New Developments in Chronic Anorexia

In recent years the correlation between Anorexia Nervosa and several groups of illnesses has become evident. Uncovering these connections, for the most part, can’t be found in medical journals. Most of the discussion occurs in lay writing and especially on social media.

However, as a clinician treating people with eating disorders, I can’t ignore the clear connections between Anorexia and these illnesses even though a clear path to diagnosis and treatment remains elusive.

The first set of connections is between Anorexia, Attention Deficit Disorder (ADD) and Autism. There is a set of people with chronic Anorexia who tend to have some if not many symptoms of the latter two disorders. The information often feels validating for people who have struggled with Anorexia and felt unlike many patients and often felt ignored for their differences.

There is no clear guideline about how to treat these patients differently at the moment other than to treat the ADD and give guidance for understanding autism and looking into ways to understand how and why relationships may feel different for these patients.

One compelling theory is that these patients with Anorexia may have a specific genetic variant that increases the likelihood of all three disorders. At this point, it is only a theory, but even the possibility of a genetic cause can be helpful for many people.

The second illnesses connected with Anorexia are a set of inflammatory and autoimmune disorders. The inflammatory diseases largely center around MCAS (Mast Cell Activation Syndrome), an illness defined by a hyperactive inflammatory response to stimuli that can cause widespread inflammation, pain and swelling throughout the body.

For some people, they also develop undefined autoimmune symptoms. Autoimmune disorders are defined by the immune system misidentifying parts of oneself as foreign and then attacking one’s own body. For many people with eating disorders, these symptoms remain undefined rather than turning into common autoimmune disorders such as Rheumatoid Arthritis or Lupus.

Treating MCAS or autoimmune symptoms has standard protocols that can be followed just as for patients who don’t have Anorexia. Diagnosis and treatment can bring a lot of relief which helps patients have energy to focus on recovery.

There are also many theories about the connection between inflammatory symptoms and Anorexia, but none of these thoughts have any scientific or medical evidence as of yet.

One critical difference between these two sets of illnesses is how they connect with food restriction. The first set of symptoms are present with or without the eating disorders. However, eating can sometimes unmask inflammatory symptoms which are possibly suppressed by food restriction.

Putting together the information connecting Anorexia and these various illnesses can begin to inform clinicians about the medical and genetic causes for eating disorders. Clinical research will need to take these connections seriously first and begin to study them before there are any clear changes in clinical treatment.