Enjoying life to the full again

Anorexia is a life-threatening disease. Psychiatrist Gabriella Milos is looking for new ways of treating it.

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Martina Grossen* has managed to get her life back on track. Three years ago she was still in critical condition in intensive care. The 19-year-old high school graduate was anorexic and weighed only 32 kilograms. Now she’s fit as a fiddle and has plans for the future.

In Switzerland, anorexia (anorexia nervosa in full) affects around 32,000 people, most of them young women. The disease is life-threatening and hard to treat. Only half of those affected make a full recovery. One in five dies as a result, and in the remaining cases there’s a relapse or it becomes chronic. Every year around 50 patients come to the Center for Eating Disorders at University Hospital Zurich (USZ) for inpatient treatment, including individual and group therapy, bodywork, and nutritional advice.

Physician Gabriella Milos has been devoted to this work for more than 20 years already. Alongside treatment, she and her team are also engaged in research into anorexia in an endeavor to clarify the many questions that remain regarding its origins and further improve the therapy. For Gabriella Milos it’s important to take a holistic view: “All too often, anorexia is still seen as a purely mental illness. But the metabolism is also affected.” If the body lacks more and more fat in the course of the disease, hormone production also changes. This in turn affects eating behavior and the psyche.

Early pointers

So far, little research has been done into why some of the people affected manage to get out of this vicious circle while others don’t. It is still unclear, for example, whether there are indications to be found in the brain as to the development of the disease in a particular individual. For this reason, Gabriella Milos is now doing a study to find out whether there are neurological pointers as to how the condition will develop that are already apparent when treatment commences. This would enable the focus of the therapy to be varied. “We want the treatment we give our patients to be as individual as possible,” explains Milos. In the study she is using magnetic resonance imaging (MRI) to investigate the brain structures of 80 anorexia patients and the concentration of specific hormones in their blood.

Helpful hormones

In another project, the team is looking into whether the drug metreleptin is a help for patients. Metreleptin is a synthetically produced analog of the hormone leptin. This is produced by the body in the fat cells and reports the existing fat mass to the brain. If the leptin level in anorexics falls below a critical threshold, the body switches to a state of hunger. Bodily functions such as the heartbeat and hormone metabolism are shut down, and the person’s mental state also deteriorates.

Together with German researchers, Gabriella Milos’s team has been able to show for the first time that metreleptin can stop this catastrophic development. In a new project they now intend to test the effects of the drug on a larger number of patients. The hope is that in the future, a therapy of this type could be used to support psychotherapy.

*anonymized/symbolic image

80% financed

Neuropsychology, Department of Psychology, University of Zurich
Department of Psychiatry and Psychotherapy, LVR-Klinikum, Essen, Germany
Department of Neuroradiology, University Hospital Zurich
Institute of Clinical Chemistry, University Hospital Zurich
Department of Clinical Psychology and Psychotherapy, University of Fribourg

Palatin Foundation
Cropmark AG