Abstract
There is a growing recognition that both the gut microbiome and the immune system are involved in a number of psychiatric illnesses, including eating disorders. This should come as no surprise, given the important roles of diet composition, eating patterns, and daily caloric intake in modulating both biological systems. Here, we review the evidence that alterations in the gut microbiome and immune system may serve not only to maintain and exacerbate dysregulated eating behavior, characterized by caloric restriction in anorexia nervosa and binge eating in bulimia nervosa and binge eating disorder, but may also serve as biomarkers of increased risk for developing an eating disorder. We focus on studies examining gut dysbiosis, peripheral inflammation, and neuroinflammation in each of these eating disorders, and explore the available data from preclinical rodent models of anorexia and binge-like eating that may be useful in providing a better understanding of the biological mechanisms underlying eating disorders. Such knowledge is critical to developing novel, highly effective treatments for these often intractable and unremitting eating disorders.
Highlights
Eating disorders are serious psychiatric conditions driven, in part, by non-homeostatic eating, including chronic underconsumption of calories in anorexia nervosa (AN) and intermittent binge eating in bulimic syndromes including binge eating disorder (BED)and bulimia nervosa (BN)
Similar results were reported in another study in which plasma levels of IL-1β and thiobarbituric acid reactive substances (TBARS; a marker of systemic oxidative stress) were found to be elevated in a mixed sample of eating disorder patients (60% were diagnosed with BN or BED), relative to healthy controls [91]
While it is clear that interactions between the gut microbiome, immune system, and nervous system are involved in the pathophysiology of eating disorders, researchers are only beginning to scratch the surface to uncover the intricate mechanisms through which these systems are intertwined
Summary
Eating disorders are serious psychiatric conditions driven, in part, by non-homeostatic eating, including chronic underconsumption of calories in anorexia nervosa (AN) and intermittent binge eating in bulimic syndromes including binge eating disorder (BED). While AN is often defined by chronic caloric restriction, other core features include increased physical activity, an intense fear of weight gain, endocrine alterations, disturbance of body image, and low body weight [1] This eating disorder disproportionately affects females with a 12-month prevalence of 0.4–1% among adolescents and young adults [1]. Binge eating in individuals diagnosed with BN or binge–purge AN are accompanied by compensatory behaviors, including self-induced vomiting, excessive exercise, laxative and diuretic abuse, and prolonged fasting [8] These compensatory behaviors often mitigate the excess calories consumed during a binge and serve to constrain weight gain.
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