Posted by Racer on February 1, 2006, at 14:14:04
In reply to Re: Is it all biological? » jack623, posted by Poet on January 31, 2006, at 21:43:11
I don't think you can separate biology from psychology in this sort of thing. Yes, biology must play some part in it. I can't imagine that anyone could be "trained" to purge otherwise.
There's a guy at UPMC called Walter Kaye who has been studying eating disorders, and has found some interesting anomolies in the serotonin systems of anorexics, for instance, that seem to show that there are abnormal levels of 5HT *before* the anorexic symptoms start up, and that semi-starvation is actually self-medicating. The semi-starvation reduces the amount of tryptophan taken in, which in turn reduces the amount of serotonin produced in the body, reducing the distress caused by that overactive serotonin system. One of these days I'd bet the same sort of thing shows up in bulimia, and binge eating disorder, and that disorder that involves purging without binging, etc.
But then again, I also think that there's another side to it: my guess is that most of these mental illnesses -- from depression to bulimia -- are actually a cluster of disparate disorders with similar symptoms. So, who knows? And I certainly don't know much, but I will share the non-knowledge I have with anyone, it seems.
Is biology all there is to it? Of course not. There's also behavior, and some sort of behavior modification can at least control the behavior, even if it doesn't help the underlying issues. That's why therapy is so necessary for bulimia, and for anorexia. Also, Topomax has been shown to reduce the urge to purge, so it might be worth looking into.
And Poet:
>If it were just biological I would think I'd reach a point where I've eaten enough. I'm satisfied. I'm satiated. I'm comforted. I'm full. Whatever physical need I'm fullfilling.
>I don't know about that. I think that those feelings of hunger and satiety are biological, but we screw them up with our behaviors. I know that I never feel full, either -- either I feel hungry, or I feel sick-from-overeating. Never anything like just neutral, or satisfied. (Actually, I do feel satisfied at times when I'm restricting most. It's only when I'm not restricting so strongly that this is true. Makes any sort of recovery so much harder.) While there is probably some psychological part to it, there's also the biology of the chemical messangers that tell the brain when you're full, when you're hungry. Those get screwy from eating disorders. Basically, I've heard it described as kinda use it or lose it. If you're going to ignore the sense of being satisfied, for instance, and keep eating -- your body will say, "Oh, you're not using it, so we'll save our energy and stop making it." That sort of thing.
I know that a big part of where I was when I still had nutritional counseling was trying to learn to recognize hunger and fullness. Didn't get far, but things were changing a bit.
Dunno if there's anything in my brain that makes sense today, but there it is if you want it.
poster:Racer
thread:604831
URL: http://www.dr-bob.org/babble/eating/20051009/msgs/605194.html