Genetics loads the gun, environment shoots the messenger

It has long seemed to me that the mental illness we call "eating disorder" is a shapeshifter. Eventually we will probably break off parts of what we call anorexia/bulimia/BED and see them as different illnesses. And eventually I think we will see that the same disease manifests itself in various ways, as in Anorexia, 'bigorexia' may have same genetic roots.

I believe treatment outcomes will improve, stigma will decrease, and collateral damage of the disease will be prevented as we better understand the biology of the illness.

Comments

  1. I have a hard time believing that all obese or overweight people are that way because of genetics. My mother and sister are both quite overweight - they don't watch what they eat and they don't exercise. I count my calories and run, and I'm a healthy weight. If it was genetics, I'd be obese no matter what I did. Sure, some people may actually be obese because of their genes, but I'm having trouble believing that they're the majority.. Did this gene randomly pop up in the last 50 years?

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  2. Anon,

    Laura didn't say that in this post (I don't think). Part of the problem is that there isn't, nor likely will there be, an "obesity gene." There are multiple genes and multiple environmental factors.

    Would your sister and mother be healthier if they included fun physical activity in their lives? Probably. Does it mean they would be thin? Maybe not. Does it mean that you are inherently healthier (mentally and physically) because you count calories and run? Not necessarily either. You might have inherited different genes that allow you to maintain a lower weight but could put you at risk for something else. Weight doesn't equal health.

    Despite the fact that both Laura and I firmly believe in a biological/genetic cause for EDs doesn't mean that either of us (sorry if I'm speaking for you too much, Laura!) discount the effects of environment.

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  3. Carrie described it well.

    I'll add this. Genetics is more like a game of dice than a recipe. You can have very different genetic profiles among family members.

    And environment has a unique interplay on genetic predispositions. The same person in two environments will be different.

    Not as different as I think we used to think, but different - even identical twins can have different experiences in the womb.

    I also think it is clear that some people are born with tendencies for certain drives. Drives to be active, drives to eat certain foods.

    We give ourselves a lot of credit for being a certain shape, color, disposition: but I think we need to have a bit more humility.

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