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Causes of anorexia, explained?

Posted Mar 29 2009 3:06pm
Perhaps, if the folks at the Great Ormond Street Hospital in London are right. New research, which will be presented at the Institute of Education conference this week, sheds light on the brain changes that accompany anorexia. Rather than a size zero fad or an overcontrolling mother, anorexia may be caused by changes to the brain that occur in the developing fetus.

In an article in the UK's The Guardian titled " Anorexia risk 'could be predicted'," lead researcher Ian Frampton says that

"Our research shows that certain kids' brains develop in such a way that makes them more vulnerable to the more commonly-known risk factors for eating disorders, such as the size-zero debate, media representations of very skinny women and bad parents."

Slight quibble: those are stereotypical risk factors. The first two may cause people to diet, which would then trigger an eating disorder, but in and of themselves, they don't have a whole lot to do with EDs. The last has been thoroughly debunked- bad parents don't help you in life, but they don't cause eating disorders, either.

And these brain changes--whatever they may be--don't make you more vulnerable to "the size zero fad and the cult of the super-thin celebrity," as the author writes. Anorexia is deadly, not a fad a little too far by a bunch of vapid teenage girls. The brain changes make you more likely to develop a serious mental illness that might look like a fad, but let me tell you: it ain't about celebrities.

Frampton and his colleagues conducted in-depth neuropsychological testing on more than 200 people in the UK, America and Norway who suffer from the condition...They found that about 70% of the patients had suffered damage to their neurotransmitters, which help brain cells communicate with each other, had undergone subtle changes in the structure of their brains, or both.

One in every few hundred girls may be affected in this way, according to Frampton, who said the condition was random and not the result of poor maternal diet or environmental factors, such as widespread use of chemicals. Imperfect wiring in the brain's insular cortex that may lead to dyslexia, ADHD or depression in other children produces what he calls "an underlying vulnerability" among some young people that makes them more likely to develop anorexia.

This research is, of course, preliminary, and there are many questions I would like to see answered, such as:

  • How do you know these brain changes aren't a result of malnutrition? If the girls being studied are currently in the hospital for AN, they're malnourished, which we know changes the brain. I'm assuming they authors have an answer for this and I am all ears.
  • How do you intend to show that these brain changes came first?
  • Are there other people with these brain changes that don't develop AN? In other words, are these brain changes diagnostic, or just suggestive?
  • If the process is random, why does AN run in families? Did you look at siblings?

These studies are absolutely important, and I'm glad they're being done, but I'm not sold that this study will "revolutionize" anorexia treatment. Yet.

The authors of the study naturally mention screening and prevention, efforts that are no doubt important. However, dieting is ineffective for everyone, and malnutrition is dangerous for everyone. There should be a zero-tolerance for it across society, not just for those with EDs. The stakes are almost certainly higher for those with the genetic wiring for EDs, but that doesn't mean everyone else has a "get out of jail free" card, either.

Still, the take-home message is this: anorexia is the result of differences in neurobiology and neurochemistry that is triggered by things in the environment.

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