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Role of the evolutionarily conserved starvation response in anorexia nervosa

Molecular Psychiatry volume 16, pages 595–603 (2011)Cite this article

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Abstract

This review will summarize recent findings concerning the biological regulation of starvation as it relates to anorexia nervosa (AN), a serious eating disorder that mainly affects female adolescents and young adults. AN is generally viewed as a psychosomatic disorder mediated by obsessive concerns about weight, perfectionism and an overwhelming desire to be thin. By contrast, the thesis that will be developed here is that, AN is primarily a metabolic disorder caused by defective regulation of the starvation response, which leads to ambivalence towards food, decreased food consumption and characteristic psychopathology. We will trace the starvation response from yeast to man and describe the central role of insulin (and insulin-like growth factor-1 (IGF-1))/Akt/ F-box transcription factor (FOXO) signaling in this response. Akt is a serine/threonine kinase downstream of the insulin and IGF-1 receptors, whereas FOXO refers to the subfamily of Forkhead box O transcription factors, which are regulated by Akt. We will also discuss how initial bouts of caloric restriction may alter the production of neurotransmitters that regulate appetite and food-seeking behavior and thus, set in motion a vicious cycle. Finally, an integrated approach to treatment will be outlined that addresses the biological aspects of AN.

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Acknowledgements

This work was supported by a grant from the Edward P Stiles Trust Fund (LSUHSC) and Biomedical Research Foundation of Northwest Louisiana.

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  1. Department of Psychiatry, LSU Health Sciences Center, Shreveport, LA, USA

    D S Dwyer & R Y Horton

  2. Department of Pharmacology, Toxicology and Neuroscience, LSU Health Sciences Center, Shreveport, LA, USA

    D S Dwyer

  3. Department of Biochemistry and Molecular Biology, LSU Health Sciences Center, Shreveport, LA, USA

    E J Aamodt

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Dr Dwyer's and Dr Aamodt's research has been funded by the NIH. Dr Dwyer has previously consulted for Eli Lilly and Co. and received compensation. Drs Aamodt and Horton declare no conflict of interest.

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Dwyer, D., Horton, R. & Aamodt, E. Role of the evolutionarily conserved starvation response in anorexia nervosa. Mol Psychiatry 16, 595–603 (2011). https://doi.org/10.1038/mp.2010.95

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