Abstract
This report summarizes the main themes addressed at a workshop on research on eating
disorders (EDs), which was hosted by the National Institute of Mental Health in December
1998. Both basic behavioral neuroscientists and clinical investigators met in an effort
to integrate areas of research and foster collaborations. Considerable advances have
been made in understanding the neuroendocrinological mechanisms that regulate appetite
and food intake. These achievements are in sharp contrast with the limited progress
in elucidating the pathogenesis of EDs and developing effective treatment and preventive
interventions. Anorexia nervosa remains a highly morbid condition with the highest
mortality of any other psychiatric disorder. Besides acute refeeding techniques, no
specific interventions have been proven effective in changing the long-term course
of anorexia nervosa. Efficacious treatments exist for bulimia nervosa, but their underutilization
calls for research on translating experimental findings into clinical practice. Closer
interface between neuroscientists and clinical researchers is required for advancing
our understanding of ED pathogenesis and developing effective treatments. Recent studies
are suggestive of a substantial genetic contribution to EDs that deserves further
investigation. Finally, there is an urgent need to examine risk and protective factors
for EDs, on which safe and effective prevention can be built. Biol Psychiatry 2000;47:777–786
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Biological PsychiatryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Pharmacotherapy of bulimia nervosa and binge eating disorder.Psychopharmacol Bull. 1997; 33: 433-436
- Pharmacologic and cognitive–behavioral treatment for bulimia nervosa.Am J Psychiatry. 1992; 149: 82-87
- One-year follow-up of psychosocial and pharmacologic treatments for bulimia nervosa.J Clin Psychiatry. 1994; 55: 179-183
- Does fluoxetine augment the inpatient treatment of anorexia nervosa?.Am J Psychiatry. 1998; 155: 548-551
- Low discharge weight and outcome in anorexia nervosa.Am J Psychiatry. 1995; 152: 1070-1072
- Eating disorders.N Engl J Med. 1999; 340: 1092-1098
- Food reward.Neurosci Biobehav Rev. 1996; 20: 1-25
- Identification of SOCS-3 as a potential mediator of central leptin resistance.Mol Cell. 1998; 1: 619-625
- Long-term follow-up of patients with early onset anorexia nervosa.Arch Dis Child. 1988; 63: 5-9
- Heritability of binge-eating and broadly defined bulimia nervosa.Biol Psychiatry. 1998; 44: 1210-1218
- Temperament in eating disorders.Int J Eat Disord. 1995; 17: 251-261
- Lack of association between 5-HT2A gene promoter polymorphism and susceptibility to anorexia nervosa.Lancet. 1998; 351: 499
- Strategies and potential molecular targets of obesity treatment.Science. 1998; 280: 1383-1387
- Phenotypes of mouse diabetes and rat fatty due to mutations in the OB (leptin) receptor.Science. 1996; 271: 994-996
- 5-HT2A gene promoter polymorphism and anorexia nervosa.Lancet. 1999; 353: 929
- Association between 5-HT2A gene promoter polymorphism and anorexia nervosa.Lancet. 1997; 350: 412
- Prior treatment received by patients with bulimia nervosa.Int J Eat Disord. 1999; 25: 39-44
- The eating disorders as addiction.Addict Behav. 1998; 23: 463-475
- Stress-induced activation of prefrontal cortex dopamine turnover.Brain Res. 1994; 664: 207-210
- Ten-year follow-up of anorexia nervosa.Psychol Med. 1995; 25: 143-156
- Family and individual therapy in anorexia nervosa.Arch Gen Psychiatry. 1997; 54: 1025-1030
- Distributions of leptin receptor mRNA isoforms in the rat brain.J Comp Neurol. 1998; 395: 535-547
- 5-HT2A promoter polymorphism-1438G/A, anorexia nervosa and obsessive-compulsive disorder.Lancet. 1998; 351: 1785-1786
- Twin studies and the etiology of eating disorders.Int J Eat Disord. 1999; 26: 349-358
- Psychotherapy and bulimia nervosa. Longer-term effects of interpersonal psychotherapy, behavior therapy, and cognitive behavior therapy.Arch Gen Psychiatry. 1993; 50: 419-428
- Risk factors for bulimia nervosa.Arch Gen Psychiatry. 1997; 54: 509-517
- What’s in a name? In search of leptin’s physiological role.J Clin Endocrinol Metab. 1998; 83: 1407-1413
Frank GW, Kaye WH, Meltzer CC, Price JC, McConaha C (1998): Bulimia nervosa: A disturbance of serotonin/orbital frontal cortex modulation? In: 37th Annual Meeting of the American College of Neuropsychopharmacology, Las Croabas, PR, December 14–18. Nashville: ACNP, 162.
- Leptin and the regulation of body weight in mammals.Nature. 1998; 395: 763-770
- An epidemiological study of eating disorders in Norwegian psychiatric institutions.Int J Eat Disord. 1995; 18: 263-268
- Insulin-induced hypoglycemia increases preprohypocretin (orexin) mRNA in the rat lateral hypothalamic area.Neurosci Lett. 1999; 262: 77-80
- Report on the National Institutes of Health (NIH) workshop on the development of research priorities in eating disorders.Psychopharmacol Bull. 1997; 33: 321-333
- Serum leptin levels in women with anorexia nervosa.J Clin Endocrinol Metab. 1996; 81: 3861-3863
- Orexin A activates locus coeruleus cell firing and increases arousal in the rat.Proc Natl Acad Sci U S A. 1999; 96: 10911-10916
- Excess mortality of mental disorder.Br J Psychiatry. 1998; 173: 11-53
- Prediction of low body weight at long-term follow-up in acute anorexia nervosa by low body weight at referral.Am J Psychiatry. 1997; 154: 566-569
- Recovery and relapse in anorexia and bulimia nervosa.J Am Acad Child Adolesc Psychiatry. 1999; 38: 829-837
- Patterns and predictors of recovery in anorexia nervosa and bulimia nervosa.J Am Acad Child Adolesc Psychiatry. 1993; 32: 835-842
- 5-HT2A receptor gene polymorphisms, anorexia nervosa, and obesity.Lancet. 1997; 350: 1324-1325
- Anorexia nervosa.J Psychosom Res. 1988; 32: 561-571
- Altered dopamine activity after recovery from restricting-type anorexia nervosa.Neuropsychopharmacology. 1999; 21: 503-506
- Alterations in serotonin activity and psychiatric symptoms after recovery from bulimia nervosa.Arch Gen Psychiatry. 1998; 55: 927-935
- Altered serotonin activity in anorexia nervosa after long-term weight restoration. Does elevated cerebrospinal fluid 5-hydroxyindoleacetic acid level correlate with rigid and obsessive behavior?.Arch Gen Psychiatry. 1991; 48: 556-562
- New directions in treatment research of anorexia and bulimia nervosa.Biol Psychiatry. 1999; 45: 1285-1292
Kaye WH, Weltzin TE, Hsu G, Sokol M, McConaha C, Plotnicov KH (1997): Relapse prevention with fluoxetine in anorexia nervosa: A double-blind placebo-controlled study. In: 150th Meeting of the American Psychiatric Association; San Diego, Ca, May 17–22, 1997, Research Abstract Book. Washington, DC: APA, 178.
- The genetic epidemiology of bulimia nervosa.Am J Psychiatry. 1991; 1148: 1627-1637
- The structure of the genetic and environmental risk factors for six major psychiatric disorders in women.Arch Gen Psychiatry. 1995; 52: 374-383
Klump KL, McGue M, Iacono WG (in press): Age differences in genetic and environmental influences on eating attitudes and behavior. J Abnorm Psychol.
- Hypothalamic CART is a new anorectic peptide regulated by leptin.Nature. 1998; 393: 72-76
- Eating and general psychopathology in a sample of Caucasian and ethnic minority subjects.Int J Eat Disord. 1997; 21: 285-293
- Gonadal steroids and hypothalamic galanin and neuropeptide Y.Endocrinology. 1998; 139: 1771-1780
- A controlled family study of anorexia nervosa and bulimia nervosa.Arch Gen Psychiatry. 1998; 55: 603-610
- Increased expression in adipocytes of ob RNA in mice with lesions of the hypothalamus and with mutations at the db locus.Proc Natl Acad Sci U S A. 1995; 92: 6957-6960
- Are two interventions worse than none? Joint primary and secondary prevention of eating disorders in college females.Health Psychol. 1997; 16: 215-225
- Clinical characteristics in patients with anorexia nervosa and obsessive-compulsive disorder.Psychol Med. 1999; 29: 407-414
- Cerebrospinal fluid leptin in anorexia nervosa.J Clin Endocrinol Metab. 1997; 82: 1845-1851
- Nigrostriatal dopamine system in learning to perform sequential motor tasks in a predictive manner.J Neurophysiol. 1999; 82: 978-998
- Response to alternative antidepressants in imipramine nonresponders with bulimia nervosa.J Clin Psychopharmacol. 1989; 9: 291-293
- A comparison study of antidepressants and structured intensive group psychotherapy in the treatment of bulimia nervosa.Arch Gen Psychiatry. 1990; 47: 149-157
National Institutes of Health (1996): Mental Research in Eating Disorders (Program Announcement No. PA-96-064, NIH Guide 25:23). Bethesda, MD: National Institutes of Health.
National Institutes of Health (1998): Priorities for Prevention Research at NIMH (Publication No. 98-4321). Bethesda, MD: National Institutes of Health.
- The medial extended amygdala in male reproductive behavior. A node in the mammalian social behavior network.Ann N Y Acad Sci. 1999; 877: 242-257
- Family functioning and life events in the outcome of adolescent anorexia nervosa.Br J Psychiatry. 1997; 171: 545-549
- Preprohypocretin (orexin) and prolactin-like immunoreactivity are coexpressed by neurons of the rat lateral hypothalamic area.Neurosci Lett. 1999; 259: 153-156
- Family therapy versus individual therapy for adolescent females with anorexia nervosa.J Dev Behav Pediatr. 1994; 15: 111-116
- An evaluation of family therapy in anorexia nervosa and bulimia nervosa.Arch Gen Psychiatry. 1987; 44: 1047-1056
- Genetic influences on eating attitudes in a normal female twin population.Psychol Med. 1993; 23: 425-436
- Orexins and orexin receptors.Cell. 1998; 92: 573-585
- The phasic reward signal of primate dopamine neurons.Adv Pharmacol. 1998; 42: 686-690
- Mice lacking melanin-concentrating hormone are hypophagic and lean.Nature. 1998; 396: 670-674
- 5-HT2A promoter polymorphism in anorexia nervosa.Lancet. 1998; 351: 1785
- Eating disorder symptoms in a cohort of 11- to 16-year-old Black and White girls.Int J Eat Disord. 2000; 27: 49-66
- Toward an understanding of risk factors for bulimia.Am Psychol. 1986; 41: 246-258
- The role of race in the development of eating disorders.in: Smolak L. Levine M.P. Striegel-Moore The Developmental Psychopathology of Eating Disorders Implications for Research, Prevention, and Treatment. Lawrence Erlbaum, Mahwah, NJ1996: 259-284
- Primary prevention of eating disorders.in: Vandereycken W. Noordenbos G. The Prevention of Eating Disorders. Athlone Press, London1998: 1-22
- Recurrent binge eating in Black American women.Arch Fam Med. 2000; 9: 83-87
Strober M, Freeman R, Lampert C, Diamond J, Kaye W (in press): A controlled family study of anorexia nervosa and bulimia nervosa: Evidence of shared liability and transmission of partial syndromes. Am J Psychiatry.
- The long-term course of severe anorexia nervosa in adolescents.Int J Eat Disord. 1997; 22: 339-360
- Mortality in anorexia nervosa.Am J Psychiatry. 1995; 152: 1073-1074
- The genetic epidemiology of binging and vomiting.Br J Psychiatry. 1998; 173: 75-79
- Sequential treatment for bulimia nervosa incorporating a self-care manual.Br J Psychiatry. 1996; 168: 94-98
- Eating disorders.Science. 1998; 280: 1387-1390
- Medication and psychotherapy in the treatment of bulimia nervosa.Am J Psychiatry. 1997; 154: 523-531
- Anorexia nervosa and anorexic-like syndromes in a population-based female sample.Am J Psychiatry. 1995; 152: 64-71
- Psychological treatment of bulimia nervosa and binge eating disorder.Psychopharmacol Bull. 1997; 33: 437-454
- Treatment of bulimia nervosa.Behav Res Ther. 1996; 34: 197-212
- Covert visual attention modulates face-specific activity in the human fusiform gyrus.J Neurophysiol. 1998; 79: 1574-1578
- Signals that regulate food intake and energy homeostasis.Science. 1998; 280: 1378-1383
- Eating disorders.Psychiatr Clin North Am. 1996; 19: 639-882
- Positional cloning of the mouse obese gene and its human homologue.Nature. 1994; 372: 425-432
Article info
Publication history
Accepted:
December 17,
1999
Received in revised form:
November 18,
1999
Received:
June 15,
1999
Identification
Copyright
© 2000 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
