How the Incorrect Belief That Eating Disorders Are Predominantly Genetic Is Maintained

2018 ◽  
Vol 20 (2) ◽  
pp. 73-78
Author(s):  
Colin A. Ross
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
American Psychiatric Association ◽  
Twin Studies ◽  
Research Data ◽  
Genetic Contribution ◽  
Compelling Evidence ◽  
Statistical Procedures ◽  
Dsm V ◽  
Heritability Estimates

The incorrect belief that anorexia nervosa is predominantly genetic is maintained in the psychiatric literature by a series of misquotations and misrepresentations of research data. An example of this type of scholarship is as an editorial in The American Journal of Psychiatry. Data from family and twin studies referenced in the editorial provide compelling evidence that the genetic contribution to the etiology of anorexia nervosa is small. The incorrect belief that anorexia nervosa is predominantly genetic is maintained, in addition, by statistical procedures such as heritability estimates. The incorrect belief that anorexia nervosa is predominantly genetic should not be endorsed by the American Psychiatric Association, in either its journals, in its published books, or in DSM–V.

A preliminary population-based twin study of self-reported eating disorder

2001 ◽  
Vol 31 (2) ◽  
pp. 361-365 ◽  
Author(s):  
L. S. KORTEGAARD ◽  
K. HOERDER ◽  
J. JOERGENSEN ◽  
C. GILLBERG ◽  
K. O. KYVIK
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Twin Study ◽  
Twin Studies ◽  
Population Based ◽  
Dizygotic Twin ◽  
Genetic Contribution ◽  
The Relationship

Background. Twin studies have concluded that there is a substantial genetic contribution to the aetiology of eating disorders. The aim of the present study was to estimate the genetic contribution to the aetiology of self-reported eating disorders in a sample of representative twins.Method. A population cohort of 34142 young Danish twins was screened for eating disorders by a mailed questionnaire.Results. Concordance rates differed significantly across monozygotic and dizygotic twin pairs for broadly defined self-reported anorexia nervosa and bulimia nervosa. Heritability estimates of 0·48, 0·52 and 0·61 respectively were estimated for narrow and broad definitions of self-reported anorexia nervosa and for self-reported bulimia nervosa.Conclusions. There is a genetic contribution to the aetiology of self-reported eating disorders in the general population. The relationship between self-reported and clinical eating disorder remains to be examined.

SOA03-01 - Eating disorders: State of the art

2011 ◽  
Vol 26 (S2) ◽  
pp. 2176-2176
Author(s):  
J. Treasure
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
State Of The Art ◽  
Explanatory Models ◽  
Top Down ◽  
Duration Of Untreated Illness ◽  
Not Otherwise Specified ◽  
Dsm V

The DSM V will probably include four categories of eating disorders, anorexia nervosa, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified. The lifetime prevalence is about 5%. Cultural, social and interpersonal elements can trigger the onset and changes in neural networks can sustain the illness. Brain based explanatory models have been developed which include an imbalance between top down control and hedonic and homeostatic elements. The longer the duration of untreated illness the harder it is to reverse the illness as a variety of maintaining factors develop. CBT remains the treatment of choice for bulimia nervosa but there is more uncertainty about treatment for anorexia nervosa although treatment with a focus on the interpersonal elements is of value

scholarly journals Avaliação da procura pelos serviços de saúde e tratamento farmacológico de pacientes com anorexia e bulimia nervosa

2019 ◽  
Vol 8 (5) ◽  
Author(s):  
Fernando Yamamoto Chiba ◽  
Suzely Adas Saliba Moimaz ◽  
Artênio José Ísper Garbin ◽  
Cléa Adas Saliba Garbin
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
World Health Organization ◽  
Young Women ◽  
American Psychiatric Association ◽  
World Health ◽  
Health Organization ◽  
The Impact

Introdução: Os transtornos alimentares são caracterizados como distúrbios do comportamento alimentar, associados ao desequilíbrio nos pensamentos, ações e atitudes dos indivíduos resultando em prejuízos à saúde do indivíduo. Estas condições são cada vez mais comuns na sociedade atual e têm ganhado crescente atenção da comunidade científica. Objetivo: Analisar a procura pelo atendimento e farmacoterapia em mulheres com anorexia e bulimia nervosa atendidas em uma faculdade de medicina em 2018. Material e método: Realizou-se análise documental dos prontuários médicos. A procura pelo atendimento foi considerada não-espontânea quando a paciente foi encaminhada pela unidade de urgência/emergência ou compareceu acompanhada por responsável legal sem admitir necessidade de tratamento. Resultados: Identificou-se 14 pacientes, com idade média de 31,21 anos. 43% apresentaram procura não-espontânea pelo atendimento, sendo 83% destas encaminhadas por unidades de urgência/emergência. Foram prescritos 21 medicamentos diferentes, sendo a maioria antidepressivos. 52% dos fármacos prescritos não são disponibilizados pelo Sistema Único de Saúde. 29% dos pacientes apresentavam polifarmácia, 43% automedicação e 57% pensamento de morte. Houve associação entre o pensamento de morte e uso de 4 ou mais medicamentos. Conclusão: Uma parcela considerável das pacientes teve procura não-espontânea pelo atendimento. Os fármacos prescritos foram principalmente antidepressivos e a maioria não é disponibilizado no Sistema Único de Saúde, evidenciando a onerosidade econômica e social do tratamento.Descritores: Transtornos da Alimentação e da Ingestão de Alimentos; Anorexia; Bulimia; Tratamento Farmacológico.ReferênciasLe LK, Barendregt JJ, Hay P, Mihalopoulos C. Prevention of eating disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2017;53:46-58.Herpertz-Dahlmann B. Adolescent eating disorders: definitions, symptomatology, epidemiology and comorbidity. Child Adolesc Psychiatr Clin N Am. 2009;18(1):31-47.Zabala MJ, Macdonald P, Treasure J. Appraisal of caregiving burden, expressed emotion and psychological distress in families of people with eating disorders: a systematic review. Eur Eat Disord Rev. 2009;17(5):338-49.Sharan P, Sundar AS. Eating disorders in women. Indian J Psychiatry. 2015; 57(Suppl 2): S286–S295.Brandys MK, de Kovel CG, Kas MJ, van Elburg AA, Adan RA. Overview of genetic research in anorexia nervosa: The past, the present and the future. Int J Eat Disord. 2015;48(7):814-25.Mitchison D, Hay PJ. The epidemiology of eating disorders: genetic, environmental, and societal factors. Clin Epidemiol. 2014;6:89-97.American Psychiatric Association; 2013. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington.Smink FR, van Hoeken D, Hoek HW. Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep. 2012;14(4):406-14.Geneva: World Health Organization; 1992. World Health Organization. The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines.Stewart TM, Williamson DA. Multidisciplinary treatment of eating disorders--Part 1: Structure and costs of treatment. Behav Modif. 2004;28(6):812-30.Donaldson AA, Hall A, Neukirch J, Kasper V, Simones S, Gagnon S, et al. Multidisciplinary care considerations for gender nonconforming adolescents with eating disorders: A case series. Int J Eat Disord. 2018;51(5):475-479.Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Política Nacional de Alimentação e Nutrição/Ministério da Saúde, Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Brasília: Ministério da Saúde, 2013. 84 p.Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. departamento de assistência farmacêutica e insumos estratégicos. Relação nacional de medicamentos essenciais: RENAME 2017. Brasília: Ministério da Saúde, 2017. 210 p.Stice E, Marti CN, Rohde P. Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective community study of young women. J Abnorm Psychol. 2013;122(2):445-57.Lewinsohn PM, Striegel-Moore RH, Seeley JR. Epidemiology and natural course of eating disorders in young women from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry. 2000;39(10):1284-92.van Son GE, van Hoeken D, Bartelds AI, van Furth EF, Hoek HW. Time trends in the incidence of eating disorders: a primary care study in the Netherlands. Int J Eat Disord. 2006;39(7):565-9.Hoek HW, van Hoeken D. Review of the prevalence and incidence of eating disorders. Int J Eat Disord. 2003;34(4):383–96.Brand-Gothelf A, Leor S, Apter A, Fennig S. The impact of comorbid depressive and anxiety disorders on severity of anorexia nervosa in adolescent girls. J Nerv Ment Dis. 2014;202(10):759-62.Bühren K, Schwarte R, Fluck F, Timmesfeld N, Krei M, Egberts K, et al. Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa. Eur Eat Disord Rev. 2014;22(1):39-44.Mizusaki K, Gih D, LaRosa C, Richmond R, Rienecke RD. Psychotropic usage by patients presenting to an academic eating disorders program. Eat Weight Disord. 2018 Jun 7. doi: 10.1007/s40519-018-0520-3. [Epub ahead of print]Fazeli PK, Calder GL, Miller KK, Misra M, Lawson EA, Meenaghan E, et al. Psychotropic medication use in anorexia nervosa between 1997 and 2009. Int J Eat Disord. 2012;45(8):970-6.Nascimento RCRM, Álvares J, Guerra Junior AA, Gomes IC, Costa EA, Leite SN et al. Availability of essential medicines in primary health care of the Brazilian Unified Health System. Rev. Saúde Pública. 2017;51(Suppl 2):10s.Fassino S, Abbate-Daga G. Resistance to treatment in eating disorders: a critical challenge. BMC Psychiatry. 2013;13:282.Becker AE, Fay KE, Agnew-Blais J, Khan AN, Striegel-Moore RH, Gilman SE. Social network media exposure and adolescent eating pathology in Fiji. Br J Psychiatry. 2011;198(1):43-50.Groesz LM, Levine MP, Murnen SK. The effect of experimental presentation of thin media images on body satisfaction: a meta-analytic review. Int J Eat Disord. 2002;31(1):1-16.

An embodied belonging

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Karin Eli
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Dsm V ◽  
Dsm Iv

Until the publication of the DSM-V in 2013, amenorrhea was one of the four criteria that comprised anorexia nervosa. Diagnostically, amenorrhea played a definitional role, dividing the ‘strictly’ anorexic from their ‘subthreshold’, menstruating peers; however, the implications that menstrual cessation, and menstruation itself, held for the lived realities and identities of women with anorexia remain under-explored. In this article, I examine the positioning of menstruation and amenorrhea in the narratives of Israeli women diagnosed with eating disorders during the eras of the DSM-IV and DSM-IV-TR. I find that the participants’ narrative uses of amenorrhea mirrored, and at times explicitly engaged with, the official diagnosis of anorexia nervosa. Notably, although the participants invoked amenorrhea as a defining sign of illness, they did not cast menstruation as a sign of health rather, they spoke of their menstrual periods as contradicting their anorexic-identified selves. Amenorrhea, then, emerged as central in the embodied making of anorexic subjectivities.

Overestimates of the Genetic Contribution to Eating Disorders

2006 ◽  
Vol 8 (2) ◽  
pp. 123-131 ◽  
Author(s):  
Colin A. Ross
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Family Studies ◽  
Monozygotic Twins ◽  
Statistical Analyses ◽  
Genetic Contribution ◽  
Erroneous Conclusion ◽  
Raw Data ◽  
First Degree Relatives ◽  
Genetic Heritability

The purpose of this article is to analyze and critique repeated claims in the literature that there is a substantial genetic contribution to eating disorders. Data from the existing twin and family studies of eating disorders were tabulated and compared to heritability estimates resulting from complex statistical analyses of the same data. Overall, concordance in monozygotic twins is 26% for bulimia and 35% for anorexia nervosa. Among the relatives of probands with bulimia, 95.1% do not have bulimia, whereas among the relatives of probands with anorexia nervosa, 97.1% do not have the disorder. The raw data refute claims that the genetic heritability of eating disorders is as high as 80%. The erroneous conclusion that there is a substantial genetic contribution to eating disorders needs to be corrected by focusing on the raw data for twin concordance and prevalence in first-degree relatives.

Pharmacotherapy for Eating Disorders

2017 ◽  
Author(s):  
Susan McElroy ◽  
Anna I. Guerdjikova ◽  
Nicole Mori ◽  
Paul E. Keck
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Mental Disorders ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Night Eating Syndrome ◽  
Night Eating

This chapter addresses the pharmacotherapy of the eating disorders (EDs). Many persons with EDs receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. This chapter first provides a brief rationale for using medications in the treatment of EDs. It then reviews the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES). It concludes by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.

Genetic Influences on Eating and the Eating Disorders

2010 ◽  
pp. 102-122
Author(s):  
Tracey D. Wade
Keyword(s):  
Eating Disorders ◽  
Disordered Eating ◽  
Association Studies ◽  
Twin Studies ◽  
Genetic Influences ◽  
Shared Environment ◽  
Complex Nature ◽  
Current State ◽  
Increase Risk ◽  
Eating Practices

The current chapter reviews our progress in understanding how genes influence eating and eating disorders (EDs) by addressing the following areas: (1) how recognition of genetic influences on eating and EDs emerged; (2) the complex nature of genetic action; (3) what twin studies can tell us about genetic influences; and (4) the current state of linkage and association studies. It is concluded that genes are an important part of the explanatory framework for the etiology of EDs, with an important contribution of the shared environment to the development of cognition and attitudes that may initiate disordered eating practices, and a critical contribution of the environment in providing a context within which genetic risk is more likely to be expressed. We currently have a limited understanding of the specific genes that are implicated, and the ways in which genes and the environment work together to increase risk for disordered eating.

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