Ascertaining Critical Transitions in Eating Disorders
NAMHC Concept Clearance:
Julia L. Zehr, Ph.D.
Chief, Trajectories of Behavioral Dysregulation Program
Chief, Integrative Studies of Biology and Behavior Program
Division of Developmental Translational Research (DDTR)
The initiative aims to support research that will advance our understanding of the biological mechanisms underlying eating disorders by studying periods of transition.
Eating disorders are associated with high morbidity and mortality, as well as frequent relapse after treatment. Clinical presentations of eating disorders are highly heterogeneous, and individuals diagnosed with eating disorders often have significant comorbid psychopathology (e.g., anxiety, depression, substance use, suicidality, and personality disorders), in combination with physiological, endocrine, and metabolic dysregulation. Research into eating disorders has identified disruptions in a variety of functional domains, including reward systems, cognitive function, and behavioral regulation. In particular, recent findings on neurobiological dysregulation of distinct circuits suggest that multi-dimensional approaches to measure brain-behavior relationships are timely and scientifically tractable ways to advance our understanding of biological mechanisms contributing to this group of disorders.
Transition periods are likely to provide unique insights into brain-behavior associations, may help separate state from trait measures of psychological and cognitive processes in disordered eating behaviors, and may help optimize the timing of intervention. For this potential initiative, transitions may include those during development (e.g., puberty, menopause), during clinical course (e.g., adaptive to maladaptive dieting, sub-threshold to threshold clinical symptoms), or over the course of treatment (e.g., illness to recovery, recovery to relapse). This initiative would encourage researchers to test integrative models and mechanisms incorporating biological, behavioral, and experiential factors during these transitions.
Anticipated outcomes include:
- Increased understanding of biological mechanisms underlying eating disorders, which may play a role in high rates of relapse and psychiatric comorbidity;
- Development of a comprehensive and empirically grounded definition of recovery from eating disorders that goes beyond body mass index and behavioral symptom profiles;
- Detection of biological and developmental markers of risk that set the groundwork for understanding etiology; and,
- Discovery of novel treatment targets and optimal windows for intervention.