Week 4 Assigned Reading

Question 1

What % of the U.S. population is anorexia nervosa thought to affect?

Answer 1

Affects just under 1% of the U.S. population, with potentially more undiagnosed cases

Question 2

In what % of cases is anorexia nervosa fatal?

Answer 2

About 10% of those affected die from it

Question 3

About 10% of those affected by anorexia nervosa die from it.

How does this % compare with other conditions mentioned in the article?

Answer 3

This mortality rate is the highest of any psychiatric condition after substance abuse, comparable to childhood leukemia

Question 4

In statistical terms, how effective is anorexia nervosa treatment?

Answer 4

About 50% of adolescents recover, and another 20-30% are helped

Question 5

Present an overall picture of the prevailing “stereotypical” view of anorexia nervosa, as described in the article.

Answer 5

The article describes the traditional view as seeing anorexia develop when girls, motivated by a culture that worships thinness, exert extreme willpower to stop eating. It was often thought to arise in reaction to unloving, controlling, or problematic parents.

Question 6

What % the risk of developing anorexia is ascribed to genes, according to the article?

Answer 6

Twin studies showed that 50-60% of the risk of developing anorexia was due to genes, indicating DNA is a powerful driver.

Question 7

What is the argument that labelling a condition as “biological” rather than cultural or societal is dangerous?

Answer 7

Some practitioners worry that emphasising biology could discourage patients about their recovery prospects. For example, some clients have said, “It’s genetic, why bother” trying to get well.

Question 8

Some practitioners worry that emphasising biology could discourage patients about their recovery prospects. For example, some clients have said, “It’s genetic, why bother” trying to get well.

What is the counterpoint offered?

Answer 8

Researchers like Bulik argue that patients are actually reassured to learn the disorder has biological roots, and that biology doesn’t determine destiny.

Question 9

Briefly describe Zelster’s study in mice

Answer 9

Zeltser developed mice with a gene variant linked to anorexia in humans. When these mice experienced calorie restriction and stress (being housed alone), they stopped eating.

Question 10

______ developed mice with a gene variant linked to anorexia in humans. When these mice experienced calorie restriction and stress (being housed alone), they stopped eating.

Answer 10

Zeltser

Question 11

‘This doesn’t look like any other psychiatric disorder,’” _____ says. “It might be the inverse of obesity—these people might be genetically predisposed to low BMI.”

Answer 11

Bulik

Question 12

‘This doesn’t look like any other psychiatric disorder,’” Bulik says. “It might be the inverse of obesity—these people might be genetically predisposed to low BMI.” Explain this statement, referencing the results from Cynthia Bulik’s lab.

Answer 12

Bulik’s genetic studies found that anorexia shared some genetic associations with other psychiatric illnesses, but also had overlapping associations with genes controlling body mass index, lipids, and other metabolic traits. This suggests people with anorexia might be genetically predisposed to low BMI, potentially making it the “inverse of obesity” in terms of genetic risk.

Question 13

Describe Walter Kaye’s findings on brain signalling in reward pathways in people with/without anorexia nervosa, plus their self-reported state.

Answer 13

In people without anorexia, hunger activated brain circuits that motivate eating and make food desirable.

In people with anorexia, these reward and motivation circuits were much less active after fasting.

Anorexia patients could identify being hungry but their brains couldn’t convert that into a desire to eat.

They also experienced heightened anxiety and inhibition, along with diminished reward signaling.

Kaye’s conclusion: People with anorexia may “miscode food as risky rather than rewarding.”

Question 14

Whose findings on brain signalling in reward pathways in people with/without anorexia nervosa concluded that people with anorexia may “miscode food as risky rather than rewarding.”?

Question 15

What is Family-Based Treatment and how effective is it?

Answer 15

FBT is a treatment approach where parents take charge of ensuring their children eat, often scaling back other activities to focus on this. It’s described as the most studied and effective strategy to date. About 50% of adolescents who try it find it effective, with this percentage potentially rising to 70% if started early in the disease course.

Question 16

What percentage of the U.S. population is estimated to be affected by anorexia nervosa?

a) Less than 0.5%
b) Just under 1%
c) About 2%
d) More than 5%

Answer 16

b) Just under 1%

“Anorexia is estimated to affect just under 1% of the U.S. population, with many more who may go undiagnosed.”

Question 17

What is the mortality rate for anorexia nervosa?

a) 5%
b) 10%
c) 15%
d) 20%

Answer 17

b) 10%

“About 10% of those affected die.”

Question 18

How does the mortality rate of anorexia nervosa compare to other conditions?

a) Lower than most psychiatric conditions
b) Highest of any psychiatric condition
c) Highest of any psychiatric condition after substance abuse
d) On par with most chronic diseases

Answer 18

c) Highest of any psychiatric condition after substance abuse

“That’s the highest mortality rate of any psychiatric condition after substance abuse, on par with that of childhood leukemia.”

Question 19

What percentage of adolescents recover from anorexia with current treatments?

a) About 30%
b) About 50%
c) About 70%
d) About 90%

Answer 19

b) About 50%

“With current treatments, about half of adolescents recover, and another 20% to 30% are helped.”

Question 20

According to twin studies, what percentage of anorexia risk is attributed to genetics?

a) 30-40%
b) 40-50%
c) 50-60%
d) 70-80%

Answer 20

c) 50-60%

“Those reports showed that 50% to 60% of the risk of developing anorexia was due to genes, implying DNA is a powerful driver.”

Question 21

What is the main concern some practitioners have about labeling anorexia as “biological”?

a) It might lead to overmedication
b) It could discourage patients about recovery prospects
c) It might increase stigma
d) It could lead to misdiagnosis

Answer 21

b) It could discourage patients about recovery prospects

“Clients started coming in, saying, ‘It’s genetic, why bother’ trying to get well?”

Question 22

In Zeltser’s mouse study, what factors triggered anorexia-like behavior in mice with a specific gene variant?

a) Overeating and exercise
b) Calorie restriction and stress
c) High-fat diet and isolation
d) Dehydration and sleep deprivation

Answer 22

b) Calorie restriction and stress

“To mimic the pullback from eating that often precedes a diagnosis, the researchers restricted the animals’ caloric intake by 20% to 30%. Then they induced stress, another factor linked to anorexia, by housing the normally social animals alone. The result: ‘The mice stop eating,’ Zeltser says.”

Question 23

According to Bulik’s genetic studies, anorexia shared genetic associations with which of the following?

a) Only other psychiatric illnesses
b) Only metabolic traits
c) Both psychiatric illnesses and metabolic traits
d) Neither psychiatric illnesses nor metabolic traits

Answer 23

c) Both psychiatric illnesses and metabolic traits

“Some of those associations tracked with results of studies of other psychiatric illnesses, including OCD and depression, which didn’t surprise Bulik. What did were overlapping associations with DNA controlling body mass index (BMI), lipids, and other metabolic traits.”

Question 24

In Walter Kaye’s brain imaging study, what was observed in the brains of people with anorexia when they were hungry?

a) Increased activity in reward circuits
b) Decreased activity in reward circuits
c) No change in brain activity
d) Increased activity in memory circuits

Answer 24

b) Decreased activity in reward circuits

“But in people with anorexia, those circuits were much less active after fasting.”

Question 25

What is the primary focus of Family-Based Treatment (FBT) for anorexia?

a) Individual therapy for the patient
b) Group therapy for families
c) Parents ensuring their children eat
d) Medication management

Answer 25

c) Parents ensuring their children eat

“FBT asks parents to set aside many of their family’s day-to-day activities—scaling back school, work, hobbies—to sit with their children, requiring them to eat.”

Question 26

What percentage of adolescents find Family-Based Treatment effective when started early in the disease course?

a) About 30%
b) About 50%
c) About 70%
d) About 90%

Answer 26

c) About 70%

“Researchers are working to understand how FBT is intertwined with the biology of the illness, but for about half who try FBT in adolescence—and perhaps 70% who try it early in the disease—the treatment is effective.”