Genetic Links Indicate Anorexia Has Both Psychiatric and Metabolic Roots

MedicalResearch.com Interview with:

Cynthia Bulik, PhD

Cynthia Bulik, PhD

Cynthia Bulik, PhD, FAED
Founding director of the UNC Center of Excellence for Eating Disorders and
Professor at Karolinska Institutet in Stockholm, Sweden.

MedicalResearch.com: What is the background for this study?

Response: Researchers and clinicians from around the world came together to create the most powerful genome-wide association study of anorexia nervosa to date. Via this global collaboration, we were able to identify the first significant locus that influences risk for anorexia nervosa. We have known that anorexia is heritable for over a decade, but now we are actually identifying which genes are implicated. This is the first one identified!

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Anorexia Nervosa: So Brain Changes Persist After Weight Restoration

MedicalResearch.com Interview with:

Guido K.W. Frank, M.D., FAED Associate Professor of Psychiatry and Neuroscience Associate Director, Eating Disorder Program Director, Developmental Brain Research Program Pediatric Mental Health Institute | Children’s Hospital | University of Colorado Anschutz Medical Campus Colorado

Dr. Guido Frank

Guido K.W. Frank, M.D., FAED
Associate Professor of Psychiatry and Neuroscience
Associate Director, Eating Disorder Program
Director, Developmental Brain Research Program
Pediatric Mental Health Institute | Children’s Hospital | University of Colorado Anschutz Medical Campus Colorado

MedicalResearch.com: What is the background for this study?

Response: Anorexia nervosa is an eating disorder that primarily affects young females and is associated with high mortality. The diagnostic criteria include restriction of energy intake that leads to significantly low body weight and an intense fear of gaining weight or becoming fat. The etiology of anorexia nervosa is complex, and only recently have we begun to better understand its underlying neurobiology. Brain scans of anorexia nervosa patients have implicated brain reward circuits in the disease, brain regions that govern food intake. On the other hand, how much we eat also affects over time reward system response and eating too much or too little has important implications on brain reward function.

Previous studies from our lab as well as basic science research suggest that underweight is associated with heightened reward system response. In this study wanted to test whether we would find heightened brain activity in adolescents with anorexia nervosa and whether this would normalize once the patient regained weight.

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Deep Brain Stimulation Shows Promise in Anorexia Nervosa

MedicalResearch.com Interview with:

Andres M Lozano OC, MD PhD FRCSC FRSC University Professor, University of Toronto Dan Family Professor and Chairman of Neurosurgery RR Tasker Chair in Functional Neurosurgery Canada Research Chair in Neuroscience Toronto Western Hospital Toronto

Dr. Andres Lozano

Andres M Lozano OC, MD PhD FRCSC FRSC
University Professor, University of Toronto
Dan Family Professor and Chairman of Neurosurgery
RR Tasker Chair in Functional Neurosurgery
Canada Research Chair in Neuroscience
Toronto Western Hospital
Toronto

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We discovered an area of the brain that is overactive in patients with depression and anxiety the subcallosal cingulate area (SCC). As these problems feature prominently in patients with Anorexia, we hypothesized that adjusting thie activity of this brain area with Deep brain stimulation (DBS) could be helpful. Our findings suggest that DBS in anorexia patients is relatively safe, can normalize abnormal brain activity and may help some with severe and resistant symptoms.

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Transcranial Stimulation Reduced Bulimia Symptoms

MedicalResearch.com Interview with:

Dr Maria Kekic PhD

Dr. Maria Kekic

Dr Maria Kekic PhD
Research Worker | The TIARA study:
Transcranial magnetic stimulation and imaging in anorexia nervosa
Section of Eating Disorders | Department of Psychological Medicine
Institute of Psychiatry, Psychology & Neuroscience | King’s College London

MedicalResearch.com: What is the background for this study?  What are the main findings?

Response: Bulimia nervosa is an eating disorder characterised by repeated episodes of binge-eating and inappropriate compensatory behaviours. It is associated with multiple medical complications and with an increased risk of mortality. Although existing treatments for bulimia are effective for many patients, a sizeable proportion remain symptomatic following therapy and some do not respond at all.

Evidence shows that bulimia is underpinned by functional alterations in certain brain pathways, including those that underlie self-control processes. Neuroscience-based techniques with the ability to normalise these pathways may therefore hold promise as treatments for the disorder.

One such technique is called transcranial direct current stimulation (tDCS) – a form of non-invasive brain stimulation that delivers weak electrical currents to the brain through two electrodes placed on the head. It is safe and painless, and the most common side effect is a slight itching or tingling on the scalp.

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Does Mom’s Anxiety During Pregnancy Make Her Child A Fussy Eater?

MedicalResearch.com Interview with:

Lisanne de Barse Department of Epidemiology Erasmus Medical Center Rotterdam

Dr. Lisanne De Barse

Lisanne de Barse PhD
Department of Epidemiology
Erasmus Medical Center Rotterdam

MedicalResearch: What is the background for this study?

Dr. de Barse: Fussy (or “picky”) eating behaviour, which is characterised by consistent rejection of particular foods, is common in childhood and a source of concern for parents. It is not well understood what affects fussy eating. It is, however, well known that internalizing psychiatric problems of parents (i.e. anxiety and depression) have an impact on children’s health and development. Studies have also shown that mothers’ internalizing problems during the child’s preschool period was linked to child fussy eating. It was not clear whether the child’s eating problems causes stress and psychiatric symptoms in mothers or whether mothers’ symptoms predict child eating behaviour. Nor was it known what potential impact the dads’ state of mind have. The purpose of this study was to examine whether mothers’ and fathers’ internalizing problems during pregnancy and during the child’s life predicts child fussy eating.

MedicalResearch: What are the main findings?

Dr. de Barse: Our main findings indicate that mothers’ anxiety and depressive symptoms during pregnancy could have an influence on children’s fussy eating. This was irrespective of mothers’ internalizing symptoms at the child’s preschool period. We also found indications that fathers’ anxiety and depressive symptoms might influence children’s fussy eating behaviour. This was studied in Generation R, a study that has been tracking the health and wellbeing of children from conception onwards, conducted by the Erasmus Medical Centre, in Rotterdam, the Netherlands.

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Dasotraline Explored For Treatment of ADHD and Binge Eating Disorders

MedicalResearch.com Interview with:

Dr. Kenneth Koblan PhD Sunovion Pharmaceuticals Inc. Fort Lee, NJ and Marlborough, MA

Dr. Kenneth Koblan

Dr. Kenneth Koblan PhD
Sunovion Pharmaceuticals Inc.
Fort Lee, NJ and Marlborough, MA

Medical Research: What is the background for this study?
Dr. Koblan: Assessing abuse potential is important in the clinical development process for any therapy affecting the central nervous system, especially those that may act on dopamine and norepinephrine neurotransmitter systems. Human abuse liability studies are conducted to evaluate the abuse potential associated with drugs that affect the central nervous system.

Drugs that increase dopamine levels may be associated with stimulant effects and abuse (e.g., cocaine and amphetamine), whereas drugs that increase serotonin and/or norepinephrine levels are not generally associated with recreational abuse (e.g., selective serotonin reuptake inhibitors). Among drugs with effects on dopamine neurotransmission, slowing the rate of absorption is thought to reduce abuse potential, and increasing the rate of elimination is thought to reduce rewarding effects and abuse liability due to sustained elevations in drug concentrations resulting in sustained inhibition of dopamine transporters (DAT).

Dasotraline is an investigational dopamine and norepinephrine reuptake inhibitor from Sunovion in late-stage development to evaluate its use in treating the symptoms of attention deficit hyperactivity disorder (ADHD) and binge-eating disorder (BED). Dasotraline has slow absorption and elimination that supports the potential for plasma concentrations yielding a continuous therapeutic effect over the 24-hour dosing interval at steady state.

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Negative Comments From Mothers Influence Asian Girls’ Body Image

MedicalResearch.com Interview with:
Samuel Chng
PhD Researcher in Psychology Applied to Health
University of Exeter Medical School
St Luke’s campus
Exeter, EX1 2LU, United Kingdom

Medical Research: What is the background for this study? What are the main findings?

Response: The study was conceptualised from the curious question from my childhood, “How did my parents influence my behaviours?” Together with my co-author, Dr. Daniel Fassnacht, we decided to explore how a specific form of parental influence, their comments, would influence the development of disordered eating symptoms. From studies conducted with Western samples that parental comments play a role in the development of eating disorder symptoms, and body dissatisfaction is one of the more studied mediator of this relationship. However, we could not find any study that investigated the influential nature of parent comments in Asia. So, we decided to focus our study on Asian parents and their children.

Singapore, a developed Asian country that continues to have strong familial roots, provided an ideal population for our study, and we would expect, the relationships we found indicated some potential differences in amongst Asian families.

We found that young women, compared to young men, in Singapore generally reported higher levels of parental comments (about their weight, body shape and eating habit), body dissatisfaction and disordered eating symptoms. However what we found for both young women and men was that negative comments from mothers (for example, ‘You need to lose weight’) was the only category of comments that predicted disordered eating and this was mediated by the presence of body dissatisfaction. Positive comments from parents, though suggested from past studies to be a protective factor, did not influence body dissatisfaction and disordered eating.

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Suicide Risk Elevated in Patients and Relatives With Eating Disorders

More on Eating Disorders from MedicalResearch.com
MedicalResearch.com Interview with:
Shuyang Yao, MSc
Department of Medical Epidemiology and Biostatistics
Karolinska Institutet, Stockholm, Sweden

Medical Research: What is the background for this study?

Response: Suicide risk is much higher in individuals with eating disorders than individuals without the disorders. The mechanism underlying the high suicide risk in eating disorders (i.e., why?) is not clear. Large studies and genetically informative designs can help us understand the nature of the association between suicide attempts and eating disorders.

Medical Research: What are the main findings?

1) Eating disorders are associated with increased risk of suicide attempts and death by suicide.

2) Increased risk of suicide attempts is also found in relatives of individuals with eating disorders.

3) Some, but not all of the increased risk for suicide in individuals with eating disorders is accounted for by the presence of comorbid major depressive, anxiety, and substance use disorders.

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Intestinal Bacteria May Play A Role in Anorexia Nervosa

Dr. Ian Carroll, PhD Professor of medicine UNC Center for Gastrointestinal Biology and DiseaseMedicalResearch.com Interview with:
Dr. Ian Carroll, PhD
Professor of medicine
UNC Center for Gastrointestinal Biology and Disease 

Medical Research: What is the background for this study? What are the main findings?

Dr. Carroll: Anorexia nervosa (AN) is a severe psychiatric disorder characterized by extreme weight dysregulation and presents with high rates of comorbid anxiety.Anorexia nervosa carries the highest mortality rate of all psychiatric illnesses and relapse is frequent. Although a prime contributor, genetic factors do not fully account for the etiology ofAnorexia nervosa, and non-genetic factors that contribute to the onset and persistence of this disease warrant investigation. Compelling evidence that the intestinal microbiota regulates adiposity and metabolism, and more recently, anxiety behavior, provides a strong rationale for exploring the role of this complex microbial community in the onset, maintenance of, and recovery from Anorexia nervosa. Our study provides evidence of an intestinal dysbiosis in AN and an association between mood and the enteric microbiota in this patient population.

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Drug Researched To Help Curb Binge Eating

Pietro Cottone, Ph.D. Associate Professor Departments of Pharmacology and Psychiatry Laboratory of Addictive Disorders Boston University School of Medicine Boston, MA 02118MedicalResearch.com Interview with:
Pietro Cottone, Ph.D.
Associate Professor
Departments of Pharmacology and Psychiatry
Laboratory of Addictive Disorders
Boston University School of Medicine Boston, MA 02118

Medical Research: What is the background for this study? What are the main findings?

Dr. Cottone: Binge-eating disorder affects over ten million people in the USA and it is characterized by excessive consumption of junk food within brief periods of time, accompanied by loss of control, uncomfortable fullness and intense feelings of disgust and embarrassment. Increasing evidence suggests that binge-eating disorder can be regarded as an addiction behavior.

Memantine, a neuroprotective drug which blocks the glutamatergic system in the brain, is an Alzheimer’s disease medication, and it has been shown potential to treat a variety of addictive disorders.

We first developed a rodent model of binge eating by providing a sugary, chocolate diet only for one hour a day, while the control group was given the standard laboratory diet. Rats exposed to the sugary diet rapidly develop binge eating behavior, observed as a 4 fold increase in food intake compared to controls. Furthermore, binge eating rats are willing to work to a much greater extent to obtain just the cue associated with the sugary food (not the actual food), as compared to controls. In addition, binge eating subjects exhibit compulsive behavior by putting themselves in a potentially risky situation in order to get to the sugary food, while the control group obviously avoids that risk.

We then tested whether administering memantine could reduce binge eating of the sugary diet, the strength of cues associated with junk food as well as the compulsiveness associated with binge eating. In addition, we studied which area of the brain was mediating the effects of memantine, by injecting the drug directly into the brain of binge eating rats.

Our data show that memantine was able to block binge eating of the sugary diet, the willingness to work to obtain a cue associated with junk food, as well as the risky behavior of rats when the sugary diet was provided in a potentially unsafe environment. When we injected the drug directly into the nucleus accumbens of rats, they stopped binge eating. Importantly, the drug had no effects in control rats eating a standard laboratory diet.

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Eating Disorders in Men Under Recognized

Ulla Räisänen Senior Researcher HERG Health Experiences Research Group Department of Primary Care Health Sciences University of Oxford Oxford OX1 2ETMedicalResearch.com  Interview with
Ulla Räisänen
Senior Researcher
HERG Health Experiences Research Group
Department of Primary Care Health Sciences
University of Oxford Oxford OX1 2ET

MedicalResearch.com : What are the main findings of the study?

Answer: We conducted a qualitative interview study exploring how young men (aged 16-25) recognise eating disorder symptoms and decide to seek help, and to examine their experiences of initial contacts with primary care in the UK.

Our data suggest that the widespread perception of eating disorders as uniquely or predominantly a female problem led to an initial failure by young men to recognise their behaviours as symptoms of an eating disorder. Many presented late in their illness trajectory when eating disorder behaviours and symptoms were entrenched, and some felt that opportunities to recognise their illness had been missed because of others’ lack of awareness of eating disorders in men. In addition, the men discussed the lack of gender-appropriate information and resources for men with eating disorders as an additional impediment to making sense of their experiences, and some felt that health and other professionals had been slow to recognise their symptoms because they were men. Continue reading

Indoor Tanning and Eating Disorders Linked in Adolescents

MedicalResearch.com Interview with
Stephen M. Amrock, SM
Department of Pediatrics
New York University School of Medicine
New York, NY 10016

MedicalResearch.com: What are the main findings of the study?

Answer: We analyzed data from a nationally representative survey on youth risk behaviors. After adjusting for other risk taking behaviors, we found that high school adolescents who indoor tan were much more likely to also engage in behaviors typically associated with eating disorders. We also noted that the link between indoor tanning and such harmful weight control behaviors was even stronger among males than females.

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