Thursday, August 22, 2013

Study: Alcohol Dependence, Binge Eating, And Compensatory Behaviors - Are There Common Genetic Factors?

Do you remember the game telephone?


For those of you who have never played telephone here are a few details provided by Wikipedia on how the game is played.
...a game played around the world, in which one person whispers a message to another, which is passed through a line of people until the last player announces the message to the entire group. Errors typically accumulate in the retellings, so the statement announced by the last player differs significantly, and often amusingly, from the one uttered by the first. Reasons for changes include anxiousness or impatience, erroneous corrections, and that some players may deliberately alter what is being said in order to guarantee a changed message by the end of it.
Telephone is sometimes referred to as: grapevine, whisper down the lane, gossip, pass the message, or operator.  One of the great things about this game is that you don't have to purchase anything...no boards, no cards, no pencils or paper...it is a game you can play anywhere and anytime with an infinite number of people from ages five to 105!

There is really no winner in the game of telephone, unless you count everyone as a winner because it can be so amusing and educational. Yes, educational...basically it teaches us how quickly and easily information can be corrupted as it is passed along, it also teaches very young children to listen carefully, training and development experts will sometimes use a game of telephone to teach employees how to share information carefully and succinctly.

News headlines can read like a game of telephone...


Just yesterday, August 21, 2013, a number of news outlets ran a story about the results of a new study which will be published in the September 2013 issue of the Journal of Studies on Alcohol and Drugs: A Twin Study of Alcohol Dependence, Binge Eating and Compensatory Behaviors. You can read the full article here. We will talk more about the study, but for the moment we want to talk about the varied headlines that were created concerning this study.  Here are some examples (and more are provided in the Related Articles section below):
  • Could Alcoholism and Eating Disorders Share a Common Link? (Science World Report)
  • Same Genes May Cause Alcohol Abuse and Eating Disorders (U.S. News & World Report)
  • Do the same genes cause alcohol dependence and eating disorders? (LA Times)
  • Alcohol dependence and bulimia may share common genetic risk (Fox News)
The study was conducted by researchers at the Washington University School of Medicine in St. Louis, Missouri; their conclusion stated very clearly: "These findings indicate that common genetic factors may underlie the vulnerability to alcohol dependence and the liability to binge eating and compensatory behaviors." 

Do you see how specific the researchers are in stating their conclusions, talking specifically about binge eating AND compensatory behaviors? And, yet, the media headlines imply that the findings are applicable to all eating disorders and none reference compensatory behaviors in the headlines. So are these clever eye-catching headlines or just another version of the game telephone?


Study's parameters...


  • Data was collected from 5,993 adult identical and fraternal twins
  • The participants included women and men
  • All participants were from Australia
  • All participants reported about their alcohol use and binge eating habits
  • Only women were asked about their compensatory behaviors, such as purging and laxative abuse

Study's results...



  • In women, the multivariate twin model suggested that additive genetic and nonshared environmental effects influenced alcohol dependence, binge eating, and compensatory behaviors, with heritability estimates ranging from 38% to 53%.
  • The best-fitting sex-limitation model was a common effects model that equated all genetic and nonshared environmental influences in men and women.
  • The heritability estimates were 50% and 38% for alcohol dependence and binge eating, respectively.
  • Overall, there were significant genetic correlations between alcohol dependence and binge eating, alcohol dependence and compensatory behaviors, and binge eating and compensatory behaviors.
According to a press release issued about the study:

Overall, genetic susceptibility appeared key in the odds of developing any of the three disorders. What's more, it seemed some of the same genetic risk factors that made people susceptible to alcoholism also made them vulnerable to bingeing or purging.
It's not clear exactly which genes are involved. For now, the findings emphasize that alcohol dependence and these eating disorder symptoms share some common roots, according to Munn-Chernoff.

"We need to be aware that these problems can occur together, in both men and women," she said. So when health providers see someone with a drinking problem, they may want to ask about bingeing and purging symptoms, or vice-versa—something that, right now, is not routinely done, Munn-Chernoff noted.

And in general, she said, it's important to keep studying the risk factors—genetic or otherwise—for alcohol and eating disorders. "If we can better understand the risk factors, we can better understand how to treat these disorders."


Treating eating disorders at Cottonwood Tucson


At Cottonwood Tucson, we pride ourselves on our internationally respected co-occurring disorders program. Frequently, substance abuse and another condition, such as depression or an eating disorder, occur together. As a first step to determine whether there is a need for co-occurring disorders treatment, each patient who enters Cottonwood participates in a detailed medical and psychiatric assessment, including a thorough physical examination with a staff physician.

This medical workup and diagnosis becomes an ongoing part of his or her treatment plan. Each patient is also evaluated by the Cottonwood therapy staff, which includes a bio-psycho social assessment for underlying mental health issues other than what is considered to be the primary problem. Presenting dual-diagnosis issues could include: drug or alcohol dependency and: depression, bipolar disorder, post-traumatic stress disorder, eating disorder, etc.

If left unattended, these problems frequently manifest into major mental health concerns, which increase in chronicity and frequency. Assessing co-occurring disorders early and addressing them during treatment brings awareness and the potential for resolution. Much of this work will be continued after treatment, following a dialogue between Cottonwood and the patient’s therapist.
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