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Published in: European Child & Adolescent Psychiatry 9/2017

Open Access 01-09-2017 | Review

Food matters: how the microbiome and gut–brain interaction might impact the development and course of anorexia nervosa

Authors: Beate Herpertz-Dahlmann, Jochen Seitz, John Baines

Published in: European Child & Adolescent Psychiatry | Issue 9/2017

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Abstract

Anorexia nervosa (AN) is one of the most common chronic illnesses in female adolescents and exhibits the highest mortality risk of all psychiatric disorders. Evidence for the effectiveness of psychotherapeutic or psychopharmacological interventions is weak. Mounting data indicate that the gut microbiome interacts with the central nervous system and the immune system by neuroendocrine, neurotransmitter, neurotrophic and neuroinflammatory afferent and efferent pathways. There is growing evidence that the gut microbiota influences weight regulation and psychopathology, such as anxiety and depression. This article reviews how the gut–brain interaction may impact the development and course of AN. A “leaky gut”, characterized by antigens traversing the intestinal wall, was demonstrated in an animal model of AN, and could underlie the low-grade inflammation and increased risk of autoimmune diseases found in AN. Moreover, starvation has a substantial impact on the gut microbiome, and diets used for re-nutrition based on animal products may support the growth of bacteria capable of triggering inflammation. As there is currently no empirically derived agreement on therapeutic re-nourishment in AN, this review discusses how consideration of gut–brain interactions may be important for treatment regarding the determination of target weight, rapidity of weight gain, refeeding methods and composition of the diet which might all be of importance to improve long-term outcome of one of the most chronic psychiatric disorders of adolescence.
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Metadata
Title
Food matters: how the microbiome and gut–brain interaction might impact the development and course of anorexia nervosa
Authors
Beate Herpertz-Dahlmann
Jochen Seitz
John Baines
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
European Child & Adolescent Psychiatry / Issue 9/2017
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-017-0945-7

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