Possible role of the gut microbiota in the pathogenesis of anorexia nervosa

Sudo, Nobuyuki

doi:10.1186/s13030-021-00228-9

Cited by 7 publications

(10 citation statements)

References 93 publications

(108 reference statements)

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“…The gut microbiome has captured the attention of the medical field and has been implicated in a myriad of conditions including neuropsychiatric disorders, encompassing eating disorders (EDs) [1], metabolic disorders, and immune-mediated diseases. Research regarding EDs and the gut microbiome remains nascent and speculative, yet promising [2][3][4][5][6][7][8][9]. Here we provide a critical analysis of the field, suggest practical steps that can be taken to move the field forward, and discuss the potential implications of this research.…”

Section: Overviewmentioning

confidence: 99%

A critical analysis of eating disorders and the gut microbiome

2022

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The gut microbiota, also known as our “second brain” is an exciting frontier of research across a multitude of health domains. Gut microbes have been implicated in feeding behaviour and obesity, as well as mental health disorders including anxiety and depression, however their role in the development and maintenance of eating disorders (EDs) has only recently been considered. EDs are complex mental health conditions, shaped by a complicated interplay of factors. Perhaps due to an incomplete understanding of the etiology of EDs, treatment remains inadequate with affected individuals likely to face many relapses. The gut microbiota may be a missing piece in understanding the etiology of eating disorders, however more robust scientific inquiry is needed in the field before concrete conclusions can be made. In this spotlight paper, we critically evaluate what is known about the bi-directional relationship between gut microbes and biological processes that are implicated in the development and maintenance of EDs, including physiological functioning, hormones, neurotransmitters, the central nervous system, and the immune system. We outline limitations of current research, propose concrete steps to move the field forward and, hypothesize potential clinical implications of this research. Plain English summary Our gut is inhabited by millions of bacteria which have more recently been referred to as “our second brain”. In fact, these microbes are thought to play a role in ED behaviour, associated anxiety and depression, and even affect our weight. Recent research has dove into this field with promising findings that have the potential to be applied clinically to improve ED recovery. The present paper discusses what is known about the gut microbiome in relation to EDs and the promising implications that leveraging this knowledge, through fecal microbiome transplants, probiotics, and microbiome-directed supplemental foods, could have on ED treatment.

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Section: Overviewmentioning

confidence: 99%

A critical analysis of eating disorders and the gut microbiome

2022

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“…Therefore, dietary reduction, psychosocial stress, and marked weight loss are considered to contribute to the establishment of a selective intestinal environment for bacterial survival favouring the development of dysbiosis [ 19 ]. So far, it has been suggested that this might explain low weight gain [ 19 , 22 ], affective symptomatology [ 19 , 22 , 23 ], altered eating behaviour [ 23 ], and even hyperactivity [ 22 ]. Thus, modifications of microbiota composition using pro-, prebiotics [ 22 ], FMT, or precision nutrition [ 19 ] have been proposed as promising therapeutic interventions.…”

Section: Introductionmentioning

confidence: 99%

“…So far, it has been suggested that this might explain low weight gain [ 19 , 22 ], affective symptomatology [ 19 , 22 , 23 ], altered eating behaviour [ 23 ], and even hyperactivity [ 22 ]. Thus, modifications of microbiota composition using pro-, prebiotics [ 22 ], FMT, or precision nutrition [ 19 ] have been proposed as promising therapeutic interventions.…”

Section: Introductionmentioning

confidence: 99%

“…In an effort to determine whether altered composition is more than a mere consequence of malnutrition, several authors have examined the underlying causal mechanisms of microbiota in the aetiology of AN. Intestinal dysbiosis has been suggested to favour tryptophan deficiency by altering serotonergic pathways that increase physical activity [ 22 ]. In the same vein, affective symptomatology has been associated with altered gut-brain communication due to increased uremic toxins [ 22 ], and reduced SCFAs [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…Intestinal dysbiosis has been suggested to favour tryptophan deficiency by altering serotonergic pathways that increase physical activity [ 22 ]. In the same vein, affective symptomatology has been associated with altered gut-brain communication due to increased uremic toxins [ 22 ], and reduced SCFAs [ 21 ]. Fetissov & Hökfelt [ 23 ] define eating disorders as the result of altered communication between microbiota, the immune system, and the neuroendocrine system.…”

Section: Introductionmentioning

confidence: 99%

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Anorexia nervosa and microbiota: systematic review and critical appraisal

Garcia

Gutiérrez

2023

Eat Weight Disord

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Purpose Recent studies have reported a gut microbiota imbalance or dysbiosis associated with anorexia nervosa (AN), which has prompted an appraisal of its aetiological role, and the reformulation of AN as a metabo-psychiatric disorder. Thus, the aim of this paper was to critically review the current scientific findings regarding the role of microbiota in anorexia nervosa. Methods A systematic study of peer-reviewed literature published in four databases between 2009 and 2022 was conducted according to PRISMA guidelines. Both human and animal studies were included. Results A total of 18 studies were included. In animal models, both the preclinical and clinical findings were inconsistent regarding microbiota composition, faecal metabolite concentrations, and the effects of human faecal microbiota transplants. Conclusion The methodological limitations, lack of standardisation, and conceptual ambiguity hinder the analysis of microbiota as a key explanatory factor for AN. Level of evidence Level I, systematic review.

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Challenges and priorities for researching the gut microbiota in individuals living with anorexia nervosa

West,

Hart,

Loughman

et al. 2023

Intl J Eating Disorders

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ObjectiveThe gut microbiota is implicated in several symptoms and biological pathways relevant to anorexia nervosa (AN). Investigations into the role of the gut microbiota in AN are growing, with a specific interest in the changes that occur in response to treatment. Findings suggest that microbial species may be associated with some of the symptoms common in AN, such as depression and gastrointestinal disturbances (GID). Therefore, researchers believe the gut microbiota may have therapeutic relevance. Whilst research in this field is rapidly expanding, the unique considerations relevant to conducting gut microbiota research in individuals with AN must be addressed.MethodWe provide an overview of the published literature investigating the relationship between the gut microbiota and symptoms and behaviors present in AN, discuss important challenges in gut microbiota research, and offer recommendations for addressing these. We conclude by summarizing research design priorities for the field to move forward.ResultsSeveral ways exist to reduce participant burden and accommodate challenges when researching the gut microbiota in individuals with AN.DiscussionRecommendations from this article are foreseen to encourage scientific rigor and thoughtful protocol planning for microbiota research in AN, including ways to reduce participant burden. Employing such methods will contribute to a better understanding of the role of the gut microbiota in AN pathophysiology and treatment.Public SignificanceThe field of gut microbiota research is rapidly expanding, including the role of the gut microbiota in anorexia nervosa. Thoughtful planning of future research will ensure appropriate data collection for meaningful interpretation while providing a positive experience for the participant. We present current challenges, recommendations for research design and priorities to facilitate the advancement of research in this field.

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Possible role of the gut microbiota in the pathogenesis of anorexia nervosa

Cited by 7 publications

References 93 publications

A critical analysis of eating disorders and the gut microbiome

A critical analysis of eating disorders and the gut microbiome

Anorexia nervosa and microbiota: systematic review and critical appraisal

Challenges and priorities for researching the gut microbiota in individuals living with anorexia nervosa

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