Eating Disorders Information (EDI)

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This blog aims to keep up with the latest research into eating disorders coming from all scientific and psychological backgrounds and present it in a concise and comprehensive manner so that you can understand better what you, or your loved one, is going through with your/his/her eating disorder.

I will be regularly checking the most relevant academic journals from each psychological discipline to bring you a summed-up and easy-to-read summary of the cutting-edge work going on to try to find a treatment for eating disorders.

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Marxism and the alienated body image

Posted by a.marlow on November 16, 2012 at 2:50 PM Comments comments (0)

When I'm not training to be a psychotherapist, I spend a great deal of my time doing a Masters degree in European Law at a French University. One of my (favourite) modules is called "Pensée Politique Contemporaine" (translated: contemporary political thought) and today's lecture covered the socialist thought of Karl Marx. Certain concepts arose in the course of this lecture that felt relevant to the psychological issues around body image, and I thought I'd share them with you.

Firstly, however, we need to detoxify the subject. "Marxism" and "socialism" have become dirty words to many people, so we need to define what we means by them.

We can crudely divide the thought of Karl Marx into two categories: the thought of Marx the critic, and the thought of Marx the revolutionary. Marx the critic would be the author of the four-volume work Capital, who provides an insightful and incisive critique of 19th century capitalism, both from an economic and a philosophical angle. Marx the revolutionary would be the author of The Communist Manifesto, who advocates, among other things, the abolition of family and religion, the setting up of a 'dictatorship of the proletariat', and the subsequent evolution of a classless, stateless society. It is perfectly possible to agree with the first Marx that capitalism has its flaws while disagreeing with the second Marx about what to do about them- and it is to the critical thought of the first Marx that we look today.

There are two key concepts central to Marxist thought that will frame this discussion: exploitation and alienation. Put very crudely, exploitation refers to the situation that occurs when a worker puts in 12 hours of labour and only gets 6 hours worth of wages (the remaining six hours making up the money re-invested in the company and the take-home profit of the capitalist). Alienation is the result of this process. There was a time, many centuries ago, when most workers were self-employed craftsmen who owned the means of their production. They took pride in their work. The labourer's work was an extension of himself, of his identity. (For Marx, man is nought but his labour. This can be boiled down to the more general idea that we are defined only by what we do and how we act.) By leaving this utopia of self-employed craftsmanship and becoming a 'wage-slave', this is no longer the case: one man's labour becomes the property of someone else (the capitalist) and, in a very real way, a key part of one's self-defined identity is taken away. The situation is not made any better during holiday time or retirement, since this time is defined by an absence of labour and, thus, by an absence of the self-edifying and self-defining properties that working on one's own project in one's own interest can bring.

This is the crux of Marx's thought and, though it has some holes in it, its general principles can be applied to the plight of the anorexic, bulimic and body dysmorphic who, perhaps, feels alienated from their body. Yet one crucial addition needs to be made to the above analysis before it makes sense: the role of the body, especially the female body, in modern society. Authors like Susie Orbach have made the case that modern capitalism has turned the body into a commodity by which one sells oneself to the world. This is especially true for women, who can seemingly go nowhere without being confronted by airbrushed photographs of models and celebrities whose very raison d'être seems to be their appearance, and little else (see this video for a powerful visual account of this fact). The effect is not lost on men, either, who are perhaps more likely to manifest the pathological effects of this phenomenon through muscle dysmorphia rather than anorexia.

So can we see conditions like anorexia, bulimia and body dysmorphia as some kind of response to a capitalism that alienates people from their own bodies, transforming them into images to be possessed for sale on the market rather than an integrative part of one's identity? Perhaps. If this were true, then women, presented with a social market where the thinnest, skinniest body sells, would do terrible things to their bodies in order to make them into marketable images, whatever the cost to their physical and mental health- for the body is viewed as an image, a possession, rather than an intrisic part of oneself.

Yet we must tread with caution. The picture is far more complicated that the one presented above, with genetic considerations and the practice of early family life to be thrown into the mix; and, while it may be argued that anorexia nervosa first appeared as a diagnostic label during the industrialisation of the 19th century, it would be rash to  jump to conclusions about potential links with capitalism, especially when similar behaviour in centuries before may simply have been presented as religious asceticism rather than a desire to lose weight.

Yet it remains a fact that certain people suffering from eating disorders may feel drawn to the explanation given above and may find it helpful in their recovery. It may even spur them on to join groups like UK Feminista or Reclaim the Night, choosing a path of activism against the system that alienated them from their own bodies- and this in itself can be therapeutic.  And it may be useful for therapists themselves to keep this possibility in mind as a way of understanding certain anorexic clients who come their way.

The therapeutic potential of Shamanism

Posted by a.marlow on October 24, 2012 at 6:20 PM Comments comments (0)

Being a shamefully shameless hippy-type, I occasionally frequent Reality Sandwich, a website full of articles on the brilliant, the bizarre and the barmy. It is there that I first came across the ideas and practice of Shamanism which, although interesting, seemed a little far-fetched. How much relevance could the ancient practice of tribal witch-doctors who claim to convene with demons and animal spirits have in the modern world?

So imagine my surprise when I find this passage in (what I assume to be) a reputable medical dictionary, which defined Shamanism as:

"a form of healing that incorporates personal healing, transformation, and regeneration through access to a "higher power." Sickness, disease, and illness are indicators that the individual is out of balance and in disharmony within the essential nature. Success can be achieved if people are, first, willing to take responsibility for the creation of the disease and, second, open to nonphysical realities of life and willing to engage with their inner spirit and their higher selves. This type of healing has been effective for sexual dysfunction, chronic fatigue syndrome, mental health concerns, and obesity and other eating disorders."

I do not know what sources or studies were used by Mosby's Medical Dictionary, but the prospect that Shamanic therapy can be effective is intriguing- and, if you'll permit me to say it, not all that surprising. For, if Jung could examine the psychological meaning behind UFO encounters without offering an opinion on their objective reality, then it is not unfitting to examine the psychological meaning of Shamanic states of consciousness while withholding an opinion on their objective reality.

Indeed, it is worth looking at how these altered states of consciousness work, especially seeing as they are the lifeblood of Shamanic healing. Whether we consider drum-induced trances or ayahuasca-induced trips (ayahuasca being a type of tea drunk by Shamans that contains DMT, the most powerful hallucinogen/psychedelic/entheogenic drug known to man), it appears that these can bring certain therapeutic benefits to those suffering from mental illnesses.

From a psychoanalytic perspective, for example, it has been suggested that the 'temporary psychosis' of Shamanic integration could be viewed as a restructuring of the ego, which could be beneficial for those suffering from conditions like anorexia nervosa that have been linked with a failure to build a sufficiently strong ego due to problems in early relationships. And from the perspective of neuroscience, one of the effects of altered states of consciousness found in Shamanic rituals is a blocking of the inhibitory effects of serotonin in the frontal lobes of the brain. Again, seeing as neurological research has repeatedly found links between altered (often increased) serotonin function and eating disorders, a reduction in serotonin activity caused by Shamanic intervention could be beneficial for someone suffering from anorexia or bulimia.

However, all of this is speculation. I have nothing to go on but an entry in a dictionary and one article I happen to have read in the Journal of Consciousness Studies, so you should take my words with a pinch of salt. The moment I find some kind of scientific study on the use of Shamanism in psychotherapy, I'll post it here- and, in the meantime, if you know anything about shamanism that could add to our shared understanding, whether it supports or contradicts the ideas espoused here, I'd love to read it in the comments section below.


Krippner, S., & Combs, A., 2002. "The Neurophenomenology of Shamanism: an Essay Review", Journal of Consciousness Studies, 9(3), 77-82

Anorexia nervosa as an "addiction to the outside world"

Posted by a.marlow on October 20, 2012 at 11:15 AM Comments comments (0)

In a second blog entry on the psychoanalytical ideas of Monsieur Marinov, we come to one of his more intriguing and sensible propositions: namely, that anorexia nervosa should be conceived of as an "addiction to the outside world [1]".

His approach, unsurprisingly for a book whose title is "Anorexia, addictions and narcissistic fagilities [2]", is to examine anorexia through the prism of narcissism and addictions. (Here, we need to understand what is meant by the psychoanalytic use of the word 'narcissism': it does not refer to the personal vice of excessive self-love and self-importance as it does in ordinary speech, but rather refers to the ordinary and healthy process in early life where we learn to love and accept ourselves, where we invest our "libido" in ourselves). His view is that, due to having been "injured" by the hostile look of another in early life, the person who is now anorexic never learnt to love herself and instead saw the outside world as her source of self-love or self-acceptance. A child who followed a healthy course of development would have learnt to love herself in a process Freud called 'primary narcissism'; a child who might later become anorexic never learnt to love herself and derives her self-acceptance from "loaned narcissism [3]", which is, evidently, loaned from others. She can therefore never take her social worth for granted- for it ends as soon as the other pierces her with a hostile or indifferent look. She must constantly try to better herself or keep herself in line with what is socially expected of her- for otherwise, deprived of the love of the Other, and lacking the love of her self, she will feel totally worthless, having no libido invested in her from  any source at all.

It is based on this logic that Marinov sees anorexia as a "submission and... addiction to the outside world [4]". The anorexic develops a "false self" by which she can negotiate it, seeming to meet others' expectations, while inside her true self is undeveloped and seeking desperately to be free, to be released from her slavery to the approval of others. She is thus confronted by a confusing conflict of emotions between, on the one hand, her need for approval from the other and, on the other hand, her need for emancipation from that very first need. The ideal of her true self is, thus, an "ideal of emancipation from body needs [5]"- an ideal that is conveniently fulfilled by her most prominent symptom: the denial of hunger and denial of food.

So what can be done to help someone suffering from anorexia? It must be remembered that, from a psychoanalytic perspective at least, the reason she never developed any self-love or "narcissism" in the first place was because she lacked the experience of an unconditional loving gaze early on in life, which would then have gone on to be the first stage of her developing a stong sense of self-respect and self-control. Having lacked such unconditional acceptance, she might have grown up to experience herself as living in a world where she must put on a False Self and conform to external expecations to earn that loving look. If you are the friend, relative, or family member of someone suffering from anorexia, one of the most important things you can do is continue to provide that loving gaze. Let the person close to you know that she is accepted for who she is without needing to meet any particular expectations and hopefully, with time, this will go on to form the basis of her developing a strong sense of herself without needing to rely on the gaze of the other to find such self-acceptance.

[1] original: "addiction au monde extérieur"

[2] original: "Anorexie, addictions et fragilités narcissiques"

[3] original: "narcissisme d'emprunte"

[4] original: "soumission et... addiction au monde extérieur"

[5] original: "idéal d'emancipation des besoins corporels"


Marinov, V., et al., 2010. Anorexia, addictions et fragilités narcissiques, Presses Universitaires de France: Paris

- Marinov, V., "Le narcissisme dans les troubles de conduites alimentaires", pp. 37-66


Psychoanalysis and feminism in the case of anorexia and hysteria

Posted by a.marlow on October 18, 2012 at 8:00 AM Comments comments (0)

At its best, psychoanalysis can give us profound insights about the unconscious causes of mental illnesses. At its worst, it can come across as sexist nonsense.

I first realised this while reading a book on the psychoanalytic account of anorexia nervosa and other conditions related to addiction. In the chapter on anorexia nervosa, I read:

"But this lilliputian perspective in the fantasies of women in general, and in anorexics in particular, is also linked in all probability to the comparison made at a certain age between the small size of the clitoris and the 'grandeur' of the boy's penis[1]"

Just before this point, the author had been making a generally insightful argument about how the failure of anorexics to realise just how thin they are relates not simply to a cognitive deficit, but is mainly due to a complex relationship between the physical sensation of space and size of the body and the emotional sensation of closeness to, or distance from, the mother, as well as the fear of being made to feel insignifant by her gaze (of course, to those unacquainted with psychoanalyic thought, the 'mother' in this case would be an unconscious image [or "object"] of her that was internalised at an early age: a distracted, empty or hateful gaze from mother towards infant might have been internalised as a constant unconscious presence to breed body self-loathing in the infant girl).  This idea has some merit, and is more convincingly developed by feminist thought, which goes on to posit a "psychology of femininity" (see Orbach) where women are raised to believe their value in society is primarily based on looks and service and to judge other women, including newborn baby girls, accordingly (even if they are unaware of it). In the logic of psychoanalysis, however, this is not even considered, and the default position is to return to a consideration of the infant's erogenous zones- which seems to me to be patently absurd.

Worse, another chapter in the same book offers this startling analysis of the related condition of 'hysteria':

"It is well known that love, as Molière said, is chiefly the business of women. This is also true of hysterics. It is here that we find the affinity between femininity and hysteria, perceived everywhere and known since time immemorial. [2]"

This isn't sexist in the sense that it's showing any kind of hatred towards women, I'll give it that. But the reasoning here seems shoddy at best. It seems to be playing on old stereotypes of how women behave without piercing through them and asking if they are true. Personally, I find the feminist account more convincing- or, at least, more intellectually rigourous- in that it views a close link between hysteria, a condition common among women in the late 19th century, and anorexia nervosa, common in contemporary culture, taking the view that both of them represent exaggerations of and unconscious protests against the social exclusion of women in their time: in the late 19th century, hysteria was a protest against/exaggeration of the romantic, frail female social role of late Victorian England, while now, anorexia can be seen as the protest against/exaggeration of the stick-thin model and all-providing mother archetypes that have defined women since the middle part of the 20th century.

What's worse, the description of hysteria given in this book verges on making a pathology out of ordinary female alienation. We read, for example, that one feature of hysteria are:

"the fears, the complaints, the accusations of women suffering from hysteria that they are not loved for who they are and are only 'sexual objects' for men [3]"

This is a key part of the feminist approach to anorexia nervosa: that women, faced with a world where they are sexually objectified by the culture around them, retreat into a child-like androgynous state where they are safe from the dangers of sexuality (as the denial of one's desire for food is taken to be a denial of desire in general, including the desire for sex; the result of this denial is that one's body loses the sexualised form of a teenage/adult woman and comes to resemble once more that of a child, free from the objectifying look of the other and the constant inconvenience of period pain). To make this an individual symptom of a mental illness, rather than a genuine complaint about a harmful culture, is to blame those suffering from eating disorders or hysteria for not managing to fit in well enough, rather than recognising the social pathology at the heart of our culture in the way that it relates to women- a pathology that must be cured on a collective level, rather than/as well as focusing treatment on individual sufferers in therapy. 

To sum up, we should not forget that psychanalysis has given us a lot of profound insight into the nature of mental illness. It is from psychoanalytic thought that we realise that the issue at the heart of anorexia nervosa is not food per se, but rather the search for self-control through the medium of food. And yet we cannot just ignore the deficits at the heart of psychoanalysis. Many of its ideas remain deeply offensive to many, and unless it wants to remain the embarrassing elderly relative of modern experimental psychology that few still take seriously, it needs to address some of its problems and adapt its ideas to the modern world and the insights of feminist thought.

[1] Marinov., V., p. 62 [translated from French].

[2] Lanouzière, L., p. 131 [translated from French].

[3] Lanouzière, L., p. 134 [translated from French]


Marinov, V., et al., 2010. Anorexia, addictions et fragilités narcissiques, Presses Universitaires de France: Paris

- Marinov, V., "Le narcissisme dans les troubles de conduites alimentaires", pp. 37-66

- Lanouzière, J., "L'hystérique et son "addiction"", pp. 131-156

"Compulsory promiscuousness" and the sexual revolution

Posted by a.marlow on October 14, 2012 at 12:25 AM Comments comments (0)

It is a common train of feminist thought that anorexia and related disorders represent a flight from the sexual objectification of the female body. However, it might be that this analysis misses the wood for the trees and ignores a far wider phenomenon.

That, at least, is the suggestion of Young-Bruehl who, writing in the 1993 edition of the International Journal of Psychoanalysis, accuses feminism of being blind to a wider culture of over-sexualisation, where children grow up under the "tyranny of youthful sexual experimentation". The accusation is that, as an ideology that grew up in the heady days of the 1960s sexual revolution, it is loathe to criticise it in its totality, instead taking the specific effects of this revolution on women and ignoring its effects on young people in general.

If feminism identifies a cultural imperative on women and girls to conform to the thinness of the model and the generosity of the mother, then Young-Bruehl suggests we might need to also consider the equally pervasive cultural imperative on young people in general to have sex. It may seem strange to some people that this would be experienced as an imperative- after all, doesn't everyone want sex? How is this an imperative rather than liberation?

Yet such thinking ignores the fact that being sexually active is experienced as something obligatory by many teenagers. The worst thing in the world is to be a virgin. Sex has become a rite of passage, a route into adulthood- and some people just aren't ready for that when they hit puberty. For some people, the idea of sex itself is terrifying, and this might, suggests Young-Bruehl, manifest itself in an eating disorder: for when one is anorexic, one almost becomes desexualised. Below a certain weight, teenage girls stop having periods. Losing weight means a flattening of the chest and, perhaps, a loss of sexual interest from others. In the end, her body might resemble that of a child more than it does that of a woman- and to someone frightened by the very thought of sex, or by growing up in general, that is a comfort.

This kind of idea had already been identified by feminism- in Orbach's book "Fat is a Feminist Issue", she describes becoming obese and becoming anorexic as two different responses to the same fear of becoming sexually objectified. Yet Young-Bruehl's insight is that this kind of fear can come not just through the tyranny of feminism's Female Beauty Ideal, but also through the general experience of being a child in a sexualised world.


Young-Bruehl, E., 1993. "On feminism and psychoanalysis - in the case of anorexia nervosa", International Journal of Psychoanalysis, 10(3), 317-330

Insecure relationships predict body image problems

Posted by a.marlow on October 10, 2012 at 10:15 AM Comments comments (0)

What causes an eating disorder or, more generally, a body image problem? One theory is that it is a mixture of parents, peers and media- and in the latest edition of Body Image, Hardit & Hannum tested that hypothesis.

Surprisingly, they found that parental critism and peer pressure were very minor factors in creating body dissatisfaction - while, unsurprisingly, the media was found to be a very significant factor indeed. What is interesting, however, is what they discovered about who was affected by the media. It was only those who had "anxious attachments"- which is a technical psychological way of saying that they were insecure in their relationships with other people. It seems, then, that, according to this study at least, a body image problem (and potentially an eating disorder- although this study did not specifically test for that) arises when one does not feel secure with one's friends or family and, surrounded by the values of our current society daily transmitted through the media, concludes that the reason one might not be acceptable to them is because of one's body. This creates dissatisfaction which, in extremes, can lead to psychological conditions like anorexia nervosa, bulimia nervosa and body dysmorphia.


Hardit, S. K., & Hannum, J. W., 2012. "Attachment, the tripartite influence model, and the development of body dissatisfaction", Body Image, 9(4), 469-475

Peer victimisation in early adolescence leads to greater body shame in girls

Posted by a.marlow on October 10, 2012 at 6:05 AM Comments comments (0)

"Objectified body consciousness" is a term invented by feminist psychologists to describe what happens when we start viewing our bodies as objects that exist for other peoples' pleasure and/or judgment rather than for our own enjoyment, as the expression of our own subjectivity. Recent research indicates that peer victimisation at a young age makes us more likely to be ashamed of our bodies and to view them in this objective, judged-by-others way.

A study published last year by Lunde & Frisén tested this hypothesis by giving a sample of 602 Swedish children questionnaires to fill in at ages 10 and 18. They found that "peer victimisation" at age 10 was linked with greater body-monitoring at age 18 for both boys and girls, but that girls were more likely to feel shame about their bodies than boys.

What this means is that being bullied or ostracised in early life for one's appearance can lead to long-term effects, perhaps even after the victimisation has stopped. While it is not clear whether those who suffered "peer victimisation" at age 10 continued to suffer it throughout adolescence, it is reasonable to assume that even among those whose suffering was short-lived, its impact can be long-term.

This study did not look specifically at eating disorders- only at body shame. It is therefore not possible to extrapolate anything from it about whether this increase in body shame led to an increase in eating disorders. However, the message is clear: bullying and ostracisation early in life can still have harmful effects much later on.


Lunde, C & Frisén, A, 2011. "On being victimised by peers in the advent of adolescence: Prospective relationships to objectified body consciousness", Body Image, 8(4), 309-314

Spending time with nature

Posted by a.marlow on October 8, 2012 at 5:40 AM Comments comments (0)

It might sound glib but, if you're suffering from a body image problem, it might do you good to get out into nature for a bit.

What does nature have to do with an eating disorder or body dysmorphia, though?

The answer lies in what might have caused that condition. It is at least partly true that our society's cultural standards of beauty and attractiveness are responsible for the creation of such disorders- from this perspective, it makes perfect sense that a woman who is constantly trying to get thinner, despite being told by her friends that she already looks like a skeleton, would be doing so because of a perceived pressure to be thin. And, from this perspective, it also makes sense that taking yourself out of the environment that made you feel that pressure in the first place could only do you good.

This idea has (not so) recently been tested by one ecopsychologist. Writing in the Journal Ecopsychology, Hennigan describes a study she conducted on the lived experiences of 12 women during time spent in nature. Hennigan concluded that: "results of this organic inquiry supported the idea that spending time in natural settings improved body image by way of distancing women from the cultural context, increasing embodied experiences, and supporting connection to nature." In plain english, this means that getting into the countryside can both take you away from the cultural pressures of living in a city where you are constantly bombarded by messages about how to lose weight etc., and also that being in nature itself is a way of experiencing your body as something positive.


Hennigan, K, 2010. "Therapeutic Potential of Time in Nature: Implications for Body Image in Women", Ecopsychology, 2(3), 135-140

Mirror exposure can help overcome body image problems

Posted by a.marlow on October 7, 2012 at 6:15 PM Comments comments (0)

If you are suffering from an eating disorder like anorexia nervosa or bulimia nervosa, or if you are simply self-conscious about your body, then chances are that looking at yourself in the mirror is the last thing you'd want to do. You probably know from experience that looking in the mirror is going to bring feelings of discomfort and make you convinced that your body is unacceptable.

And yet... looking in the mirror for an extended period of time might be just what you need to do. Research by Moreno-Dominguez et al. has found that "pure mirror exposure, based on the traditional extinction paradigm, led to strong emotional activation followed by a fast decrease in emotional reactivity." What this means in plain english is that, while you might be overwhelmed at first by feelings of disgust and unworthiness, if you keep looking at yourself in the mirror despite those feelings, they will eventually subside as you get used to your body and begin to appreciate all that is positive about it.

So next time you're in the bathroom getting ready for the day, don't hide from the mirror. Rather, look into it, embrace it, and through doing so embrace yourself as well.


Moreno-Dominguez, S., et al., 2012. "Pure versus guided mirror exposure to reduce body dissatisfaction: A preliminary study with university women", Body Image, 9(2), 285-288

A genetic link to eating disorders?

Posted by a.marlow on October 7, 2012 at 5:00 AM Comments comments (0)

Two articles in recent editions of the International Journal of Eating Disorders paint us a very interesting, but also very puzzling, picture of the roles genes might play in the formation of eating disorders.

First, the positive role they might play: Soltenberg et al. in their study found that women who had a specific variant of the serotonin transporter gene SLC6A4 were more likely to respond to childhood trauma by developing eating problems in later life. (For those who don't know, serotonin is a brain chemical that is believed to regulate appetetite and mood, and whose abnormal functioning has been implicated in the formation and experience of eating disorders).

So far, so good- but another study by Munn-Chernoff et al. found, in contrast to the above referenced study, that there was no significant correlation between any variant of the SLC6A4 gene and either binge-eating or body weight concern.

So how can we reconcile these two seemingly conflicting studies? In reality, it is not that hard. Firstly, we need to consider that they were both looking at different things: Soltenberg et al. had a more general definition of eating problems, while Munn-Chernoff et al. were looking specifically at binge-eating and body weight concern. It is entirely possible that, had the latter group been looking for links with other kinds of disordered eating behaviour (such as the self-starvation shown by anorexics), they would have found a correlation.

Secondly, for what it's worth, both studies also looked at slightly different variants of the SLC6A4 gene. Soltenberg et al. focused their study on one particular variation of this gene (or 'allele*'), while Munn-Chernoff et al. conducted a more comprehensive study looking at seven different 'polymorphisms**' of this gene. You might expect, then, that the latter study would have more comprehensive results, and we can probably say that it did- but when saying that, it is important to remember the points made in the paragraph above about what specifically Munn-Chernoff et al. were looking for.

The picture that emerges, then, is a complicated one: which variant of the SLC6A4 gene you have can affect whether you contract an eating disorder later in life; however, this gene is not linked to either binge-eating or body image concern and only really determines how you'll react to childhood experiences, rather than completely determining the future state of your mental health.


Flummoxed by some of the terms in this blog post? Don't worry, so am I. I had to look these terms up:

allele: the term 'allele' refers to an alternative form of a gene.

polymorphism: in genetics, "genotype" refers to the instructions passed down in the genetic code, while "phenotype" refers to the actual behaviour and traits exhibited by the creature that has those genes. Genotype is thus determined only by genes, while phenotype is determined by genetic and environmental factors. Here, a different "polymorphism" of the SLC6A4 gene would refer to a different phenotype of that gene i.e. different observable traits in different people carrying the same gene. When a polymorphism is genetic, as it seems to be here, the different behaviour results from an alteration in the gene itself.

I'll freely admit that genetics is not my speciality, so if I've got some of this wrong, please do correct me in the comments section.



Munn-Chernoff, M. A. et al., 2012. "Examining associations between disordered eating and serotonin transporter gene polymorphisms", International Journal of Eating Disorders, 45(4), 556-561

Soltenberg, S., et al., 2012. "Association between the serotonin transporter triallelic genotype and eating problems is moderated by the experience of childhood trauma in women", International Journal of Eating Disorders, 45(4), 492-500