Anorexia 'partly metabolic, not purely psychiatric', says research

July 15, 2019

Anorexia is at least partly a metabolic disorder and not purely psychiatric as previously thought, scientists have said.

The potentially life-threatening illness - which can cause dangerously low body weight, fear of gaining weight, and a distorted body image - is said to share its genetic basis with metabolic, lipid and body measurement traits.

According to new research published in the journal Nature Genetics, these overlaps are independent of genetic factors that influence body mass index.

Dr Gerome Breen, from King's College London (KCL), said: "Metabolic abnormalities seen in patients with anorexia nervosa are most often attributed to starvation.

"But our study shows metabolic differences may also contribute to the development of the disorder. Our analyses indicate that the metabolic factors may play nearly or just as strong a role as purely psychiatric effects."

It was also found that the genetic basis of anorexia overlaps with psychiatric disorders such as obsessive-compulsive disorder, depression, anxiety, and schizophrenia.

Another finding was that genetic factors associated with the illness influences physical activity, which could explain the tendency for people with anorexia to be highly active.

The study - led by researchers at KCL and the University of North Carolina - identified eight genetic variants linked to anorexia using two sets of data.

One set came from the eating disorders working group of the Psychiatric Genomics Consortium, while the other came from the Anorexia Nervosa Genetics Initiative.

The data included 16,992 cases of anorexia and 55,525 controls, from 17 countries spanning North America, Europe, and Australasia.

Professor Janet Treasure, also from KCL, said: "Over time there has been uncertainty about the framing of anorexia nervosa because of the mixture of physical and psychiatric features.

"Our results confirm this duality and suggest that integrating metabolic information may help clinicians to develop better ways to treat eating disorders."

The study concludes anorexia, which affects between 1% to 2% of women and 0.2% to 0.4% of men, may need to be thought of as a hybrid "metabo-psychiatric disorder".

The research adds that it may also be important to consider both metabolic and psychological risks factors when exploring new avenues for treatment.

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