Shelly Bar MD

11/08/2025

🧠 Brain Fog & Eating Disorders

When the body is undernourished, it enters “conservation mode” — a hypometabolic state where the brain slows down to preserve energy (Micali, 2025; Alberts, 2023; Smith, 2023).

Effects on the Brain:
• Blood flow and oxygen delivery decrease, making focus and attention harder (Springall, 2024; Marcolini, 2024)
• The brain prioritizes essential organs over cognitive tasks, leading to slowed memory, decision-making, and mental clarity (Shobeiri, 2022; Krug, 2024)

Why Brain Fog Happens:
It’s multifactorial: low glucose, hypometabolism, reduced cerebral blood flow, hormone and electrolyte imbalances, sleep disruption, and the mental load of disordered eating all play a role.

Clinical Takeaway:
Assessment may include electrolytes, TSH, hydration, metabolic labs, orthostatic vitals, and nutrition evaluation. Neuroimaging is also needed if there are sudden or focal neurological changes.

If you or someone you know experiences these symptoms, seeking professional help is strongly recommended.



References:

Krug, I., et al. (2024). A narrative review on the neurocognitive profiles in eating disorders. Nutrients, 16(3), 710. https://doi.org/10.3390/nu16030710

Micali, N., et al. (2025). Providing alternative fuel for the brain in anorexia nervosa: Metabolic contributors to cognitive function. Frontiers in Psychiatry, 16, 1052. https://doi.org/10.3389/fpsyt.2025.01052

Shobeiri, P., et al. (2022). Serum and plasma levels of brain-derived neurotrophic factor in eating disorders: A systematic review and meta-analysis. Journal of Eating Disorders, 10, 120. https://doi.org/10.1186/s40337-022-00610-2

Seidel, M., et al. (2024). Dynamic changes in local brain connectivity and activity in anorexia nervosa: Functional imaging studies. NeuroImage: Clinical, 38, 103444. https://doi.org/10.1016/j.nicl.2024.103444

11/06/2025

Electrolytes act like the heart’s “spark plugs.”🫀
They help keep the heart’s electrical signals steady and coordinated.

When purging occurs, the body loses important minerals — especially potassium, sodium, and chloride. These minerals are essential for the heart muscle to contract normally. When their levels drop too low, the heart’s electrical system becomes unstable, making it harder for the heart to keep a regular, steady rhythm.

This can lead to feelings of the heart racing, skipping beats, or beating unevenly, and in more severe cases, it can trigger dangerous heart rhythm problems.

Because of this, careful medical attention, monitoring, and electrolyte replacement are very important to help protect the heart.

10/31/2025

This week, let's join Tutu Thin Podcast to shed light on the side of treatment many don’t talk about, but everyone should understand.

Let us explore the medical side of eating disorders!

Follow Smith-Theodore
🎙️ Tune in and learn more. Click link below for the podcast:

https://www.buzzsprout.com/1996516/episodes/18102396

10/30/2025

If hunger and fullness feel confusing right now, please know you’re not alone. This isn’t a setback or failure — it’s a normal part of recovery.

When the body has experienced prolonged restriction, hunger and fullness cues can become disrupted. Hormones that regulate appetite — including leptin, which helps signal fullness and energy balance — may become suppressed or dysregulated. This can make it hard to “feel” hungry or satisfied, even when your body needs nourishment.

Re-learning internal cues takes time, and this process is supported best with clinical guidance. Your healthcare team — dietitian, therapist, and physician — plays an essential role in helping your body re-stabilize its signaling system, rebuild trust in your cues, and ensure that the process happens safely.

Every meal you show up for supports hormonal healing and nervous system regulation. Even when it doesn’t feel intuitive yet, you’re moving forward. 🤍

10/24/2025

Let's spread awareness and encourage open conversations‼️

Throat irritation and swollen cheeks aren’t always just “simple” symptoms. They can be silent signs of purging in eating disorders, pointing to deeper health struggles.

Clinical signs to watch for:
• Oropharyngeal lesions: sore throat or hoarseness, redness or ulcers in the mouth, dental enamel erosion, and bad breath.
• Enlarged parotid glands: “chipmunk-like” or puffy cheeks, usually painless but may feel tender, sometimes lasting weeks after purging stops.

Be vigilant. Subtle signs can speak volumes.

Ask your loved ones how they’re really doing; your support could be the start of their healing.

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10/18/2025

A 2024 study from Aston University found that parents’ own eating styles — whether emotional, avoidant, or highly food-responsive — influence how they feed their children and how their children relate to food.

What parents can do:
• Model calm, balanced eating habits at mealtimes.
• Avoid labeling foods as “good” or “bad.”
• Create a positive and pressure-free environment around meals.
• Encourage children to listen to their hunger and fullness cues.
• Use conversations — not control — to guide healthy choices.

With this, we need to be reminded that eating patterns start at home — not just on the plate, but in the mindset.

Reference:

Pickard, A., Blissett, J., Haycraft, E., & Farrow, C. (2024). Associations between parent and child latent eating profiles and the role of parental feeding practices. Aston University. Retrieved fromhttps://publications.aston.ac.uk/id/eprint/46469/1/A_Pickard_et_al_Associations_between_parent_and_child_latent_eating_profiles_and_the_role_of_parental_feeding_practices.pdf

10/14/2025

Food fear, like worrying about contamination, poisoning, or getting sick, can strongly affect how a person eats and feels about food.

These fears often come from the brain’s natural threat response, which becomes overly sensitive in eating disorders and anxiety-related conditions. Over time, this can lead to avoidance, nutritional deficiencies, and emotional distress.

But healing is possible. With the right support and therapy, people can learn to feel safe around food again.

If you or someone you love struggles with food fear, remember, speaking up and seeking help is a sign of strength.🤍



References:
Melles, H., Hagan, A., Hinrichs, J., Glinsky, J., Raevuori, A., & Hofmann, S. G. (2023). Transdiagnostic fears and avoidance behaviors in self-reported eating disorders. Journal of Eating Disorders, 11(1), Article 105.
https://doi.org/10.1186/s40337-023-00745-8

Duke University. (2024, November 8). New study sheds light on hidden fears of children with ARFID [Press release]. International Journal of Eating Disorders. Duke Department of Psychiatry & Behavioral Sciences.
https://psychiatry.duke.edu/news/new-study-sheds-light-hidden-fears-children-avoidant-restrictive-food-intake-disorder

Zhang, Y., Melles, H., Raevuori, A., & Hofmann, S. G. (2023). Food avoidance in anorexia nervosa: The role of fear conditioning and anxiety responses. Appetite, 189, 106691.
https://doi.org/10.1016/j.appet.2023.106691

10/10/2025

Why Health Is More Than a Number?

For decades, Body Mass Index (BMI) has been used as a universal marker of health — yet studies now state that it offers only a limited view of the body’s physiological state.

💡 In our latest blog, we explore the limitations of BMI and highlight a comprehensive, evidence-based framework for assessing health. This modern approach integrates metabolic, cardiovascular, behavioral, and psychological indicators to provide a more accurate and compassionate understanding of well-being.

A valuable read for anyone navigating eating disorder recovery, exploring body neutrality, or seeking a deeper understanding of how true health is defined beyond numbers.

📖 Read the full article: “From BMI to Whole-Person Care: A Shift in How We Define Health” — available now on our blog. Link below ↓

We’ve all heard it — “Check your BMI to see if you’re healthy.” For decades, that simple equation of weight and height has shaped how society — and even healthcare — defines what’s “normal.” But what if the very number we’ve been taught to trust doesn’t actually reflect our h...

10/03/2025

📖 Research shows that stress from both work and academics can play a powerful role in triggering or worsening eating disorder symptoms.

These findings remind us that eating disorders are not about food alone—they are often a response to stress, exhaustion, and feeling out of control.

However, healing doesn’t have to be faced alone. With compassion, steady support, and accessible treatment, recovery is possible. If you’re struggling, please remember: you are not defined by your eating disorder, and reaching out for help is a sign of strength.🤍🌿✨

And to those around them—family, friends, classmates, coworkers—look out for your loved ones. Sometimes, simply saying “I'm here to listen” can make all the difference. 💞



References:

Treasure, J., Duarte, T. A., & Schmidt, U. (2021). Experiences of eating disorders from the perspectives of patients: An integrative review of qualitative studies. Journal of Eating Disorders, 9(1), 36. https://doi.org/10.1186/s40337-021-00507-4

Pike, K. M., Wilfley, D. E., Hilbert, A., Fairburn, C. G., Dohm, F. A., & Striegel-Moore, R. H. (2008). Struggling with the transition to adulthood: Stressful life events, psychopathology, and relapse in women with bulimia nervosa. Psychological Medicine, 38(4), 497–506. https://doi.org/10.1017/S0033291707001311

Juvanhol, L. L., Silva-Costa, A., Rotenberg, L., Griep, R. H., et al. (2022). Is work-family conflict a pathway between job strain components and binge eating? A cross-sectional analysis from the ELSA-Brasil study. Journal of Eating Disorders, 10(16). https://doi.org/10.1186/s40337-022-00540-x

Paranjothy, S. M. (2024). A meta-analysis of disordered eating and its association with transdiagnostic mechanisms. International Journal of Eating Disorders. https://doi.org/10.1002/eat.24166

09/29/2025

🩺 Got tough cases?

You’re invited to our Free Monthly Consultation Hour for Clinicians with Dr. Shelly Bar! A dedicated space to expand your knowledge, share clinical challenges, and collaborate with peers.

📅 Date: Friday, October 10, 2025
🕛 Time: 12:00 PM (PT)
👩‍⚕️ Host: Dr. Shelly Bar

✅ Bring your cases and questions
✅ Connect with fellow clinicians
✅ Collaborate in a supportive community

📌 How to Join:
✉️ Email us at office@shellybarmd.com
📲 Or send us a direct message with your email address on Facebook, Instagram, or LinkedIn. Example: “Join, office@shellybarmd.com”

⚠️ Please note: Any direct message on our social media sites without a reply, confirmation, or acknowledgement is not considered registered. If you do not receive a reply within 1–2 business days, we highly encourage you to contact us by email at office@shellybarmd.com.

ℹ️ For any inquiries or concerns about Zoom or technical issues with the link, please email us at office@shellybarmd.com.

We can’t wait to see you there! 🌟

09/24/2025

Illusion of Control

Eating disorders are often tied to a need for control, and laxatives can feel like a way to “undo” eating or take charge of one’s body.

But research shows serious risks:

⚠️ Gut Health Impact – Misuse depletes healthy gut bacteria, harming digestion and immunity.
⚠️ Serious Health Risks – Linked to low potassium, dehydration, kidney damage, and even higher dementia risk with long-term use.
⚠️ Mental Health Link – Strongly tied to depression, compulsive behaviors, and severe ED symptoms.

💡 Takeaway: Laxatives don’t actually eliminate calories — but they do harm your health. If you or someone you love struggles with this, seeking professional support is a strong and important step. 💛

References:

Igudesman et al. (2023). Psychosomatic Medicine. https://doi.org/10.1097/PSY.0000000000001247

Puckett et al. (2023). Journal of Eating Disorders. https://doi.org/10.1186/s40337-023-00751-w

Feng et al. (2023). Neurology. https://doi.org/10.1212/WNL.0000000000201522

Zhang et al. (2024). BMC Medicine. https://doi.org/10.1186/s12916-023-03040-0

Kornstein et al. (2023). Int. Journal of Eating Disorders. https://doi.org/10.1002/eat.24261

09/23/2025

L’Shana Tova! 🍎🍯

Wishing you a sweet, healthy, and meaningful New Year!

May this season bring joy, peace, and renewal to you and your loved ones. 👨‍👩‍👦✨

Here’s to new beginnings, fresh intentions, and many blessings in the year ahead. 💛