{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T17:06:22Z","timestamp":1790442382706,"version":"4.1.0"},"reference-count":81,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,5,3]],"date-time":"2020-05-03T00:00:00Z","timestamp":1588464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["391362"],"award-info":[{"award-number":["391362"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Epigenetic mechanisms are believed to link environmental exposures to alterations in gene expression, and in so doing, to provide a physical substrate for the activation of hereditary potentials by life experiences. In keeping with this idea, accumulating data suggest that epigenetic processes are implicated in eating-disorder (ED) etiology. This paper reviews literature on putative links between epigenetic factors and EDs, and examines ways in which epigenetic programming of gene expression could account for gene-environment interactions acting in the EDs. The paper also presents evidence suggesting that epigenetic processes link malnutrition and life stresses (gestational, perinatal, childhood, and adult) to risk of ED development. Drawing from empirical evidence and clinical experience, we propose that an epigenetically informed understanding of ED etiology can benefit patients, caregivers, and clinicians alike, in the sense that the perspective can reduce judgmental or blameful attitudes on the part of clinicians and caregivers, and increase self-acceptance and optimism about recovery on the part of those affected.<\/jats:p>","DOI":"10.3390\/jcm9051332","type":"journal-article","created":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T06:41:20Z","timestamp":1588660880000},"page":"1332","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Eating Disorders, Heredity and Environmental Activation: Getting Epigenetic Concepts into Practice"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4887-7824","authenticated-orcid":false,"given":"Howard","family":"Steiger","sequence":"first","affiliation":[{"name":"Eating Disorders Continuum, Douglas University Institute, Montreal, Quebec H4H 1R3, Canada"},{"name":"Douglas Institute Research Centre, McGill University, Montreal, Quebec H4H 1R3, Canada"},{"name":"Department of Psychiatry, McGill University, Montreal, Quebec H3A 1A1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Booij","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, McGill University, Montreal, Quebec H3A 1A1, Canada"},{"name":"Department of Psychology, Concordia University, Montreal, Quebec H4B 1R6, Canada"},{"name":"Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, Quebec H3T 1C5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,3]]},"reference":[{"key":"ref_1","unstructured":"Gordon, R. (2000). Eating Disorders: Anatomy of a Social Epidemic, Wiley-Blackwell. [2nd ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1001\/archpsyc.1975.01760260095008","article-title":"A conceptual model of psychosomatic illness in children. Family organization and family therapy","volume":"32","author":"Minuchin","year":"1975","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Himmerich, H., Bentley, J., Kan, C., and Treasure, J. (2019). Genetic risk factors for eating disorders: An update and insights into pathophysiology. Ther. Adv. Psychopharmacol., 9.","DOI":"10.1177\/2045125318814734"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1038\/s41380-018-0254-7","article-title":"Epigenetics in eating disorders: A systematic review","volume":"24","author":"Hubel","year":"2019","journal-title":"Mol. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Publishing. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1001\/archgenpsychiatry.2011.74","article-title":"Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies","volume":"68","author":"Arcelus","year":"2011","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1002\/eat.22512","article-title":"Correlates of health related quality of life in anorexia nervosa","volume":"49","author":"Weigel","year":"2016","journal-title":"Int. J. Eat. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1002\/eat.20804","article-title":"Life beyond the eating disorder: Education, relationships, and reproduction","volume":"44","author":"Maxwell","year":"2011","journal-title":"Int. J. Eat. Disord."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1192\/bjp.bp.107.048686","article-title":"Adolescent-onset anorexia nervosa: 18-year outcome","volume":"194","author":"Wentz","year":"2009","journal-title":"Br. J. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.biopsych.2012.11.020","article-title":"The prevalence and correlates of binge eating disorder in the World Health Organization World Mental Health Surveys","volume":"73","author":"Kessler","year":"2013","journal-title":"Biol. Psychiatry"},{"key":"ref_11","unstructured":"Blaney, P., Krueger, R., and Millon, T. (2015). Eating disorders. Oxford Textbook of Psychopathology, Oxford University Press."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1037\/0003-066X.62.3.181","article-title":"Risk factors for eating disorders","volume":"62","author":"Bulik","year":"2007","journal-title":"Am. Psychol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1176\/appi.ajp.157.3.393","article-title":"Controlled family study of anorexia nervosa and bulimia nervosa: Evidence of shared liability and transmission of partial syndromes","volume":"157","author":"Strober","year":"2000","journal-title":"Am. J. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1037\/a0017204","article-title":"Genetic and environmental influences on disordered eating: An adoption study","volume":"118","author":"Klump","year":"2009","journal-title":"J. Abnorm. Psychol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Agras, W.S., and Robinson, A. (2018). Genetic Influences on Eating Disorders. The Oxford Handbook of Eating Disorders, Oxford University Press.","DOI":"10.1093\/oxfordhb\/9780190620998.001.0001"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1002\/eat.20811","article-title":"The 5-HTTLPR polymorphism and eating disorders: A meta-analysis","volume":"44","author":"Calati","year":"2011","journal-title":"Int. J. Eat. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1002\/ajmg.b.32771","article-title":"5-HT2AR and BDNF gene variants in eating disorders susceptibility","volume":"183","author":"Ceccarini","year":"2019","journal-title":"Am. J. Med. Genet. B NeuroPsychiatr. Genet."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1038\/sj.mp.4001402","article-title":"Association of estrogen receptor beta gene polymorphisms with bulimic disease in women","volume":"9","author":"Nilsson","year":"2004","journal-title":"Mol. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1016\/j.jpsychires.2010.10.001","article-title":"Genetic variation of the ghrelin activator gene ghrelin O-acyltransferase (GOAT) is associated with anorexia nervosa","volume":"45","author":"Muller","year":"2011","journal-title":"J. Psychiatr. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s11920-017-0842-2","article-title":"Genetics of anorexia nervosa","volume":"19","author":"Baker","year":"2017","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1038\/mp.2013.187","article-title":"A genome-wide association study of anorexia nervosa","volume":"19","author":"Boraska","year":"2014","journal-title":"Mol. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1038\/mp.2017.88","article-title":"Investigation of common, low-frequency and rare genome-wide variation in anorexia nervosa","volume":"23","author":"Huckins","year":"2018","journal-title":"Mol. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1038\/mp.2010.107","article-title":"A genome-wide association study on common SNPs and rare CNVs in anorexia nervosa","volume":"16","author":"Wang","year":"2011","journal-title":"Mol. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3847","DOI":"10.1038\/s41598-017-01674-8","article-title":"A genome-wide association study of anorexia nervosa suggests a risk locus implicated in dysregulated leptin signaling","volume":"7","author":"Li","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1176\/appi.ajp.2017.16121402","article-title":"Significant locus and metabolic genetic correlations revealed in genome-wide association study of anorexia nervosa","volume":"174","author":"Duncan","year":"2017","journal-title":"Am. J. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Zerwas, S., Larsen, J.T., Petersen, L., Thornton, L.M., Quaranta, M., Koch, S.V., Pisetsky, D., Mortensen, P.B., and Bulik, C.M. (2017). Eating disorders, autoimmune, and autoinflammatory disease. Pediatrics, 140.","DOI":"10.1542\/peds.2016-2089"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1038\/s41588-019-0439-2","article-title":"Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa","volume":"51","author":"Watson","year":"2019","journal-title":"Nat. Genet."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e776","DOI":"10.1038\/tp.2016.35","article-title":"BDNF-Val66Met variant and adolescent stress interact to promote susceptibility to anorexic behavior in mice","volume":"6","author":"Madra","year":"2016","journal-title":"Transl. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1038\/mp.2010.125","article-title":"Gene-environment interaction in anorexia nervosa: Relevance of non-shared environment and the serotonin transporter gene","volume":"16","author":"Karwautz","year":"2011","journal-title":"Mol. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.physbeh.2016.01.041","article-title":"Eating disorders, gene-environment interactions and the epigenome: Roles of stress exposures and nutritional status","volume":"162","author":"Steiger","year":"2016","journal-title":"Physiol. Behav."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.jgg.2013.06.004","article-title":"DNA methylation, behavior and early life adversity","volume":"40","author":"Szyf","year":"2013","journal-title":"J. Genet. Genom."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.euroneuro.2014.01.009","article-title":"Epigenetics, a key for unlocking complex CNS disorders? Therapeutic implications","volume":"25","author":"Szyf","year":"2015","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.neubiorev.2020.02.019","article-title":"Childhood maltreatment and DNA methylation: A systematic review","volume":"112","author":"Cecil","year":"2020","journal-title":"NeuroSci. BioBehav. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"5592","DOI":"10.1038\/ncomms6592","article-title":"DNA methylation signatures link prenatal famine exposure to growth and metabolism","volume":"5","author":"Tobi","year":"2014","journal-title":"Nat. Commun."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1002\/bdr2.1081","article-title":"Epigenetic alterations and prenatal maternal depression","volume":"109","author":"Nemoda","year":"2017","journal-title":"Birth Defects Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.jaac.2018.02.011","article-title":"The epigenetic clock at birth: Associations with maternal antenatal depression and child psychiatric problems","volume":"57","author":"Suarez","year":"2018","journal-title":"J. Am. Acad Child. Adolesc. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Marcho, C., Oluwayiose, O.A., and Pilsner, J.R. (2020). The preconception environment and sperm epigenetics. Andrology.","DOI":"10.1111\/andr.12753"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1016\/j.biopsych.2017.10.005","article-title":"Parental advisory: Maternal and paternal stress can impact offspring neurodevelopment","volume":"83","author":"Chan","year":"2018","journal-title":"Biol. Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Noor, N., Cardenas, A., Rifas-Shiman, S.L., Pan, H., Dreyfuss, J.M., Oken, E., Hivert, M.F., James-Todd, T., Patti, M.E., and Isganaitis, E. (2019). Association of periconception paternal body mass index with persistent changes in DNA methylation of offspring in childhood. JAMA Netw. Open, 2.","DOI":"10.1001\/jamanetworkopen.2019.16777"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1002\/eat.22391","article-title":"A prospective study of effects of prenatal maternal stress on later eating-disorder manifestations in affected offspring: Preliminary indications based on the Project Ice Storm cohort","volume":"48","author":"Steiger","year":"2015","journal-title":"Int. J. Eat. Disord."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1080\/15592294.2015.1063771","article-title":"DNA methylation mediates the impact of exposure to prenatal maternal stress on BMI and central adiposity in children at age 13(1\/2) years: Project Ice Storm","volume":"10","author":"Dancause","year":"2015","journal-title":"Epigenetics"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1186\/s13148-017-0418-3","article-title":"Maternal eating disorders affect offspring cord blood DNA methylation: A prospective study","volume":"9","author":"Kazmi","year":"2017","journal-title":"Clin. Epigenet."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1038\/nn1276","article-title":"Epigenetic programming by maternal behavior","volume":"7","author":"Weaver","year":"2004","journal-title":"Nat. NeuroSci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1038\/nn.2270","article-title":"Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse","volume":"12","author":"McGowan","year":"2009","journal-title":"Nat. NeuroSci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.yhbeh.2010.05.005","article-title":"Epigenetic marking of the BDNF gene by early-life adverse experiences","volume":"59","author":"Roth","year":"2011","journal-title":"Horm. Behav."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"17266","DOI":"10.1073\/pnas.1121260109","article-title":"Conserved epigenetic sensitivity to early life experience in the rat and human hippocampus","volume":"109","author":"Suderman","year":"2012","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Holmes, L., Shutman, E., Chinaka, C., Deepika, K., Pelaez, L., and Dabney, K.W. (2019). Aberrant epigenomic modulation of glucocorticoid receptor gene (NR3C1) in early life stress and major depressive disorder correlation: Systematic review and quantitative evidence synthesis. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16214280"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s13148-015-0156-3","article-title":"Epigenetic alterations following early postnatal stress: A review on novel aetiological mechanisms of common psychiatric disorders","volume":"7","author":"Jawahar","year":"2015","journal-title":"Clin. Epigenet."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.neubiorev.2019.04.010","article-title":"Stress, epigenetics and depression: A systematic review","volume":"102","author":"Park","year":"2019","journal-title":"NeuroSci. BioBehav. Rev."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/bs.pmbts.2018.03.003","article-title":"Transgenerational epigenetics of traumatic stress","volume":"158","author":"Jawaid","year":"2018","journal-title":"Prog. Mol. Biol. Transl. Sci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.neubiorev.2018.08.017","article-title":"Glucocorticoid receptor gene (NR3C1) DNA methylation in association with trauma, psychopathology, transcript expression, or genotypic variation: A systematic review","volume":"95","author":"Watkeys","year":"2018","journal-title":"NeuroSci. BioBehav. Rev."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1002\/eat.22113","article-title":"Methylation of the glucocorticoid receptor gene promoter in bulimic women: Associations with borderline personality disorder, suicidality, and exposure to childhood abuse","volume":"46","author":"Steiger","year":"2013","journal-title":"Int. J. Eat. Disord."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.pnpbp.2014.04.010","article-title":"Methylation of BDNF in women with bulimic eating syndromes: Associations with childhood abuse and borderline personality disorder","volume":"54","author":"Thaler","year":"2014","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Notaras, M., and van den Buuse, M. (2020). Neurobiology of BDNF in fear memory, sensitivity to stress, and stress-related disorders. Mol. Psychiatry.","DOI":"10.1038\/s41380-019-0639-2"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.jpsychires.2013.10.003","article-title":"Methylation of the dopamine D2 receptor (DRD2) gene promoter in women with a bulimia-spectrum disorder: Associations with borderline personality disorder and exposure to childhood abuse","volume":"48","author":"Groleau","year":"2014","journal-title":"J. Psychiatr. Res."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Amenyah, S.D., Hughes, C.F., Ward, M., Rosborough, S., Deane, J., Thursby, S.-J., Walsh, C.P., Kok, D.E., Strain, J.J., and McNulty, H. (2020). Influence of nutrients involved in one-carbon metabolism on DNA methylation in adults\u2014a systematic review and meta-analysis. Nutr. Rev.","DOI":"10.1093\/nutrit\/nuz094"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1017\/S0029665114001554","article-title":"Emerging roles for folate and related B-vitamins in brain health across the lifecycle","volume":"74","author":"McGarel","year":"2015","journal-title":"Proc. Nutr. Soc."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1080\/1028415X.2017.1331524","article-title":"Epigenetics, nutrition and mental health. Is there a relationship?","volume":"21","author":"Stevens","year":"2018","journal-title":"Nutr. NeuroSci."},{"key":"ref_59","unstructured":"Burdo, J., Booij, L., Kahan, E., McGregor, K., Greenlaw, K., Agellon, L.B., Thaler, L., Labbe, A., Isra\u00ebl, M., and Wykes, L. (2019, January 15). Association between plasma nutrient levels and methylation of selected genomic probes in women with anorexia nervosa. Proceedings of the International Conference on Eating Disorders, New York, NY, USA."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1038\/sj.mp.4001931","article-title":"Global DNA hypomethylation and DNA hypermethylation of the alpha synuclein promoter in females with anorexia nervosa","volume":"12","author":"Frieling","year":"2007","journal-title":"Mol. Psychiatry"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1002\/eat.20745","article-title":"Epigenetic dysregulation of dopaminergic genes in eating disorders","volume":"43","author":"Frieling","year":"2010","journal-title":"Int. J. Eat. Disord."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Kim, Y.-R., Kim, J.-H., Kim, M.J., and Treasure, J. (2014). Differential methylation of the oxytocin receptor gene in patients with anorexia nervosa: A pilot study. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0088673"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1002\/erv.2703","article-title":"Methylation of the OXTR gene in women with anorexia nervosa: Relationship to social behavior","volume":"28","author":"Thaler","year":"2020","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1097\/YPG.0000000000000189","article-title":"Investigation of differential HDAC4 methylation patterns in eating disorders","volume":"28","author":"Subramanian","year":"2018","journal-title":"Psychiatr. Genet."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"197","DOI":"10.3389\/fpsyt.2019.00197","article-title":"Association of leptin gene DNA methylation with diagnosis and treatment outcome of anorexia nervosa","volume":"10","author":"Neyazi","year":"2019","journal-title":"Front. Psychiatry"},{"key":"ref_66","first-page":"190016","article-title":"Peripheral serotonin transporter DNA methylation is linked to increased salience network connectivity in females with anorexia nervosa","volume":"45","author":"Boehm","year":"2019","journal-title":"J. Psychiatry NeuroSci."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"2605","DOI":"10.1038\/sj.npp.1301662","article-title":"Epigenetic downregulation of atrial natriuretic peptide but not vasopressin mRNA expression in females with eating disorders is related to impulsivity","volume":"33","author":"Frieling","year":"2008","journal-title":"Neuropsychopharmacology"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"217","DOI":"10.3389\/fncel.2017.00217","article-title":"Differential SLC1A2 promoter methylation in bipolar disorder with or without addiction","volume":"11","author":"Jia","year":"2017","journal-title":"Front. Cell NeuroSci."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1002\/eat.22200","article-title":"Assessing global and gene specific DNA methylation in anorexia nervosa: A pilot study","volume":"47","author":"Saffrey","year":"2014","journal-title":"Int. J. Eat. Disord."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"327","DOI":"10.3109\/15622975.2013.860467","article-title":"Decreased whole-blood global DNA methylation is related to serum hormones in anorexia nervosa adolescents","volume":"15","author":"Tremolizzo","year":"2014","journal-title":"World J. Biol. Psychiatry"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1002\/eat.22374","article-title":"DNA methylation in individuals with anorexia nervosa and in matched normal-eater controls: A genome-wide study","volume":"48","author":"Booij","year":"2015","journal-title":"Int. J. Eat. Disord."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1080\/15622975.2016.1190033","article-title":"High-throughput DNA methylation analysis in anorexia nervosa confirms TNXB hypermethylation","volume":"19","author":"Kesselmeier","year":"2018","journal-title":"World J. Biol. Psychiatry"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1002\/eat.22815","article-title":"Ehlers-Danlos syndrome in a young woman with anorexia nervosa and complex somatic symptoms","volume":"51","author":"Lee","year":"2018","journal-title":"Int. J. Eat. Disord."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1503\/jpn.170242","article-title":"A longitudinal, epigenome-wide study of DNA methylation in anorexia nervosa: Results in actively ill, partially weight-restored, long-term remitted and non-eating-disordered women","volume":"44","author":"Steiger","year":"2019","journal-title":"J. Psychiatry NeuroSci."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.brat.2015.08.011","article-title":"Biological or psychological? Effects of eating disorder psychoeducation on self-blame and recovery expectations among symptomatic individuals","volume":"74","author":"Farrell","year":"2015","journal-title":"Behav. Res. Ther."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.psc.2018.10.007","article-title":"Genetics of eating disorders: What the clinician needs to know","volume":"42","author":"Bulik","year":"2019","journal-title":"Psychiatr. Clin. North. Am."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1002\/jgc4.1128","article-title":"Patient perspectives on the process and outcomes of psychiatric genetic counseling: An \u201cempowering encounter\u201d","volume":"28","author":"Semaka","year":"2019","journal-title":"J. Genet. Couns"},{"key":"ref_78","unstructured":"Lock, J., and Le Grange, D. (2012). Treatment Manual for Anorexia Nervosa, Guilford Press. [2nd ed.]."},{"key":"ref_79","unstructured":"Fairburn, C.G. (2008). Cognitive Behavior Therapy and Eating Disorders, Guilford Press."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1080\/10640266.2016.1269558","article-title":"Evidence-informed practices in the real-world treatment of people with eating disorders","volume":"25","author":"Steiger","year":"2017","journal-title":"Eat. Disord."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1002\/eat.22734","article-title":"Autonomy support and autonomous motivation in the outpatient treatment of adults with an eating disorder","volume":"50","author":"Steiger","year":"2017","journal-title":"Int. J. Eat. Disord."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/5\/1332\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:52:25Z","timestamp":1760363545000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/5\/1332"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,3]]},"references-count":81,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["jcm9051332"],"URL":"https:\/\/doi.org\/10.3390\/jcm9051332","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,3]]}}}