Neuroscience is helping to unlock the reasons why anorexia is so hard to treatVicki Turner

Thirteen years ago, I was on the brink of death. My nearly year-long battle with anorexia nervosa had reached a tipping point: tests showed my heart could give out at any moment, and I was rushed to the emergency room.

But I didn’t care. I only wanted to go home and celebrate my 15th birthday with the two chocolate-covered strawberries I had allotted in my self-imposed calorie restrictions.

It wasn’t that I wanted to die. The fear of eating more and gaining weight simply felt more immediate than the reality of my heart failing. That paradox – continuing to starve yourself despite the consequences – is why anorexia nervosa remains one of the deadliest and most challenging mental health conditions to treat. Roughly a third of those affected don’t recover, even with treatment.

“We could do much, much better. That is clear,” says Ulrike Schmidt at King’s College London.