The Connection Between Anorexia And Cholesterol


Anorexia is an eating disorder that affects one percent of the American population. Anorexics typically believe themselves to be fat, even when at a dangerously low body weight, and severely restrict their caloric intake in order to lose weight. Anorexia has the highest mortality rate of any mental illness, somewhere between 10 and 20 percent according to different studies.

Anorexia’s cause remains undetermined, although most experts believe it occurs due to a combination of genetic, environmental, psychological, biological, and peer and social pressure factors. Although genetics play an important role in a person developing anorexia, research is still being done on which genes contribute to the development of the disorder.

A recent study on the genetic causes of anorexia found a surprising link: a disruption in the gene that regulates the production of cholesterol seems to have a correlation with the development of anorexia.

International Team Of Researchers


An international team of researchers reviewed genetic information of anorexia patients to determine which genes might cause anorexia. This study is one of the largest sequencing study of anorexia to date. The researchers analyzed the genetic code of over 12,000 anorexia patients and almost 2,000 non-anorexic control samples to find genetic similarities in those with anorexia that were not present in the control group.

The researchers initially studied a small sample of only 334 participants, cataloging the genes known to be associated with feeding behavior or anorexia. Out of the 150 potential genes, only a handful showed any sort of statistical indication that they might relate to anorexia.

The gene EPHX2 displayed one of the strongest signs that it might factor into the development of anorexia. This gene codes epoxide hydrolase 2, which is an enzyme that regulates the metabolism of cholesterol.

The Genetic Link

After recognizing this genetic link, which had not been identified in previous studies, they performed additional research using more genetic samples, which supported the evidence that variations of EPHX2 occurred more often in those with anorexia than control samples.


Existing data from a previous long term, large scale heart disease study was analyzed, showing that a subset of the genetic variations in the EPHX2 genes affects the normal relationship between weight gain and cholesterol. This would cause a person to have higher cholesterol the less he or she weighed.

The researchers have yet to discover why this gene and the subsequent abnormal metabolism of cholesterol might trigger anorexia. However, they have found some interesting factors that might lead to the answer. Anorexics often have high cholesterol levels even when severely malnourished. Other studies have also shown that the cholesterol levels in some people increase as they lose weight.

Further studies have shown that cholesterol can positively affect one’s mood, since cholesterol is an important building block of cells including those in the brain. This might be why some anorexics experience a better mood when not eating.

Disruption Of Metabolism

The researchers have hypothesized that disruption of the metabolism of cholesterol caused by this gene might allow anorexics to survive even though they have such a significant caloric restriction, and their mood might be positively affected by not eating.

More research is needed to better understand the correlation between cholesterol metabolism and anorexia, but this study begins to unravel some possible reasons for the development of anorexia. The researchers plan to continue their study into this gene, its affects, and its relationship with anorexia, as well as other possible genetic links.

As researchers continue to learn about the possible causes of anorexia, it might help identify those vulnerable to the condition early enough to prevent it from developing, as well as possibly help with diagnosis and treatment of the disorder.

Marissa Maldonado has spent years helping people working in behavioral health treatment centers currently she’s focusing on eating disorder treatment at Sovereign Health.

Image Credit: 1, 2, 3.

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