Is anorexia a disease like diabetes?

Anorexia is known as a mental illness characterised by obsessive fear of gaining weight.

Washington: Anorexia is known as a mental illness characterised by obsessive fear of gaining weight. But a new study has claimed that the eating disorder may be more
similar to diabetes than dementia.

The new study, which is a review of past research on the condition, found that certain genetic and cellular processes get activated during starvation in organisms ranging
from yeast to fruit flies to mice to humans.

The idea, said study researcher Donard Dwyer, is thatin people with a broken starvation response, a few initialrounds of dieting could trigger a metabolism gone haywire.

In this theory, it`s not stubbornness or a mental disorder that keeps anorexics from eating, it`s their own bodies. The theory could explain why it can be so difficult to
convince anorexic patients that anything is wrong with them, Dwyer told LiveScience.
However, this theory of anorexia as a fundamentally biological disorder rather than a psychological one is not tested and patients with the disease should not stray from
proven treatments, the researchers said.

"Unless we conceive of it as more of a metabolic function, I don`t think we`ll get past the first stage of treatment with a lot of the real hard-core patients," Dwyer

In the current understanding of anorexia nervosa – an eating disorder in which patients don`t maintain at least 85 per cent of their normal body weight for their height --
overachieving personality types attempt to control stress and emotion by restricting food and/or extreme exercising.

Dwyer, however, believes the disease is a condition similar to diabetes. Someone who becomes obese will develop insulin resistance, which then becomes diabetes.
An initial trigger -- the obesity -- is required, but once the patient has diabetes, you can`t talk him or her out of the disease.

For anorexia, Dwyer said, the potential trigger is chronic undereating or dieting, and the messed-up molecular process could be any number of biological changes that happen
during starvation.

In the current review, published in the June issue of the journal Molecular Psychiatry, he and his colleagues focus on a cascade of genetic and cellular events called the IGF-1/Akt/FOXO pathway.

Organisms from yeasts to humans activate this pathway in response to starvation, triggering all sorts of biological changes, including a desire to look for food.
If this pathway doesn`t work as it should, it could theoretically cause the warped approach to eating seen inanorexia.

If Dwyer is right, difficult-to-treat anorexic patients may need drugs to get their metabolisms back on track, much as diabetic patients have to take insulin shots.
But so far, the idea has not been tested in humans.

"This is, at the moment, speculative," Timothy Walsh, a psychiatrist at Columbia University who was not involved in the research, told LiveScience.
"There`s no human data to support it, and it`s only part of the answer. It`s not proposed as the complete solution."


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