The Neuroendocrinology of Anorexia Nervosa and Bulimia Nervosa

Abstract

Eating disorders are serious psychiatric conditions associated with severe medical complications and increased risk of death. Two of the most well-known eating disorders are anorexia nervosa (AN) and bulimia nervosa (BN). AN is primarily characterized by extreme dietary restriction that results in low body weight. BN is primarily characterized by the presence of out-of-control over-eating episodes (i.e., binge eating) coupled with extreme behaviors used to compensate for these binge-eating episodes such as self-induced vomiting, fasting, or excessive exercise. Given that these psychiatric illnesses are defined by disturbances in eating behaviors, research has focused on the potential role of appetite-regulating hormones on the development and maintenance of these disorders. The purpose of this chapter is to provide a review of studies on the neuroendocrinology of AN and BN, with a specific focus on gastrointestinal or adipose tissue hormones whose effects on eating have been well characterized and theorized to impact eating disorder symptoms. In general, findings support that disturbances in some specific hormones may contribute to the severity or maintenance of AN and BN. However, future longitudinal studies with larger sample sizes are still needed to better understand the role of feeding-related hormonal factors in the pathophysiology of these eating disorders.