What causes anorexia nervorsa?
What is anorexia nervosa? 

Generally, it is an eating disorder which is characterised by a tremendous fear of food as well as an extreme weight loss. 
Patients with anorexia nervosa do not necessarily lose their appetite but rather obsessively control and restrict their food intake.



Anorexia Nervosa as an inherited disease/genetic factors 

There has been a lot of research proposing that eating disorders are often biologically inherited and tend to run in families.


  Recent research suggests that inherited biological and genetic factors contribute approximately 56% of the risk for developing an eating disorder. Individuals who have a mother or a sister with anorexia nervosa are approximately twelve times more likely to develop anorexia and four times more likely to develop bulimia than other individuals without a family history of these disorders. Studies of twins have shown a higher rate of eating disorders when they are identical (compared to fraternal twins or other siblings).




The hormone serotonin 

There has been found that anorexics have an overproduction of serotonin, which can cause a continual state of acute stress and anxiety.


  Researchers are still puzzled as to why, if anorexics already have high levels of serotonin, then SSRIs (medications like Prozac which raise serotonin levels) are successful treatments for some individuals. These scientists speculate that that there may be different subtypes of this disease, and that different groups of anorexics may have different neurochemical characteristics.
  
  Researchers have also noted that abnormal eating behaviours and the resulting changes in the body can actually cause a disruption in serotonin levels, thus contributing to an already existing problem. Abnormalities in serotonin levels can lead to depression and anxiety. Studies also suggest that there are genetic predispositions to serotonin disruptions that appear to run in some families. 




The hormone dopamine 


  Research suggests that women who develop anorexia nervosa may have altered levels of dopamine in their brains. Dopamine disturbances can cause hyperactivity, repetition of behaviour (such as food restriction), and anhedonia (a decreased sense of pleasure). This neurotransmitter also affects reward-motivated behaviour.




The hormone cortisol/hydrocortisone 


  Numerous other hormones in the brain have also been linked to eating disorders. Stress triggers the production and release of a hormone called cortisol; chronically elevated cortisol levels have been observed in patients with anorexia. Cortisol can inhibit appetite.




The hormone leptin 


  Leptin is a protein hormone produced by the body's adipose tissue. Leptin is regarded as a hormone which can regulate fact storage and appetite. If individuals with anorexia nervosa lose extreme amounts of body fat, their levels of leptin drop which is known as hypoleptinaemia. The side effects of hypoleptinaemia can include amenorrhea, impaired metabolism, and bone loss.


Also, if people receive treatment, their leptin levels do not immediately return to normal. Initially during the treatment, leptin levels rise through the sky, which is also the reason why most patients are most susceptible of relapsing back into an eating order, since very high levels of leptin may cause a weight gain. 



Sources:


ENGEL, BRIDGET, NATALIE STAATS REISS, and MARK DOMBECK. "Causes Of Eating Disorders - Biological Factors Continued." Mental Help Causes of Eating Disorders Biological Factors Continued Comments. 2 Feb. 2007
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010958/
http://www.apa.org/monitor/mar02/genetic.aspx