What eating disorders do to the brain and body

Summary

Life Kit Podcast Summary: "What Eating Disorders Do to the Brain and Body"

Introduction

In the August 14, 2025 episode of NPR’s Life Kit, host Marielle Segarra delves into the profound impacts of eating disorders on both the brain and the body. Drawing from personal experiences and expert insights, the episode explores the surge in eating disorders among teenagers during the pandemic, the influence of diet culture, and the pathways to recovery. Pediatrician Eva Trujillo, president of the International Association of Eating Disorder Professionals, provides an in-depth analysis of the neurobiological and physical ramifications of these disorders.

Personal Stories

Marielle begins by sharing her personal battle with an eating disorder that emerged during middle school, a period that coincided with the COVID-19 lockdowns. She recounts how isolation and increased screen time exacerbated her struggles. Maria Friedman, a 17-year-old mental health advocate, also shares her journey, highlighting the challenges of initiating recovery while advocating for herself and her peers.

Neurobiological Impact of Eating Disorders

Dr. Eva Trujillo emphasizes that eating disorders are not merely emotional or behavioral issues but are neurobiological illnesses. She states, “Eating disorders literally rewire the brain. They are not just emotional or behavioral” (02:31). When the brain is deprived of adequate nutrition, there is a reduction in both gray and white matter, effectively shrinking the brain and diminishing its capacity to regulate mood, thoughts, and perceptions. Despite these severe changes, Dr. Trujillo notes, “Many of these changes can be reversed with full nutritional rehabilitation” (07:42).

Physical Consequences

The physical toll of eating disorders is extensive. Malnutrition affects every organ system, leading to a weakened heart muscle and conditions like bradycardia, which can result in sudden cardiac arrest even in seemingly healthy individuals. Digestive issues such as delayed gastric emptying, bloating, constipation, and reflux are common. Additionally, bone density decreases, increasing the risk of early-onset osteoporosis and fractures. Visible signs include hair loss, brittle nails, and dry skin, all indicators of severe nutritional deficiencies.

Cognitive and Emotional Effects

Cognitively, individuals with eating disorders often grapple with difficulty concentrating, obsessive thoughts about food, and rigid thinking patterns. Emotional regulation is impaired, leading to symptoms that can mimic ADHD or depression. Families might notice significant personality changes, with loved ones appearing unrecognizable due to the internal turmoil caused by their condition.

The Role of Diet Culture and Digital Influences

Marielle and Dr. Trujillo discuss the pervasive influence of diet culture and social media on eating disorders. Dr. Trujillo highlights the need for safer digital spaces, explaining, “Recovery is not just about weight or food. It's about reclaiming life, identity and connection” (12:02). Initiatives like banning harmful hashtags and creating helplines are crucial steps taken to mitigate the negative impact of online content. However, despite these efforts, triggering images and messages remain ubiquitous, necessitating ongoing education and critical consumption strategies.

Recovery Process

Recovery from an eating disorder is multifaceted, involving time, proper nutrition, therapy, and compassion. Dr. Trujillo underscores the importance of a holistic approach, stating, “Recovery happens in real life, but digital life is part of that reality” (12:02). Sustainable recovery extends beyond clinical settings, requiring support from family, friends, and the broader community. Education plays a pivotal role in empowering individuals to navigate and resist external pressures effectively.

Support Systems and Family Role

Families are often the first to notice the signs of an eating disorder and play a critical role in the recovery process. Dr. Trujillo advises approaching loved ones with compassion and without judgment to avoid exacerbating feelings of shame and guilt. Creating a supportive and understanding environment is essential for fostering healing and openness.

Gaps in Education and Advocacy

A significant barrier to effective treatment is the lack of comprehensive education on eating disorders within the medical community. Dr. Trujillo points out, “Medical doctors receive less than five hours in the whole career of eating disorder education” (13:43). This gap leads to underdiagnosis and undertreatment, especially in marginalized communities. Advocacy and education are imperative to address these shortcomings and ensure that all individuals have access to the necessary resources and support.

Conclusion

The episode concludes with a powerful message from Maria Friedman, who reflects on her journey towards recovery and the importance of redefining empowerment beyond societal expectations. She shares, “With eating disorders, it's never just about the food. It's never just about your body. It's all a manifestation of something that's so much more complex underneath” (15:04). Marielle and Dr. Trujillo emphasize that overcoming eating disorders requires a collective effort, embodying the adage that “it takes a village.”

Notable Quotes

• Dr. Eva Trujillo: “Eating disorders literally rewire the brain. They are not just emotional or behavioral.” (02:31)
• Dr. Trujillo: “The stereotype of the thin, white, affluent teenage girl leaves thousands of people invisible and unfortunately undertreated, underdiagnosed.” (05:52)
• Dr. Trujillo: “Recovery is not just about weight or food. It's about reclaiming life, identity and connection.” (12:02)
• Maria Friedman: “With eating disorders, it's never just about the food. It's never just about your body. It's all a manifestation of something that's so much more complex underneath.” (15:04)

This comprehensive episode of Life Kit serves as an essential resource for understanding the multifaceted nature of eating disorders, highlighting the urgent need for awareness, education, and compassionate support systems.

Transcript

[Progressive Insurance]

This message comes from Progressive Insurance and the name your price tool. It helps you find car insurance options in your budget. Try it [e-mail], progressive Casualty Insurance Company and affiliates. Price and coverage match, limited by state law. Not available in all states.

[Marielle]

You're listening to Life kit from npr. Hey, it's Marielle. Today we're bringing you an episode about eating disorders from our friends over at shortwave. Short wave host Emily Kwong talks to pediatrician Eva Trujillo about how eating disorders can impact the body and brain, about the influence of diet culture, and about what recovery looks like. Here's the episode. 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.

[Emily Kwong]

Hello and welcome to Balancing Act, a mental health and wellness and semi unfiltered podcast.

[Marielle]

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.

[Emily Kwong]

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?

[Marielle]

And Marea, who was already struggling with perfectionism and anxiety, started to feel awful about herself.

[Emily Kwong]

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.

[Marielle]

Eating disorders among teenagers skyrocketed during the pandemic. For Mareya, 2 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.

[Emily Kwong]

And it was only when we went to the doctor and they're like, no, this isn't healthy. Your heart isn't doing that well. You haven't had your period in months. Where it was like, oh, hey, that's not really healthy.

[Marielle]

Eating disorders are hard to put into words, but they are not choices. They are the neurobiological consequences of an illness that touches all areas of your life.

[Eva Trujillo]

Eating disorders literally rewire the brain. They are not just emotional or behavioral.

[Marielle]

Pediatrician Eva Trujillo is the president of the International association of eating disorder professionals. She's also the co founder of Comenzar de Nuevo, a leading treatment facility in Latin America where patients from all ages and walks of life learn skills and.

[Eva Trujillo]

Find a way out recovery is possible, but the brain needs time, food, therapy and compassion to heal.

[Marielle]

Today on the show Going it Not alone with your eating disorder. With pediatrician Eva Trujillo, we talk about how eating disorders affect the brain and the body and answer a question from MAREA about how to sustain recovery in a world steeped in diet culture. I'm Emily Kwong and you're listening to Short Wave from npr.

[Progressive Insurance]

This message comes from Apple Card did you know Apple Card is designed to help you pay off your balance faster with smart payment suggestions? And because fees don't help you, Apple Card doesn't have any. It's a credit card unlike any other subject to credit approval. Apple Card issued by Goldman Sachs Bank USA Salt Lake City Branch. Variable APRs range from 18.24% to 28.49% based on creditworthiness rates as of July 1, 2025. Terms and [e-mail] this message comes from Charles Schwab with their original podcast Choiceology. Choiceology is a show about the psychology and economics behind people's decisions. Download the latest episode and [e-mail] podcast.

[NPR Sponsor]

This message comes from NPR sponsor Lucasfilm Presenting Andor Season 2 Andor has earned 14 Emmy nominations, including writing, directing and outstanding drama series. Vanity Fair raves that ANDOR is profoundly resonant. It's the best television of the year. All episodes of Andor are now streaming on Disney.

[Progressive Insurance]

This Message comes from LinkedIn ads One of the hardest parts about B2B marketing is reaching the right audience. That's why you need LinkedIn ads. You can target your buyers by job title, company role, seniority and skills. All the professionals you need to reach in one place to get a $100 credit on your next campaign. So you can try it yourself. You just go to LinkedIn.com results. That's LinkedIn.com results. Terms and conditions apply only on LinkedIn ads. This message comes from Mint Mobile. If you're tired of spending hundreds on big wireless bills, bogus fees and free perks, Mint Mobile might be right for you with plans starting from 15 bucks a month. Shop plans [e-mail] Switch upfront payment of $45 for 3 month 5 gigabyte plan required. New customer offer for first 3 months only, then full price plan options available, taxes and fees extra. See Mint Mobile for details.

[Marielle]

Okay, so Dr. Trujillo, you worked with the Academy for Eating Disorders on a list called the Nine Truths About Eating Disorders. It's a great list. And one of those truths is about who has an eating disorder, who does this affect?

[Eva Trujillo]

Yes, this is key. The stereotype of the thin, white, affluent teenage girl leaves thousands of people invisible and unfortunately undertreated, underdiagnosed. So eating disorders do not discriminate that affect people across the entire spectrum of human identity. Men and women, trans, non, binary people, children, adults, athletes, parents, immigrants, indigenous populations, people in larger bodies and those in smaller ones. We know that eating disorders are just as likely and often more likely to go undiagnosed in people from marginalized communities, including people of color, low income individuals, and the LGBTQ population.

[Marielle]

Let's talk about the physical impacts more. And I wanna move from the top down, from your head to your toes. How do eating disorders change your brain?

[Eva Trujillo]

So when someone is malnourished, when someone is not eating all the calories they need to eat, regardless of their weight, the brain is deprived of the energy it needs to function properly. There are studies that report that there's a reduction in what we call the gray and white matter of the brain. So that means the brain is literally shrinking. And it would lose a lot of the biochemical compounds it has that can help you to determine your mood and the way you think and the way you feel and the way you perceive your environment.

[Marielle]

And how does that feel in the mind of the person who has an eating disorder?

[Eva Trujillo]

Cognitively, patients often experience difficulty concentrating, obsessive thoughts about food, rigid thinking, poor emotional regulation, and even symptoms that may resemble ADHD or depression. Or families say, sometimes my daughter disappear. It's like she's not herself anymore. 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.

[Marielle]

And, you know, thinking about the impacts, it's just so totalizing. You're saying it affects every part of the brain?

[Eva Trujillo]

Every.

[Marielle]

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?

[Eva Trujillo]

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 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 going from the top to bottom, as you said, the hair loss, the brittle nails, the dry skin are visible signs that something's wrong. Nutritional.

[Marielle]

Yeah. Let's talk about recovery. I think a lot of eating disorders are first addressed within a family, right? Families notice how 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?

[Eva Trujillo]

That is a very good question. I think that the most effective way is to approach, in a very compassionate and non judgmental way, the people who suffers from an eating disorders are already suffering a lot. And if we don't validate that suffering, then we will make them get, you know, feel, feel so much shame and so much guilt that they will close themselves that they, they won't speak with us.

[Marielle]

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.

[Eva Trujillo]

Yes.

[Marielle]

And TikTok recently banned a hashtag called Skinny Talk, which aggregated a lot of extreme weight loss content, unrealistic depictions of people's bodies. And yet this content, it is still out there, right? Even in advertisements, even on television, whether you have social media or not. So I want to ask you a question that comes from Maria Friedman, a teen mental health advocate who's on the road to recovery herself. She wanted to know what makes recovery.

[Emily Kwong]

Sustainable, especially given all these outside influences and pressures from the Internet, from diet culture in general, from the people around us. And how can we protect ourselves when these triggering images and words will inevitably appear because of the world that we live in?

[Eva Trujillo]

Very good question. First, recovery is not just about weight or food. It's about reclaiming life, identity and connection. And in today's world, that includes our digital spaces. We do a lot of education to our patients, to our families, to be critical about the things they see, they listen, and to use all the strategies that they learned with us about comparison, about body image being critical. And not only critical, but one of the things that we know is that change the conversation and you can change your environment and that will change your life. For example, here In Latin America, when the hashtagskinitalk came. We are part of the community channel. We are a community partner. So we put our suggestions to ban that hashtag. We launched the first eating disorder helpline in Latin America that is directly embedded in our website and is also embedded in the app. Because recovery happens in real life, but digital life is part of that reality. That's why we must make platforms, you know, safer, smarter and more compassionate for our people, for our patients.

[Marielle]

So it sounds like how you look at recovery that's sustainable is it has to go beyond the clinic. People surrounding the patient also need to be educated and on board.

[Eva Trujillo]

Yes. In general, medical doctors receive less than five hours in the whole career of eating disorder education.

[Marielle]

That's shocking because eating disorders have some of the highest mortality rates of any psychiatric disorders.

[Eva Trujillo]

That's exactly. Exactly. But we still have countries, complete countries, without even one specialist in eating disorders. We need to do a lot of things in education because one of the most powerful tools we have to fight eating disorders, not just in treatment, but in prevention and in advocacy. Because I always says it's not that I want to change the world, I just want to change the world of one person.

[Marielle]

Eva, thank you so much for talking to me and thank you for everything you are doing for people out there who are struggling with eating disorders.

[Eva Trujillo]

No, thanks to you for your work because I think this is. It takes a village. We need everyone in this.

[Marielle]

And that includes patients like Maria. She's advocating for herself and other teens, imagining a future where she is free.

[Emily Kwong]

I'm trying to really move forward, be like, how can I redefine what is empowering to me? How can I be whole without needing to micromanage every piece of myself? Because with eating disorders, it's never just about the food. It's never just about your body. It's all a manifestation of something that's so much more complex underneath. But now I'm really trying to do the work to separate food and my body from those other feelings in my life so that I can learn how to stop sabotaging myself and to just try to learn to be me.

[Marielle]

This episode was produced by Rachel Carlson and edited by Rebecca Ramirez. It was fact checked by Tyler Jones. The audio engineer was Maggie Luthar. Beth Donovan is our senior director and Colin Campbell is our senior vice president of podcasting strategy. I'm Emily Kwong. Thank you for listening to Short Wave, the science podcast from npr.

[NPR Sponsor]

This message comes from NPR sponsor Shopify, the commerce platform behind millions of businesses around the world and 10% of all E commerce in the US get started with your own design studio. Sign up for your $1 per month [e-mail] NPR this message comes from NPR sponsor 1Password Secure access to your online world, from emails to banking, so you can protect what matters most with 1Password. For a free two week trial, go to 1Password.com NPR this message comes from.

[Progressive Insurance]

NPR's sponsor, Thrive Market. It's back to school season, aka snack packing, lunch making schedule, juggling season. Thrive Market's back to school sale is a great way to stock up this month with 25% off family favorites easily filter by allergy or lifestyle. To find kid approved snack packs, organic dinner, staples and more, all delivered to your door, go to thrivemarket.com podcast for 30% off your first order and a free $60 gift.