ANGI - Anorexia Nervosa Genetics Initiative.

Identification of genetic variants associated with eating disorders is underway. The Anorexia Nervosa Genetics Initiative, an initiative of the Klarman Family Foundation, has contributed to advancing the field, yielding a large-scale genome-wide association study published in Nature Genetics. Eight genetic variants significantly associated with anorexia nervosa were identified, along with patterns of genetic correlations that suggest both psychiatric and metabolic origins of this serious and life-threatening illness. This article details the role of Professor Nick Martin in contributing to this important collaboration.

Orthorexia: eating right in the context of healthism.

Orthorexia is a putative new eating disorder vying for a place in the DSM, roughly meaning "eating right". While a continuum can be drawn between anorexia and orthorexia, there are enough differences to make this disorder a distinct one. In this paper, I trace the origins of the term and its clinical career to date, employing Ian Hacking's concept of "ecological niche" to establish the place of orthorexia as a contemporary cyberpathy, a digitally transmitted disorder inwardly and narrowly focused on health through the consumption of "pure" foods. I critique both the notions of "health" and "purity" in this context, showing that orthorexia can only be understood in the context of healthism, an individual preoccupation with health in the context of neoliberalism. Using Jordan Younger's Breaking Vegan memoir (2015) and "Balanced Blonde" blog as a case study, I argue that orthorexia replicates via a digital proliferation of entrepreneurship of the self. Ultimately, this excessive preoccupation with health as a neoliberal cultural pathology bares life of meaning.

[Treatment history of eating disorders between 1984-2008 at the Department of Psychiatry and Psychotherapy, Semmelweis University].

The authors summarize their experiences collected from psychotherapeutic treatment of anorectic and bulimic patients treated at the outpatient and inpatient clinics of the Department of Psychiatry and Psychotherapy, Semmelweis University in the period of 1984-2008. The introduction provides an overview of the literature, that represents a theoretical background to their therapeutic strategies. Afterwards, insights are given about the authors own treatment strategies, that varied, although only slightly in different time periods. Therapeutic outcomes are summarized separately for groups of restrictive and purging anorexia patients, bulimia patients and bulimia patients suffering from other impulse control problems. Results are evaluated on the basis of clinical assessments, symptomatic reductions of eating disorders after treatment, and based on two years follow-up data. Finally results are analysed critically, concerning the used methods and further opportunities for relapse prevention.

The evolution of our understanding and treatment of eating disorders over the past 50 years.

Although historical descriptions date back to the Hellenistic era, and Gull's naming of anorexia nervosa as a medical disorder to the late 19th century, it is only in the past 50 years that eating disorders have become widely recognized as the prevalent, potentially fatal, complex, and confounding biopsychosocial illnesses we confront today. This paper reviews the considerable advancements in our knowledge of eating disorders during three time periods: the "early years" of the 1960s and 1970s; the "middle years" of the 1980s and 1990s; and the 21st century to date. The recent Diagnostic and Statistical Manual of Mental Disorders, 5th Edition describes six major feeding and eating disorders. This historical focus addresses the interaction of multiple factors contributing to the incidence, primarily of anorexia nervosa and bulimia nervosa, in vulnerable individuals, and efforts to develop effective treatment strategies and programs in a variety of settings. Future challenges are also addressed.

Expert leadership of eating disorder services in South Australia.

OBJECTIVES: The objective of this study was to describe the history of South Australian Government eating disorder service from the perspective of changing leadership, health policies and politics. CONCLUSIONS: The history reveals a foundation of early expert academic clinical leadership changing into a centralised managerial bureaucracy correlating with a diminution of services. A threat to the survival of the service led to a solution involving reinvigoration of expert clinical and academic leadership. Expert leadership was shown to be an important part of an eating disorder service.

Back by Popular Demand: A Narrative Review on the History of Food Addiction Research.

In recent years, the concept of food addiction has gained more and more popularity. This approach acknowledges the apparent parallels between substance use disorders and overeating of highly palatable, high-caloric foods. Part of this discussion includes that "hyperpalatable" foods may have an addictive potential because of increased potency due to certain nutrients or additives. Although this idea seems to be relatively new, research on food addiction actually encompasses several decades, a fact that often remains unrecognized. Scientific use of the term addiction in reference to chocolate even dates back to the 19th century. In the 20th century, food addiction research underwent several paradigm shifts, which include changing foci on anorexia nervosa, bulimia nervosa, obesity, or binge eating disorder. Thus, the purpose of this review is to describe the history and state of the art of food addiction research and to demonstrate its development and refinement of definitions and methodologies.

Drama therapy and eating disorders: a historical perspective and an overview of a Bolognese project for adolescents.

OBJECTIVES: The authors present a description of a theater workshop ("Metamorphosis Project"), developed at the Bologna Eating Disorders Center. DESIGN: The workshops are aimed at young, hospitalized patients, and are largely based on the principles of drama therapy. In this article, this therapeutic modality is introduced by a discussion of the theoretical basis for the use of theater in psychiatry from the points of view of several preeminent psychiatrists, including Freud, Winnicott, Klein, and Moreno. RESULTS: Three (3) clinical reports are presented. The satisfaction rate among the first groups of participants was 93%. CONCLUSIONS: It is suggested that theater can be useful in decreasing defense mechanisms, allowing a patient-focused approach, mitigating specific symptoms, and improving the quality of life during the hospital stay.

Anorexia santa e anorexia contemporânea: o mesmo transtorno em épocas distintas? / Anorexia holy and contemporary anorexia: the same disorder in different periods?

Este estudo visa a analisar até que ponto é possível relacionar algumas santas da Idade Média, tidas como as santas anoréxicas e reveladoras de práticas rigorosas de jejum, com as anoréxicas da contemporaneidade, considerando-as como possuidoras do mesmo transtorno. O recurso metodológico utilizado refere-se a um estudo teórico da biografia de três dessas santas consideradas anoréxicas, confrontando-as com estudos referentes à anorexia nervosa presente nas mulheres da contemporaneidade. Percebe-se que há pontos em comuns entre ambas, mas não é possível equipará-las, uma vez que os ideais que as mesmas almejam são bastante divergentes, além de ser distinto o contexto histórico-cultural na qual se inserem. (AU)

Perspectiva histórica de la anorexia nerviosa / Historical perspective of anorexia nervosa

Antecedentes: los trastornos de la conducta alimentaria (TCA) han existido desde la antigüedad, variando en frecuencia, manifestaciones y posibles motivaciones, de acuerdo a las influencias históricas y socioculturales. Objetivo: describir desde una perspectiva histórica la evolución del concepto de anorexia nerviosa en la Edad Media ("santa anorexia") y en la época contemporánea ("adolescentes ayunadoras" victorianas). Método: revisión exhautiva de referencias históricas en torno al ayuno, publicaciones sobre TCA y artículos que describían casos de mujeres anorécticas famosas, utilizando la base de datos Medline/PubMed. Resultados: las anorécticas medievales y las actuales muestran conductas similares; rechazan el alimento para lograr la consagración divina y la delgadez absoluta, respectivamente. Ambas son muy auto-críticas, no poseen interés en las relaciones sociales, cuidan abnegadamente del prójimo, exhiben mínimas necesidades físicas (ej. hambre) y poseen madres dominantes. Entre las contribuciones más relevantes, Morton (1689) realiza la primera descripción médica de la anorexia ("consunción nerviosa"). En 1873, simultáneamente Gull en Inglaterra (quien acuñó el término anoerexia nervosa) y Lasègue ("anorexie hystérique") en Francia, la reconocen como una entidad diagnóstica definida. Bruch (1973) describe sus características clínicas nucleares (ej. distorsión de la imagen corporal, un paralizante sentimiento de ineficacia personal e incapacidad de discriminar requerimientos nutricionales), vigentes hasta la actualidad. Conclusiones: la análoga presentación de la enfermedad, transhistórica y transculturalmente, a través de los años (rechazo alimentario, emaciación, hiperactividad, amenorrea, búsqueda de un ideal), muestra que la esencia patológica (factores patogénicos) no se modelan por la edad, personalidad o cultura (factores patoplásticos), los que tendrían un rol secundario en el desarrollo de la enfermedad.

Background: Eating disorders (ED) have existed since ancient times and their frequency, manifestations and possible motivations have been varying according to historical and sociocultural influences. Objective: To describe from a historical perspective, the evolution of the concept of anorexia nervosa from Middle Ages ("holy anorexia") to contemporary times (Victorian "fasting girls"). Method: Medline/PubMed databases were use to make and exhaustive review of historical references on fasting, eating disorders and articles describing cases of famous anorectic women. Results: Medieval and contemporary anorectic show similar behaviours; they reject food to achieve a divine consecration and an absolute thinness, respectively. Both are very self-critical, are not interested in social relationship, selflessly take care others, display minimal physical needs (ie. hunger) and have dominant mothers. Among the most relevant contributions. Morton (1689) makes the first medical description of anorexia nervosa ("nervous consumption"). Simultaneously, in 1873, both, Gull in England (who coined the term anorexia nervosa) and Lasègue ("anorexie hystérique") in France, recognize it as a definite diagnostic entity. Bruch (1973) describes its core clinical characteristics (ie. distortion of body image, a paralyzing sense of personal ineffectiveness and a disability to discriminate nutritional requirements), currently valid. Conclusions: The analogous presentation of the illness, transhistorical and transculturally, through the years (food refuse, starvation, hyperactivity, amenorrhea, search for an ideal), shows that the essence of the pathology (pathogenic factors) is not modulated by age, personality and/or culture (pathoplastic factors), which, on their turn. would have a secondary role in disease's development.

La explicación social de los trastornos alimentarios: una lección de rigor frente a los trucos del ilusionismo / The social explanation of eating disorders: a lesson in rigor against the tricks of illusionists

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Disordered eating in African American and Caucasian women: the role of ethnic identity.

The influential roles of culture and ethnic identity are frequently cited in developing disordered eating and body dissatisfaction, constituting both protective and risk factors. For African American women, strongly identifying with African American cultural beauty ideals may protect against disordered eating to lose weight, but may actually increase risk in development of disordered eating directed at weight gain, such as binge eating. This study compares African American and Caucasian women on disordered eating measures, positing that African American women show greater risk for binge eating due to the impact of ethnic identity on body dissatisfaction. Findings indicate low levels of ethnic identity represent a risk factor for African American women, increasing the likelihood of showing greater binge eating and bulimic pathology. In Caucasian women, high levels of ethnic identity constitute a risk factor, leading to higher levels of both binge eating and global eating pathology. Implications for prevention and treatment are discussed.