From the Vault: The Neurobiology of Eating Disorders With Dr. Jeffrey DeSarbo, DO [Episode 23]

Understanding Disordered Eating: Eating Disorder Recovery and Body Image Healing

While we’re on summer break, we’re bringing back some of the most impactful episodes that deserve a second listen—and this one is just too good to pass up. This is our last re-release for the summer. We will be back with new episodes on September 9th, so be sure to tune back in.

In this episode, we’re going deep into the neurobiology of eating disorders with Dr. Jeffrey DeSarbo, a renowned psychiatrist and medical director of ED-180, one of the largest private eating disorder treatment centers in the U.S.

If you’ve ever wondered why eating disorder recovery can feel so hard, or what’s really going on in the brain beneath the behaviors, this episode will open your eyes and deepen your understanding. Dr. DeSarbo explains the science in a way that’s relatable, clear, and deeply compassionate. From the neurological impacts of restriction, binging, and purging to the effects of compulsive exercise and body image distress, we’re unpacking it all.

This conversation is a must-listen for clinicians, individuals in recovery, and anyone curious about the “why” behind the “what.”

In this episode, we’re talking about:

• Dr. Jeffrey De Sarbo’s unique path from finance to psychiatry, and how he became a leading expert in eating disorder neurobiology.

• Why eating disorders are “half medical, half psychiatric”—and how this complexity makes them uniquely challenging and important to understand.

• What neurobiology really means, and how our brains function through electrochemical energy.

• The role of genetics and epigenetics in eating disorders, and why some people are more biologically predisposed than others.

• How brain scans show measurable differences in individuals with eating disorders, especially in how different regions of the brain communicate.

• Why “just eat” or “just stop” is a myth, and how deeply biological factors resist simplistic solutions.

• How behaviors like binging can physically change the brain, creating patterns that mimic addiction and drive compulsion.

• What restriction does to the brain, including loss of gray and white matter and cognitive impairment, even when someone appears high-functioning.

• The dangerous effects of purging, from electrolyte imbalances to cardiac issues, and why “feeling fine” doesn’t mean you’re medically safe.

• The neurobiology of compulsive exercise, and how stress hormones and overtraining harm the brain’s ability to function and recover.

• Why body image distress is not just emotional but neurological, with altered blood flow patterns and measurable differences in perception.

• How neurobiology informs the recovery process, and why rewiring the brain is both essential and entirely possible—with time, persistence, and support.

Tweetable Quotes

"Eating disorders are not a choice. It’s something that happens." - Dr. DeSarbo

"Oftentimes, when we work with our eating disorder patients, they have 10,000 plus hours of eating disorder thought processes—so they become experts." - Dr. DeSarbo

"Restriction with anorexia nervosa is giving you a compromised brain." - Dr. DeSarbo

"You're invincible until you are not—and then it is too late." - Rachelle Heinemann

"What percentage of your free thoughts, when you're not busy actively doing something, do you spend thinking about or worrying about food, weight, body image, calories, exercise?" - Dr. DeSarbo

Resources

ED180

The Brain and Neurobiology of Eating Disorders

Translating ED

Nora Volkaw

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