Why Female Anorexics Find Closeness and Intimacy Discomforting

Anorexia nervosa is an eating disorder typically characterized by an overestimated body shape and size and atypical eating behaviors leading to an extremely low body mass index (BMI). These individuals also show disturbances in their ability to accurately sense internal body states such as taste, hunger, stomach distention, pain, and heartbeat that may contribute to the condition. Recent studies have focused on potentially misinterpreting rewarding non-food stimuli, such as gentle, caressing, and positive touching.

Affective touch processing is thought to be handled in the body by a special class of skin receptors—low-threshold mechanoreceptive—that send information to the brain via relatively thin neurons called C-fibers. These fibers respond to gentle stroking, and we generally perceive this neural input as pleasant and rewarding. For example, if someone you like is gently stroking the hairy skin of your arm while sitting next to you, a specific brain region, called the Insula cortex, is activated, and you experience a pleasurable feeling.

Watching a friend being touched positively, such as having their arm gently stroked, also activates the Insula cortex. When someone with anorexia nervosa watches a friend responding positively to being touched, they report that, although they do not like to be touched, they are aware that other individuals do.

A recent study (Bellard et al., 2022) investigated whether third-party vicarious ratings of social touch differ in women with anorexia nervosa. Women diagnosed with anorexia nervosa, women who are remitted anorexics, or healthy controls were shown videos with affective touch delivered to various body areas of actors. The women were then asked questions: “How much would you like to be touched like that?” and “How pleasant do you think that action was for the person being touched?”

Only females participated in this investigation. Females are typically more sensitive to touch discrimination and respond more positively to touch than males. Also, the incidence of eating disorders is greater in women than men. The anorexics were between age 18 and 47 with a mean BMI of 17.58. The remitted anorexics had a mean BMI of 22.59. The female controls had a mean BMI of 24.77.

The study demonstrated that current anorexics and remitted anorexics did not differ from the control subjects in their ability to rate touch with another person as a pleasant experience. However, when evaluating touch for themselves, they rated pleasant touching as being less enjoyable than the controls. Both groups of anorexics demonstrated higher sensitivity and avoidance of touch as compared to controls.

These results are consistent with reports that anorexics typically find closeness discomforting and have difficulty maintaining close intimate relationships with a romantic partner, family, and friends.