In a recent report, Child Psychologist Dr Sarah Ravin explores the belief that certain people are predisposed towards developing the particular brain disorder known as 'anorexia nervosa'. In short, she (and many other experts) believes that, while two different teenagers might embark on a weight-loss diet or significantly increase sports activities "without appropriate caloric compensation" (to give two examples only), one teenager might go on to develop anorexia nervosa whereas the other won't. The reason being that one teenager's brain chemistry is predisposed to react in a certain way to food restriction whereas the other teenager's brain is not. And anorexia is always "precipitated by a period of low nutrition".
Likewise, she explains why it's similar with, say, alcohol. Why do some people become alcoholics whereas others do not? Just as interesting, if someone were to remain a teetotal all their lives, they would never know if they were predisposed towards developing the disease, would they? Similarly, "a person predisposed towards AN will not develop the disorder in the absence of a nutritional deficit".
She goes on to way why, with this kind of genetic makeup, it is essential that "eating a complete, well-balanced diet and maintaining ideal body weight are of utmost importance in recovery from AN and preventing relapse".
Like many people, I came into the world of anorexia believing it was primarily about 'dieting gone wrong'; teenagers who were unable to stop dieting once they started and who viewed themselves as fat when they were very obviously emaciated. To me, it seemed a simple case of 'just get them to eat'. If they ate properly, they'd put on weight and be fine again. Simple as that.
The longer you live with anorexia in the family, the more you realise that this is not the case. Far from it. Ah, if only it was that simple! It's not that sufferers don't want to eat; they CAN'T. Worse, they gain comfort from the "calming and mood-elevating effects of food restriction" which seems to happen in people predisposed towards anorexia.
The more I thought about it, the more it made sense that anorexia is due to genetic makeup and the sufferer's "particular brain chemistry".
My husband's father was an alcoholic (thankfully recovered). Now it appears that his sister has developed the condition, too. My own father definitely has certain OCD tendencies. Add the two sets of genes together and - ker pow! - you (maybe) get whatever has been going on in Ben's brain chemistry over the past months.
This makes complete sense to me.
(However I am not necessarily implying that families with a history of these conditions could go on to develop anorexia; I am theorising that anorexia sufferers have some kind of 'addictive' gene that's 'hard-wired' into their genetic makeup.)
And it seems to explain why anorexia can return. Something (e.g. stress) triggers the food restriction which in turn triggers the brain chemistry and the anorexia rears its ugly head again. Just as it might if my father-in-law ever had another drink. So I am guessing that people who have 'recovered' from anorexia need to be enormously vigilant throughout their lives, able to cope with any 'triggers' before they kick off another bout of anorexia.
This is my theory, anyway, and the concept that anorexia can return seems to be backed up by Dr Sarah Ravin when she says: "Sustained full nutrition and weight restoration are essential for mental and physical recovery. Continued good nutrition and maintenance of a healthy body weight for life protect patients against relapse."
Food for thought there... the article (on the F.E.A.S.T website) is well worth reading - as is Dr Sarah Ravin's own blog about anorexia.
The latest Ed-bites blog also has a stack of links to numerous articles on similar topics.