Eating disorders are amongst the most pressing adolescent health problems affecting our population. In a recent review in the journal Current Psychiatry Reports, Professors Taylor Starr, D.O, M.P.H. and Richard Kreipe, M.D. from the Department of Pediatrics at the University of Rochester School of Medicine and Dentistry, put forward a timely update of research on anorexia and bulimia.
Eating disorders were prevalent as early as the mid-1800s, but it is only recently that there has been a surge of research in this field. Starr and Kreipe discuss epidemiological studies that question the existing stereotyping and profiling of those affected. These studies point out that eating disorders are not just affecting adolescent and young white females but prepubertal males and minority ethnic populations like Asian and Latina. Another important factor increasingly influencing the scope of eating disorders is the media.
The authors also highlight research carried out on the two most affected organs in individuals with these disorders - the brain and the bone. The advent of sophisticated imaging technologies such as fMRI (functional Magnetic Resonance Imaging) and PET (Positron EmissionTomography) has helped in mapping affected areas of the brain. Neurotransmitters or chemicals that influence communication between brain cells in these disorders have also been identified using such technologies. Research has also demonstrated that long-term effect of anorexia and bulimia leads to low bone mineral density that, in turn, leads to bone diseases like osteoporosis.
Recent studies that indicate environmental interactions coupled with genetic factors are the key drivers of anorexia and bulimia. The authors note that age of commencement of such eating disorders is typically the adolescent years, when the brain undergoes the final stage of brain development and is therefore impressionable to a host of experiences and societal influences.
The treatment strategies for both anorexia and bulimia have undergone major changes, note Starr and Kreipe. Family-based treatment with a compassionate and supporting environment has been proven to be the best practice in treating children and adolescents with these disorders. Psychoactive medications are not very effective in anorexia although there is an FDA-approved drug for treating bulimia. Body weight gain through increased caloric intake is the most effective step in the treatment of anorexia amongst all the existing interventions.