Anorexia Nervosa Research Articles (Page 1)

ABSTRACT This study examines the impact of stress on spicy food consumption (SFC) through changes in appetite and the moderating role of expressive suppression. Drawing on the transactional model of stress and coping, we surveyed 553 consumers of spicy food and analyzed their responses using partial least squares structural equation modeling with SmartPLS (version 4.0). Both stress-induced appetite gain and loss increase SFC, revealing a bidirectional influence that previous studies have often overlooked. Additionally, expressive suppression intensifies the impact of appetite gain on SFC, highlighting the important role of emotion regulation in shaping specific food preferences. Beyond insights into consumer attitudes, this study also has strategic implications for marketers of spicy foods. We propose differentiated product innovations, such as stress-relief spice kits and mood-enhancing spicy beverages, tailored to varying appetite states. Our findings inform targeted brand messaging and product positioning, thereby enhancing relevance for consumer segments defined by stress-coping and emotional regulation styles, as presented in a stress – appetite – spice marketing matrix.

The involvement of a caregiver is fundamental in the process of caring for a person with eating disorders (ED). The aim of this study is to evaluate the functioning of family unit and the emotional burden of caregivers of individuals with ED treated at an outpatient service. We contacted by telephone the caregivers of individuals in care at ED Centre of the AUSL-Modena and selected a sample of 50 caregivers of 42 individuals with ED, who provided their informed consent. The following scales were administered to caregivers: caregiver burden inventory (CBI), Beck's depression inventory (BDI), family assessment device (FAD), depression, anxiety and stress-scale (DASS-21). The following scales were administered to the care recipients: global assessment of functioning and clinical global impression severity scale. Demographic variables relating to the individuals with ED and their caregivers were collected: sex, age, employment situation, marital status, number of family members, living condition, family role. Clinical variables of care recipients were collected: body mass index, ED diagnosis, duration of ED and treatment and care at ED centre, medical complications, psychiatric comorbidities, substance use. The data was statistically analyzed. All caregivers were the parents of individuals with ED, in particular the mother (76%), and were employed. Caregivers reported a mild to moderate emotional burden in CBI and mild to severe depressive symptoms in BDI in 62% of cases. Family functioning reported by FAD scale was slightly altered in the areas of "communication", "roles" and "affective involvement". Most care recipients were females (98%), suffering from anorexia nervosa (85.6%) with an average age of 18.54 ± 4.74. At multiple linear regression, two statistically significant associations were underscored with CBI score (dependent variable): the age of individuals in a negative way and the psychiatric comorbidities of the individuals with ED in a positive way. The parents of sons with ED represented their caregivers, who suffered from a mild emotional burden and depressive symptoms and lived in altered family functioning, especially in communications. Ensuring psychological support for the caregiver may be useful for improving both caring and family relationships.

We previously developed LJ-4378, a dual ligand for A2A and A3 adenosine receptors, as a potential anti-obesity agent. In this study, we compared the anti-obesity effects of LJ-4378 with those of tirzepatide (TZP), a dual agonist of glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide receptors, and one of the most potent FDA-approved obesity therapeutics. Using a mouse model of diet-induced obesity, we assessed the effects of LJ-4378 and TZP on body weight loss, metabolic parameters, and post-treatment weight rebound. Mice fed a high-fat diet (HFD) for 10weeks were treated with vehicle, LJ-4378, or TZP for 14days. Both LJ-4378 and TZP significantly reduced body weight, adipose tissue mass, and abdominal fat volume; improved glucose tolerance; reduced white adipose tissue inflammation; and enhanced energy expenditure. To assess the durability of the treatment effects, drug administration was discontinued after 14days, and the mice remained on the HFD for an additional 4weeks. Notably, LJ-4378-treated mice exhibited attenuated body weight regain, stable food intake, persistent metabolic benefits, and sustained enhancement of energy metabolism, compared to TZP-treated mice. These findings highlight LJ-4378 as an anti-obesity agent that functions independently of appetite suppression and may offer superior long-term benefits by limiting post-treatment weight rebound and preserving metabolic improvements.

Adverse childhood experiences (ACEs) are risk factors for anorexia nervosa (AN). We compared patients with AN and Healthy Control subjects (HCs) on the frequency and type of ACEs, assessed the association between each ACE and the likelihood of having specific psychopathological features in AN, and explored the relationship between the number of ACEs and clinical severity. One-hundred and twenty-nine patients with AN and 111 HCs completed several self-report questionnaires assessing ACEs, post-traumatic symptoms, eating-related, and general psychopathology. Patients with AN reported a higher number of and more mixed (i.e.,both emotional and physical abuse) ACEs than HCs. Each ACE, except for physical abuse and neglect, was associated with an increasing likelihood of comorbid features, including self-harm, lifetime probable PTSD, and substance/alcohol abuse, independently of AN subtype. An increased number of ACEs was linked to a doubled likelihood of being in the AN versus HC group, and to emotion dysregulation, somatoform dissociation, and depression, both in patients and HCs. ACEs contributed to a more complex picture in AN, with the specific influence of each ACEs type. The study revealed a cumulative effect of ACEs on dissociation and emotional symptoms, suggesting an important role of traumatic history in individuals with AN.

Anorexia nervosa (AN) is a severe eating disorder characterized by perceptual distortions and restrictive eating behaviours. This pilot study examines portion size estimation in adolescent AN patients using a mixed-reality (MR) approach. The objective is to evaluate the potential of this method for the assessment and treatment of AN, with a particular focus on its ecological validity and its applicability for investigating portion size estimation. A total of 30 female participants were recruited: 15 adolescent AN patients and 15 healthy adults as pretest. Participants engaged in a simulated meal assembly task within an MR environment, adjusting portion sizes of virtual food components to match a "typical" meal size (100%). Decision-making patterns and self-reported eating disorder symptoms were recorded. Statistical analyses included descriptive statistics, group comparisons and correlation analysis to examine associations between clinical variables and portion sizes, decision-making time and other decision parameters. AN patients consistently selected significantly smaller portion sizes than healthy adults, particularly for high-calorie foods. No significant differences were observed in decision-making time or uncertainty indicators. The findings support the hypothesis that AN patients exhibit altered food perception in the sense that they tend to overestimate the size of visually presented food portions. The MR approach proved effective in simulating meal selection, Future studies should include larger and more diverse samples and incorporate real food intake to further validate these results.

Anorexia nervosa (AN) is a severe psychiatric disorder with the highest mortality rate among mental illnesses, characterized by an intense fear of weight gain, persistent restriction of energy intake, and a distorted perception of body image. Despite decades of investigation, the pathogenesis of AN is only partially understood and is recognized as multifactorial, involving genetic, sociocultural, and neurobiological determinants. Beyond its core psychopathological features, AN leads to a wide spectrum of systemic complications, including cardiovascular, renal, skeletal, and endocrine dysfunctions. Increasing evidence implicates autophagy and oxidative stress as key molecular mechanisms underpinning its pathophysiology, while growing attention has been directed toward immune dysregulation and alterations in the gut–brain axis as potential mediators of disease onset and progression. Therapeutic advances, however, remain limited. Current management relies primarily on nutritional rehabilitation and psychotherapeutic interventions, while treatment outcomes are constrained by high relapse rates and the lack of pharmacological agents with proven efficacy. In this context, a more comprehensive understanding of the clinical spectrum and molecular substrates of AN is essential to improving prognosis and guiding the development of novel therapeutic strategies. This narrative review synthesizes current evidence on the non-psychopathological dimensions of AN, encompassing its clinical manifestations, systemic complications, and implicated molecular pathways. It also appraises existing treatment modalities and examines emerging interventions with translational potential. Overall, this review aims to provide clinicians and researchers with an updated and integrative overview of AN, shedding light on novel directions in ongoing research.

While the efficacy of family therapy for adolescents with anorexia nervosa is well documented, the process of change across treatment is less well understood. Emerging research has looked at the young person experience, however, little is known about the parent/caregiver perspective. This study aimed to understand factors that parents/caregivers perceive as facilitating change in family therapy for anorexia nervosa (FT-AN). Twenty-three parents/caregivers of young people (age 12-18years) with anorexia nervosa who had completed FT-AN participated in individual semi-structured interviews online. Interviews were transcribed verbatim and analysed using reflexive thematic analysis. Five interconnected themes were generated: Not alone, Strong foundations, Commitment, Both/and rather than either/or, and Strengthening family connection. Parents /caregivershighlighted the importance of collaboration-both within the family and with the clinical team-in building a support network. This collaborative foundation was seen as central to facilitating change, initially through structure and boundaries, and later through increased flexibility and safe risk-taking. Maintaining a life outside the illness and ensuring a balance between physical and emotional needs across all stages of treatment emerged as critical to the recovery journey. This qualitative study explored parental experiences of supporting a young person through FT-AN. Themes generated in this study closely mirror the change processes reported by young people and align with the theoretical underpinnings of FT-AN. Parents reported that change was supported through collaboration with knowledgeable clinicians, setting clear expectations and reduced isolation. A holistic, person-centred approach to treatment that considered life outside the illness was considered as key in promoting change and building commitment from the young person and family. Additionally, finding the right balance in safe risks taking, flexibility within the approach and gradual spacing out of sessions were all described as key to promoting change.

Guided self-help family-based treatment (GSH-FBT) is emerging as a promising, more efficient alternative to traditional family-based treatment (FBT). The present study is designed to examine the real-world implementation of GSH-FBT at pediatric treatment sites across nine provinces in Canada. Implementation teams at each site consisting of a GSH-FBT coach, a medical provider, and a program administrator will be formed. Clinician coaches will be trained in this new modality and supported with weekly GSH-FBT consultation. Each site will recruit ten families with an adolescent with anorexia nervosa and the parents will undergo ten virtual GSH-FBT sessions. The implementation approach will be evaluated using qualitative and quantitative methods. Outcomes of interest include (1) treatment fidelity, (2) treatment wait times, (3) change in adolescent symptoms and parent/caregiver self-efficacy, (4) change in provider readiness, attitudes, and confidence towards the intervention, and (5) the overall experience of the implementation of the intervention from the perspective of the provider teams, and participant families. The findings of this study will help to identify factors important to the acceptability and implementation of GSH-FBT in real-world clinical settings. This study was first registered with clinicaltrials.gov (registration # NCT06851273) on February 12, 2025 (url: https://clinicaltrials.gov/study/NCT06851273?id=NCT06851273&rank=1 ).

ABSTRACT Anorexia nervosa presents a clinical paradox: its physical manifestations are overt, yet its psychological underpinnings remain opaque, often embedded in metaphor, dissociation, and unmet relational needs. This paper approaches anorexia not as a disorder of weight or control, but as a relational disorder, often born of a failed dialogue between self and other, inner and outer, body and mind. Through the case of Molly, a middle-aged Hispanic woman with chronic anorexia who did not respond to CBT or DBT treatment, the paper illustrates how psychodynamic treatment, particularly informed by self psychological principles and Winnicottian object relations theory, can facilitate the restoration of symbolic thinking and the re-emergence of a self that no longer needs to disappear to be known. This paper adds to the growing body of work that understands anorexia as rooted in relational and developmental disruptions, and shows how a therapeutic relationship, attuned to the patient’s inner world and cultural context, can help bring forward parts of the self that have been hidden, silenced, or split off.

Reduced feed intake is a common stress response in Atlantic salmon ( Salmo salar ), yet the interaction between the stress-related hypothalamic–pituitary–interrenal (HPI) axis and the appetite-regulating hypothalamic melanocortin system remains poorly understood. This study explored the potential cross-regulatory interaction between these two systems by assessing feed intake, gastrointestinal content, and hypothalamic mRNA expression of crf1 paralogs, a key factor in stress handling, and appetite-related genes npy , agrp1 , pomc , and cart in Atlantic salmon parr exposed to 21 days of unpredictable chronic stress, followed by a novel acute stressor. Our results indicated that regulation of the HPI axis and appetite-regulatory mechanisms appeared to depend on the type and duration of stress. Chronic stress reduced feed intake and gut content and increased feed conversion ratio, without changes in hypothalamic crf1 paralog expression but with reduced orexigenic npya1 transcript levels. Simultaneously, levels of the anorexigenic cart2b transcript variant were also reduced, possibly reflecting a compensatory response to prolonged appetite suppression. In contrast, exposure to the novel acute stressor induced a transient increase in crf1 paralogs and upregulated orexigenic neuropeptides npya1 and npya2 , suggesting compensatory regulation to counteract stress-induced anorexia. In contrast, cart2b expression normalized to control levels, possibly reflecting an acute stress-induced compensatory response restoring appetite regulation. These results highlight a dynamic, stress-duration-dependent interaction between stress and appetite-regulatory systems in Atlantic salmon.

Background: Anorexia nervosa (AN) is a psychiatric disorder defined by restrictive eating, fear of weight gain, and distorted body image, with a lifetime prevalence of ~4% among females. In its severe form, AN leads to multi-organ complications, particularly affecting the cardiovascular system. Bradycardia, hypotension, and asymptomatic pericardial effusions occur in up to 25% of patients. However, symptomatic pericarditis in AN has not been previously documented. Case Presentation: A 21-year-old female with depression presented with two days of sharp, positional chest pain, dyspnea, palpitations, and weakness. She reported eating less than one meal per day, running 22 miles daily, self-induced vomiting, and experiencing one year of amenorrhea. On exam, her BMI was 10.7 kg/m^2, with lanugo, proximal muscle weakness, and a pericardial friction rub. Labs showed hypokalemia, hypophosphatemia, transaminitis, elevated CK, and leukocytosis. ECG demonstrated diffuse ST elevations and PR depression in aVR. Transthoracic echocardiography revealed a moderate pericardial effusion without tamponade (Figure 1). CT chest showed pneumomediastinum and subcutaneous emphysema without evidence of esophageal perforation (Figure 2). Workup for infectious, autoimmune, ischemic, and thyroid causes was negative. She was diagnosed with severe AN and major depressive disorder. Management included IV fluids, electrolyte repletion, and nutritional support. Pericarditis was treated with ibuprofen and colchicine. Psychiatric therapy included olanzapine and mirtazapine for appetite stimulation and mood support. She was discharged to a structured inpatient nutritional rehabilitation program. Discussion: This is the first reported case of symptomatic pericarditis in AN. While pericardial effusions are often asymptomatic and linked to myocardial and pericardial fat loss, this case suggests purging-induced esophageal microperforations may cause subclinical mediastinitis, triggering pericardial inflammation. Cardiovascular complications occur in up to 87% of patients with AN. A high index of suspicion for pericarditis is warranted in malnourished patients presenting with chest pain. ECG, echocardiography, and imaging are essential. Conclusion: Symptomatic pericarditis is a rare but serious cardiac complication of AN. Early diagnosis and coordinated multidisciplinary care are essential for recovery.

In hospitalised patients with both anorexia nervosa (AN) and atypical AN, premorbid body mass index (BMI; kg/m2), estimated from premorbid weight (i.e.,weight at the onset of weight loss preceding eating disorder development) and admission height, strongly predicts admission weight loss (i.e.,premorbid weight minus admission weight). We hypothesised that maximal weight loss (i.e.,maximal historical weight minus minimal weight since eating disorder onset) is also correlated with maximal BMI. In 520 female adolescents with AN (n=503) and atypical AN (n=17), relationships between admission age, admission and maximal weight loss, and maximal and minimal BMI were analysed with non-parametric Spearman's correlation coefficients. Like premorbid BMI in previous studies, maximal BMI was strongly correlated with maximal weight loss. Maximal BMI appears to be a sound substitute for premorbid BMI in correlations with admission weight loss in hospitalised adolescents with AN and atypical AN. Consistent use of maximal (vs. premorbid) BMI and admission (vs. maximal) weight loss in research would align with the metric weight suppression (derived from both maximal and current weight), thus facilitating cross study comparisons. Additional studies should assess correlations between both premorbid and maximal BMI and admission or maximal weight loss to attempt to identify the variables with the highest predictive value.

While compulsory treatment is shown to be potentially traumatic for patients, its impact on clinicians has been insufficiently studied. This study aimed to examine clinicians' experiences with providing compulsory nasogastric tube feeding for youth with severe anorexia nervosa, with particular attention to identifying factors contributing to its negative impacts and potential areas for improvement in clinical practice. Twenty-three clinicians in various roles from four academic child and adolescent psychiatry clinics in the Netherlands shared their experiences and opinions regarding compulsory nasogastric tube feeding for youth with anorexia nervosa in semi-structured interviews. Thematic analysis was conducted after systematic deductive and inductive coding based on a framework of theory and practice. Three themes were identified. First, clinicians illustrated the immense impact of providing compulsory feeding and how this varied between different roles within a team. Second, the clinicians described myriad situations of highly distressing and potentially traumatic physical, and especially verbal resistance by patients and sometimes their parents. Third, the clinicians underlined the value of an emotionally safe working environment, the need for clear practical guidelines and the necessity of ethical debate. Providing compulsory nasogastric tube feeding for youth with anorexia nervosa may potentially cross clinicians' moral boundaries, leading to moral injury and potential traumatization, endangering the quality and sustainability of care. The necessity for education, innovation, team building, shared decision-making, practical guidelines and ethical/moral debate is discussed. This study may contribute to ongoing debate and further research on the implications of compulsory feeding for youth with anorexia nervosa.

Anorexia nervosa (AN) is a severe psychiatric disorder with structural brain alterations; however, the roles of cortical surface area (CSA) and cortical thickness (CTh) during adolescence remain unclear. Building on frequent reports of gray matter reductions in the cingulate cortex and precuneus, this study assesses CSA, CTh, and cortical volume in these regions, alongside exploratory whole-brain analyses and their associations with psychological dimensions. We included 26 adolescent females aged 12-19 years with acute AN and 24 age-matched healthy controls. Participants underwent high-resolution structural MRI and completed psychological assessments: Eating Disorder Inventory-2 (EDI-II), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Perth Alexithymia Questionnaire (PAQ), and Body Perception Questionnaire. MRI data were processed using BIDScoin, fMRIPrep, and FreeSurfer. Analyses included permutation-based non-parametric testing and multiple regression to investigate associations between brain metrics and psychological scores. In primary analyses, individuals with AN exhibited a significant reduction in precuneus CTh only. Precuneus CTh correlated negatively with EDI-II, BAI, and BDI-II scores, and positively with BMI-SDS. Regression analysis identified anxiety (BAI), specific EDI-II subscales, supra-diaphragmatic autonomic reactivity and difficulties describing negative feelings (PAQ) as predictors of precuneus CTh. Exploratory analyses revealed thickness differences in parietal and frontal regions, consistent with prior large-scale studies, with anxiety and depression scores correlating with several of these regions. Reduced precuneus CTh and its association with psychological factors highlight its role in AN's neurobiological mechanisms. Exploratory findings implicate parietal and frontal alterations, suggesting broader disruptions in body perception and behavioral control.

Pregnancy is a period marked by significant physiological and psychological changes, including notable alterations in dietary habits. Food cravings and aversions are common phenomena experienced by pregnant women and can have implications for maternal and fetal health. This study provides an overview on perception and attitude of pregnant women towards food craving and aversion in Adeun and Iberekodo primary health center, Abeokuta north local government. A descriptive cross sectional design was utilized with simple random technique; a well-constructed questionnaire was used to elicit information from (120) respondents. Data was collected using a self-structured questionnaire that explored perception and attitude that influence this method. Data obtained were analyzed using statistical package for Social Science (SPSS) version 27 and results were presented in table and figures. Result obtained from this study revealed that the most commonly (85%) craved food were sweet and sugary items during pregnancy. 95% of the respondent’s experience food aversion during first trimester. Conversely, a significant portion of respondents agreed (62%) or strongly agreed (48%) that food cravings and aversions present an opportunity to practice self-care and self-love. 75% of respondent highlighted social support using family as an important coping strategy. The study concludes that pregnant women’s food cravings and aversions are shaped by psychological, cultural, and social factors, with diverse coping strategies such as emotional support, nutrition counseling, and lifestyle adjustments aiding effective dietary management during pregnancy. It is therefore recommended that healthcare providers should address these dietary changes during prenatal care to ensure balanced nutrition and positive pregnancy outcomes.

Background/Objectives: Eating disorders (EDs) often affect fertility, yet many women with ED still become mothers. The pattern of ED symptoms during pregnancy and postpartum, along with their effects on maternal and child health, is not yet fully understood. This longitudinal study aimed to (1) examine the course of ED symptoms from conception to postpartum, (2) evaluate pregnancy outcomes and children’s health and developmental milestones, and (3) assess ED status approximately four years after the initial evaluation. Methods: Thirty women with a prior ED diagnosis (21 with anorexia nervosa, 9 with bulimia nervosa) were evaluated at two time points. Time 1 with the Eating Disorders Examination and the Oxford Risk Factors for Eating Disorders: Interview Schedule; Time 2, approximately four years later, with the Eating Disorders Examination and the Clinical Interview on Reproductive History and Eating Behavior that also included clinical data related to mother’s health and baby’s health and development accessed through the Pregnant Women’s Health Bulletin and the Child and Youth Health Bulletin using the national health records. Results: ED symptoms (dietary restriction, self-induced vomiting, laxative misuse) persisted from conception through postpartum. BN participants reported more severe symptoms and higher rates of pregnancy complications (hyperemesis gravidarum, gestational diabetes, preeclampsia), while premature births occurred only in AN participants. Children of mothers with AN more frequently showed delays in developmental milestones (sitting, walking, speaking, sphincter control) compared to those of BN mothers. Conclusions: A substantial proportion of women with prior ED continued to experience symptoms during and after pregnancy, and nearly half still met diagnostic criteria four years later and are still in treatment. Cognitive features such as body dissatisfaction persisted despite partial symptom remission. These findings highlight the chronicity of ED and underscore the need for systematic screening, psychological support, and interdisciplinary follow-up during pregnancy and early motherhood.

A comparative neuropsychological assessment of anorexia nervosa, bulimia nervosa, binge eating disorder and healthy control: a cross-sectional study in female university students

Irisin/BDNF pathway dysfunction subserves anorexia nervosa pathophysiology.

Association of glucagon-like peptide-1 receptor agonists and seven common mental disorders: A drug target and mediation Mendelian randomization.

Getting lucky: Clinical characterization of compulsive sexual behavior compared with gambling disorder and intermittent explosive disorder.