Redefining anorexia may unlock new treatments, therapies

(Medical Xpress)—New findings from Western suggest characterizing anorexia as a 'passion' will yield immediate and practical results in terms of treatment and therapy.

The study, led by Louis C. Charland of Western's Rotman Institute of Philosophy, is novel in that philosophers have collaborated with psychiatrists, scientists and clinicians to arrive at this new recommended categorization. That categorization compares the condition to other mental illnesses and holds fundamental implications for treatment, especially in the area of decisional capacity to consent to, or refuse, treatment.

The study," Anorexia Nervosa as a Passion," was published in a recent issue of Philosophy, Psychiatry & Psychology.

"Anorexia nervosa is associated with fear and anxiety over gaining weight and has strong attachments with becoming thin," said Charland , a professor at Western's Arts & Humanities and Health Sciences faculties, as well as the Schulich School of Medicine & Dentistry. "Anorexia nervosa is notorious for being enduring and difficult to treat. Current treatments are highly cognitive in nature and are not always effective."

Charland says categorizing anorexia as a 'passion' may lead to more affective approaches to treatment that target the nature of the disorder more directly.

The research team based the study on the theory of 'passions' proposed by Théodule Ribot, founder of scientific psychology in France. According to Ribot, passions are different from emotions as they organize feelings and emotions over time.

"A passion is relatively stable, lasting months or years. It plays a significant role in motivating, determining, and organizing a person's long-term behavior around a fixed idea," Charland said. "This makes passions different from feelings and emotions, which are simpler states of shorter duration."

A passion as described by Charland and his co-authors, psychiatrists Tony Hope, Anne Stewart and Jacinta Tan, represents an important, recognizable form of behavior, which is invaluable when it leads to creativity or innovation but entirely destructive when it becomes a 'disorder.'

In a published commentary supporting the Philosophy, Psychiatry, & Psychology study, Dr. George Szmukler, a professor of Psychiatry and Society at the Institute of Psychiatry, King's College London, and an honorary consultant psychiatrist at the South London and Maudsley NHS Foundation Trust, called the findings an "original contribution" and "a promising way forward for our understanding and treatment of anorexia nervosa."

"Passions force us to work through some difficult issues, for example, justifications for involuntary treatment based on impairments of decision-making capacity," wrote Szmukler, who also notes an interesting parallel with addiction that deserves to be explored.