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Physical causes of anorexia: how research may change the way nurses are trained

Findings could influence the care we provide and remove stigma for patients
Genes illustration forming face. Picture: iStock

Findings could influence the care we provide and remove stigma for patients

Recent developments from an international research collaboration show that the debilitating condition anorexia nervosa could be amenable to metabolism-based therapies.

The Psychiatric Genomics Consortiums team of researchers, led by geneticists at Kings College London and the University of North Carolina in the US, compared the DNA of 16,992 people with anorexia and 55,525 healthy controls.

Not purely a psychiatric illness

They identified eight genes that linked anorexia to other mental health conditions, such as depression, anxiety, schizophrenia and obsessive-compulsive disorder. But the researchers also found genetic links to physical activity, the metabolism of glucose and how the body burns fat, suggesting that anorexia is not purely a psychiatric illness.

At this early stage, there is a reluctance to predict how this understanding may play out in

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Findings could influence the care we provide and remove stigma for patients


Picture: iStock

Recent developments from an international research collaboration show that the debilitating condition anorexia nervosa could be amenable to metabolism-based therapies.

The Psychiatric Genomics Consortium’s team of researchers, led by geneticists at King’s College London and the University of North Carolina in the US, compared the DNA of 16,992 people with anorexia and 55,525 healthy controls.

Not purely a psychiatric illness

They identified eight genes that linked anorexia to other mental health conditions, such as depression, anxiety, schizophrenia and obsessive-compulsive disorder. But the researchers also found genetic links to physical activity, the metabolism of glucose and how the body burns fat, suggesting that anorexia is not purely a psychiatric illness.

At this early stage, there is a reluctance to predict how this understanding may play out in the real world of this dangerous psychiatric condition. But there does seem to be the possibility of predicting relapse, or better understanding the causes of anorexia.

Could affect how disorders are conceptualised

This early indication of a dynamic between the physical and psychological also has other significant implications. The long-established divide between physical and mental health may be getting narrower, even if only by a gene’s width. Not only could this affect how disorders are conceptualised but how services are delivered. 

It could also have implications for health professionals who deliver services related to anorexia, and how they are trained. If therapeutic interventions become more physically oriented, we may need to consider how we prepare professionals to work in such a world.

For mental health nurses, what they need to know – and how they learn this – will need to be considered if they are to work in such a biologically driven model of care.

For our psychiatrist colleagues, this further legitimises their presence in a world of mental health that now endorses their (mainly) biological view. It also affirms their place, as graduates of firstly physical medicine, as the final arbiters in matters of diagnosis.

Removing blame and shame

For those receiving diagnoses and accessing services, there could be some positive outcomes of this trend.

Firstly, acknowledging that a genetic component may be driving a sequence of life responses could remove the awful sense of blame and shame sometimes experienced by those with anorexia.

Other neurological conditions with a recognised physical genetic component, such as autism, do not engender such responses. Parity of esteem means something real and tangible here.

Secondly, the development of an understanding of an interaction between genetic factors and environmental issues could one day lead to early detection and more effective interventions.

Perhaps we are witnessing a new understanding of mental health that will see the demise of a divided and unhelpful concept of ourselves.


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Ian Hulatt is consultant editor of Mental Health Practice 

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