Human culture has suggested for thousands of years that the darkest demons should go unspoken — uninvoked, relegated to nightmares and whispered folklore. Formal language calls this taboo.
Eating disorders occupy one of the most shadowed corners of psychological conversation. Few people go looking for that territory. But taboos — like demons — have a way of finding their hosts anyway.
During her tenure co-directing the Michigan State Twin Registry, Kelly Klump uncovered one such taboo buried inside an otherwise straightforward dataset. Camouflaged within rows of twin metrics and developmental markers were clues pointing toward something many researchers historically avoided discussing directly.
“I found really minimal heritability on eating disorder symptoms in preadolescence, around age 11 and 12,” Klump said. “Then, at late adolescence, heritability was about 50%. That really told me something biological and genetic was changing across that time period.”
That turning point appears to be puberty — already notorious for reshaping identity, emotion, and physiology — now increasingly linked to the onset risk window for eating disorders.
“Through a series of studies, we found age didn’t matter at all,” Klump said. “What mattered was the level of pubertal development the girl was in.”
The distinction helps to explain why eating disorders remain comparatively rare in young children while rising sharply in commonality during and after pubertal transition.
Hormonal cycling appears to play a role as well. Research from Klump’s lab and from others has shown that binge-eating symptoms tend to increase during the mid-luteal phase — the post-ovulatory portion of the menstrual cycle — when progesterone is elevated.
“From an evolutionary and reproductive standpoint, seeing higher rates of binge eating in the mid-luteal phase makes intuitive sense,” Klump said. “If pregnancy occurs, that’s when increased caloric intake would support early development.”
What emerges from this work is more than compelling basic science. With her background in clinical psychology — and game-changing genetic and behavioral data — Klump has built multidisciplinary teams positioned to translate hormonal and genetic findings into prevention and treatment strategies — bringing what was once taboo into measurable, actionable territory.
The birth control pill is one of the most consequential medications ever developed. Yet adherence rates remain lower than many clinicians would like.
When asked why they discontinue or skip doses, many women cite side effects — particularly weight change and increased binge-eating symptoms.
“Our data suggest it’s not all women who are going to gain weight on these pills,” Klump said. “It’s not all women who are going to binge eat on these pills. Our lab would argue it’s women who are at genetic risk to have hormone-sensitive systems who are the most likely to gain weight and binge eat while on these pills.”
Findings like these suggest that screening for genetic and hormonal sensitivity — for birth control and other medications — may be closer to a practical reality than previously imagined.
In the immediate term, genetically at-risk women may be referred to other methods of birth control, such as IUDs, to alleviate the most challenging side effects of hormonal birth control.
“I think it’s a really exciting time for the lab,” Klump said. “This kind of back and forth between the basic science and the clinical application is something that I didn’t know if I’d ever get to in my career, honestly.”
By allowing taboo and modern science to intersect, academia can begin solving problems it wasn’t even looking for.
