Science & Technology/Families Don't Cause Anorexia Nervosa, Eating-Disorder Researchers Emphasize

Claiming that families “cause” eating disorders is like blaming parents for diabetes, asthma, or cancer, says an international group of eating-disorders researchers that includes Pitt psychiatry professor Walter H. Kaye.

Recent statements by fashion model Gisele Bundchen that unsupportive families cause anorexia nervosa only perpetuate misconceptions and further stigmatize eating disorders, the researchers said, adding that there is no scientific evidence that families cause anorexia nervosa.

In fact, scientists are finding that anorexia nervosa’s causes are far more complex than the desire to be slim and achieve some fashionably slender ideal. Data show that anorexia nervosa has a strong genetic component that may be the illness’ root cause.

“We often hear that societal pressures to be thin cause many young women and men to develop an eating disorder,” said Kaye. “Many individuals in our culture, for a number of reasons, are concerned with their weight and diet. Yet less than half of 1 percent of women develop anorexia nervosa, which indicates to us that societal pressure alone isn’t enough to cause someone to develop this disease.

“Our research has found that genes seem to play a substantial role in determining who is vulnerable to developing an eating disorder,” Kaye continued. “However, the societal pressure isn’t irrelevant; it may be the environmental trigger that releases a person’s genetic risk. Families should not be blamed for causing anorexia. In fact, they are often devastated and suffer from the consequences of this illness.”

Kaye is a member of an international group of researchers attempting to find, through a National Institute of Mental Health-funded study of families with a history of anorexia nervosa, which genes cause the illness. The current study builds on data from 10 years of groundbreaking research, sponsored by the Price Foundation, on the genetics of eating disorders.

Anorexia nervosa is a serious and potentially lethal illness, with a mortality rate greater than 10 percent. It is characterized by the relentless pursuit of thinness, emaciation, and the obsessive fear of gaining weight. Anorexia nervosa commonly begins during adolescence, but strikes throughout the victim’s lifespan. It is nine times more common in females than in males.

Personality traits such as perfectionism, anxiety, and obsession are often present in childhood before the eating disorder develops and may contribute to the risk of developing this disorder.

“An uninformed opinion such as Bundchen’s causes harm on a number of levels. By contributing to the stigma, it drives sufferers underground and creates obstacles to seeking help. It damages attempts at advocacy and hurts parents who are desperately fighting for their child’s recovery,” said Allan S. Kaplan, Loretta Anne Rogers Chair in Eating Disorders at the University of Toronto. “Such thinking also misinforms third-party payers who may not want to pay for the treatment of these biologically based illnesses if they think its primary cause is family dysfunction.”

“We need to understand all the factors that influence eating disorders, both genetic and environmental, and find ways to address them in order to prevent people from developing these potentially deadly conditions,” said Cynthia Bulik, William and Jeanne Jordan Distinguished Professor of Eating Disorders at the University of North Carolina at Chapel Hill. “Understanding how genes and environment interact both to increase risk for eating disorders and to protect those who are genetically vulnerable from developing the disorder will require the cooperation of professionals in the eating disorders field, the media, and the fashion and entertainment industries. Only cooperatively will we be able to move the field forward toward the elimination of this disease.”

“Anorexia nervosa has the highest death rate of any mental illness, yet so few dollars are dedicated to the cure,” stated Lynn Grefe, CEO of the National Eating Disorders Association. “These scientific advances demonstrating a genetic component are significant and so meaningful to our families, wiping away the myths and emphasizing the need for even more research to help the next generation.”

The team of researchers involved in the Genetics of Anorexia Nervosa collaboration invites families to help them unravel the genetic underpinnings of this disorder. Families in which two or more relatives have had anorexia nervosa (this includes siblings, cousins, aunts, uncles, or grandparents) are encouraged to contact the team for more information about participation.

The study involves phone interviews, questionnaires, and a blood draw. Participants are compensated for their time. For more information, call 1-888-895-3886, e-mail EDResearch@upmc.edu, or visit www.angenetics.org.

Study sites are located in seven U.S. cities (Baltimore; Fargo, N.D.; Los Angeles; New York City; Philadelphia; Pittsburgh; and Tulsa, Okla.) and in Toronto, Munich, and London.