Purpose of review To review the recent literature on the epidemiology of anorexia nervosa and bulimia nervosa in terms of incidence, prevalence and mortality. Recent findings Although the overall incidence rate of anorexia nervosa is considerably stable over the past decades, the incidence among younger persons (aged <15 years) has increased. It is unclear whether this reflects earlier detection or earlier age of onset. Nevertheless, it has implications for future research into risk factors and for prevention programs. For bulimia nervosa, there has been a decline in overall incidence rate over time. The lifetime prevalence rates of anorexia nervosa might be up to 4% among females and 0.3% among males. Regarding bulimia nervosa, up to 3% of females and more than 1% of males suffer from this disorder during their lifetime. While epidemiological studies in the past mainly focused on young females from Western countries, anorexia nervosa and bulimia nervosa are reported worldwide among males and females from all ages. Both eating disorders may carry a five or more times increased mortality risk. Summary Anorexia nervosa and bulimia nervosa occur worldwide among females and males of all age groups and are associated with an increased mortality risk.

ObjectivesTo investigate how the genetic susceptibility gene DIO2 confers risk to osteoarthritis (OA) onset in humans and to explore whether counteracting the deleterious effect could contribute to novel therapeutic approaches.MethodsEpigenetically regulated expression of DIO2 was explored by assessing methylation of positional CpG-dinucleotides and the respective DIO2 expression in OA-affected and macroscopically preserved articular cartilage from end-stage OA patients. In a human in vitro chondrogenesis model, we measured the effects when thyroid signalling during culturing was either enhanced (excess T3 or lentiviral induced DIO2 overexpression) or decreased (iopanoic acid).ResultsOA-related changes in methylation at a specific CpG dinucleotide upstream of DIO2 caused significant upregulation of its expression (β=4.96; p=0.0016). This effect was enhanced and appeared driven specifically by DIO2 rs225014 risk allele carriers (β=5.58, p=0.0006). During in vitro chondrogenesis, DIO2 overexpression resulted in a significant reduced capacity of chondrocytes to deposit extracellular matrix (ECM) components, concurrent with significant induction of ECM degrading enzymes (ADAMTS5, MMP13) and markers of mineralisation (ALPL, COL1A1). Given their concurrent and significant upregulation of expression, this process is likely mediated via HIF-2α/RUNX2 signalling. In contrast, we showed that inhibiting deiodinases during in vitro chondrogenesis contributed to prolonged cartilage homeostasis as reflected by significant increased deposition of ECM components and attenuated upregulation of matrix degrading enzymes.ConclusionsOur findings show how genetic variation at DIO2 could confer risk to OA and raised the possibility that counteracting thyroid signalling may be a novel therapeutic approach.

Objective Despite a growing literature on potential risk factors for eating disorders, longitudinal research starting before adolescence is scarce, and little is known about risk factors in males. We investigated risk factors in preadolescent boys and girls for the development of eating pathology in adolescence and young adulthood. Method This study is part of TRAILS (TRacking Adolescents' Individual Lives Survey), a Dutch population‐based cohort study (N = 2,229) from preadolescence into adulthood. Potential risk factors were measured at age 11, based on self‐report, reports of one of the parents, and records of the Preventive Child Healthcare. Variables included sociodemographic variables, pregnancy and perinatal factors, eating‐ and weight‐related factors, psychological functioning, stressful experiences and family factors. At age 19, two‐stage screening including interviews by eating disorder experts was used to examine the prevalence of eating disorders. At age 22 and 26, eating pathology was assessed by the Eating Disorder Diagnostic Scale. Results Preadolescent anxious distress and high weight were associated with eating pathology in adolescence and young adulthood in both boys and girls. Overeating in preadolescence was found to be a prodromal symptom of eating disorders during late adolescence. No evidence was found for sex‐specific risk factors. Discussion Anxious preadolescents with high weight are at increased risk for the development of eating pathology later on. Clinicians should be aware of eating disorder symptoms — like overeating — in this high‐risk group of children, and could consider an early intervention to prevent the development of full‐blown eating disorders.