What Actually Is Going On?

Most people think eating disorders are about appearance. They’re not.

For me, it was about control. For someone else, it might be anxiety, trauma, or perfectionism. What all of these have in common is that they change how the brain processes reward, risk, and fear.

Some examples:

  • The insula misreads internal cues like hunger and fullness.

  • The dopamine system starts to treat restriction as rewarding.

  • The amygdala overreacts to food the same way it does to actual danger.

  • The prefrontal cortex, which helps with judgment and flexibility, can be underactive when restriction is extreme.

The brain isn’t broken—it’s trying to protect you. But it gets it wrong.

Mapping the Misfires

I used to think I was just disciplined. What I didn’t realize was that my brain had started rewarding restriction like it was an achievement. Hunger made me feel calm, focused—even proud. Later, I learned that the dopamine system can rewire itself to treat harmful behaviors as rewards, especially under stress. At the same time, my amygdala, the brain’s fear center, was reacting to food like it was danger. I wasn’t being dramatic—my brain was trying to protect me, just in the wrong way. The insula, which helps process body awareness, was part of it too; I couldn’t see what other people saw, no matter how unhealthy I’d become. And the more I understand this science, the more it all makes sense. I’ve been taking an online MIT course on neuroscience that dives into the brain’s structure, how different regions work together, and what happens when they don’t. It’s the first time I’ve seen my experience explained—not in emotional terms, but in circuitry. That’s what drew me to the field in the first place: I wanted to know why my brain reacted the way it did, and how it could change. Now, I want to help others make sense of theirs.

Interview with Neurologist Betul Gundogdu

MD - UCSD Neurology

Dr. Betul Gundogdu is a board-certified neurologist at UC San Diego Health specializing in neuromuscular disorders like ALS and myasthenia gravis. She directs the EMG lab, teaches in the Department of Neurosciences, and trained at top institutions including the Mayo Clinic and University of Chicago.

šŸ§ Understanding the Brain, Its Power, and Its Mysteries

Q: What first inspired you to pursue neurology, and what keeps you passionate about the field?

Neurology is one of the most complex and elegant fields in medicine. The brain governs everything—our motor abilities, our senses, our thoughts. It requires deep focus and critical thinking. Unlike other specialties that rely heavily on lab results, neurology demands that we consider each patient's unique backstory while solving diagnostic puzzles. It's a very cerebral field, and that's what makes it exciting. There’s still so much we don’t understand about the brain, which keeps the work both challenging and meaningful.

Q: What do you wish more people understood about how the brain and mental health are connected?

Many people don’t realize that mental health conditions like depression and anxiety involve real biological changes in the brain. These aren't just emotional or psychological—they have physical and chemical roots. If more people understood that, it would help reduce stigma. For example, antidepressants target specific chemicals in the brain to help improve mood. It's science, not weakness.

Q: Are there any recent discoveries in neuroscience that you find especially exciting or hopeful?

Yes—especially in the neuromuscular field. Brain-computer interfaces (BCIs) are allowing real-time decoding of speech, which is revolutionary. We now have AI technology that enables patients who have lost the ability to speak to generate speech through devices. These advancements improve quality of life and independence. Some interfaces even help with motor control—allowing patients to turn on lights, adjust the TV, or move a cursor using only their brain signals.

Q: Why is understanding the brain important for our overall health and well-being?

The brain is the command center of the body. It governs everything—movement, emotion, decision-making, even basic biological functions. Every system in the body ultimately connects back to the brain. To understand the body, you have to understand the brain first.

Q: What are some of the most common neurological conditions you encounter, and how do they typically affect the brain?

I often care for patients with motor neuron diseases, such as ALS, which result in progressive weakness and motor impairments. These diseases affect the brain's ability to communicate with muscles, leading to loss of movement. In conditions like dementia, different areas of the brain are impacted depending on the type, leading to memory loss, cognitive decline, or changes in behavior. These diseases reflect how different types of neurons—and their degeneration—affect our everyday functions.

Q: What advice would you give to students who want to study the brain or pursue a career in neurology?

Stay curious and open-minded. The brain is incredibly complex, but that’s what makes it so fascinating. Don’t be intimidated by the uncertainty—let it guide your questions. There are so many new technologies and areas of research that will help you along the way. Connect with professionals, stay engaged, and always remember that this work impacts both patients and the future of medicine.