A new genetic study reveals that individuals with severe anorexia nervosa are nearly four times more likely to carry rare, damaging mutations in PLIN4, a gene primarily expressed in adipose tissue and skeletal muscle rather than the central nervous system. The discovery challenges the longstanding assumption that anorexia is purely a psychiatric or brain-based condition, highlighting peripheral metabolic dysfunction in lipid storage as a key biological driver………Continue reading…
By: Bethany Mauger
Source: Neuroscience News
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Critics:
Anorexia nervosa is an eating disorder characterized by attempts to lose weight by way of starvation. A person with anorexia may exhibit a number of signs and symptoms, the type and severity of which may vary, or be present without being readily apparent. Although anorexia is often recognized by physical indicators, it is a mental disorder that can occur at any body weight; in cases where body mass index (BMI) remains at a healthy level in adults, but other symptoms are present, the diagnosis may be atypical anorexia nervosa instead.
Anorexia, and the associated malnutrition from self-imposed starvation, causes complications in every major organ system in the body. It can cause permanent changes in the brain due to a lack of essential nutrients in the body. Hypokalemia, a drop in the level of potassium in the blood, is a sign of anorexia: a significant drop in potassium can cause abnormal heart rhythms, constipation, fatigue, muscle damage, and paralysis.
Interoception involves the conscious and unconscious sense of the internal state of the body, having an important role in homeostasis and regulation of emotions. Aside from noticeable physiological dysfunction, interoceptive deficits also prompt individuals with anorexia to concentrate on distorted perceptions of multiple elements of their body image. This exists in both people with anorexia and in healthy individuals, due to impairment in interoceptive sensitivity and interoceptive awareness.
Aside from weight loss and external appearance, people with anorexia may also report abnormal bodily functions, such as indistinct feelings of fullness.[56] This is due to miscommunication between internal signals of the body and the brain. Due to impaired interoceptive sensitivity, powerful cues of fullness may be detected prematurely in highly sensitive individuals, which add to decreased calorie consumption and generate anxiety surrounding food intake in anorexia patients.
People with anorexia also report difficulty identifying and describing their emotional feelings, and an inability to distinguish emotions from bodily sensations in general (known asalexithymia), likely due to the miscommunication of signals within the body. Interoceptive awareness and emotion are deeply intertwined. Anorexia patients also exhibit emotional regulation difficulties that ignite emotionally-cued eating behaviors, such as restricting food or excessive exercising.
Impaired interoceptive sensitivity and interoceptive awareness can lead anorexia patients to adapt distorted interpretations of weight gain that are cued by physical sensations related to digestion (e.g. fullness). Combined, these interoceptive and emotional elements could together trigger maladaptive and negatively reinforced behavioral responses that contribute to the maintenance of anorexia.
In addition to metacognition, people with anorexia also have difficulty with social cognition, including interpreting others’ emotions and demonstrating empathy. Abnormal interoceptive awareness and interoceptive sensitivity shown through all of these examples have been observed so frequently in anorexia that they have become key characteristics of the illness.
Both prenatal and perinatal obstetric complications may factor into the development of anorexia nervosa, such as preterm birth, maternal anemia, diabetes mellitus, preeclampsia, placental infarction, and neonatal heart abnormalities. Neonatal complications may also have an influence on harm avoidance, one of the personality traits associated with the development of anorexia.
Neuroendocrine dysregulation—the altered signaling of peptides that facilitate communication between the gut, brain and adipose tissue, such as ghrelin, leptin, neuropeptide Y and orexin—may contribute to the pathogenesis of anorexia nervosa by disrupting regulation of hunger and satiety. People with gastrointestinal diseases may be more at risk of developing disorders of eating practices than the general population, principally with restrictive eating disturbances.
An association of anorexia with celiac disease has been found. Individuals with good dietary management may develop anxiety, food aversion, and eating disorders because of concerns around cross contamination of their foods. Some authors suggest that medical professionals should evaluate the presence of unrecognized celiac disease in all people with an eating disorder, especially if they present any gastrointestinal symptoms .
Such as decreased appetite, abdominal pain, bloating, distension, vomiting, diarrhea or constipation, weight loss, or growth failure. It is also recommended to routinely ask celiac patients about weight or body shape concerns, and dieting or vomiting for weight control to evaluate the possible presence of an eating disorder, especially in women.
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