Etiology of Eating Disorders: A Model of "Empirical Structure"

Hello all, Saren here. I’m honored that Tetyana asked me to be her co-contributor to ScienceofEDs, and am looking forward to collaborating on the project. My interests and background tend more towards the clinical; I don’t have the neuroscience training that she does, so I hope to bring a slightly different perspective while remaining committed to the research focus of the site. I can be reached at saren[@]scienceofeds[.]org with any questions, critiques or suggestions – I’d love to hear from you!

For my first post, I’m going to focus on one of the basic areas that much of the recent ED research aims to address:

WHAT CAUSES EATING DISORDERS?

We hear a lot about how eating disorders are complex syndromes with multiple causes. Articles in the popular press run the gamut from asserting genetic risk factors to proclaiming that Facebook causes eating disorders. In addition, disordered eating practices and poor … Continue reading →

A Meta-Analysis of Mortality in Eating Disorders

You often hear that anorexia nervosa has the highest mortality rate of any psychiatric illness, but you might struggle to find the rates for bulimia nervosa or EDNOS. Even for AN, the most common cause of death is rarely reported and the reported rates often vary a lot (depending on the study (and the media outlet).

I wanted to find out what are: (1) the mortality rates in BN and EDNOS and (2) the common causes of death in these disorders.  A relatively recent meta-analysis (click here for some background, pros and cons of meta-analyses) of 36 studies, which addressed some of my questions, was published by Arcelus and colleagues.

They excluded studies that had less than 15 patients and/or <1-year follow-up.

SO, WHAT DID THEY FIND?

Mortality in Anorexia Nervosa:

  • 35 studies, mean follow-up time: 12.8 years (maximum 36.2), mean sample size was 361 (maximum 6009).
  • Total
Continue reading →

EDs Don’t Discriminate: Psychiatric Comorbidity in Men with Eating Disorders

Eating disorders don’t discriminate, they just have a bias (more on this in the future). While the majority of eating disorder patients are females, males suffer from eating disorders as well. In fact, it is about, roughly, a 10:1 ratio.

Men tend to just keep quiet about it (and who can blame them, given the stigma women face, it only gets worse for the men.) But, on the inside, their experiences, thoughts, behaviours and recovery span the same spectrum.

There’s relatively little research out there on men with eating disorders, in large part due to the low prevalence rates which makes it harder to get a large enough sample size. So, you have to get creative, as the authors of this study did: they reviewed the prevalence of eating disorders and comorbid psychiatric disorders using data from the Veterans Affairs medical centers of male patients in the fiscal year of … Continue reading →

Eating Disorders and Psychiatric Comorbidities in Female Inpatients

Patients with eating disorders commonly exhibit comorbid psychiatric disorders, including anxiety, depression and OCD. The presence of comorbid disorders has been shown to exacerbate the severity and chronicity of the disorder, and unfavourably affect treatment outcome. Moreover, comorbid disorders may necessitate specialized treatment plans that take into account all the co-occuring disorders. Recovery from an eating disorder is hard enough, but when it is complicated by depression and severe anxiety, it can be a lot harder.

Nonetheless, commonly co-occuring psychiatric disorders may also provide researchers and clinicians clues about the etiology of eating disorders, the underlying neuronal processes as well as possible pharmacological interventions.

Researchers have been identifying disorders that commonly co-occur with eating disorders and studying the differences in co-morbidity between disorders. I picked one to write about today, it is a study by Blinder and colleagues that came out in 2007. It is by no means the best, … Continue reading →