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A massive breakthrough in our understanding of anorexia nervosa

For decades, therapists, doctors and lay people alike have believed that eating disorders result from emotional issues linked to body image and low self-esteem. Now, a newly published study has affirmed what we in the eating disorder recovery field have long suspected: the roots of anorexia nervosa are actually linked to the genes that regulate human metabolism and neurochemistry.

We have long said, “Genes load the gun and experience pulls the trigger.” This new research adds more evidence and specificity to the genetic underpinnings of what we now know to be a brain disease, with profound impact on eating behavior and body perception.

The study, which was published last month, found 8 new genetic markers for anorexia, suggesting that we need to rethink the way we view and treat the disorder that affects up to 2 percent of women and 0.3 percent of men worldwide. The findings are based on a scientific study of more than 17,000 patients living with anorexia – the largest study of its kind ever conducted.

“Now we know that (anorexia is) a complex mixture of aspects from the body and mind,” says study co-author Janet Treasure, a psychiatrist at King’s College London.

How this research helps us see anorexia more objectively

Until fairly recently, anorexia has been seen mainly as a psychological disorder. With advances in both basic and clinical research, the field has moved closer to viewing these potentially fatal illnesses as medical illnesses, in part because of the dramatic impact that eating disorders can have on physical health.

Many people with anorexia suffer from repeated episodes of extreme weight loss, even after they have undergone extensive treatment that helps restore them to a normal weight while in controlled settings. Over the past 20 years, we have seen few new interventions for the unremitting illness that involves frequent relapses – a condition so deadly it has the highest early mortality of any of the so-called mental illnesses. (I refer to them in this way because in my view, they are all organic diseases that are NOT “all in the patient’s mind.”)

Realizing that genetics may drive the symptoms of anorexia places these symptoms – and, in fact, the illness itself – in a new light for many patients. Clearly, behaviors and beliefs are only part of the story. The key takeaways from the study affirm that:

  • Anorexia is likely to be linked to the body’s inherited ability to metabolize sugars and fats.
  • Genetic differences in people with anorexia may mute body signals that would normally stimulate appetite during a period of extreme weight loss.
  • Anorexia has been linked with higher levels of physical activity.
  • People living with anorexia share genetic traits with people who have other mental health conditions such as obsessive-compulsive disorder, major depressive disorder and schizophrenia.

Greater compassion and support for those facing anorexia

It may be years before we know how to use these genetic differences to develop new treatments focused on the biology that regulates development and recovery from anorexia. We may someday be able to re-balance the body’s metabolic responses, helping to dramatically improve outcomes for those facing the disease.

But for now, the study has immediate impact on the terrible stigma that surrounds eating disorders, addiction and other mental illnesses. As a medical professional who has recovered from anorexia herself, I am closely attuned to the negative attitudes about mental illness that pervade society and even the professional community.

Too many of us blame the patient and blame the family when treatments fail to arrest a mental illness such as anorexia. This new research helps move the needle where it needs to be, taking blame and shame away from a deadly disease that patients and families didn’t choose or ask for.

Knowing that anorexia has biological origins, with genes linked to brain function and metabolism, helps us fight these unfounded beliefs. It also helps us as professionals and family members to separate the disease from the person. With the new findings in mind, we can have greater compassion for people suffering from anorexia, remembering that they are struggling with a disease that overtakes the brain – which is, after all, the organ we depend on to perceive reality, make decisions, and execute behaviors, day in and day out.

If you or someone you love is struggling with an eating disorder, we are ready to help you right now. Get in touch with us today to find caring, effective treatment for anorexia, bulimia, orthorexia, binge eating or any related issue.

 

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