Rethinking Anorexia: Biology as a Driver

Question-and-answer flashcards covering key concepts and findings from the article on anorexia nervosa and its biological underpinnings.

What do twin studies suggest about the heritability of anorexia nervosa?

Approximately 50% to 60% of the risk is due to genetic factors.

Which brain region is linked to habit formation and shows altered activity in anorexia during food choice tasks?

The dorsal striatum.

What were the main findings of the large Nature Genetics study on anorexia nervosa?

Identified eight significant genomic regions; overlaps with OCD, depression, BMI, and lipid traits; suggests biology is a strong driver and possible inverse relationship with obesity.

How is BMI/metabolic biology connected to anorexia genetics in the study findings?

Some genetic associations track with BMI and metabolic traits, indicating metabolic regulation plays a role and that risk may relate to low BMI.

What did MRI studies by Steinglass reveal about brain circuits in people with anorexia compared to controls during food decisions?

The dorsal striatum, a habit-related region, showed different engagement in anorexia, suggesting altered decision-making and potential relapse risk.

What observation about the antipsychotic olanzapine challenges the idea that anorexia is purely about self-control?

Olanzapine caused weight gain in the general population but had little to no effect on weight in people with anorexia.

What is Family-Based Treatment (FBT) and its reported effectiveness for anorexia in adolescents?

Parents take an active role to help their child eat; about half of adolescents improve, with around 70% success when started early.

What early treatment predictor is associated with better long-term outcomes in adolescents receiving FBT?

Early weight gain of about 2.3 kilograms in the first month predicts better prognosis.

What brain intervention is being explored for severe enduring anorexia and is studied for OCD overlap?

Deep-brain stimulation (targeting shared neural networks with OCD).

Which psychedelic compound is being tested in Johns Hopkins trials for anorexia nervosa?

Psilocybin.

What funding challenge does anorexia research face compared with other psychiatric disorders?

NIH funding for anorexia has been around $11 million (FY2019), far lower than conditions like schizophrenia, hindering progress.

What is the Eating Disorders Genetics Initiative?

A planned effort to collect genetic data from about 100,000 people with anorexia, bulimia, and binge eating disorder to identify genetic factors.

Why do researchers argue that biology should be a central focus in understanding anorexia, rather than attributing it solely to culture or parenting?

Biology is supported by genetic and brain-imaging findings showing heritability and distinct neural signaling; culture and environment interact but do not wholly explain the disorder.

How do current findings relate anorexia to other psychiatric conditions like addiction?

There are overlaps in brain reward signaling and circuits with OCD and addiction-like features, guiding exploration of shared mechanisms and treatments.

What does the article say about relapse risk in recovered patients and the brain circuits involved?

As eating behavior shifts across different brain circuits, relapse can occur because the targeted circuits become harder to change.