Reframing anorexia nervosa as a metabo-psychiatric disorder

Abstract

Anorexia nervosa (AN) is a serious and often fatal illness. Despite decades of research, investigators have failed to adequately advance our understanding of the biological aspects of AN that could inform the development of effective interventions. Genome-wide association studies are revealing the important role of metabolic factors in AN, and studies of the gastrointestinal tract are shedding light on disruptions in enteric microbial communities and anomalies in gut morphology. In this opinion piece, we review the state of the science through the lens of the clinical presentation of illness. We project how the integration of rigorous science in genomics and microbiology, in collaboration with experienced clinicians, has the potential to markedly enhance treatment outcome via precision interventions.

Keywords: GWAS; eating disorders; endocrinology; genetics; metabolism; microbiome.

Figure 1.

Integration of genetic and microbiology science on anorexia nervosa encourages precision nutrition approaches that target the gut-brain axis to restore healthy weight and gut function and reverse hormonal dysregulation and entrenched cognitions that maintain the illness and contribute to relapse.