The Growth Hormone-IGF-1 Axis in Anorexia Nervosa

Abstract

Anorexia nervosa is a psychiatric disorder characterized by low body weight and serves as a model of chronic human starvation. Humans have evolved hormonal adaptations to survive periods of starvation. One critical response to periods of decreased nutrient intake is growth hormone (GH) resistance. This adaptive response allows for the maintenance of the beneficial counter-regulatory properties of GH during periods of low caloric intake, while minimizing energy expenditure on growth-related processes. This chapter will review the GH-insulin-like growth factor-1 (IGF-1) axis in anorexia nervosa. We will also describe potential mechanisms of GH resistance in this disorder, the effects of GH resistance on bone mass in anorexia nervosa, and the effects of treatment with exogenous GH and IGF-1 in anorexia nervosa.