Addiction in Reverse: The Link Between Anorexia and Reward Deficiency

By | Addiction, Mental Illness, Teens | One Comment

What if food restriction fuels the cycle, not breaks it?

Imagine a netball carnival buzzing with teenage energy – a kaleidoscope of team colours and high-fives. Beneath the surface of this vibrant scene, a silent disease persists, one measured not in coughs and sniffles, but in barely touched lunches and secretly discarded snacks. This is the hidden world of teenage eating disorders, where food avoidance can mask a complex neurological struggle.

We’re used to thinking of addiction as a state of excess – the insatiable craving for more drugs, more alcohol, more stimulation. But what if anorexia nervosa represents a chilling flipside? What if the relentless restriction we see in some teens is fueled by a reward system chronically deprived of even the smallest pleasures? This theory, known as the inverse addiction hypothesis, proposes that a chronically under-stimulated reward system can fuel the restrictive behaviours seen in anorexia nervosa. 

The Inverse Addiction Hypothesis

Could a starved reward system drive anorexia nervosa?  This theory suggests that restricting food intake for prolonged periods may have profound effects on the brain’s reward pathways, making it difficult to find satisfaction in eating.

The Starved Brain

In the world of addiction, a protein called DeltaFosB plays a crucial role. It accumulates in the brain’s reward system with repeated exposure to pleasurable stimulation, often triggered by dopamine spikes. Over time, this buildup of DeltaFosB leads to tolerance: we need a bigger hit to achieve the same level of pleasure, reinforcing compulsive behaviours in a quest for that initial feeling. But what happens when the stimulation is absent?

Some researchers theorise that prolonged food restriction, regardless of the cause, may lead to abnormally low levels of DeltaFosB. While research is ongoing, this offers a possible explanation: with chronic undernourishment, the brain might decrease DeltaFosB production. This decrease could then trigger a vicious cycle of further restriction. Because DeltaFosB levels are low, the brain misinterprets even small amounts of dopamine, released in response to any eating, as a signal of fullness.  This leads the individual to restrict their intake even further, but this only worsens the problem. With continued restriction, DeltaFosB levels are likely to decline even further, perpetuating the cycle until the sufferer cannot consume any food at all.

The Testosterone Factor and Dopamine

Testosterone, a hormone much more prevalent in males, is a dopamine stimulant. This means that adolescent boys, who generally have access to levels of testosterone hundreds of times higher than adolescent girls, have higher baseline levels of both dopamine and DeltaFosB. This may offer some protection against the inverse addiction cycle of anorexia nervosa.

This biological difference could be a contributing factor to the significantly higher rates of anorexia nervosa in adolescent girls compared to boys (often a tenfold difference). Girls, with much lower baseline testosterone levels and therefore potentially less dopamine stimulation, might be more susceptible to the development of the reward system dysfunction seen in anorexia.

Beyond the Surface

It’s important to note that unlike traditional addictions, anorexia nervosa does not appear to be increasing in incidence. It remains a relatively rare disorder, affecting a small minority of people (approximately 0.1% to 0.2%) with a significant gender disparity – the overwhelming majority of sufferers are female. This pattern of rarity and stable incidence strongly suggests that predisposition plays a crucial role, with biology influencing who is most likely to develop the condition.

And not everyone is equally susceptible to reward system dysfunction. Emerging research offers a fascinating glimpse into factors that might influence a teen’s predisposition to different eating disorders. Think of your index finger and ring finger: the difference in their lengths (the 2D:4D ratio) may reflect how much testosterone and oestrogen a foetus was exposed to. Some studies suggest that girls with lower 2D:4D ratios (meaning, likely higher prenatal testosterone) might have a higher susceptibility to anorexia, potentially due to a hypersensitive reward system. Those with higher 2D:4D ratios might be more likely to develop bulimia, perhaps linked to a blunted reward response, making them more attracted to food.

The Path Forward

Acknowledging the potential biological underpinnings of anorexia doesn’t mean excusing it or minimising the psychological struggle. Eating disorders are complex, influenced by genetics, environment, and individual experiences. But if the inverse addiction hypothesis proves true, it could revolutionise how we approach these conditions:

  • Reframe Our Understanding: Instead of seeing anorexia as purely about willpower or body image, we might focus on a brain being satisfied way before the body actually is.
  • Compassionate Treatment: By understanding the neurological factors, we can reduce stigma and tailor treatments to rebalance the starved reward system– potentially including therapies that directly target these reward system deficiencies.
  • Early Intervention: Research into prenatal influences may help identify at-risk teens, offering preventative support.

The adolescent meticulously restricting their food deserves our empathy, not our judgement. The answers to eating disorders may lie in the hidden workings of the teenage brain, and a better understanding might pave the way for healing.

What if parenting doesn’t change who your kids are?

By | Psychopaths, Teens | No Comments

In 2021, a group of researchers set out to determine whether parenting style had any effect on the personalities of their children.  They wanted to know whether it mattered if you show physical affection, whether you are consistent, whether you are predictable, whether you are encouraging and attentive or whether you are more likely to be scolding and controlling. They were shocked to discover the answer was a resounding – no.  When it came to the most well known and widely used model of personality type, parenting style made no real difference.

The study used data from almost 4,000 students in 99 German schools who first undertook personality testing in year 5 and were then followed up for each of the next three years.  Their parents also answered questionnaires designed to categorise their parenting style. The personality trait measure used was the Big Five model, the most widely accepted personality theory in psychology today.

The Big 5 personality traits are openness, conscientiousness, extraversion, agreeableness, and neuroticism (often remembered using the acronym OCEAN). Each trait represents a continuum between two extremes, such as introversion and extraversion.

Openness emphasises imagination and insight the most out of all five personality traits. People who score high on openness tend to be curious, creative, and adventurous. They enjoy trying new things and learning new skills. They also have a broad range of interests and are not afraid to express their opinions. People who score low on openness tend to be conventional, practical, and conservative. They prefer routine and familiarity over novelty and change. They may also be more sceptical and critical of new ideas.

Conscientiousness describes a person’s ability to regulate impulse control to engage in goal-directed behaviours. It measures elements such as control, inhibition, and persistence of behaviour. People who score high on conscientiousness are organized, disciplined, detail-oriented, thoughtful, and careful. They also have good impulse control, which allows them to complete tasks and achieve goals. People who score low on conscientiousness may struggle with impulse control, leading to difficulty in completing tasks and fulfilling goals. They tend to be more disorganized and may dislike too much structure. They may also engage in more impulsive and careless behaviour.

Extraversion represents a continuum between extreme extraversion and extreme introversion. It reflects how sociable, outgoing, energetic, and assertive a person is. People who score high on extraversion are friendly, talkative, enthusiastic, and enjoy being around others. They seek stimulation and excitement from social interactions. People who score low on extraversion are reserved, quiet, thoughtful, and prefer solitude or small groups of close friends. They seek depth and meaning from their experiences.

Agreeableness refers to how people tend to treat relationships with others. Unlike extraversion which consists of the pursuit of relationships, agreeableness focuses on people’s orientation and interactions with others. People who score high on agreeableness are kind, cooperative, compassionate, trusting, and helpful. They value harmony and avoid conflict at all costs. People who score low on agreeableness are suspicious, uncooperative, competitive, distrustful, and manipulative.

Neuroticism often involves sadness or emotional instability as well as anxiety or nervousness about various aspects of life such as health or work performance . People who score high on neuroticism experience negative emotions more frequently or intensely than those who score low on neuroticism . They also tend to be more sensitive to stressors , criticism , or rejection . People who score low on neuroticism are calm , confident , resilient , optimistic ,and emotionally stable.

Your position on the scale for each of these five main traits can help you figure out if you have other additional personality traits. These other traits are usually divided into two groups: positive personality traits and negative personality traits. Positive traits include being creative, friendly, co-operative, humble, optimistic, insightful and thorough. Negative traits include being aggressive, arrogant, deceptive, egotistical, intolerant and judgemental.

Using this model other researchers have found that most people fall into one of four personality types.

  • Average – the most frequent type, marked by high levels of extroversion – friendliness and enthusiasm – and neuroticism – nervousness and anxiety – and low levels of openness – not open to new experiences)
  • Self-centered – Self-Centered people score very high in extraversion and below average in openness, agreeableness and conscientiousness. These are people you don’t want to hang out with.
  • Reserved – emotionally stable, but not open or neurotic. They are not particularly extraverted but are somewhat agreeable and conscientious.
  • Role models – low in neuroticism and high in all the other traits. These are people who are dependable and open to new ideas. They are good people to be in charge of things. Life is easier if you have more dealings with role models.

The parents were asked to rate their involvement in the child’s school on a 4 point scale with questions like “I have enough time and energy to get involved in my child’s school.” They also had to rate their level of structure and cultural stimulation with questions like “I make sure that my child does his homework at fixed times every day,” and “How often do you go to a museum with your child?” Lastly they were asked to rank their parental goals from 1 to 17 from a list that included “order and discipline”, “intellectual curiosity”, and “righteous and helpful behaviour”.  The questionnaires also included controls for the parent’s socioeconomic status and where each of the parents rated in the Big 5 model themselves.

After the data was in and some serious maths was performed the results were, well, surprising. In short the relationship between parenting style and children’s personality types “were not statistically significantly different from zero.”  Being a supermum (or dad), hugging the kids constantly, turning up to every parent teacher night, helping them with their homework, being encouraging, not scolding, would not change the type of kid you raised.  If they were a self-centred brat at Year 5, they still were by the time they hit Year 8.  And the same was equally true of parents who didn’t get involved with the school, didn’t encourage their kids to experience culture and had no particular parenting goals.  The kid will be who they are going to be regardless of parenting style.

This study didn’t look at the extremes of parenting.  There are definitely types of parenting which are more about chaos and neglect which would seriously affect the way a kid grows up, but even so, this study suggests that we are who we are wired to be from birth and whether our mum helps us with our homework or not is unlikely to change that.

Yes sugar really does make kids hyper, but not for the reasons you think

By | Addiction, Sugar, Teens | No Comments

I really thought we had moved on from the kind of codswallop I noticed being recycled in the paper last weekend.  But apparently not.

In a feeble attempt to encourage higher levels of sugar consumption someone had the hoary old ‘sugar doesn’t make kids hyper’ story dusted off and wheeled out.  It is, no doubt, stored next to the ‘chocolate is good for you’ piece that gets regurgitated every Easter.

The article looks at the science and concludes its not the sugar making your kids crazy it’s the food colouring or it’s parents telling the kids they will go nuts and the kids obliging or it’s that it’s an exciting event like a birthday party. In short it’s anything but the sugar.

Dietitian Miriam Raleigh is worried a mistaken belief that sugar makes kids hyper may lead to parents, gasp, limiting their children’s sugar intake.  The article even goes on to suggest that doing so may result in the child developing an eating disorder.  Miriam decides the solution is to eat sugar in moderation, a phrase that means exactly nothing.  Or more precisely and conveniently, means you eat as much as you think is moderate.

So, are we wrong to demonise sugar for its effect on kids?  Of course we’re not. It is very bad for them. It causes tooth decay, obesity, type 2 diabetes and kidney disease (at least and its benefits are, well, nothing.  So whether it causes hyperactivity is really neither here nor there.  Even so, it does.

Sugar is addictive.  Like all addictive substances, we crave the dopamine hit it delivers.  Each hit increases our tolerance for dopamine until we just can’t focus or function without those dopamine hits.  When we have less dopamine than our addicted brain thinks we need, we struggle to focus and we become hyperactive, symptoms that look a lot like ADHD.

Does sugar make our kids more hyperactive immediately after consumption?  No.  If anything, it is likely to calm them down as they get the dopamine hit they have been craving.  Does it create symptoms that look a lot like ADHD in the longer term?  Yes, because the dopamine acclimatisation makes us dopamine deficient in between sugar hits.  And when we are dopamine deficient, we struggle to hold a coherent thought in our head for even a few seconds.  We acquire the attention span of the proverbial gnat and the meditative practices of a Mexican jumping bean.

If we add other sources of dopamine into the mix like gaming or social media, then we can significantly accelerate the effect of sugar.  You can probably induce ADHD like symptoms in half the time if the kid is sucking down sugar while shooting his friends on Fortnite.

So no matter how many times you see this sugar is really not that bad chestnut recycled in the local paper, remember just one thing, its nonsense.  Sugar is very bad for children (and adults) and it also makes them hyper.  And no amount of moderation by dietitians or marketing by the sugar industry will change that.

Leaked internal research shows Instagram knows how much it harms teens (and does nothing about it)

By | Addiction, Mental Illness, Teens | No Comments

We don’t let kids smoke, drink, gamble or take drugs, so why do we let them use Instagram?

At senate hearings last week, US Senator Edward J. Markey, said, “Facebook is just like Big Tobacco, pushing a product that they know is harmful to the health of young people, pushing it early, all so Facebook can make money … Instagram is that first childhood cigarette, aimed to get teens hooked early ”.  The Senator was talking about internal research conducted by Facebook on its subsidiary Instagram over the last three years.  The studies had been leaked by a whistle-blower and  former Facebook employee and they came to some stunning conclusions.

Some of the research concludes “We make body image issues worse for one in three teen girls,” and “Teens blame Instagram for increases in the rate of anxiety and depression. This reaction was unprompted and consistent across all groups.”  Other internal documents described children aged 10-12 as a valuable ‘untapped audience’ and even suggested they could appeal to younger children by ‘exploring playdates as a growth lever’.

Another leaked internal study of teens who struggle with their mental health, found that 35 percent of UK teenage girls felt Instagram made things worse and 13 percent of UK teenage girls felt their suicidal thoughts started on Instagram.   When the researchers asked teens how Instagram harmed their mental health they cited, “the pressure to conform to social stereotypes,” “pressure to match the money and body shapes of influencers” and “the need for validation – views , likes and followers.”

Other research not funded by Instagram has shown similar things for at least the last five years, but this is the first time it has been clear the company has known this. All the while it has made public statements to the contrary.  It smells a lot like Big Tobacco’s, public denials in the eighties while it sat on a mountain of internal evidence of harm.  It is no wonder the Senator drew the parallel.

Social media like Instagram destroys teen mental health because it is addictive. It is not accidentally addictive.  It is very much on purpose.  Or as Tristan Harris, a former in-house ethicist at Google puts it, “the largest supercomputers in the world are inside of two companies — Google and Facebook — and … we’re pointing them at people’s brains, at children.”

The purpose of all this computing power is to get more minutes of your attention.  Attention is gold. It can be sold for billions to an army of eager advertisers.  Every extra minute of a child’s attention mined by those super computers is money in the bank. To do it, the programmers use everything we know about how our reward system works.

We like to be liked by others, so we’re constantly scanning our peers for signs that we’re liked. We’ll actively seek out things we think will mean we’re liked more, and we’ll avoid things that might mean we’re liked less. We call this peer pressure, and it drives us to ensure our behaviour is consistent with that of the others in our group.

At the biochemical level peer pressure is driven by a hormone called oxytocin.  Oxytocin is our super reward for bonding with others. When we think people like us, oxytocin is released and it, in turn,  stimulates dopamine release, ensuring we desire the thing producing the oxytocin response.  Every time we gain a follower or something we post to social media collects a like, comment or view, we get a little bump in oxytocin.

In real life, we might receive a compliment or a smile every now and then, but there is no equivalent for receiving hundreds of ‘likes’ for everything we do or say.  Social media is a high speed simulator of stimulating social interaction and just like other high speed computer simulations like gambling, gaming and porn, it is intoxicating and powerfully addictive.

The reward pathway in women is significantly more sensitive to oxytocin than that in men. This means women are significantly more sensitive to social cues than men, and find social interaction more rewarding than men do. Because of the low GABA levels in adolescents, teenage girls have this sensitivity dialled up to ‘maximum’, making them desperate for the approval of others and extraordinarily vulnerable to technologies that exploit that need.

The brain adapts to addiction by temporarily rewiring into a dopamine adapted state. It makes addiction harder to break and simultaneously makes us anxious, depressed and prone to suicidal thoughts.  The teens in the Instagram research felt worse after using the app for the same reason a drug addict feels worse when they are not high.  Addiction is a powerful driver of anxiety and depression.  Addictive behaviour is stress relieving behaviour for the anxiety that addiction creates. It is a highly destructive vicious circle.

The latest leaked research makes it clear how sinister the social media giants are. They have known all of this, have done for a long time and don’t care. As Chamath Palihapitiya, Facebook’s former vice president for user growth, said in 2017, “the short-term, dopamine-driven feedback loops we’ve created are destroying how society works.”

We don’t let children buy cigarettes, alcohol or drugs. We don’t let them gamble and they are not legally allowed to access pornography. Hell, we even have confectionary-free checkouts in supermarkets.  We don’t want our kids to be exploited for profit by merchants of addiction. Big Social Media has demonstrated that it is more than happy to addict kids for profit regardless of the consequences.  It’s time we recognised there is very little to distinguish them from Big Tobacco. It’s time we revoked their right to operate. And its time they paid the price for the massive damage they are doing.

 

Photo by ROMAN ODINTSOV from Pexels

Gaming under the guise of sport has no place in our schools

By | Teens, Uncategorized | No Comments

Exposing high school students to addictive gaming under the guise of sport is reprehensible and is no better than addicting them to booze. Parents must wake up to the risks and stop schools from allowing it.

AUSTRALIAN high schools are increasingly signing up to eSports programs. They might as well be opening lunchtime pubs in their canteens. Addicting their students to gaming is no better than addicting them to booze and it certainly isn’t sport.

From the very beginning of computer gaming, just as with real life games, people have been keen to watch others play.

In 1980, just two years after the release of the first major commercial computer game, Space Invaders, Atari organised the world’s first tournament. Ten thousand players battled little green invaders across the US, with Rebecca (then Bill) Heineman being crowned the ultimate winner, and taking home a Missile Command video game console then worth US$3000.

For a long time the revenue earning power of computer gaming competitions was limited by the inability to compete directly against other humans. The competitions were essentially overblown High Score shootouts, where every player was pitted against the game algorithm and the winner was the one who understood how it worked the best. It understandably had limited mass appeal.

And then came the internet and with it, the ability to design games which pitted people against people. Sure, the game controlled the environment and its rewards and punishments, but now for the first time the skills of other humans could affect your ability to win. It was suddenly a lot more like a physical sport. And with that, a new age of gaming dawned, the age of eSports.

That industry is now worth around US$1 billion a year and growing very fast. It is predicted to have worldwide revenue of US$1.8 billion by 2022, when eSports will be included as a full medal sport in the Asian Games in China, the world’s second largest multi-sport event (behind the Olympics).

These “eSports” are free online computer games played in teams. Usually five players co-operate and attempt to destroy a base protected by another team of five players while protecting their own base. The most popular games at the moment are DOTA 2, League of Legends and Overwatch but the list is growing all the time and the new kid on the block is the wildly popular, Fortnite.

And just like real sports, the audiences are eating it up. The global audience is currently well north of 380 million people. Needless to say, an audience that big attracts hundreds of millions in sponsorship dollars, not to mention in-game purchases and merchandise.

It is this potential honey pot and massively accelerating growth that has attracted media, telecom and the owners of traditional sports. Telcom companies are buying teams and securing streaming rights and sporting organisations are funding leagues to expand their audiences.

Locally, several AFL franchises have ploughed money into eSports. In 2017. the Adelaide Crows purchased a franchise. It was quickly followed by Essendon the following year and North Melbourne, Collingwood, Geelong, West Coast and GWS are actively considering following suite. Adelaide now run the Meta High School eSports League, with the 2019 season involving 160 schools in Australia and New Zealand.

Participating schools establish “teams” of competitive gamers who “train” for hours each week after school and compete in the online leagues. The games are free to play and can be played all the time regardless of being in a “team”, so I suspect most of the players get in a lot more “training” than the hour or two they do at school. And probably use the need to “train” as an excuse for access to their devices at home.

The graphics and sound are exhilarating. The excitement and tension in the players is real.

These games are the very best, the most addictive, the most evolved, the gaming industry has to offer. Their purpose is to addict young minds to the point of obsession, so that billions can be drained from their bank accounts in the form of micro purchases (of costumes and characters) and billions more can be drained from the accounts of sponsors who want access to the players and their fans. And our schools have just signed up as part of the gaming industry sales force.

We wouldn’t tolerate a brewery sponsoring a Chug-a-lug competition at the local high school. And we wouldn’t be too keen on a casino installing pokies, sorry eMaths machines, in the library.

So why on earth are we allowing companies whose entire purpose is to addict young minds open up shop in our schools.

It isn’t sport just because they call it sport. eSport is addictive gaming, pure and simple, so don’t let your school fall for the marketing BS designed to turn your kids into a product for sale to the highest bidder.

 

First published in the Courier Mail.

Excerpt from Teen Brain

By | Teens | 8 Comments

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I started researching this book because two mothers of teenagers told me to. My wife, Lizzie, said she was barely able to get through a conversation with another mother of teens without hearing about a child in counselling or on medication for anxiety and depression. Then my publisher, Ingrid, said exactly the same thing. Both of them felt something wasn’t right. This wasn’t how they grew up. They felt something was going on in the world of teenagers that was being hidden by the happy selfies on Facebook and Instagram, and they both wanted me to start digging to see if their hunches were right.

Before I started, I really wondered why I was bothering. Surely, I thought, everything that could possibly be written about parenting teens had already been done, and done better than I could ever do. Sure, there seemed to be more fuss in the media about teens overusing their phones, but I put that down to the perennial intergenerational problem of ‘teens these days’. Yes, it was a minute-by-minute fight in our house to keep the kids away from their school mandated iPads. And yes, the presence of those devices in the house had introduced a whole new level of sneaky behaviour and teen angst. But I put all that down to normal growing pains.

Then I started reading the research on the significant changes in reward pathways in adolescence. I wondered why I’d seen nothing much in the press about that well established biological reality. And I wondered why I saw even less about why that might be a problem in an age when billions are being spent by tech companies to encourage teenagers to become addicted to their products.

I knew software is engineered to addict. When it comes to non-business-related software, addictive products sell. Non-addictive products die a fast death. This is especially the case when every product in the category is ‘free’. I’d worked long enough in the industry to know how product management and marketing work. But I didn’t know that teens are particularly susceptible to addiction.

I knew it was always a struggle to prise a screen from our teenagers’ hands, but I tended to have a vaguely dismissive, ‘What harm can it really do?’ approach. And yes, I felt devices in schools were a significant distraction likely to impair performance, but I had no sense of how uniquely destructive to teen wellbeing they could be.

In short, I was happy to drift, uncomfortably, through allowing teen access to devices and accept, uneasily, the assurances that while they might be distracting, it was for the best or at least would do no permanent harm. That was until the union-of-the-mothers-of-teens told me to have a good hard look at it. In a nutshell, here’s what I found:

  1. The biology of puberty makes the teen brain uniquely fragile. It makes teens susceptible to addictions that can last for life and usher in mental illness.
  2. Parenting is much more permissive and parents need to harden up to save their kids.
  3. Unfettered access to screens is driving an epidemic of addiction, depression and anxiety, the likes of which we have never witnessed before.

What I found was frankly terrifying. In less than a decade we’ve totally changed the future of the human race, and we’ve done it without so much as a backward glance. Think that’s an overreach? Bear with me while I explain. …