When you consider eating disorders to be a form of addiction and a powerful addiction to the internal state of energy deficit, you can then begin to make sense of what is happening in the brain to drive the eating disorder—and from this, what needs to happen to overcome it.
The deep learning model of addiction makes it easier to understand the brain processes that occur in any addiction when it comes to habit formation and neuroplasticity. The model also highlights the fact that with any addiction, including restrictive eating disorders, there's nothing 'diseased' happening within the brain. Brain based learning that has occurred as a result of the addiction or the eating disorder is the same as any other strongly formed habits a person can develop and as such, can very definitely be unlearnt, while new habits are learnt and formed.
What is the Deep Learning Model?
The deep learning model of addiction describes the processes that are occurring within the brain whenever someone forms any new habits that are, at least at first, highly rewarding.
Engagement with an addictive drug (and here, for people with restrictive eating disorders, energy deficit can be considered their drug) creates an increase in the brain's reward circuits, which includes the dopamine system. This creates even greater feelings of desire for more of the drug and high levels of motivation to pursue it.
At the same time, the person develops much less ability to engage their pre-frontal cortex (PFC), which is usually responsible for judgment and decision making, when it comes to pursuit of their drug.
Insight, decision-making and judgment are usually applied to the pursuit of goals to ensure they are achieved safely and optimally. This all happens within the PFC and through pathways that then connect the PFC to the striatum, which is the brain area responsible for habit formation and behaviours. When someone forms an addiction, the communication between the striatum and PFC breaks down when it comes to pursuit of the addiction, so the behaviours become ingrained and automatic. This results in the person losing perspective on the reality of their actions whenever their drug is on the horizon. They become less capable of considering their own sense of future or whether pursuing the drug in that moment is worth it.
In this way, the constant pursuit of the drug leaves someone only able to think about the here and now in terms of obtaining that reward and much less capable of understanding or considering longer term consequences. Things that used to be attractive, such as family, social situations or old hobbies, fall away to the point that with time, the synapses in their brain relating to pursuit of those things are pruned out because they are being used much less.
Some people argue that because the PFC of people with addictions (including eating disorders) can be seen on brain images to be thinner than those without, that they have brain changes that reflect disease. Others, however, argue that these brain changes and the thinned out PFC is merely a brain that has become streamlined at pursuing its goals and the brain will thin out and 'prune' unneeded connections and pathways as a healthy way to consolidate learning. The brain will undertake the same processes in response to any highly rewarding learning - it is just that those that are considered unhelpful, such as addictions and eating disorders become labelled a disease and a diseased brain, whereas those that are considered acceptable or even applaudable, such as the pursuit of money or falling in love are not.
And the good news is that all these brain changes that have occurred through the deep learning processes of developing an eating disorder, can be changed again as you overcome it. The brain can unlearn old behaviours and develop new brain networks driving healthier pursuits (what could be considered unwiring old habits and wiring in new ones).
The other positive point is that once someone consciously decides to pursue new behaviours to form new pathways and habits, if those pathways have been used in the past (for example, before the addictive disorder developed), then the brain is very likely to still have some wiring for it, which it can pick up again and follow with more ease each time.
Additionally, when someone stops pursuing their addiction and finds new goals to pursue, the brain thinning seen in the PFC increases in volume again and does so to a point of crossing a baseline when compared to those who never had an addiction. This implies the brain can recover in full, and people can learn new habits that can further promote the decline of old networks used during the addiction. Therefore, the brain changes seen in addiction and eating disorders are not chronic, pruned synapses can be replaced, and the brain can rewire and heal.
The deep learning model should offer you hope and allow you to trust that overcoming an eating disorder is possible. The deep learning your brain has undertaken with the eating disorder, which drives the compulsive and habitual eating disorder behaviours, is powerful. However, there's nothing fundamentally different in the way your brain works compared to the workings of any brain that's learnt to pursue something that was initially very attractive and rewarding. Studies are showing that when a person does overcome an eating disorder, their brain function is the same as someone who never had an eating disorder at all. This should reassure you that even after years or decades of an eating disorder, the brain can function normally.
When you stop pursuing the habitual eating disordered behaviours and pursue the goals of eating without restriction and avoiding any means of compensation, your brain can and will create new neuronal networks, and over time the old circuits driving the pursuit of energy deficit will decline… something many refer to as brain rewiring.
Reference - The deep learning model of addictions is something that Dr Marc Lewis has written about extensively in his research and work, including some discussion of eating disorders.
**The information here is taken from my newly available book, 'Addicted to Energy Deficit - A Neuroscience Based Guide to Restrictive Eating Disorders' which you can buy now!**
If you like to listen, as well as (or instead of read!) then this blog post is the transcript of a podcast episode which you will find on my podcast series,
available on this website, on all mainstream podcast platforms and on YouTube!