Beautiful Edinburgh, Scotland was the setting for the 17th Annual Meeting of the Eating Disorders Research Society (EDRS), September 22-24, 2011. Many exciting topics were covered by researchers from all over the world, including several UNC Eating Disorders Program faculty, fellows, and students. Particularly “hot topics” included the NORA (noradrenergic) model of anorexia nervosa (AN); the ARIADNE (Applied Research into Anorexia Nervosa and Eating Disorders Not Otherwise Specified) program; and new research focusing on bone and endocrine health in AN. The NORA model posits that underlying noradrenergic dysregulation leads to high levels of anxiety and to low blood flow to a key brain area (insula) where body image is “stored”. The melding of these two factors causes high levels of body-focused anxiety that promotes intense dieting. In the short term, dieting reduces noradrenaline, which “turns down” the anxiety level. But, in the long term, dieting behavior increases in order to maintain this “anti-anxiety” effect. Interesting supportive preliminary data from a brain imaging study were presented, but much more research is needed to validate or refute the model.
ARIADNE is a 5-year research program in the UK that aims to translate findings from experimental neuroscience into clinical practice toward the goal of developing optimal management strategies for patients at all stages of illness. Four (of seven total) sub-projects of the program were highlighted: (1) MANTRA (Maudsley Model of AN Treatment for Adults), which is a novel trait-focused psychological therapy for AN; (2) CREST (Cognitive Remediation and Emotion Skills Training), which teaches patients how to accept, tolerate, manage and express emotions; (3) ECHO (Expert Carers Helping Others) and OAO (Overcoming Anorexia Online), which are low intensity, distance learning interventions to reduce distress and to change self-factors that may help maintain care recipients’ disordered eating thoughts and behaviors; and (4) a community-based study of mothers with eating disorders and their offspring.
The symposium on bone health in AN provided important information about (1) the roles of low levels of lean body mass and insulin like growth factor-1 and high levels of cortisol in persistent bone deficiencies even after patients regain weight; (2) the impact of AN and binge eating on infertility and polycystic ovary syndrome; and (3) the potential to stop bone loss in young girls with AN through low dose estrogen replacement.
Topics covered by UNC researchers focused on (1) a novel glucose measure that may be helpful in gauging the severity of binge eating; (2) a community-based approach to engaging Latino family members in eating disorder treatment; (3) the impact of proposed changes in the DSM-5 for binge eating frequency in the diagnosis of bulimia nervosa and binge eating disorder; (4) body image and disordered eating in women over age 50; (5) an update on the Genetic Consortium for AN (GCAN) genomewide association study; and (6) factors associated with time to recovery in AN.
In addition to all this great new science, conference attendees were treated to a “haggis ceremony” and reception at the Edinburgh Castle, and to dinner at the beautiful Royal Botanical Gardens. It will be a hard act to follow, but no doubt next year’s EDRS conference in Porto, Portugal, September 20-22, 2012, will be just as exciting.