Can you name the psychiatric illness with the highest mortality rate? It’s anorexia nervosa. This condition and other eating disorders carry increased risks for suicide and serious medical complications. This is one of “nine truths” about eating disorders, a list released by the Academy for Eating Disorders as part of World Eating Disorders Day on June 2. The list was compiled with the help of leading eating disorders experts, including Cynthia Bulik, PhD, FAED, director of the UNC Center of Excellence for Eating Disorders (CEED).
Here’s another truth: people suffering from eating disorders don’t necessarily “look sick.” In fact, many look healthy and lead active lifestyles. But these individuals can be suffering from serious biological conditions, such as anorexia nervosa, bulimia nervosa or binge-eating disorder.
“Sometimes people expect that someone with an eating disorder is going to ‘look ill’ on the outside,” Bulik said. “But that’s not the case at all. People can look totally healthy. They can be physically active. They can go to work. But on the inside, they’re suffering from an eating disorder.”
Bulik, who holds the first endowed professorship in the field of eating disorders in the country, is currently leading a global research initiative called The Anorexia Nervosa Genetics Initiative – or ANGI – to analyze 26,000 genetic samples and isolate genes that play important roles in the underlying biology of eating disorders. ANGI is the largest global study ever to search for the genes that influence risk for anorexia nervosa.
“One way of looking at this is that genes ‘load the gun,’ but environment ‘pulls the trigger.'”
“We know that genetic factors influence risk for the development of an eating disorder,” said Bulik, who is also Distinguished Professor of Eating Disorders in the Department of Psychiatry in the UNC School of Medicine. “We also know that genes don’t act alone. So one way of looking at this is that genes ‘load the gun,’ but environment ‘pulls the trigger.’”
The “nine truths” about eating disorders are:
1. Many people with eating disorders look healthy, yet may be extremely ill.
2. Families are not to blame, and can be the patients’ and providers’ best allies in treatment.
3. An eating disorder diagnosis is a health crisis that disrupts personal and family functioning.
4. Eating disorders are not choices, but serious biologically influenced illnesses.
5. Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations and socioeconomic statuses.
6. Eating disorders carry an increased risk for suicide and medical complications.
7. Genes and environment play important roles in the development of eating disorders.
8. Genes alone do not predict who will develop eating disorders.
9. Full recovery from an eating disorder is possible. Early detection and intervention are important.
Bulik and fellow researchers at CEED stress the importance of early diagnosis and intervention to treat these curable but deadly diseases.
Stephanie Zerwas, PhD, assistant professor of psychiatry and clinical director of CEED, said, “One of the first questions I hear from patients and their parents is, ‘Will recovery really be possible?’ We have seen time and time again we can help people triumph over this disease. If we see them earlier in their illnesses, they will do better in the long run.”
“One of the things that we know is very important in recovery from these illnesses is early detection and treatment.”
Bulik added, “People often ask me, ‘are eating disorders like alcoholism—once an alcoholic, always an alcoholic?’ My answer to that question—for all eating disorders—is ‘no.’ They’re completely different. People can recover from anorexia nervosa, bulimia nervosa and binge-eating disorder at any time and at any age. One of the things that we know is very important in recovery from these illnesses is early detection and treatment.”
As part of World Eating Disorders Action Day, people are asked to use the hashtag #WeDoAct.
For media interested in conducting interviews or covering World Eating Disorders Action Day, Dr. Zerwas will be available for interviews on Thursday, June 2.
For more information about World Eating Disorders Action Day, visit the website or follow the Twitter or Facebook accounts. More information on Drs. Bulik and Zerwas, as well as on the UNC Center of Excellence for Eating Disorders, can be found here. Information on the Anorexia Nervosa Genetics Initiative can be found here.