Latest research
Latest research
Assessment of maladaptive exercise history among individuals with eating disorders: Validation of a brief, self-report measure
Katherine Schaumberg, Hunna J Watson, Laura M Thornton, Hannah L Kennedy, Shu H Ong, Preston Roche, … Michaela A Pettie, Richard Parker, Sarah Maguire, Jennifer Jordan, Martin A Kennedy, Cynthia M Bulik
European Eating Disorders Review
Published 2026 (in press)
Maladaptive or compulsive exercise is a common feature of eating disorders, yet it can be difficult to measure consistently in research and clinical settings. This study evaluates a brief self-report questionnaire designed to assess individuals’ history of maladaptive exercise behaviours.
Using data from participants with eating disorders across large international collaborations, the researchers examined whether the measure reliably captures patterns of problematic exercise behaviour. The results support the questionnaire as a valid and efficient way to assess maladaptive exercise history.
A brief and reliable tool may help improve understanding of how compulsive exercise contributes to eating disorders and support more consistent measurement in large international studies such as the Eating Disorders Genetics Initiative (EDGI).
Māori Experiences of Eating Disorders: A Scoping Review of How Little We Know
Michaela A Pettie, William Simcock, Adam Whiskin, Mau Te Rangimarie Clark, Hannah L Kennedy, Martin A Kennedy, Jennifer Jordan
European Eating Disorders Review
Published 2026 (in press)
Despite increasing recognition of eating disorders globally, very little research has explored the experiences of Māori with eating disorders. This scoping review examines the available literature to understand what is currently known about eating disorders among Māori, including prevalence, recognition, and access to care.
The review identified very limited research focused specifically on Māori populations. Existing evidence suggests that eating disorders do occur among Māori but may be under-recognised and under-represented in both research and clinical services.
The authors highlight the urgent need for culturally informed research approaches and stronger partnerships with Māori communities to ensure eating disorder research and treatment services are equitable and culturally responsive.
Maladaptive exercise in people with a lifetime history of eating disorders: A multicountry observational study
Hunna J Watson, Katherine Schaumberg, Laura M Thornton, Hannah L Kennedy, Shu H Ong, Preston Roche, … Michaela A Pettie, Richard Parker, Sarah Maguire, Jennifer Jordan, Martin A Kennedy, Cynthia M Bulik
International Journal of Eating Disorders
Published 2026
Maladaptive exercise, such as compulsive or excessive exercise driven by weight or shape concerns, is commonly reported by people with eating disorders. This large multicountry study examined patterns of maladaptive exercise among individuals with a lifetime history of eating disorders.
Using data from international collaborations including the Eating Disorders Genetics Initiative (EDGI), researchers explored how often maladaptive exercise occurs and how it varies across diagnoses and illness histories.
The findings suggest maladaptive exercise is widespread among people with eating disorders and may play an important role in illness maintenance and recovery. Identifying and understanding problematic exercise behaviours may help inform more comprehensive approaches to treatment.
The Eating Disorders Genetics Initiative 2 (EDGI2): Study Protocol
Natasha Berthold, Casey MacDermod, Laura M Thornton, Richard Parker, Shantal Anid Cortés Morales, Liv Hog, Hannah L Kennedy, … Jennifer Jordan, Martin A Kennedy, Sarah Maguire, Laura M Huckins, Yi Lu, Lisa Dinkler, Nicholas G Martin, Cynthia M Bulik
Published 2025
The Eating Disorders Genetics Initiative 2 (EDGI2) is a large international research project investigating the genetic and environmental factors that contribute to eating disorders. Building on earlier collaborations such as ANGI and EDGI1, EDGI2 aims to recruit participants across multiple countries and combine genetic, clinical, and environmental data.
This paper outlines the study design, including recruitment strategies, data collection methods, and research goals. By bringing together large and diverse datasets, EDGI2 aims to improve understanding of the biological and environmental factors involved in eating disorders.
Researchers from the University of Otago and other New Zealand institutions are part of the international collaboration working to advance knowledge and ultimately improve prevention and treatment.
Nanopore sequencing as a novel method of characterising anorexia nervosa risk loci
Natasha Berthold, Simon Gaudieri, Sarah Hood, Markus Tschochner, Allison L Miller, Jennifer Jordan, Laura M Thornton, Cynthia M Bulik, Paolo A Akkari, Martin A Kennedy
Published 2024
New genomic technologies are helping researchers better understand the biological mechanisms underlying eating disorders. This study explores the use of nanopore sequencing, a relatively new DNA sequencing technology, to investigate genetic regions associated with risk for anorexia nervosa.
Nanopore sequencing allows researchers to examine complex regions of the genome in greater detail than some conventional sequencing approaches. The study demonstrates how this method can help characterise genetic regions linked to anorexia nervosa more precisely.
Improving understanding of these genetic regions may help researchers identify biological pathways involved in eating disorders and contribute to international efforts to better understand their genetic foundations.
Mapping the genetic landscape across 14 psychiatric disorders
Andrew D Grotzinger, Jakob Werme, Wouter J Peyrot, Oleksandr Frei, … Laura M Thornton, Philip H Lee, Kenneth S Kendler, Jordan W Smoller
Published 2026
This large international study examined the genetic relationships across 14 psychiatric disorders, including depression, anxiety disorders, ADHD, and eating disorders.
Using genetic data from hundreds of thousands of individuals, researchers mapped patterns of shared and disorder-specific genetic influences across psychiatric conditions. The results reveal substantial overlap in genetic risk across many disorders, highlighting the complex biological relationships between mental health conditions.
Members of the EDGI team contributed to this work through the Psychiatric Genomics Consortium Eating Disorders Working Group (PGC-ED), which brings together researchers worldwide to advance genetic research on eating disorders.
Leveraging transdiagnostic genetic liability to psychiatric disorders to dissect clinical outcomes of anorexia nervosa
Zhaorong A Lu, Alexander Ploner, Andreas Birgegård, … Mikael Landén, Cynthia M Bulik, Sarah E Bergen
Published 2025
This study explored how shared genetic risk across psychiatric disorders may influence clinical outcomes in people with anorexia nervosa. Many mental health conditions share underlying genetic influences, and understanding these overlaps may help explain differences in illness course.
Using large international genetic datasets, the researchers examined how transdiagnostic genetic liability—genetic risk shared across multiple psychiatric conditions—relates to variations in anorexia nervosa outcomes.
Researchers from the EDGI team contributed to this study through the Psychiatric Genomics Consortium Eating Disorders Working Group (PGC-ED), supporting international collaboration to better understand the genetics of eating disorders.
Time taken to reach treatment for eating disorders in New Zealand.
Rachel Lawson, Roma Watterson, Martin A Kennedy, Cynthia M Bulik, Jennifer Jordan
Published November 2024
Abstract
Objective: The significant cost burden of eating disorders (EDs) could be lessened with quicker access to treatment. Little is known about the time it takes to reach treatment. We aimed to examine the time to access treatment in New Zealand. Method: 468 respondents of the Costs of Eating Disorders online survey provided data including demographics; diagnoses; treatment journey, length of time to seek help; time to diagnosis after seeking help; GP referral to a specialist after diagnosis; and waiting time to see an EDs specialist. Results: Half the sample took more than a year to seek help. Those with bulimia nervosa (BN) and binge-eating disorder (BED) took significantly longer to seek help than those with anorexia nervosa and Other EDs. Once participants sought help, half the sample was diagnosed within 1 week. GPs referred most participants to an EDs specialist. Of those placed on a waiting list to see an EDs specialist, just under half were seen within 6 weeks, with no significant differences by diagnosis in waiting time. Conclusions: Improving the acceptability of seeking help, particularly in those with BN and BED, early recognition of symptoms, and improving treatment pathways are key to minimising longer term impacts.
Genome-wide copy number variation association study in anorexia nervosa
Alicia Walker… Laura M. Thornton… Jennifer Jordan, Martin A. Kennedy… Cynthia M. Bulik & Naomi R. Wray
Molecular Psychiatry – This is a free to read article.
Published November 2024
Abstract: This study represents the first large-scale investigation of rare (<1% population frequency) copy number variants (CNVs) in anorexia nervosa (AN). Large, rare CNVs are reported to be causally associated with anthropometric traits, neurodevelopmental disorders, and schizophrenia, yet their role in the genetic basis of AN is unclear. Using genome-wide association study (GWAS) array data from the Anorexia Nervosa Genetics Initiative (ANGI), which included 7414 AN case and 5044 controls, we investigated the association of 67 well-established syndromic CNVs and 178 pleiotropic disease-risk dosage-sensitive CNVs with AN. To identify novel CNV regions (CNVRs) that increase the risk of AN, we conducted genome-wide association studies with a focus on rare CNV-breakpoints (CNV-GWAS). We found no net enrichment of rare CNVs, either deletions or duplications, in AN, and none of the well-established syndromic or pleiotropic CNVs had a significant association with AN status. However, the CNV-GWAS found 21 nominally associated CNVRs that contribute to AN risk, covering protein-coding genes implicated in synaptic function, metabolic/mitochondrial factors, and lipid characteristics, like the CD36 (7q21.11) gene, which transports long-chain fatty acids into cells. CNVRs intersecting genes previously related to neurodevelopmental traits include deletions of NRXN1 intron 5 (2p16.3), IMMP2L (7q31.1), and PTPRD (9p23). Overall, given that our study is well powered to detect the CNV burden level reported for schizophrenia, we can conclude that rare CNVs have a limited role in the etiology of AN, as reported for bipolar disorder. Our nominal associations for the 21 discovered CNVRs are consistent with AN being a metabo-psychiatric trait, as demonstrated by the common genetic architecture of AN, and we provide association results to allow for replication in future research.
The role of co-occurring conditions and genetics in the associations of eating disorders with attention-deficit/hyperactivity disorder and autism spectrum disorder
Gitte Bundgaard Christiansen… Cynthia M. Bulik… & Janne Tidselbak Larsen
Molecular Psychiatry – This is a free to read article.
Published November 2024
Avoidant/restrictive food intake disorder (ARFID) in New Zealand and Australia: a scoping review
Hannah L Kennedy, Leonie M Hitchman, Michaela A Pettie, Cynthia M Bulik, Jennifer Jordan
Journal of Eating Disorders – This is a free to read article.
Published November 2023
Eating disorders, disordered eating, and body image research in New Zealand: a scoping review
Lana Cleland, Hannah L Kennedy, Michaela A Pettie, Martin A Kennedy, Cynthia M Bulik, Jennifer Jordan
Journal of Eating Disorders – This is a free to read article.
Published January 2023
Common Genetic Variation and Age at Onset of Anorexia Nervosa.
Hunna J. Watson, Laura M. Thornton… Cynthia M. Bulik
Biological Psychiatry Global Open Science – This is a free to read article.
Published October 2022
Recommendations to encourage participation of individuals
from diverse backgrounds in psychiatric genetic studies
Casey MacDermod, Michaela A Pettie… Hannah L Kennedy… Martin A Kennedy, Lana Cleland, Jennifer Jordan… Laura M Thornton, & Cynthia M Bulik
Published July 2022
Predicting eating disorder and anxiety symptoms using disorder-specific and transdiagnostic polygenic scores for anorexia nervosa and obsessive-compulsive disorder.
Zeynep Yilmaz, Katherine Schaumberg, Matthew Halvorsen, Erica L. Goodman, Leigh C. Brosof, James J. Crowley, Anorexia Nervosa Genetics Initiative, Eating Disorders Working Group of the Psychiatric Genomics Consortium, Tourette Syndrome/Obsessive-Compulsive Disorder Working Group of the Psychiatric Genomics Consortium, Carol A. Mathews, Manuel Mattheisen, Gerome Breen, Cynthia M. Bulik, Nadia Micali, and Stephanie C. Zerwas.
Published March 4, 2022
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Shared genetic risk between eating disorder- and substance-use-related phenotypes: Evidence from genome-wide association studies.
Melissa A. Munn-Chernoff, Emma C. Johnson, … Cynthia M. Bulik and Arpana Agrawal.
Published 16 February, 2020
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The Eating Disorders Genetics Initiative (EDGI): study protocol.
Cynthia M. Bulik, Laura M. Thornton, Richard Parker, Hannah Kennedy, Jessica H. Baker, Casey MacDermod, Jerry Guintivano, Lana Cleland, Allison L. Miller, Lauren Harper, Janne T. Larsen, Zeynep Yilmaz, Jakob Grove, Patrick F. Sullivan, Liselotte V. Petersen, Jennifer Jordan, Martin A. Kennedy & Nicholas G. Martin
Published 4 May, 2021
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Continuity of Genetic Risk for Aggressive Behavior Across the Life-Course.
Camiel M. van der Laan, José J. Morosoli-García, Steve GA. van de Weijer, Lucía Colodro-Conde on behalf of the ACTION Consortium, Michelle K. Lupton, Brittany L. Mitchell, Kerrie McAloney, Richard Parker, Jane M. Burns, Ian B. Hickie, René Pool, Jouke-Jan Hottenga, Nicholas G. Martin, Sarah E. Medland, Michel G. Nivard and Dorret I. Boomsma
Published 14 August, 2021
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Genetic correlations of psychiatric traits with body composition and glycemic traits are sex- and age-dependent.
Christopher Hübel, Héléna A. Gaspar, … Cynthia M. Bulik and Gerome Breen.
Published 18 December, 2019
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Associations between eating expectancies and Eating disorder symptoms in men and women
Leigh C.Brosof, Melissa A.Munn-Chernoff, Cynthia M.Bulik, Jessica H.Baker
Volume 141, 1 October 2019, 104309
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A longitudinal study of eating behaviours in childhood and later eating disorder behaviours and diagnoses
Moritz Herle, Bianca De Stavola, Christopher Hübel, Mohamed Abdulkadir
Published online by Cambridge University Press: 05 August 2019
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Epigenetics in eating disorders: a systematic review
Christopher Hübel, Sarah J. Marzi, Gerome Breen, Cynthia M. Bulik
Molecular Psychiatry volume 24, pages901-915(2019) Published: 23 October 2018
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Association of etiological factors across the extreme end and continuous variation in disordered eating in female Swedish twins
Lisa Dinkler, Mark J. Taylor, Maria Råstam, Nouchine Hadjikhani
Published online by Cambridge University Press: 17 December 2019
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Genetic and environmental contributions to diagnostic fluctuation in anorexia nervosa and bulimia nervosa
Shuyang Yao, Henrik Larsson, Claes Norring, Andreas Birgegård
Published online by Cambridge University Press: 29 October 2019
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Exploring the gene-environment nexus in eating disorders
Cynthia M. Bulik
Journal of Psychiatry and Neuroscience 2005 Sep; 30(5): 335-339.
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Environmental and Genetic Risk Factors for Eating Disorders: What the Clinician Needs to Know
Suzanne E.Mazzeo PhDa, Cynthia M.Bulik PhD
Child and Adolescent Psychiatric Clinics of North America
Volume 18, Issue 1, January 2009, Pages 67-82
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This page contains some of the interesting and meaningful peer-reviewed academic publications we have released while working on EDGI.
If you have any questions or would like to know more about our publications, please contact us at edgi@otago.ac.nz or 021 279 0882.