The Brain ... It Is Time to Start Using It.

The Brain.

A Biologically Based Disease.

Hormonal Imbalance.

Endocrine Deficiency.

When talking about eating disorders today, how often do you hear counselors, nutritionists, medical directors at treatment centers or doctors explain and emphasize these terms when discussing eating disorders?  For that matter, how many of our primary care physicians, pediatricians or general practitioners even know that these terms pertain to eating disorders?

On March 17, 2018, I gave a TEDx talk at the TEDxOakLawn event here in Dallas, Texas.  The presentation was entitled, "Let there be Light - A Bold Solution to the Ineffective Treatment of Eating Disorders."  One of the talking points was addressing the current state of medical training about eating disorders. The following facts were mentioned:  

1.  In an average, three-year medical residency program, our doctors are receiving on average, ONE HOUR of eating disorder training.  (I did congratulate those in attendance that after listening to my presentation for 15 minutes, that they had now received 1/4 of the total education on eating disorders that our medical professionals are receiving.

2.  In 2012, the American Medical Association offered its members an optional 17 minute online course on eating disorders. Only .04% of eligible members viewed that course. That is for every 1000 medical professionals, only FOUR bothered to educate themselves.

3.  A few months ago, I was assisting a family in Maine in their complaint against a doctor with their State Board of Medical Examiners.  In its ruling, Maine's State Board issued this finding: “This case is colored by educated parents trying to get state of the art care from a state known to have slim resources for this condition.”

The disease that has the highest mortality rate amongst all mental illnesses is being referred to by the very State Agency which oversees the discipline and education of its medical professionals as a "condition"  Oh... and we are sorry you good people in the State of Maine, but we do not have the resources to educate our medical professionals so you and your loved ones will just have to soldier on.  For that to be a state’s official position on this disease is irresponsible at best … reprehensible at worst.

And yet, going back in time, in the early 1900s, the belief of the medical industry was that eating disorders were thought to be physical diseases due to a medical condition, hormonal imbalances or endocrine deficiencies.  And at that time, the medical industry was going in the right direction!  But, primitive and flawed, or non-existent technology doomed any progress or advancement.  And then, “modern medicine” came into the picture. 

So today, how is “modern medicine” trying to render treatment to people suffering from this deadly disease?  In essence, by attempting to “talk it to death” and by throwing prescription drugs at the symptomology. Family Based Therapy the Maudsley Method,  CBT, DBT, Equine Therapy, Art Therapy, Dance Therapy, Yoga Therapy.  Depending on with whom you talk and the specific year, each of these therapies alone or in combination hold the key!  Perhaps as long as you can afford to keep coming back time and time again and perpetuate the “treatment cycle.” And all the while, they are ignoring the key component to possible recovery … research and treatment into the brain.

Now I am not a doctor, I do not play a doctor on television and I did not stay at a Holiday Inn Express last night.  Doctors like our Carrie McAdams at UT Southwestern and Walter Kaye at UC San Diego have damaged or killed more brain cells drinking martinis than I have active in my head. Yet, I can muddle through research and can connect dots. I also know when a system is broken and needs to be overhauled. So, as little closed groups of parent advocates fight amongst themselves over petty squabbles and argue about which program is best on social media and the “image of the messenger becomes more important than the power of the message,” let’s take a quick look at the brain … and what can possibly be explored.

Many research scientists believe that eating disorders process in certain parts of the brain including the insula and as the insula processes feelings of hunger, and other sensations such as taste, flavor and texture the anterior cingulated cortex then becomes involved in terms of decision making and anticipation of reward.  Finally, the dorsolateral prefrontal cortex (the brain region associated with the ability to manage negative emotions and impulses), gets involved and hopefully, regulates self control.  And yet, depending on the type of eating disorder, those brain areas process information differently.  What we do know is that studies are showing a dysfunctional development and/or hormonal imbalance, endocrine deficiency and electrical activity in those parts of the brain.

So, what happens in the brain of a person with an eating disorder?  According to doctors like Carrie McAdams, there is a weak sense of self, the patient believes that something is wrong with them, they do not fit in, but as their thought process muddles through a white curtain of noise and distraction they think that by changing their appearance will change how they feel about themselves through dieting, bingeing, purging. And the starvation and purging behavior negatively impact the levels of protein in the blood and the neural circuitry related to how they perceive others and themselves which could actually perpetuate the cycle of the disease. So, can this be addressed and changed and if so, how do we change this?

One possible solution is Photobiolmodulation. Studies show the brains of people with treatment resistant eating disorders are not functioning normally.  As previously stated, there is a lack of electrical activity and reduced hormones in those certain parts of the brain. Some studies have also shown that near infrared light treatment penetrates the skull and dermis, stimulates the mitochondria in brain cells, which then releases nitric oxide and Adenosine Triphosphate. Nitric oxide is absorbed by the nucleus, which then through its interaction with ribosomes releases oxytocin, dopamine, endorphins, and other natural neural hormonal secretions. This increases electrical activity and hormonal production flowing into those areas of the brain.  

Photobiomodulation is designed to quiet the noise by regenerating activity on a cellular level in the brain by increasing electrical activity, hormonal production, and regeneration of cellular activity. So instead of hearing a curtain of white noise, a patient can hear and process clear, life affirming messages while significantly reducing their dependence on prescription drugs. Further, it empowers the patient to take control over their recovery program to a greater degree and more importantly, it gives HOPE.  Not just hope for the person suffering, but the family and those who love the person afflicted.

Will it work?  There is tremendous promise.  Is it a cure all?  I do not believe anything is a “cure all” for this insidious disease and our loved ones will continue to die.  But, if we can get off this horrid merry-go-round of death, if we can look forward with the courage of our convictions, if we embrace the possibilities afforded by new technology and progressive thinking, the future could be bright. We have a given problem to solve. If we undertake a bold solution, there is of course always a danger that we may initially fail … that we may not solve the problem at first; but to refuse to undertake a bold solution simply renders it a certainty that we cannot possibly solve the problem.