Chapter 1: What are the physical impacts of eating disorders on the brain?
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You're listening to Shortwave from NPR. Maria Friedman is truly one of the coolest 17-year-olds I've ever met. We started talking a year ago because she wanted advice on how to start a podcast.
Our conversation, though, quickly turned to something else that happened to both of us.
We both developed an eating disorder in middle school. Eating disorders among teenagers skyrocketed during the pandemic. Maria's began during the COVID lockdown. She was cut off from her peers and spending way more time watching TV.
You see the protagonists and they're all like so beautiful. And you're like, do I have to look like that to be worthy, to be lovable?
And Maria, who was already struggling with perfectionism and anxiety, started to feel awful about herself.
The world was spiraling out of control and now my body was spiraling out of control. And so what did I try to do? I tried to control it.
Eating disorders among teenagers skyrocketed during the pandemic. For Maria, two servings of pasta became one serving of pasta became no pasta at all. She had intense exercise goals, all in an effort, in her mind, to become healthier.
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Chapter 2: How did the COVID-19 pandemic influence eating disorders in teenagers?
And that's not an exaggeration. The brain is starving. Yeah. But the good thing, the good news is that many of these changes can be reversed with full nutritional rehabilitation.
And, you know, thinking about the impacts, it's just so totalizing. You're saying it affects every part of the brain. Every. But, you know, that should come as no surprise because how cells work is they need nutrients to sustain energy. So what happens to the rest of your body over time if a person is malnourished through an eating disorder?
Well, every organ can get affected. For example, malnutrition slows the metabolism and the heart response by becoming smaller, weaker. You know, the most important muscle we have in the body is the heart. So we can find bradycardia, which is a dangerously slow heart rate. And that can trigger sudden cardiac arrest, even in young people who look healthy.
Also, people can have delayed gastric emptying or bloating or constipation or reflux. And these are not only from what's eaten, but from how the body adapts to a starvation or purging. And another area that can be affected is the bone density, which drops, putting even teenagers at risk of developing early osteoporosis or fractures. And, you know, going from...
The top to bottom, as you said, you know, the hair loss, the brittle nails, the dry skin are visible signs that something's wrong nutritionally.
Yeah. Let's talk about recovery. I think a lot of eating disorders are first addressed within a family, right? Families notice, oh, there's something not okay with my kid or with my cousin or with my sister. And families... can be patients' and providers' best allies in treatment.
So how should someone approach a loved one if they're seeing some of these physical and behavioral and cognitive signs that you're describing?
That is a very good question. I think that the most effective way is to approach in a very compassionate and nonjudgmental way. The people who suffer from an eating disorder are already suffering a lot. And if we don't validate that suffering, then we will make them feel so much shame and so much guilt that they will close themselves. They won't speak with us.
And part of treatment also is creating an environment for healing. So, Eva, you were a part of a consulting panel for TikTok and Meta, which owns Facebook and Instagram, on safety policies related to body image and eating disorders.
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