Decoding Anorexia is the first and only book to explain anorexia nervosa from a biological point of view. Its clear, user-friendly descriptions of the genetics and neuroscience behind the disorder is paired with first person descriptions and personal narratives of what biological differences mean to sufferers. Author Carrie Arnold, a trained scientist, science writer, and past sufferer of anorexia, speaks with clinicians, researchers, parents, other family members, and sufferers about the factors that make one vulnerable to anorexia, the neurochemistry behind the call of starvation, and why it's so hard to leave anorexia behind. She also addresses: - How environment is still important and influences behaviors - The characteristics of people at high risk for developing anorexia nervosa - Why anorexics find starvation "rewarding" - Why denial is such a salient feature, and how sufferers can overcome it Carrie also includes interviews with key figures in the field who explain their work and how it contributes to our understanding of anorexia. Long thought to be a psychosocial disease of fickle teens, this book alters the way anorexia is understood and treated and gives patients, their doctors, and their family members hope.
Sufferers of eating disorders are often familiar with the misunderstandings that can come with a diagnosis -- the assumption that anorexia is about the drive to look like celebrities or that bad parenting is always to blame. Arnold takes some of the latest research -- information that I haven't found except in obscure places -- and breaks it down, using both scientific data and personal examples.
In short, Arnold paints a picture that's so much wider than food or weight. There's some chewy, interesting stuff here, like measurable differences in the brain (even after recovery) around areas of reward, anxiety, and set-shifting. There's also an intriguing new evolutionary theory that describes anorexia as the body's urge to migrate. It's not just that we're having a hard time eating, we might tell ourselves. Like hummingbirds, caribou, earthworms, monarchs, salmon, whales, and geese -- when times get tough, our drive to ignore food and rev up activity levels might be an urge to migrate, to head over the mountain, to find and bring back food for the tribe.
Maybe it's the sharing of food and taking part in a tribe that hold the key to recovery. Maybe it's our culture's loss of tribe that marks the real suffering for those with anorexia who (if I've read Arnold correctly) are particularly socially aware, particularly tuned to the needs of others, particularly concerned with participating appropriately in the group, helping when help is needed, worrying over their place in the world. In a society of individualism, commodity, and overabundance, such a person is left to migrate without a cause.
Looking at anorexia through a biological lens, _Decoding Anorexia_ illuminates the evolutionary, neurochemical, physiological, and psychological factors underlying the darkness of this disorder.
From the outside, anorexia seems to go against our natural human drives. After all, how could an ability to ignore hunger, increase activity, and buy into severe body image distortions be adaptive? The book presents a fascinating new theory—called the Adapted to Flee Famine response (or Migration Theory)—which proposes that these anorexic traits could have had evolutionary value during Pleistocene times of famine: “The starving person needs to be unable to recognize their own emaciation, [otherwise] they may be shocked out their food denial and hyperactivity. This could put countless Pleistocene people in danger if hunter-gatherer groups didn’t have at least one person able to ignore the starvation and search for food. Thus, far from being rather bizarre and crazy-making, the profound body image distortion and an inability to recognize that there’s anything wrong are actually helpful, if you view anorexia from the point of view of the Pleistocene.” (p. 104)
This Adapted to Flee Famine response also helps to explain why the recovery process for anorexia can be so relentless: “Females who go on to develop anorexia generally weigh less than their [peers], even before illness onset. If inadequate amounts of body fat trigger the Adapted to Flee Famine response, then this leanness loads the gun with even more ammunition. Combine this with the perfectionistic temperament, and you end up with someone with the psychological endurance to withstand deprivation and very little buffer between their normal weight and the havoc of starvation…Once this weight loss starts, the [anorexic] body essentially panics…It can take weeks or even months for the body to escape from ‘panic mode.’ Thus, even after an individual regains physical health, the biological drive to restrict food and over-exercise remains.” (pp. 106-107)
In addition to exploring this evolutionary explanation for anorexia, the book also unravels how anorexia results from a complex interaction between malfunctioning hunger signals, disrupted hormone levels, anxiety, depression, difficulties with decision-making, as well as predisposed personality traits including perfectionism, inflexibility, rule-boundedness, excessive doubt and cautiousness, and an intense drive for order and symmetry.
A trained scientist and freelance science writer, the author does an exceptional job in translating scores of academic research papers and interviews into concepts and explanations that are easily digestible. As someone who has personally suffered under the grips of anorexia, she chooses words that are often quite powerful in decoding the complexities of anorexia. Sample for yourself:
“When you have too much on your plate metaphorically, you make sure you have too little on your plate literally…Anorexia nervosa is about making everything small again and reducing the complexity of everything.” (p 66)
“The behaviors are the tip of the iceberg. They’re the ten percent of the iceberg that’s out of the water, and that’s what everyone sees. But that’s only a tiny fragment of the condition. Most of what anorexia is sits below the surface of the water. It’s the cognitions, the perfectionism, the anxiety. It’s the depression, the alterations in hunger cues and appetite, and the interoceptive difficulties. It’s also why weight gain alone isn’t enough to treat anorexia. To recover you have to melt the whole iceberg.” (p. 141)
“Full recovery is a hard, complicated task. It’s not just about the absence of things, but about the presence of things. It’s not just the absence of the obsessive thoughts about food and weight, but the presence of a great variety of things that come from being in the moment.” (p. 166)
I highly recommend this book to anyone who wants to better understand the enigma of anorexia. _Decoding Anorexia_ definitely lives up to its name.
My first book for the new year 2013. Found it mostly fascinating but also frustrating at certain junctures. Carrie Arnold tries to do everything: science reporting, journalism (interviewing scientists), memoir of her own experiences, and dialogue. The dialogue is ridiculous, hokey. Some editor forgot to think that quoting yourself in a conversation with a scientist when you are writing about a conversation is too vain, too much, just needs a big long strikethrough. That said, she has gathered a lot of interesting insights into eating disorders, melded together a lot of current research, debunked a bushel of myths and babble, and generally freshened up the subject with some inspiring, thought-provoking ideas. I especially liked the idea of the biological-genetic roots toward eating disorders -- that it could have been a response to typical starvation/food shortages in early societies. Someone needed to be able to go without food and have the energy to go get food for the others who were hunkered down at home. No one can explain why that situation/ability might have set off a pattern of food aversion and not eating even after the famine was over and there was abundant food. But very helpful to start thinking about why some people are prone to this. And helpful to stop the blame circle that does nothing to end the disorder.
Thank you, Ms. Arnold, for writing about SCIENCE and caring about PEER REVIEW! This is probably the smartest writing on anorexia I've seen. Incredibly insightful on chronicity...sets the record straight regarding this anorexia-is-"about" issue...differentiates between sensational news stories and actual scientific evidence...explains the superficial (but fundamentally different) resemblance of dieting to anorexia...and lots more here. This long overdue book should ring true for people who've lived it, and come as an important surprise to many others.
An incredible book detailing qualitative and quantitative evidence for the development, maintenance, and recovery process from anorexia. The book summarizes the body of knowledge so far in anorexia in a succinct and clear way. My only criticism is my annoyance with the author's tone and voice in the book; it shifts from science writing quickly to personal anecdote which was frustrating at times. I respect the author and her research and work but often times it felt as though she was trying to dwell on her own experience in a tone that was almost boasting about her worst periods in life with anorexia, almost with a hint of glorification. Also finding out that she has already written a memoir about her experiences with anorexia back in 2007, it seems a bit unnecessary to include so many personal anecdotes in a book with a title containing the words "Breakthroughs in Science".
It gives you the broad and the detailed view into Anorexia, a complex illness which needs more than several ways to be understood and tackled. This book and memoir gave me the understanding of the physical, psychological and emotional parts in a very simple way of putting things on the table. It’s a must read for anybody who has a relative or friend dealing with ED.
Written in a way that is easy to understand. Does not glorify the illness but is informative and the information based of the current research. I recommend this to anyone struggling to better understand eating disorders.
The book was recommended to me by my therapist. As someone with a large background and interest in science it was extremely helpful to read in a point of view with mostly scientific data and explanation on something I struggle with. Overall, super educational and well done!
To tag this book as pure science would be to do it an injustice for non science people like me. Arnold writes a beautiful, intelligent, science based but easily readable book about the biology of eating disorders.
I adored this book - it is full of science alongside anecdotes and stories from the mass of friends and fans of Arnold and the huge readership of her edbites website and blog.
Her "other job" as a science writer (so proud of her) serves her well.
This book debunks SO many myths about eating disorders and is a brilliant and enjoyable way to keep up to date with the latest scientific research and treatment protocols for ALL people involved in helping (and treating) people with eating disorders.
I read 3/4s of this book in January and then came back this month, after my daughter was diagnosed with Anorexia, and read it again...to the end. I needed to know everything about this condition, what 'may' cause it, what happens during the course of the illness, what the prognosis is for recovery and what treatment options are out there. This book supplied those answers in spades, and now that I'm going to encourage my daughter to read it, it certainly has the validation of coming from someone who has "walked the walk". So, I wish I had 10 copies that I could give to all our family and friends who want to be supportive, but really don't "get it". Read it. You will get it. Then you will be a more valuable support system to your loved one.
Confession: I'm not finished with this book, but I read bits and pieces here and there and it really is excellent. It's just a wee bit sciency, so it's best in small doses. This book drills down into the brain and anorexia/eating disorders better than anything out there for the lay-person. And Arnold is a recovered (-ing?) anorexic who brings a personal spin to the science as well. If you want to more about the nitty gritty behind eating disorders, this is your book.
The first up to date collection of real science of anorexia. Carrie Arnold has a perfect mix of anecdote and scientific explanation. Tremendously readable and accurate. Nothing about controlling mothers or trying to imitate cover models in this book. Just biology and what really drives this illness.
This book should be required reading for anyone recovering from an eating disorder, caring for or friends with someone who is suffering from an eating disorder, or practicing any sort of treatment modality for people who are recovering from eating disorders.
Excellent resource for those with eating disorders, their caregivers, the medical community and anyone else interested in hat the real, scientific evidence show us about eating disorders. (Hint: the "common knowledge" about eating disorders is full of myths and untruths...)