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A new genetic explanation for anorexia



Some of the genetic factors associated with anorexia nervosa are also related to metabolism, suggesting that there is a biological explanation for why patients with eating disorders are losing weight fast and having difficulty gaining weight hold.

The discovery was part of the largest genome-wide disease association study ever conducted. The study, published July 15 in the journal Nature Genetics, found eight genetic regions associated with anorexia.

Anorexia affects up to 4% of women and a lower percentage of men. It is among the deadliest psychiatric disorders. People with this disease have long struggled against stigmatization and were considered vain, driven by a desire to be thin. However, researchers cite the study as the most specific and definitive evidence that genes and biology play a prominent role. The researchers hope that the discovery in the distant future will help to develop therapies that target the biology of the disease.

"Many of us have long wondered if anorexia is more than the psychological component," says Cynthia Bulik, founding director of the UNC Complexity Center for Eating Disorders at Chapel Hill, NC, who led the study. "These people simply override normal biology, overriding hunger signals. We have often wondered what enables them to lose so much weight and stay down there. This may explain why they are metabolically out of control.

The study analyzed the genome of nearly 1

7,000 patients with the disease and compared it to 55,525 controls from 17 countries. Nevertheless, the results are preliminary and, according to the researchers, must be replicated.

Researchers also found that people with this condition are genetically susceptible to high levels of physical activity and are more likely to have other medical conditions, including obsessive-compulsive disorder, depression, anxiety, and schizophrenia.

Dr. According to Bulik, 100,000 genetic samples are to be collected. She estimates that researchers will find hundreds of genes associated with the disease.

Only about 30% of people with anorexia nervosa recover completely. The study emphasizes the importance of patients achieving a healthy weight in order to stabilize their metabolism before leaving the hospital. This could reduce the risk of relapse after they go home, Dr. Bulik.

June Alexander, a 68-year-old writer in Melbourne, Australia, donated a blood sample for the study of genetic links to anorexia. She has been struggling with this disease since she was eleven years old and says that finding the study was a great relief.


Photo:

Martin Reddy

June Alexander, a 68-year-old writer in Melbourne, Australia, was among the nearly 17,000 individuals who contributed a blood sample to the study.

wife. Alexander was diagnosed with anorexia in the thirties after starting the disease at the age of 11. She says she was not successfully treated until she was 55 years old. "At that time, I could eat three meals a day and did not feel guilty." She says.

The results of the study are a "great relief."

"This disease really shames you," says Ms. Alexander. "This study says that this is definitely a disease. I have no mistakes. It is the disease that makes me feel and shine.

Tom Hildebrandt, head of the Center for Eating Disorders and Weight Disorders Center of Excellence at the Mount Sinai School of Medicine in New York, described the research as the "first step in identifying a roadmap for the neurobiology of the disease. "

That about 20% of the disease could be from metabolic genes is enormously important to reduce the stigma associated with the disease, says dr. Hildebrandt, who was not involved in the disease study. "Anorexia is considered a self-control problem, just eat it and it will solve the problem," he says. "The reality is that they work against their own physiology – it's actually much harder for them to eat, not just because of the psychiatric resistance to weight gain, but they also fight against a basic biology that does not really want them to gain weight either increase. "

Dr. Hildebrandt says he sees this in his own patients, who are struggling to gain weight and hold on to it. "One of the reasons they get stuck is from a psychiatric point of view, they're scared of eating and the effects of eating, and they have to eat a lot more, they have to work harder to eat than the average," he says. It is unclear whether humans are born with such metabolic genes or whether such genes are activated by starvation.

According to Dr. Hildebrandt, the study was not an independent sample and included samples from 17 individual studies without a uniform standard of measurement.

Walter Kaye, a professor of psychiatry and executive director of the Eating Disorders Program at the University of California, San Diego, contributed materials from previous genetic studies.

Dr Kaye says he has noticed how difficult it is for some of his patients, Anorexia patients may need to consume 4,000 to 5,000 calories per day to do this Sliced ​​woman needs 2,000 calories a day to maintain her weight. "That's a tremendous amount of food," he says.

He has also published studies showing that people often need to eat significantly more than most people to maintain their weight after recovering from anorexia. "We do not know why these people are susceptible to hypermetabolic disease, although it may not stay that way in the long run," he says.

Laura Collins Lyster-Mensh, Managing Director of FEAST, a non-profit advocacy group for families with eating disorders, said the group helped recruiting participants for the study and raised funds to finance them. "Many of us parents see clearly that what happens to our children is biological and metabolic, but we have no proof," says Ms. Lyster-Mensh, whose daughter suffered from anorexia in 2002 when she was 14 years old. old.

"DNA research confirms what the FEAST families have long been saying: Help us to feed our children properly and no longer make our loved ones responsible for choosing a vanity disorder," says Ms. Lyster-Mensh. "You have not chosen it."

Please call Sumathi Reddy at [email protected]

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