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Case studies contact database; research contacts; case studies with personal experience of eating disorders; male eating disorders.

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Socio-cultural? In the West, idealised notions of body shape presented in the media have become thinner over time. However, only a fraction of people exposed to these images develop eating disorders ... why might this be

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Socio-cultural? In the West, idealised notions of body shape presented in the media have become thinner over time. However, only a fraction of people exposed to these images develop eating disorders ... why might this be

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Are eating disorders a female disorder? See graph below

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Are eating disorders a female disorder? See graph below

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Links to placement & future employment? 

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Links to placement & future employment? 

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Website with useful numbers and contacts to support individuals with behavioural addictions such as eating disorders

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Website with useful numbers and contacts to support individuals with behavioural addictions such as eating disorders

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Anorexia is a severe form of eating disorder which stems from an abnormal obsession with becoming thin. It often begins with normal levels of dieting and exercising but becomes a problem when the sufferer starts obsessing over the need to become thinner and thinner. No matter their real physical condition, anorexics always see themselves as "too fat" and have a severely distorted body image which has negative effects on their self esteem.

Most anorexia sufferers are young woman and teenage girls, although there is a worryingly rising trend in pre-teen sufferers and a significant percentage of anorexics are older women and even men.

It is important to remember that eating disorders are not just bad habits and poor for someone's diet - they are a serious illness and often point to many underlying psychological issues including poor body image, lack of self-confidence and even remembrance of serious trauma.

Symptoms of Anorexia

Do you know someone who is worrying you by exhibiting possible signs of anorexia? Try asking yourself the following questions.

Do they appear very underweight,? Not all anorexics are skeletal or emaciated, however!

Are they secretive about their eating habits, claiming to have eaten and becoming angry when questioned?

Do they seem to gain self esteem and confidence from seeing the figures on the scales drop?

Are they moody and sulky, and try to avoid being present at meals?

Are they exhibiting other physical symptoms such as excess body hair growth (this often happens to keep the body warm), dry skin or (for females) irregular or absent periods?

Do you know someone who is suffering from anorexia? Call us now for free help and advice on how simple and easy it can be to get free of anorexia and live a happier, healthier life.

Get Help For Anorexia

Finding the right treatment service that can help you live free of anorexia is often a complicated and time-consuming process. If you need urgent help and are finding the wide variety of treatments on offer overwhelming, that's where we come in.

Our anorexia treatment assistance gives you:

A free help and evaluation service to help you choose

Guidance on the best treatment options for your circumstances

Assistance in picking out the most cost-effective options

Information on quality of care, best clinical practice and more

Complete clarity so you can make the right choice of treatment

Call today in complete confidence on 08000 886 686 to take your first steps on the road to a happy and healthy new life.
"I feel happy and free again. Thank you for helping me turn my life around."
Jenny, Luton
With Clinics throughout the UK we can help you get back on track

We accept most private
health insurers

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Anorexia is a severe form of eating disorder which stems from an abnormal obsession with becoming thin. It often begins with normal levels of dieting and exercising but becomes a problem when the sufferer starts obsessing over the need to become thinner and thinner.

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The biological approach. Is anorexia in the genes? Click on the web site and scroll down to video clip featuring Professor Janet Treasure from the Eating Disorders unit at the Maudsley NHS Trust

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The biological approach. Is anorexia in the genes? Click on the web site and scroll down to video clip featuring Professor Janet Treasure from the Eating Disorders unit at the Maudsley NHS Trust

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The study found a link between the EHPX2 gene and anorexia

"Anorexia could have genetic link," The Daily Telegraph reports.

The headline might lead you to think that a role for genes in anorexia is a completely new finding. However, studies in twins and families affected by the condition have already suggested such a link.

The news highlights a study in which researchers found that some variants in and around a gene called EPHX2 are more common in people with anorexia nervosa.

They compared 152 genes in more than 1,000 women with anorexia and almost 1,500 women who did not have the condition.

The EPHX2 gene is involved in cholesterol function in the body, and has not previously been linked with anorexia.

In a complex disease like anorexia, multiple genes are likely to play a role, as well as environmental factors. This makes it difficult to identify the genes involved.

This study gives us only a small piece in a large and complex puzzle.

Where did the story come from?

The study was carried out by researchers from The Scripps Translational Science Institute in the US, and other research centres in the US, Canada, Italy, and the UK. It was funded by the Price Foundation, and the authors also received support from grants from the US National Institutes for Health and other university and charitable organisations.

The study was published in the peer-reviewed journal Molecular Psychiatry.

The Telegraph's headline implies that a genetic contribution to anorexia had not been suspected previously, which is not the case. Similarly, the Mail Online implies that previous thinking was that anorexia is purely down to social pressures, which is also incorrect.

Many experts believe that the condition is caused by a combination of psychological, environmental and biological factors (including genetics), which lead to a destructive cycle of behaviour.

What kind of research was this?

This was a case-control study looking at whether variations in specific genes might be linked to anorexia. Genetic factors are thought to play a role in people's risk of developing anorexia, as well as environmental factors.

However, it is likely that multiple genes play a role, and different genes might be playing a role in different people, and that makes it hard to identify these genes. So far, studies have not been able to provide robust evidence about which genes are involved.

In the current study, researchers wanted to focus on a number of genes which they thought might play a role in anorexia, based on what is known about what these genes do. This approach is called a "candidate gene" approach, as the genes are "candidates" for contributing to disease risk. This is one of a number of standard ways to study the genetic basis of a condition.

What did the research involve?

The researchers studied DNA from 1,205 people with anorexia (cases) and 1,948 people without the condition (controls). They looked at the sequence of 152 candidate genes that might play a role in causing anorexia, to try and identify variations in these genes that were more common in cases than controls.

The researchers initially started with 262 white European women with early-onset severe anorexia and 80 matched controls who were not underweight (matched for ethnicity, age and where they were recruited). The cases:

had been clinically diagnosed with a history of restricting type anorexia (where a person limits their calorie intake) with or without purging (vomiting) and were an average age of 14 years when they first experienced these symptoms

had a body mass index (BMI) of 15 or less during their lifetime, and had an assessment age of 19 years or older (to give evidence of a persisting disease course)

Women who reported regular binge eating were not included in this sample, to ensure women in the sample were all as similar as possible (to try and ensure that participants had anorexia and not another diagnosed eating disorder such as bulimia nervosa). Tightly defining the study population helps researchers to identify genes that might contribute to causing the condition. This is because different eating disorders might be caused by different genes, and this makes teasing out these genes from a mixed sample difficult.

After initially looking at the candidate genes in these women, they went on to test their findings in 500 anorexia cases and 500 controls, and also data on a further 444 cases of anorexia or eating disturbances and 1,146 controls from previous studies. All of these participants were of European ancestry. This method of looking for associations in one sample and then confirming what you find in another sample (called a "replication sample") is a standard way of increasing confidence that the genes identified are truly associated with the disease.

For some of the cases and controls in previous studies, the researchers had data on BMI and metabolic measurements, such as cholesterol, taken over time. This allowed them to look at whether the variants they identified were related to these changes. They also looked at where the genes they identified as being associated with anorexia were active in the brain.

What were the basic results?

The researchers identified just over 8,000 single nucleotide differences and other small differences in the 152 genes they were interested in, in different individuals.

The two variants which showed the strongest association with anorexia (those that showed the greatest difference between cases and controls in how common they were) were in the Estrogen Receptor Beta gene (ESR2). Previous studies have suggested that oestrogen and oestrogen receptors might play a role in anorexia.

They also used another form of analysis, which looked at groups of variants together, and in this analysis variants in two genes - ITPR3 and EPHX2 - showed the strongest association with anorexia. When they tested these variants in their replication samples, the variants in EPHX2 and ESR2 still showed evidence of an association with anorexia.

The researchers then focused on the EPHX2 gene, as its association with anorexia has not been described previously.

The gene is involved in cholesterol function, and although this may seem counterintuitive, people with anorexia often show high cholesterol levels that return to normal once they return to normal weight.

The researchers found that one of the variants in EPHX2 was related to how BMI and cholesterol levels changed over time. The EPHX2 variants also showed some evidence of association with depressive and anxiety symptoms in women with anorexia, and appeared to affect how BMI related to depressive symptoms. The EPHX2 gene was found to be active in some parts of the brain relating to feeding behaviours, anxiety, and depression.

How did the researchers interpret the results?

The researchers concluded that they had identified "a novel association of gene variants within EPHX2 to susceptibility to [anorexia nervosa] and provide a foundation for future study of this important yet poorly understood condition".

Conclusion

The current study has identified an association between a gene called EPHX2 and anorexia in women, in what is reported to be the largest DNA sequencing study in anorexia to date. Even so, the researchers note that it will be essential to test their findings in a larger sample for confirmation.

The exact causes of anorexia are not known, although both genetic and environmental factors are thought to play a role. In complex diseases such as anorexia, many genes may potentially play a role, and different genes may play a role in slightly different forms of the condition. This makes identifying the genes involved very challenging.

A strength of the current study from a genetic perspective was it looked at a very well-defined group of women with anorexia However, the downside of this type of study design it that it does limit the extent to which findings can be extended to other groups. For example, it only looked at women and those who did not binge, so results may not apply to men or people who may have another eating disorder diagnosis, such as bulimia.

As the study authors note, more work is needed to confirm a role of this gene in anorexia. There will also be other genes playing a role, so this finding is only one small piece in an evolving puzzle.
Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter.

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New genetic clue in 'puzzle' of anorexia

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"Anorexia could have genetic link," The Daily Telegraph reports. The headline might lead you to think that a role for genes in anorexia is a completely new finding. However, studies in twins and families affected by the condition have already suggested a link...

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The good news is 46% of individuals fully recover & 33% improve. Find evidence of treatment & evaluate it's effectiveness. Is this treatment available on the NHS?

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The good news is 46% of individuals fully recover & 33% improve. Find evidence of treatment & evaluate it's effectiveness. Is this treatment available on the NHS?

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However, that means 21% do not recover. Can you shed light on why this might be? Provide evidence to support your answer

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Information & statistics about eating disorders in the UK, such as the most common eating disorders and the number of people affected.

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What percentage of individuals in the UK have a diagnosed eating disorder? Of this percentage, what is the ratio in terms of gender? Is there a link to social class? Does it just affect teenagers?

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What percentage of individuals in the UK have a diagnosed eating disorder? Of this percentage, what is the ratio in terms of gender? Is there a link to social class? Does it just affect teenagers?

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Type your answer here

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What is an eating disorder? What are the signs & symptoms? What are the possible causes / factors? 

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What is an eating disorder? What are the signs & symptoms? What are the possible causes / factors? 

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Type your definitions into this box

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What is Psychotherapy?- accessible and user-friendly information from The Royal College of Psychiatrists on the different kinds of psychotherapy

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1.Discuss psychological approaches in the management of an eating disorder: A1 4.1 & A2

2. Analyse a psychological approach in relation to an eating disorder: A*1 4.2 & A*2

You will be divided into small groups  to research one of the approaches for anorexia or bulimia in order to meet the criteria listed above
The 5 psychological approaches are:
1. Social Learning theory (Emma, Roisin & Portia)
2. Biological (Madelleine & Gracie)
3. Psychodynamic (Lesharn, Charlotte & Lauren)
4. Humanistic (Rachel, Holly & Shae)
5. Behaviourism (Emily, Georgina & Denia)

Extended task:
Shae, Emily, Madelleine, Lauren & Emma to analyse their findings & stay with their posters whilst other member(s) of their groups visit their peers from the 4 other groups to ask questions and learn how other psychological approaches differ from theirs.