Relations key to anorexia treatment, study shows

Anorexia nervosa isn't really about the food-not at its very core, anyway.

To effectively battle the most deadly psychological illness and the leading cause of psychiatric mortality in adolescent females, doctors and counselors must tackle anorexia from a more personal approach, said Dr. Nancy Zucker, director of the Duke Eating Disorders Program and a clinical professor at the Duke University Medical Center.

"Before folks develop eating disorders, they often have trouble with interpersonal situations because they feel very self-conscious and anxious," she said. "That's before they even develop anorexia, and they continue to struggle with social situations when they're ill. Even if they recover, these problems tend to persist."

Zucker's ongoing study examines the interpersonal relationships of individuals with anorexia, and she said she hopes her findings will revolutionize current treatment. Treatment for anorexia is now too focused on eating patterns alone and does not address the mentality of the patients, she added.

Understanding how patients interpret social interactions is key to helping them recover, said Zucker, who collaborated with colleagues at both Duke and the University of North Carolina at Chapel Hill. She said she focused her research on interpersonal skills, as opposed to the conventional emphasis on specific symptoms of anorexia like an individual's diet or eating habits.

She said she hopes to discover more detailed information about how individuals with anorexia process social interactions and whether they perceive relationships the same way as unaffected individuals. To better understand the phenomena of social interactions, Zucker referred to research on autism, a mental condition that results in an inability to gauge others' emotions.

"There are certain key features that people look to in other people that give information about how they're feeling," Zucker said. "We look at your eyes and nose and mouth, and that tells us a lot about what we need to know. When [researchers] did eye tracking studies on folks with autism, they found out that they didn't direct their attention to these features at all."

Autistic individuals focused on these emotion-conveying regions less frequently and for shorter durations of time, she said. These studies on autism may shed light on how people suffering from anorexia interact with others in different environments, she added.

"Almost one quarter of Duke women scored in the abnormal range on this screening test for eating disorders," he said.

Students who scored in the abnormal range have disordered eating patterns, but cannot be clinically diagnosed with anorexia from the survey alone, he added.

Freshman Anna Brown, a member of the Healthy Devil Peer Educators group Educating Students to Eliminate Eating Misconceptions, said these trends need to be addressed directly, adding that she personally knows people at Duke with eating disorders.

"People with these disorders are very focused on comparing themselves with impossible standards and are always measuring themselves against other people," Brown said. "That's not interacting in a healthy manner. We need to address social norms and challenge them with our perceptions of what a nutritious lifestyle is."