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Eating behavior in anorexia nervosa—an excess of both orexigenic and anorexigenic signalling?

Molecular Psychiatry volume 6, pages 620–624 (2001)Cite this article

Abstract

Anorexia nervosa (AN) is a disorder characterized by abnormal eating behavior, weight regulation, and disturbances in attitudes and perceptions toward body weight and shape. Although progress has been made in the treatment of AN, a substantial portion of patients have a limited response to treatment. Multiple endocrine and metabolic changes occur after prolonged starvation, conserving energy and protein. A number of the endocrine findings in patients with AN may be secondary to adaptive mechanisms. However, AN differs from simple starvation in that excess of both feeding-stimulatory (orexigenic) and feeding-inhibitory (anorexigenic) signalling is characteristic, producing the ‘mixed’ signal about satiety and desire to feed. This leads to a failure of the adaptive feeding response that is initiated by a decrease in leptin, an adiposity signal from fat tissue, and the resultant increase and decrease of orexigenic and anorexigenic signalling, respectively. The hypothesis of unbalanced shift of feeding-regulatory circuitry places anorexigenic corticotropin-releasing factor and orexigenic neuropeptide Y in the final common neurobiological substrate for AN. Therapeutic intervention using such receptor antagonists may lead to more successful and targeted psychopharmacological treatment.

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Acknowledgements

I am indebted to Professor Masato Kasuga and Professor Shigeaki Baba (Kobe University) for many stimulating discussions. The work was supported by grants from the Ministry of Education, Science, Sports, and Culture of Japan.

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  1. Second Department of Internal Medicine, Kobe University School of Medicine, Kobe, Japan

    A Inui

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Inui, A. Eating behavior in anorexia nervosa—an excess of both orexigenic and anorexigenic signalling?. Mol Psychiatry 6, 620–624 (2001). https://doi.org/10.1038/sj.mp.4000944

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