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Eating disorders Q&A: dissecting the role of metabolism and growth

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Dr Nadia Micali from University College London is exploring whether specific changes in metabolic function, appetite and growth factors lead to the onset of eating disorders.

Why is it important to study the role of metabolism, appetite and growth in the development of eating disorders?

We still know little about why eating disorders develop, although we do know both nature and nurture play a role. New research suggests that eating disorders, particularly anorexia nervosa, might be better explained as an illness that has a metabolic component – i.e. the largely natural process of converting food into energy - as well as a psychiatric component.

Some of our previous research has shown that appetite and propensity for higher weight might also put individuals at risk for eating disorders, such as bulimia nervosa and binge eating disorders. Our latest research aims to bring this all together to develop a better picture of the role of childhood eating, metabolism and genes in the development of eating disorders.

How might these factors lead to the onset of an eating disorder?

It could be either via genetic risk (nature), or via what happens around us (nurture/environment), or a combination of both. In our study we are particularly focusing on the genetics of anorexia nervosa and being overweight or obese. We think this genetic risk might set children on a path, and certain environmental factors might lead to the development of eating disorders. We're also studying how children eat in childhood and whether these patterns are related to eating disorders in later life.

How will insights from this study aid future research?

We hope that when this research is completed, we will have a better understanding of the mechanisms that lead to the development of an eating disorder, allowing clinicians to develop better preventative and early intervention strategies. For example, early findings show that adolescents who have a higher genetic propensity for having a higher body mass index (BMI) are at higher risk of developing some behaviours related to eating disorders (such as binge eating). This suggests that efforts in preventing obesity might also be useful for preventing some eating disorders, or that in the future we might be able to target prevention on those who have this higher genetic propensity.

What could these findings mean for people with eating disorders?

We still have very few treatment options for eating disorders. Certain treatments work well in some people, but it’s often difficult to predict those who will not respond to treatment. Therefore, we need to get better at detecting young people at risk, in order to improve prevention and develop new approaches to treatment.

Find out more about Dr Micali's research, which is funded by the Medical Research Foundation and the MRC.