Despite new findings, anorexia is still a mental illness

Sam Hancock, The Independent

A new study in the journal Nature Genetics has suggested that anorexia originates in the body, as well as the mind. I was actually relieved when I first read the news. Having lived with the disorder myself for over four years, any research, in my eyes, is good research. Necessary too. After all, eating disorders are an issue that continue to affect roughly 1.25 million people across the UK, according to UK charity Beat.

But after I went back a few days later to examine the study’s findings, I found the conclusions didn’t sit comfortably with me. Specifically the part that states people who develop anorexia are “genetically predisposed to have an increased metabolic rate, less body fat and higher physical activity”.

Personally, I don’t come from a family that boasts an annoyingly good metabolism, or one that trains together to do bi-monthly half marathons and eat protein-fuelled brunches, and yet I still spent a chunk of my life starving myself for days, sometimes weeks, on end. Surely no one is simply “predisposed” to restrict intake? In 20 per cent of anorexic cases, people do so for the rest of their lives. Sometimes even to the point of death – lest we forget the tragic case of 19-year-old Averil Hart who died in 2017 following a four-year battle with anorexia.

Today, I am able to read these findings, think about them and subsequently make a rational decision about what I perceive them to mean – specifically for my body and mind. But four years ago, in the midst of battling anorexia, bulimia and depression, this wouldn’t have been the case. Reading this research would have felt like a huge blow during the period where I already had a pretty bleak daily routine (wake up, avoid food, avoid people, avoid food, sleep, repeat). I’d have felt like I was being told I shouldn’t have anorexia. That I didn’t have the genetics for it.

Of course, there’s reason to explore the physical side of the disorder, like this study does. After all, it’s a mental illness with tangibly apparent symptoms. As the triggers increase, the sufferer’s body weight does the opposite. In the Love Island age, where ITV bosses are permitted to argue that the reality show’s lack of body diversity is to encourage people to “be attracted to one another”, it’s vital to have discussions that focus on our bodies as much as our minds. This is especially the case with new phenomena like muscle dysmorphia, which sees people “bulk up” and fail to recognise how much muscle they already have. But it seems wrong to reduce the severity of anorexia, an illness that manifests itself in the mind, to the result of low body fat and the inclination to go on a morning run.

By examining the disorder’s possible physical origins, doctors are at risk of playing into one of the biggest misunderstandings surrounding anorexia awareness: that there is just one way someone living with the illness should, or can, look.

It’s easier to understand an illness in physical terms than in mental ones, hence the ongoing battle that the medical field is having around the world to combat mental illness. It’s easier to think that only some of us are predisposed to get a certain illness of the mind – that only some of us have the right genes, because it lessens the amount of people the disease can potentially harm. But, sadly, anorexia – like so many other mental illnesses – is not an exclusive club. Anyone is able to join. Trust me, I know.

So, yes, research about eating disorders is vital in all its forms and we need more of it. Although this study is also a reminder that, as progressive as we think we may be in this age of mental health awareness, there is still a dangerous temptation to try and understand what quite simply is a mental illness as a physical one instead – because then, surely, we’re more likely to find a cure.