Anorexia nervosa, an eating disorder that causes a person to develop an intense fear of gaining weight, starve themselves and have an abnormally low body weight, has so far, had a poor record of being diagnosed and treated. However that may change. A new study has revealed that the disorder is not a purely psychiatric one, but could also be because of metabolic problems: a ‘metabo-psychiatric’ disorder.

The global study, led by researchers at King’s College London and The University of North Carolina at Chapel Hill, sampled genetic data from almost 17,000 people with anorexia, from 17 countries. One of its key findings is that “the genetic factors associated with anorexia, are also associated with metabolic traits,” in particular, a tendency to be more physically active. So, the team of researchers has inferred that, “Metabolic factors may play nearly or just as strong a role as purely psychiatric effects.”

Bengaluru-based Dr Shyam Bhat, who heads Mindfit, points out that a body-mind link is true of almost all psychiatric disorders. “There is a fundamental problem with the phrase ‘metabo-psychiatric’ disorder, because it seems to suggest that other psychiatric disorders don’t have physical and metabolic components, which is not true,” says Dr Bhat, who has specialised in both psychiatry and internal medicine.

Adding that other studies on conditions like depression have shown that it is influenced by the immune system and hormone levels, he says, “We should see this movement in all psychiatric disorders: the idea that something is mental, and something physical, is wrong.”

What would this mean for anorexia treatment? Although research is in early stages, this would spur further study into the metabolic solutions instead of just psychiatric medications. “In time, as research becomes clearer, maybe we can target certain genes, or metabolic pathways,” he says.

That is not to forget, eating disorders such as anorexia have significant social and environmental influences. Which could explain why women are more likely to develop anorexia than men. “The messages we are conditioned to receive from the media play a role as well. This interacts with the person’s psychology and metabolic conditions, to develop into a disorder,” he says, summing up with: “Genes are not your destiny, your environment can switch them on or off.”

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