Altered Body State Processing in Anorexia Nervosa

The brain mechanisms of Anorexia Nervosa (AN), a severe mental illness, are still poorly understood. Altered body state processing (“interoception”) has been documented in AN, and disturbances in these processes may contribute to distorted body perception, extreme dietary restriction, and anxiety. Previous research has suggested a potential mismatch between the expectation and the actual experience of this processing in AN. Berner and colleagues looked at whether AN was associated with altered brain activity (measured by functional magnetic resonance imaging [fMRI]) before, during, and after an unpleasant body state processing change (breathing through a hose that intermittently restricted their breathing). They found that women who had recovered from AN (compared to healthy women) showed decreased brain activity in one portion of the brain when anticipating the change, while there was an increase in other portions of the brain during and after the actual change. The researchers concluded that this contrast between decreased brain response before the change and the exaggerated brain response during and after the change may contribute to difficulty predicting and adapting to internal body state fluctuations. Because eating changes our internal body state, restriction may be one method of avoiding negative, unpredictable internal change in AN.


Berner, L.A., Simmons, A.N., Wierenga, C.E., Bischoff-Grethe, A., Paulus, M.P., Bailer, U.F., Ely, A.V., Kaye, W.H. Altered interoceptive activation before, during, and after aversive breathing load in women remitted from anorexia nervosa. (2018). Psychological Medicine, 48, 142-154.

about the author: Heather


Heather, MSW, LICSW, QCSW, ACSW has served on the Board of the National Eating Disorders Association (NEDA) since 2013, and collaborates with her NEDA colleagues on Eating Disorder research studies, papers, and presentations. Through her position at Brown University Department of Psychiatry and Human Behavior, she has also been collaborating with her local Rhode Island Hospital/Hasbro Children’s Hospital Eating Disorders Partial Hospital, Outpatient, and Home-Based clinical programs since 2013.  Heather had Anorexia Nervosa for 23 years, and has been recovered since 2012.

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