Entry - %607499 - BULIMIA NERVOSA, SUSCEPTIBILITY TO; BULN - OMIM
 
% 607499

BULIMIA NERVOSA, SUSCEPTIBILITY TO; BULN


Alternative titles; symbols

BN


Other entities represented in this entry:

BULIMIA NERVOSA, SUSCEPTIBILITY TO, 1, INCLUDED; BULN1, INCLUDED

Cytogenetic location: 10p     Genomic coordinates (GRCh38): 10:1-39,800,001


Gene-Phenotype Relationships
Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
10p {Bulimia nervosa, susceptibility to} 607499 Mu 2
Clinical Synopsis
 

INHERITANCE
- Multifactorial
NEUROLOGIC
Behavioral Psychiatric Manifestations
- Recurrent episodes of binge eating
- Recurrent inappropriate conpensatory behavior to prevent weight gain, including self-induced vomiting, laxative or diuretic abuse, fasting, excessive exercise
- Overconcern with weight and body shape
- Feelings of guilt associated with episodes
MOLECULAR BASIS
- Susceptibility conferred by polymorphisms in the brain-derived neurotrophic factor gene (BDNF, 113505.0002 and 113505.0003)

TEXT

Description

Bulimia nervosa (BN) is a psychiatric disorder characterized by episodes of binge-eating (eating an unusually large amount of food in a discrete period of time and feeling out of control), compensatory behavior (e.g., self-induced vomiting or laxative abuse), and over-concern with weight and shape.

Eating disorders such as bulimia nervosa are complex disorders that can be influenced by many genes.


Inheritance

There is evidence that bulimia (as well as the related eating disorder anorexia nervosa (AN; see 606788) and eating disorders not otherwise specified) is strongly familial (Lilenfeld et al., 1998; Strober et al., 2000; Bulik et al., 2000). Twin studies estimate the heritability of syndromic bulimia to be 54 to 83% (Kendler et al., 1991; Bulik et al., 1998; Wade et al., 1999; Kortegaard et al., 2001).


Mapping

Bulik et al. (2003) conducted a linkage analysis in multiplex families with eating disorders that were identified through a proband with bulimia nervosa. Linkage analysis of the entire sample of 308 families yielded a double peak, with the highest nonparametric multiplex maximum lod score (MLS) of 2.92 on chromosome 10. Given the high heritability of self-induced vomiting and the reliability with which it could be measured, Bulik et al. (2003) performed linkage analysis in a subset of 133 families in which at least 2 affected relatives reported a symptom pattern that included self-induced vomiting. The highest MLS (3.39) observed was on chromosome 10, between markers D10S1430 and D10S1423. These results provided evidence for the presence of a susceptibility locus (BULN1) for bulimia nervosa on 10p. Another region on 14q met the criterion for genomewide suggestive linkage, with MLSs of 1.97 (full sample) and 1.75 (subset) at 62 cM from the end of 14p.

Bacanu et al. (2005) measured over 100 attributes thought to be related to liability to eating disorders in affected individuals of multiplex families from the AN cohort that had previously been studied by Grice et al. (2002) and Devlin et al. (2002) and the BN cohort that had previously been studied by Bulik et al. (2003). Six traits were selected for linkage analysis on the basis of expert evaluation and statistical analysis, including obsessionality, age at menarche, anxiety for quantitative trait locus (QTL) linkage analysis, lifetime minimum body mass index (BMI), concern over mistakes, and food-related obsessions. Using QTL linkage analysis, the BN cohort produced 4 suggestive signals: for age at menarche at 10p13 and for anxiety for QTL linkage analysis at 1q31.1, 4q35.2, and 8q13.1. Using covariate-based linkage analysis, the BN cohort showed the most significant and suggestive linkages: for minimum BMI, 1 significant linkage at 4q21.1 and 3 suggestive linkages at 3p23, 10p13, and 5p15.3; for concern over mistakes, 2 significant linkages at 16p13.3 and 14q21.1 and 3 suggestive linkages at 4p15.33, 8q11.23, and 10p11.21; and for food-related obsessions, 1 significant linkage at 14q21.1 and 5 suggestive linkages at 4p16.1, 10p13.1, 8q11.23, 16p13.3, and 18p11.31. For the AN cohort, results were less compelling. Using QTL linkage analysis, they found 2 suggestive linkages, for obsessionality at 6q21 and for anxiety for QTL linkage analysis at 9p21.3. Covariate-based linkage analysis of the AN cohort revealed 5 suggestive signals: for minimum BMI at 4q13.1, for concern over mistakes, at 11p11.2 and 17q25.1, and for food-related obsessions at 17q25.1 and 15q26.2. There was minimum overlap between the 2 cohorts for substantial linkage signals.


Molecular Genetics

Monteleone and Maj (2008) reviewed the genetics of eating disorders, including bulimia nervosa, and stated that there was no convincing evidence for association of candidate genes with eating disorders; they noted that the heterogeneity of eating disorder phenotypes was most likely responsible for the contradictory and inconclusive results.

Associations Pending Confirmation

For discussion of an association between susceptibility to bulimia (formerly symbolized BULN2) and polymorphism in the BDNF gene, see 113505.0002 and 113505.0003.


REFERENCES

  1. Bacanu, S.-A., Bulik, C. M., Klump, K. L., Fichter, M. M., Halmi, K. A., Keel, P., Kaplan, A. S., Mitchell, J. E., Rotondo, A., Strober, M., Treasure, J., Woodside, D. B., Sonpar, V. A., Xie, W., Bergen, A. W., Berrettini, W. H., Kaye, W. H., Devlin, B. Linkage analysis of anorexia and bulimia nervosa cohorts using selected behavioral phenotypes as quantitative traits or covariates. Am. J. Med. Genet. 139B: 61-68, 2005. [PubMed: 16152574, related citations] [Full Text]

  2. Bulik, C. M., Devlin, B., Bacanu, S.-A., Thornton, L., Klump, K. L., Fichter, M. M., Halmi, K. A., Kaplan, A. S., Strober, M., Woodside, D. B., Bergen, A. W., Ganjei, J. K., Crow, S., Mitchell, J., Rotondo, A., Mauri, M., Cassano, G., Keel, P., Berrettini, W. H., Kaye, W. H. Significant linkage on chromosome 10p in families with bulimia nervosa. Am. J. Hum. Genet. 72: 200-207, 2003. [PubMed: 12476400, related citations] [Full Text]

  3. Bulik, C. M., Sullivan, P. F., Kendler, K. S. Heritability of binge-eating and broadly defined bulimia nervosa. Biol. Psychiat. 44: 1210-1218, 1998. [PubMed: 9861464, related citations] [Full Text]

  4. Bulik, C. M., Sullivan, P. F., Wade, T. D., Kendler, K. S. Twin studies of eating disorders: a review. Int. J. Eat. Disord. 27: 1-20, 2000. [PubMed: 10590444, related citations] [Full Text]

  5. Devlin, B., Bacanu, S.-A., Klump, K. L., Bulik, C. M., Fichter, M. M., Halmi, K. A., Kaplan, A. S., Strober, M., Treasure, J., Woodside, D. B., Berrettini, W. H., Kaye, W. H. Linkage analysis of anorexia nervosa incorporating behavioral covariates. Hum. Molec. Genet. 11: 689-696, 2002. [PubMed: 11912184, related citations] [Full Text]

  6. Grice, D. E., Halmi, K. A., Fichter, M. M., Strober, M., Woodside, D. B., Treasure, J. T., Kaplan, A. S., Magistretti, P. J., Goldman, D., Bulik, C. M., Kaye, W. H., Berrettini, W. H. Evidence for a susceptibility gene for anorexia nervosa on chromosome 1. Am. J. Hum. Genet. 70: 787-792, 2002. [PubMed: 11799475, images, related citations] [Full Text]

  7. Kendler, K. S., MacLean, C., Neale, M., Kessler, R., Heath, A., Eaves, L. The genetic epidemiology of bulimia nervosa. Am. J. Psychiat. 148: 1627-1637, 1991. [PubMed: 1842216, related citations] [Full Text]

  8. Kortegaard, L. S., Hoerder, K., Joergensen, J., Gillberg, C., Kyvik, K. O. A preliminary population-based twin study of self-reported eating disorder. Psychol. Med. 31: 361-365, 2001. [PubMed: 11232922, related citations] [Full Text]

  9. Lilenfeld, L. R., Kaye, W. H., Greeno, C. G., Merikangas, K. R., Plotnicov, K., Pollice, C., Rao, R., Strober, M., Bulik, C. M., Nagy, L. A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity. Arch. Gen. Psychiat. 55: 603-610, 1998. [PubMed: 9672050, related citations] [Full Text]

  10. Monteleone, P., Maj, M. Genetic susceptibility to eating disorders: associated polymorphisms and pharmacogenetic suggestions. Pharmacogenomics 9: 1487-1520, 2008. [PubMed: 18855537, related citations] [Full Text]

  11. Strober, M., Freeman, R., Lampert, C., Diamond, J., Kaye, W. Controlled family study of anorexia nervosa and bulimia nervosa: evidence of shared liability and transmission of partial syndromes. Am. J. Psychiat. 157: 393-401, 2000. [PubMed: 10698815, related citations] [Full Text]

  12. Wade, T., Neale, M. C., Lake, R. I. E., Martin, N. G. A genetic analysis of the eating and attitudes associated with bulimia nervosa: dealing with the problem of ascertainment in twin studies. Behav. Genet. 29: 1-10, 1999. Note: Erratum: Behav. Genet. 29: 205 only, 1999. [PubMed: 10371753, related citations] [Full Text]


Ada Hamosh - updated : 04/25/2018
Marla J. F. O'Neill - updated : 6/3/2009
John Logan Black, III - updated : 5/12/2006
George E. Tiller - updated : 8/18/2004
Creation Date:
Victor A. McKusick : 1/22/2003
carol : 04/26/2018
carol : 04/25/2018
terry : 03/15/2013
wwang : 6/12/2009
terry : 6/3/2009
carol : 7/22/2006
wwang : 5/17/2006
terry : 5/12/2006
carol : 5/18/2005
alopez : 8/18/2004
alopez : 8/18/2004
joanna : 3/19/2004
tkritzer : 5/8/2003
ckniffin : 2/27/2003
carol : 1/24/2003
carol : 1/24/2003

% 607499

BULIMIA NERVOSA, SUSCEPTIBILITY TO; BULN


Alternative titles; symbols

BN


Other entities represented in this entry:

BULIMIA NERVOSA, SUSCEPTIBILITY TO, 1, INCLUDED; BULN1, INCLUDED

Cytogenetic location: 10p     Genomic coordinates (GRCh38): 10:1-39,800,001


Gene-Phenotype Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
10p {Bulimia nervosa, susceptibility to} 607499 Multifactorial 2

TEXT

Description

Bulimia nervosa (BN) is a psychiatric disorder characterized by episodes of binge-eating (eating an unusually large amount of food in a discrete period of time and feeling out of control), compensatory behavior (e.g., self-induced vomiting or laxative abuse), and over-concern with weight and shape.

Eating disorders such as bulimia nervosa are complex disorders that can be influenced by many genes.


Inheritance

There is evidence that bulimia (as well as the related eating disorder anorexia nervosa (AN; see 606788) and eating disorders not otherwise specified) is strongly familial (Lilenfeld et al., 1998; Strober et al., 2000; Bulik et al., 2000). Twin studies estimate the heritability of syndromic bulimia to be 54 to 83% (Kendler et al., 1991; Bulik et al., 1998; Wade et al., 1999; Kortegaard et al., 2001).


Mapping

Bulik et al. (2003) conducted a linkage analysis in multiplex families with eating disorders that were identified through a proband with bulimia nervosa. Linkage analysis of the entire sample of 308 families yielded a double peak, with the highest nonparametric multiplex maximum lod score (MLS) of 2.92 on chromosome 10. Given the high heritability of self-induced vomiting and the reliability with which it could be measured, Bulik et al. (2003) performed linkage analysis in a subset of 133 families in which at least 2 affected relatives reported a symptom pattern that included self-induced vomiting. The highest MLS (3.39) observed was on chromosome 10, between markers D10S1430 and D10S1423. These results provided evidence for the presence of a susceptibility locus (BULN1) for bulimia nervosa on 10p. Another region on 14q met the criterion for genomewide suggestive linkage, with MLSs of 1.97 (full sample) and 1.75 (subset) at 62 cM from the end of 14p.

Bacanu et al. (2005) measured over 100 attributes thought to be related to liability to eating disorders in affected individuals of multiplex families from the AN cohort that had previously been studied by Grice et al. (2002) and Devlin et al. (2002) and the BN cohort that had previously been studied by Bulik et al. (2003). Six traits were selected for linkage analysis on the basis of expert evaluation and statistical analysis, including obsessionality, age at menarche, anxiety for quantitative trait locus (QTL) linkage analysis, lifetime minimum body mass index (BMI), concern over mistakes, and food-related obsessions. Using QTL linkage analysis, the BN cohort produced 4 suggestive signals: for age at menarche at 10p13 and for anxiety for QTL linkage analysis at 1q31.1, 4q35.2, and 8q13.1. Using covariate-based linkage analysis, the BN cohort showed the most significant and suggestive linkages: for minimum BMI, 1 significant linkage at 4q21.1 and 3 suggestive linkages at 3p23, 10p13, and 5p15.3; for concern over mistakes, 2 significant linkages at 16p13.3 and 14q21.1 and 3 suggestive linkages at 4p15.33, 8q11.23, and 10p11.21; and for food-related obsessions, 1 significant linkage at 14q21.1 and 5 suggestive linkages at 4p16.1, 10p13.1, 8q11.23, 16p13.3, and 18p11.31. For the AN cohort, results were less compelling. Using QTL linkage analysis, they found 2 suggestive linkages, for obsessionality at 6q21 and for anxiety for QTL linkage analysis at 9p21.3. Covariate-based linkage analysis of the AN cohort revealed 5 suggestive signals: for minimum BMI at 4q13.1, for concern over mistakes, at 11p11.2 and 17q25.1, and for food-related obsessions at 17q25.1 and 15q26.2. There was minimum overlap between the 2 cohorts for substantial linkage signals.


Molecular Genetics

Monteleone and Maj (2008) reviewed the genetics of eating disorders, including bulimia nervosa, and stated that there was no convincing evidence for association of candidate genes with eating disorders; they noted that the heterogeneity of eating disorder phenotypes was most likely responsible for the contradictory and inconclusive results.

Associations Pending Confirmation

For discussion of an association between susceptibility to bulimia (formerly symbolized BULN2) and polymorphism in the BDNF gene, see 113505.0002 and 113505.0003.


REFERENCES

  1. Bacanu, S.-A., Bulik, C. M., Klump, K. L., Fichter, M. M., Halmi, K. A., Keel, P., Kaplan, A. S., Mitchell, J. E., Rotondo, A., Strober, M., Treasure, J., Woodside, D. B., Sonpar, V. A., Xie, W., Bergen, A. W., Berrettini, W. H., Kaye, W. H., Devlin, B. Linkage analysis of anorexia and bulimia nervosa cohorts using selected behavioral phenotypes as quantitative traits or covariates. Am. J. Med. Genet. 139B: 61-68, 2005. [PubMed: 16152574] [Full Text: https://doi.org/10.1002/ajmg.b.30226]

  2. Bulik, C. M., Devlin, B., Bacanu, S.-A., Thornton, L., Klump, K. L., Fichter, M. M., Halmi, K. A., Kaplan, A. S., Strober, M., Woodside, D. B., Bergen, A. W., Ganjei, J. K., Crow, S., Mitchell, J., Rotondo, A., Mauri, M., Cassano, G., Keel, P., Berrettini, W. H., Kaye, W. H. Significant linkage on chromosome 10p in families with bulimia nervosa. Am. J. Hum. Genet. 72: 200-207, 2003. [PubMed: 12476400] [Full Text: https://doi.org/10.1086/345801]

  3. Bulik, C. M., Sullivan, P. F., Kendler, K. S. Heritability of binge-eating and broadly defined bulimia nervosa. Biol. Psychiat. 44: 1210-1218, 1998. [PubMed: 9861464] [Full Text: https://doi.org/10.1016/s0006-3223(98)00280-7]

  4. Bulik, C. M., Sullivan, P. F., Wade, T. D., Kendler, K. S. Twin studies of eating disorders: a review. Int. J. Eat. Disord. 27: 1-20, 2000. [PubMed: 10590444] [Full Text: https://doi.org/10.1002/(sici)1098-108x(200001)27:1<1::aid-eat1>3.0.co;2-q]

  5. Devlin, B., Bacanu, S.-A., Klump, K. L., Bulik, C. M., Fichter, M. M., Halmi, K. A., Kaplan, A. S., Strober, M., Treasure, J., Woodside, D. B., Berrettini, W. H., Kaye, W. H. Linkage analysis of anorexia nervosa incorporating behavioral covariates. Hum. Molec. Genet. 11: 689-696, 2002. [PubMed: 11912184] [Full Text: https://doi.org/10.1093/hmg/11.6.689]

  6. Grice, D. E., Halmi, K. A., Fichter, M. M., Strober, M., Woodside, D. B., Treasure, J. T., Kaplan, A. S., Magistretti, P. J., Goldman, D., Bulik, C. M., Kaye, W. H., Berrettini, W. H. Evidence for a susceptibility gene for anorexia nervosa on chromosome 1. Am. J. Hum. Genet. 70: 787-792, 2002. [PubMed: 11799475] [Full Text: https://doi.org/10.1086/339250]

  7. Kendler, K. S., MacLean, C., Neale, M., Kessler, R., Heath, A., Eaves, L. The genetic epidemiology of bulimia nervosa. Am. J. Psychiat. 148: 1627-1637, 1991. [PubMed: 1842216] [Full Text: https://doi.org/10.1176/ajp.148.12.1627]

  8. Kortegaard, L. S., Hoerder, K., Joergensen, J., Gillberg, C., Kyvik, K. O. A preliminary population-based twin study of self-reported eating disorder. Psychol. Med. 31: 361-365, 2001. [PubMed: 11232922] [Full Text: https://doi.org/10.1017/s0033291701003087]

  9. Lilenfeld, L. R., Kaye, W. H., Greeno, C. G., Merikangas, K. R., Plotnicov, K., Pollice, C., Rao, R., Strober, M., Bulik, C. M., Nagy, L. A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity. Arch. Gen. Psychiat. 55: 603-610, 1998. [PubMed: 9672050] [Full Text: https://doi.org/10.1001/archpsyc.55.7.603]

  10. Monteleone, P., Maj, M. Genetic susceptibility to eating disorders: associated polymorphisms and pharmacogenetic suggestions. Pharmacogenomics 9: 1487-1520, 2008. [PubMed: 18855537] [Full Text: https://doi.org/10.2217/14622416.9.10.1487]

  11. Strober, M., Freeman, R., Lampert, C., Diamond, J., Kaye, W. Controlled family study of anorexia nervosa and bulimia nervosa: evidence of shared liability and transmission of partial syndromes. Am. J. Psychiat. 157: 393-401, 2000. [PubMed: 10698815] [Full Text: https://doi.org/10.1176/appi.ajp.157.3.393]

  12. Wade, T., Neale, M. C., Lake, R. I. E., Martin, N. G. A genetic analysis of the eating and attitudes associated with bulimia nervosa: dealing with the problem of ascertainment in twin studies. Behav. Genet. 29: 1-10, 1999. Note: Erratum: Behav. Genet. 29: 205 only, 1999. [PubMed: 10371753] [Full Text: https://doi.org/10.1023/a:1021429604095]


Contributors:
Ada Hamosh - updated : 04/25/2018
Marla J. F. O'Neill - updated : 6/3/2009
John Logan Black, III - updated : 5/12/2006
George E. Tiller - updated : 8/18/2004

Creation Date:
Victor A. McKusick : 1/22/2003

Edit History:
carol : 04/26/2018
carol : 04/25/2018
terry : 03/15/2013
wwang : 6/12/2009
terry : 6/3/2009
carol : 7/22/2006
wwang : 5/17/2006
terry : 5/12/2006
carol : 5/18/2005
alopez : 8/18/2004
alopez : 8/18/2004
joanna : 3/19/2004
tkritzer : 5/8/2003
ckniffin : 2/27/2003
carol : 1/24/2003
carol : 1/24/2003