Pat Hartman | Childhood Obesity News

What Is ILSI, and Why Does It Hate Our Kids?

Pat Hartman May 27, 2025 No Comments

Wherever there is a hugely populated country, there is ILSI. Some years back, this was a problem in India because many people wanted manufacturers to begin placing red warning labels on the packaging of highly processed foods. But strangely, the leader of the committee responsible for achieving this reform turned out to be a member of the American non-profit, International Life Sciences Institute, funded by all the biggest producers of ultra-processed foods on the planet.

A reader might ask, “Just a moment, please. Isn’t that exactly backwards?” As a matter of fact, yes. A recent Childhood Obesity News post mentioned what has been deemed a “shadowy industry group,” the International Life Sciences Institute, which has managed to get its fingers into all sorts of places where they don’t belong.

ILSI’s publicly avowed mission is to improve “public and planetary health by convening international experts from academia, the public sector, the private sector, and other NGOs to advance evidence-based scientific research.” The federation currently includes 10 “entities,” namely: Mesoamerica, North Andean, Brazil, Europe, India, Japan, Korea, Taiwan, Southeast Asia, and U.S./Canada/Global (headquartered in the U.S.).

The grim details

It is a 501(c)(3) non-profit which, by law, ought not to “engage in lobbying or political activities.” On its homepage, ILSI’s science videos boast a collective total of 33,726 YouTube views, which is not a lot. (By not a lot, we mean that a podiatrist’s single YouTube video titled “Two-Inch Toenails Trimmed” has accrued 227,000 views.)

Internet searches like ILSI+scandal, ILSI+corruption, ILSI+exposed, and ILSI+unethical bring up alarming results. Even Coca-Cola, which had long been a prominent financial backer, broke up with the non-profit. Mars, Nestlé, and other companies have also severed ties. Apparently, the outfit’s efforts have been focused on such dubious goals as convincing the world that obesity is caused solely by insufficient exercise, and sugar has nothing to do with it. Like so many other organizations that want something quite badly (and quite bad), it entices its members with nice conference vacations, at the very least.

Journalism to the rescue

A few years back, ILSI was examined comprehensively by The New York Times reporter Andrew Jacobs. For the public’s benefit, he broke down for general comprehension information originally made available in professional journals about ILSI, which at the time ran 17 branches around the world. At first, outrage was mainly focused on what was going on in China, with the encouragement and support of that country’s government.

A few months later, Jacobs expanded on the first round of reportage. Harking back to the initial paragraph of our blog post, it turned out that the committee head who put a stop to the red warning labels was ILSI’s own Dr. Boindala Sesikeran. Of course, all suggestions of conflict of interest were righteously denied. “Under no circumstance does ILSI protect industry from being affected by disadvantageous policy and laws,” the official statement attested.

But the jig was up. Jacobs wrote,

After decades largely operating under the radar, ILSI is coming under increasing scrutiny by health advocates in the United States and abroad who say it is little more than a front group advancing the interests of the 400 corporate members that provide its $17 million budget… Over the past year, researchers have documented how the organization’s China affiliate helped shape anti-obesity education campaigns…

But what is wrong with anti-obesity education? Well, it seems the philosophy advocated by ILSI did not call for dietary change, especially if that change involves reducing the amount of sugar that humans consume, even the obese ones. The organization was all about promoting physical activity, which, of course, is excellent advice. But not when it comes along with complete, uncritical acceptance of all the sugar anybody wants.

Your responses and feedback are welcome!

Source: “ ILSI: Collaborative science for safe, nutritious and sustainable food,” ILSI.org, undated
Source: “ How Chummy Are Junk Food Giants and China’s Health Officials? They Share Offices,” NYTimes.com, 01/09/19
Source: “A Shadowy Industry Group Shapes Food Policy Around the World,” NYTimes.com, 09/16/19
Image by NB_art/Pixabay

The Worldwide Growth of Growth

Pat Hartman May 22, 2025 No Comments

Back in 2014, the Centers for Disease Control and Prevention released several charts and tables that collectively told a dismal story of how, since the 1950s, child obesity rates had doubled and adolescent numbers had quadrupled. This led to the publication of an article titled “6 real culprits that are making American kids fat.”

What were those villains deemed to be? For starters, people were eating an enormous amount of sugar, like an average of 132 pounds per year per capita. Even way back at the turn of the century, in 1900, that figure had been 90 pounds per year, and at no point since then had it decreased. Also, awareness was dawning that sugar, especially in the form of high fructose corn syrup, is wickedly addictive.

At the same time, people were eating lots of fast food, which is mostly highly processed fare, and fresh fruits and vegetables were much less popular than pizza, pancakes, pasta, and potatoes of the fried variety.

Bad habits grow fast

People, especially the young, were watching way too much television and neglecting physical activity in droves. Lack of exercise also contributed to insulin resistance, which is associated with both diabetes and obesity. To and from school, kids were traveling by car rather than walking or bicycling.

Among average people and their average meals, portion sizes had grown humongous. Since the 1950s, the standard portion size for soda pop had grown from seven ounces to an astounding 42 ounces, while the size of a hamburger tripled, and an order of fries did too. Last but not least, advertising convinced people to buy more and more of those processed, excessively large meals.

Of course, all these factors sound very familiar to today’s well-informed public, but back then, more than a decade ago, awareness of such matters was nowhere near as acute. In 2019, a randomized controlled trial, led by Kevin D. Hall, Ph.D., stirred things up by finding an association between ultra-processed foods and weight gain that did not exist with an unprocessed diet.

So, what else is new?

In the same year, The New York Times published an exposé of a “shadowy industry group” called ILSI. Reporter Andrew Jacobs commenced by remarking that, when the food corporations objected to the proposed inclusion of red warning labels on junk food, the government of India had backed down. Those who wanted warning labels were, naturally, unhappy; so the government set up a panel of experts to review the proposal yet again.

However, the choice of a Nestlé S.A. adviser to head the three-member committee did not go over well. Dr. Boindala Sesikeran was also a representative of the International Life Sciences Institute, an American nonprofit funded by agribusiness, food, and pharmaceutical corporations that works with, or some say infiltrates, governmental bodies in charge of nutrition and health. ILSI had been founded by a high-ranking Coca-Cola executive, so what could go wrong?

Jacobs writes,

In China, the institute shares both staff and office space with the agency responsible for combating the country’s epidemic of obesity-related illness. In Brazil, ILSI representatives occupy seats on a number of food and nutrition panels that were previously reserved for university researchers.

Sounds cozy.

(To be continued…)

Your responses and feedback are welcome!

Source: “6 real culprits that are making American kids fat,” MarketWatch.com, 01/18/15
Source: “A Shadowy Industry Group Shapes Food Policy Around the World,” NYTimes.com, 09/16/19
Image by Hans/Pixabay

When NOVA Came on the Scene

Pat Hartman May 20, 2025 No Comments

As mentioned in a recent post, the NOVA system classifies ultra-processed foods according to their potential to do harm. The term (shortened to UPF) was brought into the mainstream by Carlos Monteiro, a Brazilian epidemiologist.

In the early 1970s, curious about why so many people were both obese and malnourished, he learned that his fellow citizens were at the same time buying less “fattening” grocery items like sugar, oil, and salt, and none of it made sense. In 2009, he published a research paper, writes newyorker.com journalist Dhruv Khullar, M.D.,…

[…] suggesting that something very bad had happened when industrial food systems started churning out cheap, convenient, and tempting foods. He argued that scientists should classify foods by their most unnatural ingredients and by their means of production.

Group 1 foods are as basic as it gets, either minimally processed or left alone, and the examples given are nuts, eggs, vegetables, and pasta. Group 2 includes stuff you put on or in those basic foods: butter, salt, oil, sugar, etc. The combination of the two is labeled Group 3, food that is technically somewhat processed, but not necessarily unhealthful.

But then comes the great leap into Group 4 where anything goes, including the examples given here — “modified cornstarch, whey-protein concentrate, xanthan gum, and disodium phosphate” — to name just a few of the possibilities, and there are hundreds. These are the additives now required to be listed on product labels and scrutinized with a magnifying glass.

Khullar explains the next stage thusly:

The ingredients of a Group 4 meal tend to be created when foods are refined, bleached, hydrogenated, fractionated, or extruded — in other words, when whole foods are broken into components or otherwise chemically modified. If you can’t make it with equipment and ingredients in your home kitchen, it’s probably ultra-processed.

It took a while for Monteiro’s theory to catch on. Eventually in 2015, researcher Kevin Hall, of the National Institutes of Health Clinical Center, got interested. He had been working with contestants from “The Biggest Loser” and saw an opportunity to understand more about obesity, which was becoming a national concern of immense proportions.

Hall recruited 20 subjects to spend a month at the Center, closely watched, on a minimally processed diet for half the time and an ultra-processed diet the other half. With the former, they tended to lose a pound per week, and with the latter, to gain a pound per week. Of course weight gain and loss were not the only factors the team tracked.

One important observation was that dehydration necessarily concentrates the ingredients of a product and makes it energy-dense. The hyper-palatability factor (irresistible taste) showed up as pretty important. Many interesting details were revealed. For example:

The occasional whole egg, which contains more than half the daily recommended dose of cholesterol, might be preferable to packaged liquid eggs, which are protein-rich and sometimes cholesterol- and fat-free, but often contain preservatives and emulsifiers.

Then Harvard University scholars performed a massive study of 200,000 people’s eating habits, and reclassified ultra-processed foods into 10 subgroups. Eventually they came up with contradictory and puzzling conclusions:

Two types of ultra-processed foods (sugary sodas and processed meats) increased people’s risk of cardiovascular disease, but three types (breads and cold cereals, certain dairy products such as flavored yogurts, and savory snacks) seemed to decrease their risk. Another five didn’t appear to affect it at all.

The end results were not very definitive, but did inspire an official warning against processed meats. Meanwhile another expert, Prof. Alan Levinovitz, defined the whole research effort as a waste of time and money: “We already know why populations are gaining weight: ubiquitous, cheap, delicious, calorie-dense foods.” Dr. Khullar, meanwhile, summed up his article with words from Michael Pollan’s 2008 book, In Defense of Food:

Eat food. Not too much. Mostly plants.

Your responses and feedback are welcome!

Source: “Why Is the American Diet So Deadly?,” NewYorker.com, 01/06/25
Image by johnhain/Pixabay

Ultra-Processed Food — the Scoop Goes On

Pat Hartman May 15, 2025 No Comments

About half a year back, a new study made the case that probably far too much of the average child‘s diet is composed of ultra-processed food, familiarly known as UPF. Measuring consumption in terms of calorie intake, researchers reckon that for 7-year-olds, processed foods comprise 59% (well over half) of their diets. But just wait until you hear about the younger ones:

Researchers found processed foods made up 47% of toddlers’ calories… The nutritional culprits may not be what you expect. The biggest offenders weren’t ice cream, fries or candy. They were products like high fiber cereals, flavored yogurt, and breads — foods that are often marketed as “healthy.”

Toddlers are commonly understood to be children whose walking skills are not yet fully developed; from one to three or even four years old, depending on whom you ask. Also, to be fair, some babies start to toddle at nine months, so of course they must be included in the classification.

It will come as no surprise, that kids who are set on the UPF path by heedless adults, will probably continue upon it. Most people like to stick with what they already know, so hyper processed it is. But even if they don’t cling to the familiar, that curious adventure-seeking tendency will send them eagerly in pursuit of more exciting junk food. Yet, at the same time, these early adapters to ultra processing are rarely adventurous about exploring ultra-nutritious alternatives to balance out their diets.

Regrettably hooked minors

The consumption of excessively processed foods (and food-adjacent substances) is believed to correlate with an overall higher mortality rate. For instance, research published by the American Journal of Preventive Medicine showed that chowing down on a lot of UPF “increased the risk of premature death from all causes,” and the authors cited numbers:

A new study has found that for each 10% increase in calories from these foods, the risk for premature death increases by almost 3%.

According to a very recent piece published by BBC.com, a study that covered eight countries, including the United States and the United Kingdom (which are the worst two in terms of junk food’s effects on their citizens), suggests a connection between UPF and early death.

One factor that makes it so difficult to keep track is that the typical hyper-processed food tends to contain five or even more ingredients with shady reputations. Sacrificing safety to favor aesthetics, these additives, sweeteners, and other chemicals are tossed in to improve the texture, flavor, eye appeal, or some other aspect of the product. Also, human life is complicated, so the individual’s general dietary preferences, exercise, sleep, medications, and many other factors can affect the equation.

Regrettable limits

This fact is hard to accept, but we have no other choice: To perform really undeniable research in this area would require keeping humans in conditions matching those of experimental laboratory animals, for decades. Because otherwise, there are just too many variables, and too many opportunities for accidental mistakes in reportage, or even deliberate sabotage.

But when people are just living their ordinary human lives, any attempt at strict accounting is vulnerable to colossal amounts of randomness, which is not compatible with good science. The uncontrollable quality of life holds less true with infants and very young, who can sometimes be satisfactorily managed. There is no excuse for not exercising some amount of conscious deliberation in feeding them.

A moment’s consideration will reveal that children whose ambulation is still uncertain, even at the advanced age of four, are probably not able to hike to the convenience store on their own. Also, few of them drive, and even if they did, they might not be able to reach up to the counter to pay for their junk food.

The hard truth is that no child gets hold of UPF unless some nominally responsible adult supplies it to them. Grownups, there is no point in trying to squirm out of responsibility. This is a “you problem.” Please don’t feed those kids junk, or let other people do it either.

Your responses and feedback are welcome!

Source: “Study finds how much ultra-processed foods children are eating,” WBay.com, 11/11/24
Source: “Every Bite of Ultra-Processed Foods May Increase Risk of Early Death, Study Says,” VeryWellHealth.com, 05/05/25
Source: “Ultra-processed foods may be linked to early death,” BBC.com, 04/28/25
Image by angelicavaihel/Pixabay

The Scoop on Ultra-Processed Foods, Continued

Pat Hartman May 13, 2025 No Comments

We discussed the NOVA classification system, where the designated fourth group, ultra-processed food, is the villain of the day. A lot of humans feel very strongly that meat-eating is not only okay, but beneficial to the system. And yet, even if meat is available and philosophically acceptable, it might still be problematic.

A slab of beefsteak is one thing, but a tampered-with burger is something else. Sausage, hot dogs, bacon, and deli meats are under suspicion, because they are likely to be spiffed up with nitrates or miscellaneous preservatives. Meat that has been salted, cured, smoked, and otherwise processed is a whole different animal. (Incidentally, for protein, experts recommend such alternatives as tuna, grilled chicken, and boiled eggs.)

Likewise, frozen meals that only need to be heated up in a microwave or standard oven are likely to have been ultra-processed, and replete with plenty of sodium and an inordinate amount of fat, and garnished with flavor enhancers, emulsifiers, and preservatives.

What’s inside those crunchy, irresistible chips and crackers? Emulsifiers, saturated fat, preservatives, artificial flavors, and lots and lots of sodium. Salty chips go great with chilled, intensely sweetened beverages, whose coldness and fizziness block the mouth’s ability to perceive the overdose of sugar they deliver. Speaking of which… how about those cookies and cakes? You got your heaping helping of sugar, your refined flour, your preservatives, your fake colors and flavorings — what more could a person ask?

Morgan Pearson, M.S., R.D., goes on to say that aside from those major players, it is also a good idea to check the credentials of some more innocent-looking items. Supermarket bread, instant soups and noodles, fruit yogurts and drinks, and even baby formula can all conceal unwelcome surprises.

“But the customers like it,” and other weak excuses

The sad fact is, plenty of players (mainly the manufacturers and purveyors, including advertisers, of NOVA Group 4 products) will defend the stuff with their last breath. We will not hazard a guess about the exact percentage of miscreants in the field. But for most of them, it’s all about profit, and more specifically, about how much of the profit finds its way into their own personal pockets.

Then there are folks who work for the food industry and in related fields, who are not necessarily people with bad intent. It’s just that, for them, the evidence does not add up in the same way it does for more cautious medical specialists.

Prof. Kevin McConway, emeritus professor of applied statistics, The Open University (a distance-learning university based in U.K.), said of a particular study that it “makes lots of mathematical assumptions which make him cautious about what the findings mean,” and he is not the only one with reservations. Is all ultra-processed food unequivocally bad for all people? Would it be possible to pinpoint certain recipes that could be improved, and still produce the same results of customer satisfaction and loyalty?

Many executives and other defenders point out that it is “impossible for any one study to be sure whether differences in mortality between people who consume different UPF amounts are actually caused by differences in their UPF consumption.” University of Oxford diet and obesity expert Dr. Nerys Astbury agrees that the research so far has its limitations.

It is no secret that diets high in fat and sugar can increase disease risk, and ultra-processing does tend to hang out with bad company like sugar and fat. Of course the industry calls that sort of food “energy dense,” a description which has a more respectable ring to it.

Your responses and feedback are welcome!

Source: “Ultra-Processed Foods to Avoid If You Want to Lose Weight,” VeryWellHealth.com, 04/09/25
Image by Create4fun/Pixabay

The Scoop on Ultra-Processed Foods

Pat Hartman May 8, 2025 No Comments

Ultra-processed (aka hyper-processed) edible products are a blight on public wellness and society at large. VeryWellHealth.com prefers “ultra-processed,” and it was possible to glean copious information on this food genre from three of the website’s recent articles (authors: Stephanie Brown and Kathleen Ferraro), all listed at the bottom of the post.

Some experts say that these abominations constitute over 70% of the total USA food supply, which if true is pitiful. Others say they make up 50% or even close to 60% of the average American’s diet. All those sources could be correct. Still, large amounts of research on this matter have taken place not only in the U.S., but in Australia, Brazil, Canada, Chile, Colombia, Mexico, and the United Kingdom.

Back in 2009, a research team led by Carlos A. Monteiro (M.D., Ph.D.) defined ultra-processed foods as the most extreme of four possible categories, according to the NOVA classification system. This system has been refined somewhat over time, and its creators have put together an online research tool, TrueFood, which extracts data from systems run by the Food and Drug Administration and the U.S. Department of Agriculture.

The website uses machine learning whose algorithm assigns ultra-rating numbers to more than 50,000 food products, based on how much they have been messed with. In theory, the number indicates the hazard level of the different foods, in terms of their degree of processing. (That web address is not included here because your computer’s security system may issue a danger warning — probably because the site uses Artificial Intelligence to rate the thousands of items, and the results include “margins of error” anyway.)

So, get on with it

Group 1 includes unprocessed or minimally processed foods; Group 2 signifies processed culinary ingredients. In the third group, “processing” is a benign word that does not indicate danger, but just means that the edible item has been washed, chopped, peeled, steamed, or something else that an old-fashioned cook might do — in other words, any basic prep level at all.

With Group 4, however, we are now in ultra-processed land, where the problems dwell. Dr. Monteiro suggested that “[…] the end products of food ultra-processing are products that perhaps we shouldn’t call foods…” His official definition deemed them to be…

[…] industrial formulations made mostly or entirely with substances extracted from foods, often chemically modified, and from additives, with little if any whole food added.

These agglomerations of predominantly harmful (or at best, useless) stuff are likely to contain plenty of fat, sugar, salt, and weird additives. Apparently, if the product is made with any additive, or with even one NOVA Group 4 ingredient, it can be considered ultra-processed.

What these alleged groceries will likely not contain are whole foods or even identifiable elements of food, like fiber, vitamins or minerals. The allegedly edible substances may have been subjected to chemical modification and recombination. Here is a fact with a sinister ring to it:

Sequences of processes are and must be used to obtain, alter, and combine the ingredients and to formulate the final products.

As a definition, that sentence encompasses so much it actually turns out to be meaningless. Because multiple various factors are involved, and because studying the actual habits of people is problematic unless they can be kept in environments equivalent to lab cages, some experts are not convinced of the potential harm.

(To be continued…)

Your responses and feedback are welcome!

Source: “What Does ‘Ultra-Processed Food’ Actually Mean?,” VeryWellHealth.com, 07/06/22
Source: “Every Bite of Ultra-Processed Foods May Increase Risk of Early Death, Study Says,”
VeryWellHealth.com, 05/05/25
Source: “What Happens to Your Body When You Eat Fewer Ultra-Processed Foods,” VeryWellHealth.com, 04/11/25
Image by jodiandbrett/Pixabay

Eggs on our Minds

Pat Hartman May 6, 2025 No Comments

To mention that eggs have been in the news lately would be a laughable understatement. For approximately the past three months they have been on everybody’s mind, and even that is far from being the whole picture. For EatThis.com, Sarah Garone and Olivia Tarantino wrote:

If there’s any food fraught with a tug-of-war over its healthfulness, it’s eggs. Over the years, eggs have been viewed as everything from an example of the perfect whole food to a dreaded harbinger of heart disease.

Too many eggs can bring on an undesirable effect: too much cholesterol. The authors note that nutritional guidelines no longer mention a specific cholesterol limit, but recommend that consumption of it be “as low as possible.” On the other hand, a spectacularly large study (half a million adult Chinese subjects) revealed that “up to one egg per day actually decreased the chances of developing cardiovascular disease.”

But with more, the benefits drop off precipitously. The people of China are known for their per-capita egg consumption, and collectively they account for around 400 billion eggs per year.

A recent article from ScienceDirect.com delved into the effect on obesity of the various nutrients found in eggs. Some of them actually play a role in regulating lipid metabolism in ways that prevent obesity. Apparently, it is not even certain that the consumption of egg cholesterol increases human blood cholesterol. When it comes to diabetes risk, the jury is still out.

As for weight gain, eggs seem to suffer from a certain amount of guilt by association. People like to eat them with bacon, sausage, hash-brown potatoes, and other unwise choices. Some helpful suggestions in this area include studying up on heart-healthy cooking fats, and combining eggs with vegetables.

What is going on, anyway?

A review published at around the same time in the journal Poultry Science looked at a meta-study that had reviewed two decades of nutritional literature and found that most of the nutrients in eggs are not obesogenic but surprisingly appear to “reduce the probability of obesity via lipid metabolism regulation.”

However, there seems to be an exception among “high responders,” or individuals who are particularly prone to significant changes in their cholesterol levels because they metabolize it either more or less effectively. The body of course needs the stuff, but normally our own livers produce enough of it. There seems to be a feeling that more research in this area would be welcome.

Leaving that aside, “[E]ggs are one of the healthiest sources of protein, essential amino acids, and micronutrients beneficial to human health.” Not surprisingly, the cooking method makes a noticeable difference, with soft-boiled eggs being the safest bet.

In “9 Steps to Perfect Health,” Chris Kesser has noted that nutrients in animal products like fish, meat, poultry, dairy, and eggs are highly bioavailable, meaning that we can absorb them easily. Pasture-raised animals are known for their nutrient-dense meat, while pasture-raised hens make eggs that contain as much as 10 times more omega-3 than factory hen eggs, as well as being noticeably higher in B12, folate, vitamin A, protein, and fat-soluble antioxidants like vitamin E.

Can we agree to disagree?

The consensus seems to be that eggs are great for just about everyone, except people troubled by diabetes or cardiovascular disease. But even for folks who do not have to deal with those conditions, there is still such a thing as too many. Agreement seems to have settled on the notion that an average of one egg per day is reasonable, although they can be distributed throughout the week as multiple eggs on some days, and none on others.

Some authorities are even okay with healthy folks eating 10 eggs per week, although cholesterol-sensitive individuals need to tone it down. For those who forego the yolks, two egg whites count as the equivalent of one whole egg.

Your responses and feedback are welcome!

Source: “ 5 Dangerous Side Effects of Eating Too Many Eggs, According to Science,” EatThis.com, 09/01/24
Source: “Association between egg consumption and risk of obesity: A comprehensive review: Egg Consumption and Obesity,” ScienceDirect.com, February 2025
Source: “Eggs are back on the menu: Study finds no link to obesity with moderate intake,” News-Medical.net, 12/19/24
Source: “9 Steps to Perfect Health,” Chris Kresser, undated
Image by stevepb/Pixabay

The 7th of the 9 Truths

Pat Hartman April 29, 2025 No Comments

This is Truth #7 in a series that encompasses all nine of them, as proposed several years ago by the Academy for Eating Disorders. By this point, a reader might begin to suspect that not much more is known today, than was back when “Nine Truths about Eating Disorders” first appeared.

Many of the conclusions demonstrate unchanging precepts — like the fact that two things can be true at the same time. In the words of #7’s subtitle, both genes and environment “play important roles in the development of eating disorders.”

Anorexia nervosa, bulimia nervosa, and binge eating disorder all run in families. Which exact genes are responsible, is still a mystery. One current source says, “There is a known phenotypic link between AN, growth, and sexual maturation, yet the genetic overlap between these phenotypes remains enigmatic.” So, there we have it.

On the other hand, generalizations apply, and there is one thing we do know. Science did not need to wait for the telescope or the microscope to discover that eating disorders run in families, or to notice that the cultural environment has a lot to do with how individuals (and nations) feel about human bodies and food customs. Still, psychological pressure does not seem to cause as much distress as it would, if not affected by other factors.

Can we ever know anything?

It is interesting that most people who, according to the signs, “should” develop eating disorders, do not. To discover the reasons behind this and so many other mysteries, the authors warned, would require scientists to inspect “very large sample sizes (in the tens of thousands).” But of course, volume is only one facet of discovery. Life, as always, is multifactorial. As the 2017 authors phrased it,

Eating disorders are “complex traits,” meaning that multiple genetic and environmental factors — each of small to moderate effect — act together to increase risk. Genetic and environmental factors may not only act in an additive manner, but may co-act in other ways.

Additionally, little as was known about AN at the time, even less was known about BN and BED. Moving on to Truth #8, we will not even go into why eating disorders do not follow Mendelian transmission patterns. And besides, in many cases, a family with an afflicted child will be at a loss to identify any relative who suffered from one of the conditions. Of course, war, adoption, and other socially unstabilizing vicissitudes can break connections which might have aided logical causation assumptions.

Too much togetherness presents another research problem, called confounding. In a family, there are a lot of shared genes and a lot of shared environmental factors, and how are scientific observers supposed to separate the effects of each influence? For this and many related reasons, “Rigorous studies of gene-environment interaction in eating disorders are sparse.” But basically, Truth #8 goes like this: “Genes alone do not predict who will develop eating disorders”:

[H]undreds (or perhaps thousands) of genes act in concert and are influenced by environmental factors. An individual’s risk is a composite of the cumulative number of genetic and environmental risk and protective factors to which they are exposed.

And then, there is the whole field of epigenetics, with DNA methylation, and the modification of things we never imagined could be modified, and the need to differentiate between epigenetic changes seen in the blood and what might happen in the brain; and how to figure out prevention, which is so much preferable to spending years and billions on cures.

One more, for the road

Truth #9 is short and sweet: “Full recovery from an eating disorder is possible. Early detection and intervention are important.” The authors define physical recovery as “the resumption and maintenance of a healthy body weight and a normalization of all physical parameters affected by the eating disorder”:

[B]ehavioral recovery means the absence of eating-disorder related behaviors such as food restriction, binge eating, and purging. Psychological recovery, including the attainment of normal attitudes toward food and the body, is important yet often overlooked.

Then, it gets complicated again due, for starters, to a “lack of consensus on the exact definition”:

It has been proposed that full recovery is achieved only when patients are indistinguishable from healthy controls on all eating disorder related measures, including psychological aspects.

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: “An evolutionary perspective on the genetics of anorexia nervosa,” Nature.com, 02/19/25
Image by Prawny/Pixabay

The Nine Truths and Mortality

Pat Hartman April 24, 2025 No Comments

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

The Nine Truths, Again

Pat Hartman April 22, 2025 No Comments

The final line of the previous post mentioned “biologically-driven maintenance patterns that impede recovery,” which can be quite troublesome. Today’s post continues to examine the sections of a very long and explicit paper about nine distinct areas of concern in the overall subject of eating disorders.

This publication from the Academy for Eating Disorders, titled “Nine Truths about Eating Disorders,” points out that where hazards are concerned, sexual maturity raises the stakes much higher.

Actually, two different and contrary reactions have been observed. In acute cases of anorexia nervosa (AN) and bulimia nervosa (BN), many women have reported that during pregnancy, their illness improved or even temporarily disappeared. But at the same time, anorexic women who had already been in remission have reported that pregnancy brought on relapse.

The gravid state is also one in which binge eating disorder (BED) may present itself for the first time; and even in the absence of pregnancy, BED symptoms may fluctuate according to the menstrual cycle. Less estrogen and more progesterone might increase or even initiate the symptoms of disordered eating. Even more disconcerting for women who just want some peace, menopause can make an eating disorder come back or even start for the first time.

It is all very confusing, and if little is understood about how these processes work in females, the masculine situation is even more mysterious. Males are more elusive to study, partly because they tend to not seek help. If they do start psychological therapy or another sort of healing program, they are more likely than women to drop out.

In both sexes, with the advent of sexual maturity, the chemistry becomes incredibly complicated, and in many cases, each new discovery throws up another question, or several. To get a sense of how convoluted the whole subject is, here are a few ideas the authors proposed for further research:

— examining neuropsychologically-based treatment approaches and outcomes
— treatment matching based on phenotypic psychobiological profiles
— evaluation of childhood behavioral and neurobiological traits
— systematic reviews on altered response to food and exercise in eating disorders and brain function
— additional investigation of neurotransmitter availability and function in eating disorders

Just those few suggestions have subsequently led to deep work in the areas of the measurement and function of cerebrospinal fluid, positron emission tomography (PET scans), magnetic imaging spectroscopy, the role of neural circuitry in eating disorder risk, and postmortem brain analysis. Moving on, what these authors deem Truth #5 is a biggie:

Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses.

That’s right, age provides no protection against eating disorders, which impartially strike children, elders, and everyone in between. Not surprisingly, it has been observed that “divorce, loss of family members, or somatic illness could serve as triggers.”

Researchers have meta-analyzed reports from at least 30 different countries and found that eating disorders do not discriminate against people of any particular race and ethnicity, but happily afflict people of every sort. In America, with its lavishly variegated population, some distinctions have been found. In contrast to non-Latino whites, members of ethnic minorities seem to favor binge eating. White people tend slightly more toward AN, and other small irregularities have been found, but on the whole, any eating disorder is an equal-opportunity destroyer.

Eating disorders occur in individuals of all shapes and sizes, although some unexpected oddities in the statistics do occur. Overweight and obese adolescents are prone to BN. On the other hand, “Individuals with BED are commonly overweight or obese… [Y]et a substantial minority of individuals with BED are normal-weight, particularly early in the course of illness.” Again, every answer seems to spawn more questions, some of which get stuck for a long time in the category of appearing unanswerable.

Another area of extreme complication exists in the realm of sexual orientation and gender. Even socioeconomic status insists on being a mystery, with “no consistent association” between fiscal security and eating disorder occurrence. The numbers may be there, but the reasons for them are often obscure. Just when researchers seem to have something figured out, along comes another study to upset the academic applecart.

As research findings shift like the ever-changing patterns inside a kaleidoscope, certainty remains elusive. One thing the authors know for sure is that, in quite a few areas, many more longitudinal studies are needed, and they of course cannot be arbitrarily hurried, so a lot of answers are destined to remain cloudy for quite some time.

Your responses and feedback are welcome!

Source: “Source: “The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders,” NIH.gov, October 2017
Image by geralt/Pixabay

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