The Nine Truths and Mortality

Again, the document of interest here is a very inspiring piece of scientific journalism titled “The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders”, which predicted the directions in which research proceeded after its publication. Among the foundations of this branch of the science, we have reached Truth #6 — and this is major: Eating disorders come along with increased risk for medical complications, as well as suicide, making premature death the most significant outcome in which an eating disorder may result.

A seemingly inexplicable link

Over 20 years ago, researchers who dove more deeply into this found that for females between the ages of 15 and 26 afflicted with anorexia nervosa (AN), “the mortality rate is 12 times higher than the death rate of all other causes of death.” Overall, amid the multitude of psychiatric illnesses, the self-starvation route notoriously claims one of the highest death tolls. Even that statistic is equivocal because “one in five deaths in AN is attributable to suicide.”

In fairness, it would seem that, if any of them are deemed to be suicide, they all should be. It’s just that hanging or shooting oneself takes a lot longer than pure, classic starvation. At any rate, here is a shocker:

A large clinical study found that 35.6% of eating disorder patients had attempted suicide at least once, and patients with binge eating and/or purging behaviors were associated with an elevated risk for suicide attempts compared with patients without such behaviors.

Back then, scientists suspected a genetic basis for the “co-occurrence of eating disorders and suicide,” which is intriguing enough to break off from reviewing the past, to look up some more recent news, and indeed it is very current.

About two months ago, Cambridge University Press published a paper with a remarkably long Conclusions section. Here is an excerpt:

On a phenotypic level, we identified a common latent factor contributing to susceptibility to eating disorders and suicidal ideation, both of which also presented substantial proportions of independent variance. These findings suggest a moderate degree of shared genetic architecture, supporting the hypothesis that these conditions are partially influenced by overlapping genetic factors.

By combining observations from the genetic, neurobiological, and psychological perspectives, researchers identified in patients markers of the shared risk for eating disorders and suicidal ideation. Like never before, it became possible to begin understanding shared neurocognitive deficits. In addition, both eating disorders and suicidal ideation are influenced by environmental factors.

Among many other questions, the exploratory teams wanted to discover if eating disorders lead to suicidal ideation, or vice-versa. If there is nothing resembling a causal relationship either way, that strengthens the possibility that they “emerge concurrently from shared vulnerabilities.”

The interested scientists hoped to find numbers of individuals with “elevated genetic predisposition for the general susceptibility factor” and conduct longitudinal studies which ultimately reveal protective factors that could be used to reduce the risk of both eating disorders and suicidal ideation. This type of knowledge is expected to have powerful ethical, social, and clinical ramifications.

As if that were not enough

The following month (last month, as of this writing) saw the publication of “Genetic links between eating disorder symptoms and suicidal ideation” by Bryony Doughty, which summarizes the latest news on the heritability of eating disorders, in conjunction with suicidal ideation and behavior. Not surprisingly, the newest reports are hardly more informative than the ones a decade old or more. The whole subject has turned out to be an incredibly tough nut to crack. As an action plan, it is suggested…

[…] that mental health professionals should routinely screen for suicidality in patients with any disordered eating symptoms, even if they aren’t showing symptoms of mood disorders… For individuals struggling with an eating disorder, understanding that suicidality may have a genetic root can be validating.

Your responses and feedback are welcome!

Source: “The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders,” NIH.gov, October 2017
Source: “Genomic links between symptoms of eating disorders and suicidal ideation,” Cambridge.org, 02/19/25
Source: “Genetic links between eating disorder symptoms and suicidal ideation,” MQMentalHealth.org, 03/17/25
Image by morganharpernichols/Pixabay

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources