From Weight Restoration to Brain Rescue: Shifting the Conversation About Eating Disorders

The importance of nourishing young bodies and minds

Conversations about eating disorders often revolve around bodies and weight — but there’s so much more going on beneath the surface, especially for kids and teens.

During adolescence, children are still developing. This means what they eat affects not only their body but also their brain. When a young person struggles with a restrictive eating disorder, their brain often doesn’t get the nutrition required to think clearly, process emotions and fully develop.

In many cases, traditional eating disorder treatment focuses on weight restoration for recovery. But Ovidio Bermudez, MD, FAAP, FSAM, FAED, F.iaedp, CEDC, senior medical advisor at Eating Recovery Center (ERC), coined and prefers the concept of “brain rescue” to reframe the conversation around treatment.

Let’s explore how this shift can lead to more meaningful discussions about disordered eating behaviors with patients, parents and providers alike.

What is weight restoration?

Weight restoration is the process of helping someone return to their ideal body weight after they’ve experienced malnourishment. While it isn’t necessary for every patient in eating disorder treatment, it is a critical step when the lack of nutrients has affected the body’s ability to function optimally.

Through weight restoration:

• The brain begins to recover
• The body leaves survival mode
• Organs and tissues start to heal
• The risk of a future eating disorder relapse decreases

Weight restoration  during eating disorder treatment can be a challenging process, and the time it takes is different for everyone. But as the body begins to heal, so do other essential functions. Hormones, body composition, growth and stress responses start to normalize — which is essential for recovery.

How eating disorders affect the brain

When someone severely restricts their food intake — by cutting out certain foods, reducing calories or avoiding entire food groups — they can start to experience the effects of starvation and malnutrition.

Here are some common effects of brain malnourishment:

• Psychosis: This can show up as hallucinations, like seeing your body differently than it is or feeling like the food you eat is somehow seeping into your tissues. It can also involve delusions, such as believing your body is changing as you eat, even though it isn’t.
• Obsessive fears: Thoughts about eating and weight can become so overwhelming that it’s hard to focus on anything else.
• Phobias: Eating or gaining weight can trigger intense anxiety, which can grow as someone reaches their “phobic threshold,” or the point where weight gain feels terrifying.
• Paranoia: A strong sense of distrust can develop along with feeling like others are trying to trick you into gaining weight or pushing you to get better when you’re not ready.
• Entrapment: Feeling stuck, like no matter how much you want to change, you feel like you can’t.

While anyone navigating a restrictive eating disorder can experience these effects, Dr. Bermudez explains why it’s particularly concerning for kids and teens.

“Between the ages of 12 and 25, adolescents lose about 15% of their gray matter at a rate of about 7% per year. During this period, the brain usually strengthens important connections while trimming away the ones that are less used. But starvation undermines this normal development process, leading to brain atrophy and dysfunction.”

The good news is that as weight normalizes and nutritional health is restored, the damage is reversible.

“As the brain heals, other interventions like therapy and medications will work better, and they will become more capable of identifying and utilizing coping skills,” explains Dr. Bermudez.

Focusing on brain rescue can motivate kids and teens

The brain is deeply affected when the body doesn’t receive proper nutrition, making discussions around food and weight particularly challenging. Shifting the focus from weight restoration to brain rescue can help patients see the importance of treatment.

“The conversation is not about weight gain but about protecting the brain,” says Dr. Bermudez. “Patients need to know that the nutritional insult could be significant enough to cause the brain to malfunction and derail brain development.”

This shift turns the idea of weight gain into something far more immediate, i.e., protecting their brain from lasting damage.

“For many young patients, brain rescue becomes a rationale and a justification to see treatment through,” says Dr. Bermudez. With this shift in focus, recovery is about more than gaining weight — it’s about saving their brain and their future.

Five ways to support your child’s brain health

Knowing how to support kids and teens with eating disorders is one of the best ways to protect their brains. Here are five ways you can help.

1. Recognize the signs of an eating disorder

If you notice behaviors like restrictive eating, excessive focus on body image or sudden weight changes, it could be a sign your child needs support. The sooner you recognize this, the more likely you are to prevent the effects of eating disorders — such as the long-term effects of bulimia or anorexia — on your child’s brain.

2. Create a safe space to talk

Conversations about your child’s eating disorder can be tough, especially when you aren’t sure what to say. Start by asking your child how they’re feeling. By listening with an open mind and validating their experiences without judgment, you can help them feel safe enough to share more.

3. Establish consistency

Building routines can give your child something to count on when everything else feels uncertain. Help them stick to regular mealtimes, plan check-ins to see how they’re feeling or set times for them to do activities they love.

4. Encourage independence

Empower your loved ones to make decisions in the best interest of their nutrition, mental health and brain development. This sense of ownership can help build their confidence in navigating their eating disorder recovery.

5. Guide them to the care they need

If your child is struggling with an eating disorder, connecting them with professional care is one of the best ways to support them. Tailored mental health treatment can address current challenges, ease the overwhelm and help your child’s brain heal for their future well-being.

The path to protecting kids’ and teens’ brains

The effects of restrictive eating disorders on the body and the brain can be profound. However, with the right support, recovery is possible for everyone. Focusing on brain health instead of weight restoration helps kids and teens understand the importance of healing and stay motivated throughout the process.

At ERC, we work closely with each child and their family to provide personalized care that supports physical and mental health for lasting recovery. When weight restoration and renourishment were part of the treatment plan, 100% of kids and teens were discharged at or above 90% of their ideal body weight ^[1].

To learn more about how we can support your child, call us at 866-622-5914 or reach out for a free assessment. We’ll listen to what your child is going through and help you find the exact support they need. It just takes one call to get started.

Read more on this topic:

Eating Disorders in Teens: What Parents Need to Know
Anorexia in Teens: A Guide for Parents
ARFID in Children: Symptoms and Treatment Options
Warning Signs of Bulimia
The Dangers of Bulking Up in Youth Sports