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DURHAM, NC -- Understanding how individuals with anorexia nervosa interact with others may lead to entirely new approaches to treating the disease which affects up to 10 million adolescents.

Current treatments focus primarily on managing symptoms like starvation and low body weight. Although that's important, it is not always enough to result in lasting health, says Nancy Zucker, Ph.D, Director of Duke University Medical Center's Eating Disorders Program.

In a comprehensive review of data published in the November issue of Psychological Bulletin, Zucker pinpoints many patterns of social dysfunction among individuals with anorexia nervosa. She and her colleagues at the University of North Carolina at Chapel Hill believe treatment focusing on these areas may help patients engage better with their family, friends, and health care providers. Ultimately it may help them be more successful in treatment and prevent relapse.

"Overlooking the importance of social functioning might hinder our progress with these patients," she says. "If we can help them develop skills to become more comfortable and effective in interpersonal interactions, this might be a critical step to improving the efficacy of the treatments we deliver."

Zucker set out to explore this new concept in treatment after being unable to answer some obvious questions.

"I wanted to find out why some people with anorexia have so much trouble remaining in treatment, being successful in treatment and engaging with their therapists. How do you explain that they are so competent in some areas, yet have trouble forming intimate relationships?"

After combing through the literature, she discovered evidence that people with anorexia nervosa often have difficulty reading the emotions of others, and are often anxious in social situations. Published research also demonstrated a link between social dysfunction and poor treatment response.

"The research shows their relationship difficulties are not just a scar of the disease," she says. "There is evidence that the social challenges predate their anorexia, and persist after they recover."

Zucker looked at the body of research on autism, a disorder characterized by problems with interpersonal interaction. "There were parallels with anorexia nervosa that we simply could not ignore."

With support from a National Institute of Mental Health grant, Zucker is collaborating with Kevin Labar from Duke's Center for Cognitive Neuroscience and researchers at the UNC School of Medicine including, Cynthia Bulik, Director of the UNC Eating Disorders Program, Joseph Piven, MD, Director of UNC's Neurodevelopmental Disorders Research Center, and Molly Losh, Assistant Professor of Allied Health and Psychiatry. They will be exploring ways to help patients with anorexia improve their social relationships.

Individuals currently struggling with anorexia nervosa or with a prior history of anorexia nervosa who are interested in participating in this study can contact 919-684-0149 or edresearch@mc.duke.edu.