In this podcast Tabitha Farrar talks to Dr Cynthia Bulik about recent study that identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa.
Link to paper: https://www.nature.com/articles/s41588-019-0439-2
Dr. Bulik, a clinical psychologist, is Distinguished Professor of Eating Disorders in the Department of Psychiatry, professor of nutrition in the Gillings School of Global Public Health and founding director of the UNC Center of Excellence for Eating Disorders.
She is also professor of medical epidemiology and biostatistics at Karolinska Institutet in Stockholm, Sweden, where she spends half of her time.
Her research includes treatment, laboratory, epidemiological, twin and molecular genetic studies of eating disorders and weight regulation. She has written more than 590 scientific papers and chapters on eating disorders and is the author of Crave: Why You Binge Eat and How to Stop, The Woman in the Mirror, Midlife Eating Disorders: Your Journey to Recovery, and Binge Control: A Compact Recovery Guide.
She is a recipient of the Eating Disorders Coalition Research Award, the Academy for Eating Disorders’ Leadership Award for Research, the Price Family National Eating Disorders Association Research Award and the Women’s Leadership Council Faculty-to-Faculty Mentorship Award.
Dr. Bulik is past president of the Academy for Eating Disorders, past vice-president of the Eating Disorders Coalition and past Associate Editor of the International Journal of Eating Disorders. She holds the first endowed professorship in eating disorders in the United States.
Her academic life is balanced by being happily married with three children and performing as an ice dancer and ballroom dancer.
I’ll spit in a pot. Whatever it takes to get this disorder studied, discoveries made, treatments developed and stigmas torn down.
Great interview, it is wonderful to hear Dr. Bulik’s insights on this very important study. On the issue of treatment of “AAN” vs. AN in terms of refeeding…Many have observed that their person’s state improved once they reached or went above their pre-existing weight, even if this weight would be considered “overweight” or “ob*se* on a bmi chart. That combined with the fact that getting renourished as quickly as possible bodes for a better long term outcome would seem to indicate the rate of gain should not be any slower than someone with “typical” AN. Not everyone will need 6000 calories/day to gain, some gain 1 kg /week on 3000 calories/day. I think that part can be individually tailored based on observation, but based on what has been observed in those who have reached recovery, I would think that gain should be encouraged to one’s natural body type and a good state as quickly as someone with “typical” AN. https://www.eatingdisordertherapyla.com/are-we-setting-recovery-weights-too-low/
I have a deep brain stimulator that’s is very very cutting edge and I definitely think it’s helping me.
So much research needs to be done to begin to understand this devastating disease
Thank you, Tabitha, for interviewing Dr. Bulik and for giving the ED community a more specific explanation about the recent studies/findings. The results about these loci have made even local news in Nashville, TN, which should illustrate the importance of these recent discoveries, ha! I fear the subsequent experiments will require a lot of time before anything concrete can be further said about the metabolic components of anorexia and all eating disorders, which means that for now, we cannot assume anything from this study other than that strong genetic/biological factors fuel the disease….Now, forgive me for my criticism, but I did find this discussion a bit troublesome from the standpoint of a person recovering from anorexia in the here-and-now, knowing that, possibly, I could have a predisposition for BED or some other eating disorder encoded in me. That news discourages me. So, I just want to give my two-cents about the present recovery process: no matter what size I am, and no matter if I “binge” or want to “binge,” etc., since I have a history of restricting and tortuous food-thoughts that I have ignored for years, I can eat all I want. No calorie counting, no limits to plating, no weight goals in either direction. I would like to say the same philosophy extends to all sufferers currently out there, no matter the body size, but I just want to speak for myself and not interfere with anyone else’s journey. In any event, overall, I do think these findings are marvelous, and I am just adding a caveat….Typical me, but I thought it was important to do so!
How does this study align with your more recent post “If you’re not actively recovering, you are dying”? It seems to be in direct conflict to your notion that all an adult with an eating disorder needs to do (in fact, you suggest that if they aren’t doing it, they’re bullshitting themselves and do not want to recover) is eat in an unrestricted fashion. This study suggests that eating disorders, at the very least anorexia, have a very strong genetic basis that is closely related to other psychiatric diseases as well as metabolic disorders.