Anorexia: new research findings open up treatment options

Anorexia is a very complex illness that affects both mind and body. Although treatment is available and recovery is possible, for many people it is often a long and bumpy journey.

Now, a new study looking at the genetic make-up of anorexia has uncovered the option of supporting recovery through developing treatment targeted at the metabolism.

The definition of anorexia (as it currently stands)

Anorexia is known as a mental health condition, with extreme weight loss and an unhealthily low body mass index (BMI), commonly less than 17.5kg/m2.

The dangerously low weights reached by anorexia sufferers are usually put down to restrictive food intake and a distorted body image, caused by this complex mental illness. As a result, treatment is predominantly directed at addressing the psychological aspects, through cognitive behavioural therapy (CBT).

Now that new genetic research findings suggest anorexia has metabolic components too, there are calls to consider anorexia a ‘metabo-psychiatric’ disorder, with a push for metabolic factors to be addressed alongside those of mental health.

A (quick) summary of the research

The Anorexia Nervosa Genetics Initiative, together with the Eating Disorders Working Group of the Psychiatric Genomics Consortium, looked at the genetic data of 16,992 people with anorexia and compared it against 55,525 people without anorexia.

People with anorexia were found to have 8 loci in their chromosomes, meaning 8 areas in their DNA blueprint appearing to be related to anorexia.¹

As expected, some of the loci were linked to psychiatric disorders, including obsessive compulsive disorder (OCD), depression and schizophrenia. But the fascinating thing was that about half of the loci were for metabolic traits, unseen in other mental health conditions.

What’s more, the metabolic traits were ones typically considered ‘healthy’, including:

• Increased physical activity levels
• Increased ‘good cholesterol, HDL’ levels
• Lower risk of type 2 diabetes
• Lower risk of insulin resistance

What the research findings really mean

It is very possible that these so-called ‘healthy genes’ have undesirable (and in this case damaging) effects, such as causing people with anorexia to use energy from food more quickly, or store less of it as fat,² explaining why anorexia is such a challenge to treat.

The findings also open up new avenues for the development of medication. Developing treatment aimed at metabolic factors could potentially help break the cycle of recurrent relapse and severe weight loss that is sometimes encountered after completing current standard treatment.

Never losing sight of the mental health aspect

Tragically, anorexia carries a sixfold increased risk of death when compared to the general public and this is not, as many believe, all down to the effects of starvation.³

Between 20 and 40% of deaths are due to suicide.⁴ This is a stark reminder of the mental health aspect of anorexia and why we mustn’t ever lose focus of the need for earlier, more and better mental health support.

Recovery from anorexia is possible. On average, 50% of sufferers recover, and 30% improve.⁵ Unfortunately 20% remain chronically ill and there is real hope that with more research and a greater understanding of this condition, more people will have the potential to recover.

Need to speak to someone?

If anything in this article has caused distress or concern about anorexia or eating disorders, please reach out for help. You can contact your GP or call B-EAT (the UK eating disorders charity).

If you are worried about a friend or family member, visit the BEAT website for more information and support on eating disorders.

B-EAT contact details

Email (adults): [email protected]

Email (u18s): [email protected]

Adultline: 0808 801 0677

Studentline: 0808 801 0811

Youthline: 0808 801 0711

References

1. Watson, H. et al (2019). Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa. Nature Genetics.

2. The Independent. (2019). Anorexia may originate in the body, not just the mind, groundbreaking study says. [online] Available at: https://www.independent.co.uk/... [Accessed 21 Jul. 2019].

3. Arcelus, J. (2011). Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders. Archives of General Psychiatry, 68(7), p.724.

4. Anorexiabulimiacare.org.uk. (2019). Statistics | Anorexia & Bulimia Care. [online] Available at: http://www.anorexiabulimiacare... [Accessed 21 Jul. 2019].

5. Steinhausen, H.C. (2002). "The Outcome of Anorexia Nervosa in the 20th Century." American Journal of Psychiatry, 159, 1284-1293