The Anorexia Nervosa Brain: A Summary of Neuroimaging Studies – Part 1

Journalists like to report on novel and exciting findings regardless of how likely they are to be replicated or how well they fit with everything else known about the topic. It is an all too common occurrence that a small pilot study which has favourable results, creates a buzz and gets into our heads, only to produce negative results once the sample size is increased. But the latter, negative finding, rarely makes it to the printing press. So, we are left thinking the results of the pilot study are correct, when they might be an outlier or a false positive.

Given this, I wanted to summarize an article that provides a critical overview of the current neuroimaging studies in anorexia nervosa. We can use this as an introduction to neuroimaging in AN: to get a sense of the scientific consensus, the trends that emerge and what can be learned from … Continue reading →

Chances Are, What You Know About Eating Disorders is Wrong

Although clinicians (and medical professionals not specializing in eating disorders) often carry a lot of false beliefs about EDs, the public is even worse. Way worse. The portrayal of eating disorders in the news contributes to the myriad of myths and misconceptions that surround EDs. O’Hara and Clegg-Smith wanted to find out how exactly newspapers “contribute to shaping public perception of EDs.” 

It is awful when doctors are dismissive and ignorant, but it is even worse when you encounter these attitudes from your friends and family. When they not only don’t get it, they don’t want to get it. As O’Hara & Clegg-Smith point out, this ignorance and “disconnect potentially prevents timely ED diagnosis and reinforces a stigma that limits treatment availability.”

While researchers and ED specialists increasingly understand that eating disorders are “caused by a combination of genetic and environmental factors” (for example, evidence from twin studies … Continue reading →

More on the Problematic EDNOS Category (and Diagnostic Crossover)

I’ve been thinking a lot lately about the eating disorder not otherwise specified (EDNOS) category. ED-NOS is a diagnostic category for all individuals with subthreshold anorexia or bulimia nervosa or those with a mix of symptoms that don’t fit neatly into AN or BN. ED-NOS is essentially everything else. A mixed bag, if you will. It doesn’t tell the clinician nor the researcher anything useful, outside of what it isn’t. So, is there any use for it? If it doesn’t tell the clinician about patient symptoms or guide choice of treatment, why even bother? Does it help researchers understand EDs or do they just want to avoid this messy and heterogenous group (that by the way makes up most of those with eating disorders)? In this entry (and many more to come), I want to further explore these questions.

There’s been a push by researchers to minimize the … Continue reading →

The Genetics of Anorexia Nervosa

Is it the culture of thinness, obsession with dieting or just bad mothering? When it comes to determining the causes of anorexia nervosa, the answer appears to be none of the above. Increasingly, the evidence is pointing to genetics playing an important role in predisposing individuals to anorexia nervosa. Among clinicians and researchers, the notion that genetic factors are important in the development of anorexia nervosa seems uncontested. In this short review, Dr. Cynthia Bulik and colleagues summarize some of the findings in the genetics of anorexia nervosa.

Currently (DSM-IV), to be diagnosed with anorexia nervosa, a patient must show:

  • An inability to maintain normal weight (<85% of what is expected)
  • Intense fear of weight gain and/or becoming fat, though underweight
  • Obsession with body weight and shape, giving it undue importance in evaluating self-esteem/self-worth
  • Amenorrhea (missing 3 or more consecutive periods)
  • There are two AN-subtypes: restricting type (AN-R) and
Continue reading →