1) The Netflix algorithm has done great work lately bringing me movies it thought I would like and being correct. I loved “Society of the Snow” a Spanish language film about the famous Uruguay rugby team plane crash in the Andes back in 1972. I’ve never actually seen the movie “Alive” but damn did I love this.
2) Really good from Lee Drutman, “Why You Might Be a Democracy Hypocrite (And Why I Might Be Too)” [all emphases in original]
I’m not going to go through the entire survey here to diagnose you. Instead, I’ll just ask you five questions:
First off, and I hope this is an easy one: Would you say that having a democratic system is a good form of government?
I’m hoping you said yes. (If not, please see me after class)
But now we get into more complicated territory:
Please read the following scenarios and consider: How appropriate would it be for President Biden to take action on his own, even if the Constitution does not give him the explicit power to act without congressional approval.
– The country is facing an immediate military threat
– A large majority of the American people believe that the president should act
– The president knows it is the right thing to do for the American people
– The president has sought a compromise with Congress but the other party is playing partisan games
Think about these scenarios. Conjure up, if you like, an issue you care a lot about, and imagine Republican congressional intransigence. That’s what I’m doing as I write. And I’m … struggling here. If it’s a significant act on climate or gun safety — or another issue I really care about. Then … maybe? I mean, these are some urgent life and death issues, right? And I can’t trust Republicans to do the right thing, can I? And a Democrat might only be in the White House for a limited time. And the Constitution is silent on lots of things, and so maybe… and Oh Sugarplum Fudge! I might really be a democracy hypocrite!
I’m a political scientist. I know that democracy is a fragile agreement that relies on restraint. So I know what the “correct” answers are supposed to be. I know that extra-constitutional executive aggrandizement and overreach are key drivers of democratic breakdown. I know that these are the typical excuses would-be autocrats give for over-stepping constitutional lines. And I know that if “President Biden” were swapped out for “President Trump” I would feel completely differently.
I just co-wrote this whole report about democracy hypocrisy. And yet, here I am, admitting for all the world that when the stakes are high, commitment to democratic norms is… hard. Very, very hard.
I’m not alone.
Only about 1 in 4 of Americans consistently and uniformly support democratic norms.
Support drops to 1 in 12 when we consider specific scenarios of unilateral executive action.
In short: Our democracy is on spongy ground
3) Josh Barro covers a lot of ground in this critique of universities, but I hate seeing political activists trying to forward their activism by being Political Science professors (a growing problem), so, I really like this part:
Matt Yglesias wrote a few weeks ago about a paper by Jenny Bulstrode, a historian of science at the University of London, who alleges that a moderately-notable metallurgical technique patented in England in the late 1700s was in fact stolen from the black Jamaican metallurgists who really developed it. The problem with Bulstrode’s paper is that it marshals no real evidence for its allegation — not only failing to show that Englishman Henry Cort was aware of a Jamaican metallurgical technique similar to the one he patented, but failing to show even that such a technique was ever used in Jamaica.
The paper, because it fit into the fashionable category of Historian Finds Yet Another Thing That Is Racist, garnered a lot of credulous press coverage. And when people pointed out that the paper didn’t have the goods, the editors of the journal who published it came out with a What Is Truth, Anyway-type word salad in defense of the article, including this:
We by no means hold that ‘fiction’ is a meaningless category – dishonesty and fabrication in academic scholarship are ethically unacceptable. But we do believe that what counts as accountability to our historical subjects, our readers and our own communities is not singular or to be dictated prior to engaging in historical study. If we are to confront the anti-Blackness of EuroAmerican intellectual traditions, as those have been explicated over the last century by DuBois, Fanon, and scholars of the subsequent generations we must grasp that what is experienced by dominant actors in EuroAmerican cultures as ‘empiricism’ is deeply conditioned by the predicating logics of colonialism and racial capitalism. To do otherwise is to reinstate older forms of profoundly selective historicism that support white domination.
These ideology-first, activism-oriented, the-truth-depends-on-who’s-looking approaches also extend into the soft social sciences — see, for example, the theme of the 2024 American Anthropological Association annual meeting, which declares an intention to “reimagine” anthropology in a way that breaks down the barrier between theory and practice to make more room for more social activism, so that anthropology better serves as a tool to respond to “systemic oppression.”
4) And my new favorite public intellectual Tyler Austin Harper (also cited by Barro in the previous):
The reigning assumption is that scholars of color are disproportionately represented in activism-oriented fields such as “decolonial theory,” which means that deans—always seeking more brown faces to put on university websites—are more likely to approve new tenure lines in ideologically supercharged, diversity-rich disciplines. It is often faculty who are trying to safeguard their fields from the progressive machinations of their bureaucratic overlords. But faced with a choice between watching their departments shrink or agreeing to hire in areas that help realize the personnel-engineering schemes of their bosses, departments tend to choose the latter.
Outside observers mock job ads looking for scholars working on “anti-racist Shakespeare,” and these listings are frequently tortured and ridiculous. However, such ads do not always reflect the scholarly priorities of the professors on the hiring committees. Rather, they’re often a product of the plotting of superiors who care more about their university’s public-facing diversity data than they do the intellectual needs of the English department, the interests of its students, or the health of the discipline more broadly. A humanities faculty member at an elite research university—who did not want to be identified, because he does not have tenure—is only one of several professors who told me that his department struggles to balance its curricular needs with the more political subfields being pushed by administrators…
Hiring activist faculty and making curricula more directed toward justice aren’t just about professors courting (or failing to court) the favor of a college’s higher-ups. These tendencies have also been a bid to defend the very existence of humanities departments. In a brave new world where every major must prove its worth to its debt-saddled “student-customers,” the humanities have a hard time mounting a credible case that their disciplines catapult graduates into six-figure salaries. What humanities departments can offer their young charges—who grow more progressive by the year—is the promise that their majors can help them understand power and fight for equality.
5) And more Harper in a great interview with Yascha Mounk
There was a great piece in The Chronicle recently, and the author argues that humanities professors need to emphasize our passion again, that these are texts that are interesting and vital. And sometimes they’re problematic, but they’re also beautiful and fascinating. And I think we’ve definitely lost some of that. I often joke that a lot of humanities courses, and a lot of humanities discourse, seems to act as though the goal of reading is a kind of “find the racism treasure hunt,” where you approach a text and point out all the things that are problematic about it. And that doesn’t mean that that’s not valuable. And it doesn’t mean that there is not a place within humanities scholarship and discourse to talk about the weird racial politics of Shakespeare’s Othello or whatever. That’s not what it means at all. But it does mean that we seem to have abandoned some of the key mission of defending these texts on the basis of their aesthetic merits.
When I was in grad school I took this philosophy course with a classicist, and at one point we were reading one of Plato’s Dialogues when there was a moment that was sort of sexist, and a student started complaining about the sexism in Plato. The professor, sort of an arch-feminist, stopped that student short and said, “We read texts generously in this classroom.” She’s somebody who’s devoted her life to feminist philosophy, and said we’re going to start with an appreciation, from a place of enjoyment, we’re going to try to actually wrangle with the ideas. And then once we’ve assessed the text on its merits and in its own terms, let’s talk about some of those problematic aspects. And so, from my point of view, I don’t think it has to be a trade-off. We can strike some balance between the two. And what seems to me to be the change in recent years is that we’ve lost that balance.
I think the culture war is a war against nuance. Folks on the right want to sort of scrub all identity, politics, all discussions of race, gender, whatever, out of the humanities. And then people on the other side of the equation want to cling to it desperately. And both of those just feel deeply unsatisfying to me. And it feels really nihilistic to turn it into a zero-sum game where we can only have one or the other and where we can have our appreciation of Byron alongside a reckoning with gender or whatever.
6) Radley Balko on Virginia’s insane attorney general. It’s long– Claude’s summary:
Here are the key takeaways from the article:
- Jason Miyares abruptly fired the entire conviction integrity unit shortly after taking office as Virginia’s attorney general. This unit investigated potential wrongful convictions.
- Miyares campaigned on a “tough on crime” platform and solicited endorsements from police groups, but dissolved a unit dedicated to correcting injustices.
- Virginia has seen 20 DNA exonerations but likely has many more undiscovered wrongful convictions based on red flags like aggressive prosecutors, inadequate public defense, and unscientific forensics.
- Miyares created a replacement unit that supposedly does innocence work, but its main focus appears to be waging culture wars and raising Miyares’ profile.
- The new unit brought unsuccessful criminal charges related to a debunked narrative about assaults in a Virginia school district used to criticize LGBTQ policies.
- Miyares also opened similarly unsuccessful investigations into Virginia elections despite no evidence of widespread fraud. This feeds dangerous conspiracy theories.
- Meanwhile, Miyares withdrew support for two likely innocent men serving life sentences for murdering a police officer based on shaky evidence.
- Miyares portrays himself as tough on crime but Virginia voters largely reject his hardline stances on issues like the death penalty, abortion, and sentencing reform.
- Miyares was elected by less than 1% of the vote but governs as if he has a sweeping mandate to wage cultural battles.
- Miyares can still do significant damage before Virginia voters get another chance to potentially vote him out of office.
7) Leading NC Republican gubernatorial candidate has decided January 6 was a “small debacle.”
8a) This is depressing:
Florida’s top health official called for a halt to using mRNA coronavirus vaccines on Wednesday, contending that the shots could contaminate patients’ DNA — aclaim that has been roundly debunked by public health experts, federal officials and the vaccine companies.
Florida Surgeon General Joseph A. Ladapo’s announcement, released as a state bulletin, comes after months of back-and-forth with federal regulators who have repeatedly rebuked his rhetoric around vaccines.Public health experts warn of the dangers of casting doubt on proven lifesaving measures as respiratory viruses surge this winter.
“We’ve seen this pattern from Dr. Ladapo that every few months he raises some new concern and it quickly gets debunked,” said Ashish Jha, dean of Brown University’s public health school who led the White House’s national coronavirus response before stepping down last year.“This idea of DNA fragments — it’s scientific nonsense. People who understand how these vaccines are made and administered understand that there is no risk here.”
8b) What’s fascinating, is that this guy has amazing medical credentials. Kind of wild that you can actually be brilliant and accomplished and a complete moron at the same time.
9) This is excellent, “To Save Democracy, Help Men“
Globally, men vote for radical parties at rates much higher than women. Spain’s far-right, populist, and conspiracy-minded Vox party received roughly double the number of votes from men than from women. So did Slovakia’s similarly-inclined Slovak National Party. While men and women voted for Poland’s anti-democratic Law and Justice Party at similar rates, men voted for the even more extreme Konfederacja nearly three times as much as women. A 2009 study of European parties that leaned authoritarian or populist found that men were generally around twice as likely as women to vote for them—and up to five times more likely in the case of the nationalist-populist Swedish Democrats.
It’s not just Europe: Brazil’s Jair Bolsonaro performed 10-points better among men than women in the 2018 election which brought him to power. Roughly the same gender difference pushed Argentina’s new populist libertarian leader over the top in November.
In some countries, gender aligns very closely with other social or demographic variables like class, education, and employment—but in a number of places, being male makes a big difference, independent of other factors.
The U.S. is no exception to these trends. The gap between male and female voting was greater for Trump than in a half century of exit polling. Men started leaning Republican in 1976, such that Mitt Romney had an 8-point lead among men – so some of the gap reflects real policy preferences rather than a mark of more extreme politics. But the lead among men for a candidate who bragged about grabbing women by the pussy was much greater.
While much has been written on the role of race in recent elections, gender is playing a crucial and different role. White men formed Trump’s core support in 2016, but by 2020, Trump polled 12-points better with Black men than Black women, winning 18% of the Black male vote. Among Latino men, 44% voted for Trump in 2020, 6-points more than in 2016, and 10-points more than Latina women.
As with international trends, these numbers are not confined to an older generation who will soon leave the stage. In fact, the tilt is even more pronounced for young men. While 18- to 29-year-olds had been becoming less conservative since the early 2000s, something about Trump generated a resurgence of support. The change was most pronounced among the youngest part of that demographic: the number of twelfth graders who claimed to be conservative or very conservative skyrocketed when Trump was on the ballot.
People who care about democracy could read these numbers and conclude that they should simply double down on getting women to vote. But giving up on half of one’s country is not good civics—nor is it smart electoral math.
Moreover, this approach gets the diagnosis wrong. The problem is not that men are natural crusaders for authoritarian populists. In fact, U.S. men are much more likely to be politically apathetic, and most young men are better characterized as confused and drifting. The problem is that anti-democratic and violent forces are trying to weaponize that aimlessness. Politics is coming into most men’s lives subtly. They look for belonging, purpose, and advice, and find a mix of grifters, political hacks, and violent extremists who lead them down an ugly road. And few people are fighting back.
10) Love this chart, “Which college teams are best at preparing players for the NFL? See where your team ranks.”
11) This is awesome. Biotech will save us.
12) On gender discrimination in hiring
13) Good stuff from Michael Powell, “The Curious Rise of Settler Colonialism and Turtle Island: The problem with shoehorning a Middle Eastern war—or American history—into a trendy academic theory”
Settler colonialism—academic jargon for the violent process by which colonial empires empower settlers to push out and oppress Indigenous inhabitants and form a dominant new society—is a term much in vogue among activists and academics on the left. To talk of settler states and oppressed Indigenous people, and claim an umbilical connection between Palestinian struggles and those of Native Americans, is to construct a morality tale stripped of subtleties—a matter not of politics, but of sin.
Israel, in this view, is not a flawed and contentious democracy engaged in a war with an enemy that vows to destroy it. It is a settler-colonialist state built upon the oppression and exploitation of Indigenous Palestinians. A left-wing kibbutznik who lives a few miles from Gaza and drives sick Palestinians to Israeli hospitals is no less a colonialist than a right-wing theocratic settler who brandishes an automatic rifle and insists on the annexation of stolen lands on the West Bank…
Many supporters of the Palestinian cause insist on using the terms settler colonialism and Indigenous, the better to render Israel and Israelis as an oppressive other. To assail a colony of outsiders with an “imagined” connection to Palestine, as some left-wing scholars put it, makes it all too easy to brush aside the practicalities of coexistence with an Israel that is now 75 years old and has about 9 million citizens, including about 2 million Arabs.
Settlers, the theory goes, are mere pawns of imperial patrons, and impermanence is implied. Settlers can be uprooted, sojourns violently terminated. What matters is that Indigenous people reclaim their rightful inheritance…
I put the question of settler colonialism to Roger Berkowitz, the academic director of the Hannah Arendt Center at Bard College. He said he is taken aback both by the speed with which the ideological construct of settler colonialism has entered the global discourse and by how intently people who espouse the theory focus on Israel. Berkowitz was careful to say he does not see them all as anti-Semites, although the word anti-Semitism does keep leaping to his mind.
In invocations of settler colonialism, Berkowitz hears progressives giving up on effecting change through political means. “The left has replaced its faith in proletarian subjects and utopian solutions with a view of the Indigenous as innocent and oppressed. It’s an ethics rather than a politics.”
14) So cool, “All the Biomass of Earth, in One Graphic”
15) More cool biotech, “New antibiotic uses novel method to target deadly drug-resistant bacteria, study says”
16) Good thread on how amazing the measles vaccine is and the insanity of people not taking it.
17) This is good, “The real problem at Harvard: The ouster of the university’s president underscores a harsh truth: The nation’s oldest institution of higher learning talks a good game about diverse views, but it doesn’t actually protect them.”
18) Scott Alexander with a fascinating take on depression:
In anorexia, some psychosocial event (like criticism from a ballet coach and subsequent voluntary self-starvation) causes a shock to the lipostat. Instead of correctly activating regulatory processes to get body weight back to normal, it accepts the new level as its new set point, and tries to defend it.
Depression is often precipitated by some psychosocial event (like loss of a job, or the death of a loved one). It’s natural to feel sad for a little while after this. But instead of correctly activating regulatory processes to get mood back to normal, the body accepts the new level as its new set point, and tries to defend it.
By “defend it”, I mean that healthy people have a variety of mechanisms to stop being sad and get their mood back to a normal level. In depression, the patient appears to fight very hard to prevent mood getting back to a normal level. They stay in a dark room and avoid their friends. They even deliberately listen to sad music!
The feverish person feels too cold, and the anorexic person feels too fat, so we might expect the depressed person to feel too happy. I think something like this is true, if we put strong emphasis on the “too”. One of the official DSM symptoms of depression is “feelings of guilt/worthlessness”. A depressed person will frequently think things like “I don’t deserve my friends / job / money / talents.” In other words, they believe they’re too happy! They think they deserve to be sadder!
Depressed people seem to purposefully seek out the most depressing thoughts they can. They find that, unbidden, they are forced to think about the most humiliating thing they ever did, dwell on their worst failures, consider all the things that could go wrong in the future. They’ll be trying to cook dinner, and their brain will tell them “Consider the possibility that you could die alone and unloved.” Why is their brain so insistent that they spend time considering this possibility? Maybe it’s for the same reason that a feverish person’s brain makes them shiver: it’s trying to maintain an extreme state, and it needs to pull out all the stops.
We know that if we make depressed people stop doing these things, they feel happier. This is the principle behind behavioral activation, opposite action, and cognitive behavioral therapy, three of the most powerful therapies for depression. If you depression tells you to do something, do the opposite. Go on a nice walk in the park! Listen to happy music! Spend time with your friends! If you do these things, your depression is pretty likely to go away. The problem isn’t that they don’t work, the problem is that it’s like a feverish person trying to take an ice bath, or an anorexic trying to eat a big meal – all their instincts are telling them not to do it. And if your depression tries to get you to think in a specific way, think in a different way. When it tells you that you should still feel bad for that embarrassing thing you did in third grade, tell it that makes no sense, and that you’ve done plenty of things you’re proud of since then. Again, this often works if you do it. It’s just really hard.
Psychologists already suspect the existence of a happiness set point (thymostat?); this is the principle behind ideas like the “hedonic treadmill”. So my theory here is that at least some cases of depression involve recalibrated happiness set points. A set point can either recalibrate randomly (ie for poorly understood biological reasons) or after a specific shock (ie interpreting a prolonged period of sadness as “the new normal”). Once a patient has a new, lower, happiness set point, their control system works to defend it. It enlists both biological systems (possibly changing the levels of various neurotransmitters?) and behavioral systems to defend the new set point. If it “succeeds”, the person maintains an abnormally low mood.
19) Guest post in Slow Boring on the need to reform sports gambling. I heartily agree.
In 2019, gambling industry experts predicted that in 10 years, 90% of the sports gambling market would go mobile. That figure has already been reached in New York and New Jersey, two of the largest gambling states in the country. A Drive Research survey found that three-quarters of sports gamblers prefer to bet online. In our convenience economy, where you can order groceries and literally anything from the comfort of your own home, it makes sense that gamblers enjoy the same convenience.
But that’s not a good thing.
As I mentioned earlier, when I lived in DC, my gambling habit never really took hold because it took a significant amount of effort to head out to Arlington. The trip was treated as a ceremonial event, complete with hot soup.
Clearly, in states where sports gambling exists in the convenience of one’s pocket, gamblers are choosing the most convenient option to place their bets, and that’s leading to compulsive and repeat gambling behavior. That same Drive Research survey found that in-game wagering is the most popular form of betting. And a 2022 Harris poll found that 70% of sports gamblers bet at least once a week.
Those numbers are good for Fanduel and Draft Kings, but bad for the American public. Amongst most recreational gamblers, in-game bets are often more impulsive and lack careful consideration. This issue is exacerbated when individuals already have a bet on the game, as some sports gambling companies aggressively send push notifications encouraging additional in-game bets. Clinical psychologist Meredith K. Ginley, a specialist in gambling addiction, emphasizes that these in-game notifications are strategically crafted to trigger risky behavior in individuals predisposed to such tendencies. Essentially, these gambling apps, driven by profit motives, exploit psychological triggers to encourage habitual and hazardous betting practices among their customers.
20) “Whatever Happened to Zika?” Good question.
Suddenly, pregnant women in America and elsewhere were told not to travel to the Caribbean and South America. Expecting mothers in Miami, where local mosquitoes were transmitting the virus, stayed inside all summer long. Today, thousands of Brazilian families struggle to care for profoundly disabled 8-year-olds, “their limbs rigid, their mouths slack, many with foreheads that sloped sharply back above their dark eyes,” as The New York Times described in 2022.
Then, as quickly as it appeared, Zika vanished from global awareness. In 2016, most major news sites, including this one, largely stopped covering the disease regularly. Despite the absence of a treatment or vaccine, the world’s attention moved on.
There are good reasons for this: Zika cases dropped precipitously after 2016. And just a few years later, COVID ravaged the planet, giving us all something new to worry about. But that doesn’t mean Zika is gone. The disease is still out there, infecting people every day. There is still no Zika vaccine, and experts say another outbreak is likely before too long. In this way, Zika reflects a typical epidemic cycle—an emergent crisis, followed by a brief influx of resources, followed by rich countries’ long and fateful forgetting. “A lot of people have forgotten about Zika,” says Anna Durbin, a professor of global health at Johns Hopkins. “They think because we don’t see a big outbreak that it’s not there, but it’s definitely there. And it can be devastating for children born with congenital Zika syndrome.”
By 2017, Zika had burned through entire cities. Some experts estimate that the virus infected half the residents of Recife, a Northeastern Brazilian city and the outbreak’s epicenter. This swift onslaught was tragic, but it had an upside: Countries in the Caribbean and the Americas quickly achieved herd immunity, essentially starving the virus of new hosts. Cases fell off rapidly—in 2018, about 30,000 Zika cases were reported in the Americas, a region that spans between Argentina and Canada. Compare that with nearly 650,000 in 2016.
But despite this overall improved picture, the virus continues to circulate. In 2022, the Americas saw 40,528 cases of Zika. Brazil had the greatest number of cases that year, at more than 34,000, but Belize had the highest incidence per capita. As of early December, 31,780 cases were reported in the Americas in 2023. Microcephaly is far less prevalent, but it, too, is still occurring: Brazil saw 163 cases of Zika-linked microcephaly in 2022, according to the Pan American Health Organization, down from 2,033 in 2016. And growing evidence indicates that Zika can cause brain damage beyond microcephaly, including calcification in the brain and other, less noticeable issues. These effects are even less well tracked.
21) Loved this, “Personality and politics of 263 occupations”
22) Donald Trump wants revenge. Drum:
The Daily Mail recently conducted a poll asking people what they thought of Joe Biden and Donald Trump. They made a word cloud of the most popular responses, and Trump was so proud of his that he posted it on Truth Social:
23) Not releasing completed movies seems crazy:
The SAG-AFTRA strike may be over, but studio shenanigans are evergreen. Warner Bros. has decided not to release its planned Wile E. Coyote movie, Coyote vs. Acme, despite its being a completed project, according to The Hollywood Reporter. As with Batgirl before it, the studio will instead opt for a tax write-off. The film stars John Cena and cost $72 million to make. “For three years, I was lucky enough to make a movie about Wile E. Coyote, the most persistent, passionate, and resilient character of al time,” director Dave Green tweeted in response to the cancellation. “I was surrounded by a brilliant team, who poured their souls into this project. … Along the ride, we were embraced by test audiences who rewarded us with fantastic scores.” In a statement to THR, Warner Bros. said the cancellation was due to a shifting “global strategy to focus on theatrical releases.” James Gunn, who co-wrote and produced the film, has not said anything about its being killed. Vulture has reached out for comment.
The cancellation does have a certain irony, given that, on a recent earnings call, Warner Bros. CEO and media supervillain David Zaslav said that “we haven’t really been able to crack the kids. We have a huge amount of kids content. We’re going to attack that. We think that really differentiates us and we’re going to have to really promote it. We haven’t been.” Promptly pulling the plug on a complete kids’ project for a tax write-off doesn’t seem super in line with that sentiment, but hey, we’re not the CEO.
24) Interesting! “We Have No Drugs to Treat the Deadliest Eating Disorder: There are pills for bulimia and binge-eating disorder. Why not anorexia?”
Despite nearly half a century of attempts, no pill or shot has been identified to effectively treat anorexia nervosa. Anorexia is well known to be the deadliest eating disorder; the only psychiatric diagnosis with a higher death rate is opioid-use disorder. A 2020 review found people who have been hospitalized for the disease are more than five times likelier to die than their peers without it. The National Institutes of Health has devoted more than $100 million over the past decade to studying anorexia, yet researchers have not found a single compound that reliably helps people with the disorder.
Other eating disorders aren’t nearly so resistant to treatment. The FDA has approved fluoxetine (a.k.a. Prozac) to treat bulimia nervosa and binge-eating disorder (BED); doctors prescribe additional SSRIs off-label to treat both conditions, with a fair rate of success. An ADHD drug, Vyvanse, was approved for BED within two years of the disorder’s official recognition. But when it comes to anorexia, “we’ve tried, I don’t know, eight or 10 fundamentally different kinds of approaches without much in the way of success,” says Scott Crow, an adjunct psychology professor at the University of Minnesota and the vice president of psychiatry for Accanto Health…
Despite nearly half a century of attempts, no pill or shot has been identified to effectively treat anorexia nervosa. Anorexia is well known to be the deadliest eating disorder; the only psychiatric diagnosis with a higher death rate is opioid-use disorder. A 2020 review found people who have been hospitalized for the disease are more than five times likelier to die than their peers without it. The National Institutes of Health has devoted more than $100 million over the past decade to studying anorexia, yet researchers have not found a single compound that reliably helps people with the disorder.
Other eating disorders aren’t nearly so resistant to treatment. The FDA has approved fluoxetine (a.k.a. Prozac) to treat bulimia nervosa and binge-eating disorder (BED); doctors prescribe additional SSRIs off-label to treat both conditions, with a fair rate of success. An ADHD drug, Vyvanse, was approved for BED within two years of the disorder’s official recognition. But when it comes to anorexia, “we’ve tried, I don’t know, eight or 10 fundamentally different kinds of approaches without much in the way of success,” says Scott Crow, an adjunct psychology professor at the University of Minnesota and the vice president of psychiatry for Accanto Health…
Psychiatrists have found that many patients with anorexia don’t improve with treatment even when medicines are prescribed for conditions other than their eating disorder. If an anorexia patient also has anxiety, for example, taking an anti-anxiety drug would likely fail to relieve either set of symptoms, Attia told me. “Time and again, investigators have found very little or no difference between active medication and placebo in randomized controlled trials,” she said. The fact that fluoxetine seems to help anorexia patients avoid relapse—but only when it’s given after they’ve regained a healthy weight—also supports the notion that malnourished brains don’t respond so well to psychoactive medication. (In that case, the effect might be especially acute for people with anorexia nervosa, because they tend to have lower BMIs than people with other eating disorders.)
Fully Myelinated 
Recent Comments