Anorexia and Bulimia: Cracking the Genetic Code

"bring eating disorders rightly under the rubric of medical/psychological conditions as opposed to social phenomena"

Anorexia and Bulimia: Cracking the Genetic Code


  1. I've got a question. Are you pro-gene therapy for people with eating disorders, or do you simply want to prove that EDs are genetic? What are your goals and ideas? Do you think gene research could be dangerous in that parents might abort children who will develop EDs? Thanks. :) KC

  2. Hi kc -
    I just wanted to comment on your questions.
    The importance of whether or not EDs have a genetic basis has to do with the effectiveness of the treatment that is offered.
    If a physician or therapist believes that a disease has it's origins in a physical or biochemical abnormality - like depression, diabetes, hyperthyroidism, hypertension - then the treatment that gets offered is aimed at correcting or compensating for that abnormality.
    If, on the other hand, the disease is supposed to have a psycho-social origin alone, then the treatment options tend to the psycho-dynamic, behavioral, and cognitive therapies. There are very few disorders of the brain that are purely psycho-social. The only ones I can think of, or have seen credible evidence of, are paralyses that develop in response to traumas (what used to be called hysterias). As we've come to understand the brain better, we've come to realize that mood disorders, thinking disorders, and expressive disorders like autism all start with underlying problems in the brain's bio-chemistry. The strong genetic influence of EDs that research has revealed means that these diseases belong solidly in the bio-chemical model, rather than in the psycho-social model.
    Which means that effective treatment should be aimed FIRST at correcting the physical aspects. It does not mean that the social aspects aren't important, or that they get ignored or anything else. It just means that progress cannot be expected until relatively normal function is first restored.
    Media reports make gene research and gene therapy sound further along than they actually are. Gene therapy, such as it is, is only really even possible when you are talking about 1 or 2 genes, affecting a trait in a very direct way. Diseases like Parkinsons or sickle cell anemia fall into this class. The basic idea would be that you could treat the affected cells so that the gene mutations that lead to the disease would be replaced with ones that worked correctly. Or that you would use stem cells that would mature into healthy cells that would work properly. Anyway, we can't really do this yet for simple traits we know. For complex traits - and there are liable to be many as yet unidentified contributors to ED - we are miles away from using gene research - except maybe in the area of tailoring known drugs to people who are likely to benefit from them.
    The ethics of genetically tailoring children is under hot debate. Leaving aside the question of can we identify if a blastula/fetus is at risk for EDs (we can't), there is always the chance that someone can use knowledge to an unethical or negative end. But that shouldn't stop us from trying to gain knowledge in the first place. It means we have to think carefully about how to prevent abuse of information, and what the implications of our new knowledge are. Currently, legislation is being developed that would prevent employers and insurers from discriminating against people on the basis of genetic information, and that's a big start.
    If we were rats, our genes would more or less determine our life-course and our fates. But luckily, we're humans, and we have lots of ways to "adapt, improvise, and overcome" so that knowing someone's genes is only a part of the story, and it can turn out to be the least interesting part at that.

  3. KC,

    I think Irish addressed the gene therapy and gene thing well.

    Let me add that knowing what eating disorders really are doesn't mean getting rid of people with these genes or getting rid of these genes. It means understanding what these genes can do, and working with that person to make these predispositions into assets and not life-threatening illness.

    The same predispositions that cause eating disorders also make wonderful scientists, engineeers, doctors, artists... but only when nurtured and balanced in the right ways for that person.

    I accept and love and embrace my daughter - all of her. And as a recovered person she is not diminished, she is wonderfully strong and unique and vibrant!

  4. thanks for the clarifications :)

  5. I have quite a family history of bulimia, anorexia, other extreme eating behaviors, etc. Perhaps I am misunderstanding this "gene therapy," but is it too late for me to receive gene therapy, or gene therapy would be treated to my unborn child to prevent an eating disorder in he or she? I've had along time battle with bulimia (I would like to think I am over that chapter of my life) but I would never rule out continuous treatment. Its funny how bulimia controlled my life back then, now I feel like my whole existence is concentrated on getting out the word about how we can battle bulimia, and if gene therapy is an option, I just want to be able to share the information correctly.


  6. Mike - I think we are far off from really knowing what genes or gene combinations lead to eating disorders - and what the environmental triggers may be. I don't see gene therapy in the cards for a long time, if ever.

    But there are VERY effective treatments and full recovery is absolutely in reach. If you, or your unborn child, show signs of struggling you don't have to suffer - get treatment!


Post a Comment

Popular Posts