In the United States alone, an estimated 8 million individuals struggle with an eating disorder. To many people, such an affliction might seem silly. Ostensibly, one should be able to simply eat more, right? What is an eating disorder, and how have they established themselves with such great prevalence in our country? The fact of the matter is, eating disorders are not so simple. The term “eating disorder” is an umbrella that casts a large shadow over many separate and distinct incarnations such as anorexia nervosa, bulimia, muscle dismorphia, as well as food maintenance syndrome, to name a few. The differences in individual expression of eating disorders makes it very difficult to simply categorize them, let alone ascertain their specific causes and potential treatments. Furthermore, eating disorders often come pre-packed with some psychopathology as well. In fact, eating disorders have been found to be connected in some way with almost every single well known psychiatric disorder such as chronic depression and bipolar disorder. Their causes and their nepenthe have yet to be fully determined. Also, the immense body of research in the topic is riddled with the influence of the classic and still raging debate regarding the importance of nature versus nurture.
The effects of upbringing (nurture) in catalyzing the development of an eating disorder seem clear and numerable. Many researchers point demonstrate the obvious: the American society has created an unobtainable standard of physical appearance that has left young children far more vulnerable to feeling low ratings of person appearance, which has likely enforced the disgustingly high prevalence of eating disorders as well as mood disorders. Schreiber (1996) reports that 40% of girls aged nine and ten are already trying to lose weight. Such is the true price of the unrealistically proportioned barbie doll, as it appears to represent more of a cartoonish caricature than a true woman. The heroines (but more often damsels in distress) found in every Disney movie ever made reflects this sad trend as well with their corset-tortured waists. Furthermore, the social bi-products of our myspace generation as well as the fine programming on MTV have both enforced a personal obsession with our own appearance at a level unprecedented. The influence of nurture in catalyzing eating disorders seems clear. But is there more to it than that? Can one, for example, simply have genes that leave them more likely to experience an eating disorder in their lifetime?
Some researchers think so. Many brain imaging studies have demonstrated that, on average, people with eating disorders (specifically anorexia and bulimia) exhibit non-normal function in the neurotransmission of serotonin and dopamine. This seems quite interesting because serotonin controls the regulation of mood, appettite, and impulse control; while a failure of one’s dopaminergenic systems might experience atypical reward-seeking behaviors, a disturbed or disoriented decision making process, and an unbalanced appetite. Mikolajczyk, Gryzwacz, and Samochowiec (2009) were interested in whether genes that can alter serotonin and dopamine levels would have a statistical connection with the occurrence of eating disorders. They identified one gene in particular, catechol-O-methyltransferase (COMT), that seems to be related to such disturbances, and it also has been implicated as a possible culprit of psychosis and mood disorders. They demonstrated that two specific genotypes (different allele configurations in the COMT gene) left women five times more likely to have an eating disorder and seven times more likely to have bulimia. This is strong evidence that some element of nature is at play in here. This begs the question: if researchers have found a gene that might cause eating disorders, could they also find a medicine to cure it as well? Unfortunately, the answer is seldom so simple.
Rossi (2010) closely observed the efficacy of different psychiatric treatments in a sample size consisting of pre-adolescent girls. These treatments mostly consisted of both a therapy component and a medicinal component, consisting of a battery SSRI’s, tricyclics, first and second antipsychotics…pretty much the works. These researcher note that there exists no evidence which suggests that any of these drugs can be benificial in alleviating an eating disorder on their own. However, therapy often works very well. This particular study found that a combination of therapy and medication seems to offer the best hope of returning to a normal, healthy weight and dispelling personal feelings of inadequacy. As far as treatments go, neither nurture nor nature should be discounted. The complexity of the affliction is such that an effective assault against it must be multi-pronged. But like most other related studies, this work suffers from limitations such as small sample sizes and purely correlative data. In the future, a vast amount of work awaits researchers if they ever hope to find a “cure” for eating disorders. In order for better treatments to be found, the researchers must be able to better understand the causes.