What would it be like if we could add a blood test to our evaluation of a patient with anorexia nervosa? This might sound an outlandish question but recent published research on schizophrenia, another severe mental illness (i.e. brain disorder) suggests that this may not be far off.

Groundbreaking work led by Sabine Bahn, MD, director of the Cambridge Institute of Psychiatric Research at the University of Cambridge, as reported in Chemical & Engineering News up to 40% of changes that occur in the brains of schizophrenic patients also occur in other body parts. Scientists are studying biomarkers in the skin, immune cells, and serum to find samples that give a real-time picture of the disease in a patient. Previously, studies of schizophrenia have focused mainly on examining potential biomarkers in brain tissue harvested at autopsy.

So what exactly is the implication for diagnosis and treatment of anorexia nervosa?

Well, as regular readers of this blog will surely know, anorexia nervosa, like schizophrenia, is a brain disorder. And this isn’t just an opinion; it’s the official statement of the National Institute of Mental Health (NIMH), whose director, Dr Thomas Insel, stated as early as 2006, anorexia nervosa to be “a brain disease with severe metabolic effects on the entire body. While the symptoms are behavioral this illness has a biological core, with genetic components, changes in brain activity and neural pathways currently under study.”

Because anorexia is also a brain disorder, a diagnostic test (with the patient still alive, thank you!) clearly would revolutionize eating disorder treatment. It would change everything: suddenly anorexia could be treated with the respect and awe this life-threatening illness deserves.  Perhaps most crucially it would allow us to move away from anorexia being “a mere professional opinion” to a diagnosis that could be (independently) substantiated in the laboratory. It would enable providers to identify early cases and improve treatment before the illness had a chance to ravage a person’s brain and destroy their social/familial/professional life. Ultimately, anorexia nervosa would be added to the list of rare but severe human ailments, rather than as something that wealthy, Western, “self-involved” women and girls choose as a way of “dealing with life.”

So are there persons and organizations who may be resistant to the implications of this scientific research?  Sure.  I imagine those who make a living addressing this illness as a “life-style choice,” a “control issue,” etc., would feel the scientific ground shift beneath them disconcertingly. 
 
Citations:  

Chemical & Engineering News. 2010;88:26.

Schwarz E, Izmailov R, et al.    Biomarker Insights. 2010 May 12;5:39-47.
Validation of a blood-based laboratory test to aid in the confirmation of a diagnosis of schizophrenia.