the disorder. Returning the body to normal nutrition levels is a crucial component of treatment. The ultimate goal is to restore adequate nutrient intake and reverse the effects of malnutrition on the brain.

In the long term, the treatment team consists of a psychiatrist, a therapist, and a dietitian. Therapy helps people develop healthier relationships with food, challenge distorted beliefs about body image, and address any co-occurring mental health conditions. Though the way back to health is tough, it’s worth it, both for your body and your mind.


  1. Walton, E., Bernardoni, F., Batury, V. L., Bahnsen, K., Larivière, S., Abbate-Daga, G., … & Ehrlich, S. (2022). Brain Structure in Acutely Underweight and Partially Weight-Restored Individuals with Anorexia Nervosa-A Coordinated Analysis by the ENIGMA Eating Disorders Working Group. Biological Psychiatry.
  2. Grau, A., Magallón-Neri, E., Faus, G., & Feixas, G. (2019). Cognitive impairment in eating disorder patients of short and long-term duration: a case–control study. Neuropsychiatr. Dis. Treat., 15, 1329.
  3. Seitz, J., Belheouane, M., Schulz, N., Dempfle, A., Baines, J. F., & Herpertz-Dahlmann, B. (2019). The Impact of Starvation on the Microbiome and Gut-Brain Interaction in Anorexia Nervosa. Front. Endocrinol., 10, 428075.

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