Eating disorders: Psyche or soma?

Abstract

Speculation about the etiology of eating disorders has gone through different phases, variously favoring familial, organic, and psychosocial factors. Recent evidence has particularly contributed to our understanding of the organic view. We review the evidence for an organic contribution to the illness and present a series of cases in which organic factors were present. The cases illustrate the complex interaction between biological and psychological factors. In particular, a growth hormone‐producing pituitary adenoma was discovered in a patient following successful treatment of her bulimia by psychological means alone. Etiological theories of eating disorders need to encompass both organic and psychosocial factors, allowed to interact in complex ways. Focusing exclusively on either aspect is a disservice to our patients. © 2000 by John Wiley & Sons, Inc. Int J Eat Disord 27: 279–287, 2000.

A case-control study of family composition in anorexia nervosa

“…Over recent years, the pendulum has swung to consideration of biologic, as opposed to more exclusively psychological, factors in the etiology of anorexia nervosa (Kaye, 1999;Ward, Tiller, Treasure, & Russell, 2000). The putative biologic factor in etiology most relevant to our findings is obstetric complications.…”

Brain lesions and eating disorders

“…[31][32][33][34][35][36][37][38] The damage was predominantly localised in the frontal and temporal lobes (six frontal, four temporal, three frontotemporal) of the right hemisphere (nine right, three left, one bilateral). In eight cases, there was evidence suggestive of causal association between the lesion and eating disorder.…”

“…39 Case 45 is of atypical bulimia with growth hormone producing adenoma of the pituitary. 38 In case 46, a boy developed typical anorexia nervosa at age 12 followed by a psychotic episode 2 years later; magnetic resonance imaging revealed parietal arachnoidal cyst and frontal lobe atrophy. 40 Cases 47-50 had disseminated tumours affecting more than one brain structure.…”

Nutrients, Stress, and Medical Disorders

“…Two types of AN are identified: a restrictive type, characterized by inhibition of food intake and no regular purging, and a binge-eating/purging type, where regular binging and purging occur. The biological component can be demonstrated by animal studies of neurotransmitter functions or by examples of eating disorders induced/maintained by intracranial lesions (Ward, Tiller, Treasure, & Russell, 2000). The genetic component is estimated to account for 48-76% of the risk, as inferred from twin studies.…”