President of Üsküdar University and Psychiatrist Prof. Nevzat Tarhan was a live guest on the program Balçiçek İle Bu Gece, broadcast on EKOL TV. Prof. Tarhan made striking evaluations regarding the topics of “the psychological pressures women face in the pursuit of beauty and thinness, and the moral degradation in society and entertainment culture.” Emphasizing that anorexia cases are rapidly increasing on a global scale, Prof. Tarhan stated that this is a brain disorder. He underlined that compulsory treatment is necessary for anorexia and that the disorder cannot be corrected with advice alone. Prof. Tarhan also noted that digital showcases have a serious influence on young people, who tend to admire and imitate the individuals they see on social media.
“Anorexia cases are rapidly increasing worldwide”
Speaking live on EKOL TV, Prof. Nevzat Tarhan addressed the topic of anorexia nervosa, which came into public attention again following the death of Nihal Candan. Stating that the illness is a brain disease, Prof. Tarhan noted that it is increasing at a global level. He said:
“Anorexia cases are rapidly increasing worldwide. Anorexia nervosa is a brain disorder. In this disease, the way the brain perceives body image is distorted. Brain regions such as the insular cortex and fusiform area, which are related to body image, are connected to the reward and control systems. In some individuals, the risk increases due to genetic predisposition in these regions. Even if the person weighs twenty-nine kilograms, they may perceive themselves as weighing one hundred fifty kilograms. This is a matter of perception—they are not lying; they genuinely feel that way. For instance, even if the person drops from twenty-nine to twenty-three kilograms, they may still see themselves as one hundred fifty kilograms. Their brain plays this trick on them. At this point, the person cannot recover through advice, persuasion, or classical therapy methods. However, if the disorder is identified early, when symptoms are mild, treatment is easier. In advanced stages, the brain’s neuroplasticity deteriorates, and neural networks are damaged. Eventually, the brain begins to accept the distorted perception as normal. At that stage, you cannot convince or change the person through persuasion. Long-term hospitalization becomes necessary.”
“This condition cannot be resolved with advice”
Emphasizing the need for compulsory treatment in anorexia, Prof. Tarhan stated:
“Psychiatric disorders are not only psychological but also have neuropsychological dimensions. In the past, there was a prevailing belief that ‘a person will recover only if they want to.’ Treatment was left to the patient’s free will. However, this understanding has changed. New brain research shows disruptions in the neural networks of such individuals. Through brain mapping techniques, these disruptions can now be identified. There are network databases specifically developed for eating disorders. The person’s brain map is generated and compared to the database to determine which regions are impaired. This system is called SW-LORETA, a QEEG-based brain mapping system. With this method, we can visually present which brain functions are impaired. When patients see this concrete data, the process of convincing them to accept treatment becomes much easier. Because this condition cannot be resolved with advice. It is a biological and tangible illness. Therefore, when a person’s body mass index drops below eighteen, this situation can no longer be evaluated within the scope of free will. Compulsory treatment is required. No one can be granted the freedom to harm themselves. If a person says, ‘I will jump from the tenth floor,’ can we say, ‘That is your freedom’? This is no different.”
“Some individuals may develop excessive control due to aesthetic concerns”
Stating that some individuals may become excessively preoccupied with aesthetic concerns, Prof. Tarhan explained: “In a brain under stress, the need for dopamine increases. The brain starts to rapidly consume dopamine, and the person turns to pleasure-seeking. A vulnerability to pleasure develops. If the individual has been raised in a cultural environment that glorifies physical appearance, this search for pleasure becomes directed toward body image. For this reason, some individuals may develop excessive control due to aesthetic concerns. In others, the same pleasure-seeking drive may lead to substance use. In both cases, similar biochemical processes occur in the brain. At this point, genetic background also plays an important role. For instance, the serotonin transporter gene (5-HTT) affects serotonin regulation in the brain. In individuals who carry the SS allele of this gene, it functions more slowly, making them more sensitive to stress. Even minor stress can lead to a serotonin deficiency in the brain. This sets the stage for depression or anxiety. These are not disease genes, but rather risk genes. This genetic predisposition increases a person’s vulnerability to stress. Today, these biological dimensions have been scientifically proven. If a biological predisposition is detected in the individual, a more disciplined and consistent treatment plan should be followed.”
“The more one consumes, the more happiness one is made to believe they will achieve”
Emphasizing that serotonin-based happiness is more lasting, Prof. Tarhan said:
“Endocrinologist Dr. Robert Lustig wrote a book in 2017 titled The Hacking of the American Mind: The Science Behind the Corporate Takeover of Our Bodies and Brains. In this book, Lustig criticizes the hedonistic, pleasure-focused life philosophy that dominates modern times. In fact, this distinction was made by Aristotle two thousand five hundred years ago. Aristotle divided happiness into two types. Hedonic happiness is short-term, dopamine-based pleasure. Eudaimonic happiness, on the other hand, is more lasting, based on serotonin, and rooted in meaning and purpose. According to Lustig, modern society, particularly American culture, encourages people to constantly chase pleasure within the cycle of consumption. The ‘earn, consume, spend’ cycle influences individuals through neuromarketing techniques that target the brain’s dopamine system. Within this system, people are led to believe that the more they consume, the happier they will be. However, this biologically exhausts the brain and ultimately prevents true satisfaction.”
“Now, what is popular is regarded as valuable”
Stating that eating disorders deeply affect body perception, Prof. Nevzat Tarhan said, “The criteria for being valued have changed in today’s world. What is now popular and visible is considered valuable. This mindset deeply influences body image, especially in eating disorders. Therefore, in the early stages of treatment, we apply the body neutrality approach. The goal here is to help the individual establish values regarding their body based not only on appearance but also on its function. In other words, the person is able to say, ‘I exist not because of how my body looks but because of what it enables me to do. My body is a tool; it has a duty to help me live, move, and produce.’ This method is called brain neutrality therapy. Additionally, we use virtual reality technology to support this treatment. We have implemented a VR program developed in Vienna in our hospital. At first, we planned to develop our own software, but after seeing how well-designed this program was, we decided to use it. In this application, the individual sees their own body image in a three-dimensional environment. This experience, which feels very real, creates a high level of anxiety in the individual. However, as they repeatedly experience this anxiety in a controlled manner, they gradually become desensitized. In this way, the brain’s perception of the body is restructured, and the fear decreases. This process must be supported not only by classical psychotherapy but also by neuropsychiatric treatment.”
“There is a global system that sanctifies popularity”
Explaining that popular culture leads to a narcissism epidemic, Prof. Tarhan said, “In the treatment of eating disorders, we always conduct a family assessment as well. Because the values with which the child is raised at home shape their mental infrastructure. If the child grows up in a family environment where physical appearance is glorified, even sanctified, they begin to think, ‘If I look good, I am valuable; if not, I am worthless.’ This causes a serious shift in meaning within the brain, ultimately leading to a loss of meaning. There is a global system that sanctifies popularity. Sometimes this is even legitimized under the name of artistic freedom. However, this system targets the biological vulnerabilities of the human brain. One of these vulnerabilities is the desire to be seen. The human brain is particularly sensitive to stimuli such as sexuality and violence. The desire to display oneself is also a part of this biological structure. This trait exists in everyone, but certain aspects of it vary by gender. In the female brain, the tendency to display oneself through physical appearance is more dominant. In the male brain, arousal is more often centered around erotic stimuli. The global capitalist system traps people by exploiting these vulnerabilities, purely for commercial gain. However, the heavy consequences of this system are now beginning to emerge. Especially during adolescence, this culture causes a narcissism epidemic among youth because visibility, popularity, and external validation are constantly glorified. Therefore, a meaning-centered life philosophy needs to be reintroduced on a global scale.”
“This is a psychotic-level case of anorexia”
Speaking about a recent case that came to public attention, Prof. Tarhan said, “This is a psychotic-level case of anorexia. At this stage, the individual’s ability to test reality is impaired. That is, the brain’s network system that analyzes whether incoming information is real or not ceases to function properly. When this system is disrupted, the person begins to live as if in a different universe. They possess a false but internally consistent reality constructed in their own mind. In this world, they are not always unhappy. Even though we from the outside think they are suffering, they continue to live in their encapsulated world. For this individual, eating is perceived as a threat or even an enemy. Because the brain has coded the act of eating as a danger. The underlying cause of this situation is that certain parts of the brain become disconnected from overall brain functioning and begin to operate independently. In other words, the person lives within an isolated system, separate from the rest of the brain’s operations. In such a level of dysfunction, classical therapy methods are no longer sufficient. A treatment process is required that can completely reconstruct the brain’s disrupted neuroplasticity.”
“Digital showcases have a serious impact on young people”
Discussing the concept of digital showcases, Prof. Tarhan said, “Digital showcases have a serious impact on young people. They admire and begin to imitate the people they see on social media. This behavior is especially common among individuals with low emotional awareness. There are two types of awareness. Cognitive awareness is being aware of one’s thoughts. Emotional awareness, on the other hand, is the ability to recognize and manage one’s feelings. In conditions like anorexia, emotional awareness is often impaired. The person recognizes their emotions but is unable to analyze or manage them. These individuals are quickly overtaken by their emotions and, due to weak emotional literacy, do not know how to handle them. As a result, a small emotional trigger is enough for them to start imitating what they see on the digital showcase. At this point, we work on emotional regulation during the treatment process. When the individual learns to recognize and manage their emotions, they also gain the strength to say no to digital showcases. There is a frequently overlooked issue here. Young individuals are not being encouraged to embark on their own inner journey of discovery. Society constantly presents them with a model of happiness that is based on external validation. Yet, true happiness is built within the individual’s inner world and through a sense of internal responsibility. This is where the greatest mental failure of modernism begins. People are taught external happiness, but they are not provided with a meaning-based, internal life philosophy.”
Üsküdar News Agency (ÜNA)