Gastrointestinal symptomatology, diagnosis, and treatment history in patients with underweight avoidant/restrictive food intake disorder and anorexia nervosa: Impact on weight restoration in a meal‐based behavioral treatment program

Background: Anorexia nervosa (AN) is a serious, multifactorial mental disorder affecting predominantly young females. This systematic review examines neuroimaging findings in adolescents and young adults up to 24 years old, in order to explore alterations associated with disease pathophysiology. Methods: Eligible studies on structural and functional brain neuroimaging were sought systematically in PubMed, CENTRAL and EMBASE databases up to 5 October 2020. Results: Thirty-three studies were included, investigating a total of 587 patients with a current diagnosis of AN and 663 healthy controls (HC). Global and regional grey matter (GM) volume reduction as well as white matter (WM) microstructure alterations were detected. The mainly affected regions were the prefrontal, parietal and temporal cortex, hippocampus, amygdala, insula, thalamus and cerebellum as well as various WM tracts such as corona radiata and superior longitudinal fasciculus (SLF). Regarding functional imaging, alterations were pointed out in large-scale brain networks, such as default mode network (DMN), executive control network (ECN) and salience network (SN). Most findings appear to reverse after weight restoration. Specific limitations of neuroimaging studies in still developing individuals are also discussed. Conclusions: Structural and functional alterations are present in the early course of the disease, most of them being partially or totally reversible. Nonetheless, neuroimaging findings have been open to many biological interpretations. Thus, more studies are needed to clarify their clinical significance.

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Responses to hypothetical high risk situations: Do they predict weight loss in a behavioral treatment program or the context of dietary lapses?

Health Psychology ◽

10.1037/0278-6133.14.5.427 ◽

1995 ◽

Vol 14 (5) ◽

pp. 427-434 ◽

Cited By ~ 38

Author(s):

Rita G. Drapkin ◽

Rena R. Wing ◽

Saul Shiffman

Keyword(s):

Weight Loss ◽

High Risk ◽

Treatment Program ◽

Behavioral Treatment ◽

Predict Weight Loss

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Anorexia Nervosa and Depression in a Woman Blind since the Age of Nine Months

The Canadian Journal of Psychiatry ◽

10.1177/070674379303800701 ◽

1993 ◽

Vol 38 (7) ◽

pp. 469-471 ◽

Cited By ~ 11

Author(s):

Clifford W. Sharp

Keyword(s):

Eating Disorders ◽

Body Image ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Major Depression ◽

Food Intake ◽

Older Women ◽

The Body ◽

Atypical Presentation ◽

History Of

A woman aged 58 who has been blind since the age of nine months presented with major depression and a 40 year history of an eating disorder characterized by a restriction of food intake and body disparagement. The case is additional evidence that a specifically visual body image is not essential for the development of anorexia nervosa and supports the view that the concept of body image is unnecessary and unproductive in eating disorders. Greater emphasis should be placed on attitudes and feelings toward the body, and the possibility of an eating disorder should be considered in cases of older women with an atypical presentation.

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Prevalence of autism spectrum disorder and autistic traits in children with anorexia nervosa and avoidant/restrictive food intake disorder

BioPsychoSocial Medicine ◽

10.1186/s13030-021-00212-3 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Takeshi Inoue ◽

Ryoko Otani ◽

Toshiyuki Iguchi ◽

Ryuta Ishii ◽

Soh Uchida ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Anorexia Nervosa ◽

Food Intake ◽

Autistic Traits ◽

Autism Spectrum ◽

Eating Attitudes ◽

Spectrum Disorder ◽

Autism Spectrum Quotient ◽

Multicenter Cohort Study ◽

Feeding And Eating Disorders

Abstract Background Autism spectrum disorder (ASD) and feeding and eating disorders (FEDs) such as anorexia nervosa (AN) are strongly linked as evidenced by frequent comorbidity and overlapping traits. However, eating and social behaviors are shaped by culture, so it is critical to examine these associations in different populations. Moreover, FEDs are heterogeneous, and there has been no examination of autistic traits in avoidant/restrictive food intake disorder (ARFID). Methods Therefore, we investigated the prevalence of ASD and autistic traits among Japanese children with AN (n = 92) or ARFID (n = 32) from a prospective multicenter cohort study using the Autism Spectrum Quotient Children’s version (AQC) and Children’s Eating Attitudes Test (ChEAT26). Results ASD prevalence was high in both AN and ARFID (16.3 and 12.5%, respectively). The AN group exhibited significantly higher scores on all AQC subscales than an age-matched healthy control (HC) group, but there were no significant correlations between AQC scores and ChEAT26 scores. In the AFRID group, AQC scores did not differ from HCs, but significant correlations were found between total AQC and ChEAT26 scores and between several AQC and ChEAT26 subscales. Conclusions Both the AN and ARFID groups had high prevalence rates of ASD. The AN group showed a significantly higher degree of autistic traits than the HC group; however, no difference was found between the ARFID and HC groups. Clinicians need to be aware of these rates when working with children with ED.

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The Gut Microbiome Derived From Anorexia Nervosa Patients Impairs Weight Gain and Behavioral Performance in Female Mice

Endocrinology ◽

10.1210/en.2019-00408 ◽

2019 ◽

Vol 160 (10) ◽

pp. 2441-2452 ◽

Cited By ~ 15

Author(s):

Tomokazu Hata ◽

Noriyuki Miyata ◽

Shu Takakura ◽

Kazufumi Yoshihara ◽

Yasunari Asano ◽

...

Keyword(s):

Body Weight ◽

Anorexia Nervosa ◽

Weight Gain ◽

Food Intake ◽

Brain Stem ◽

Body Weight Gain ◽

Field Tests ◽

Compulsive Behavior ◽

The Brain ◽

Poor Weight Gain

Abstract Anorexia nervosa (AN) results in gut dysbiosis, but whether the dysbiosis contributes to AN-specific pathologies such as poor weight gain and neuropsychiatric abnormalities remains unclear. To address this, germ-free mice were reconstituted with the microbiota of four patients with restricting-type AN (gAN mice) and four healthy control individuals (gHC mice). The effects of gut microbes on weight gain and behavioral characteristics were examined. Fecal microbial profiles in recipient gnotobiotic mice were clustered with those of the human donors. Compared with gHC mice, gAN mice showed a decrease in body weight gain, concomitant with reduced food intake. Food efficiency ratio (body weight gain/food intake) was also significantly lower in gAN mice than in gHC mice, suggesting that decreased appetite as well as the capacity to convert ingested food to unit of body substance may contribute to poor weight gain. Both anxiety-related behavior measured by open-field tests and compulsive behavior measured by a marble-burying test were increased only in gAN mice but not in gHC mice. Serotonin levels in the brain stem of gAN mice were lower than those in the brain stem of gHC mice. Moreover, the genus Bacteroides showed the highest correlation with the number of buried marbles among all genera identified. Administration of Bacteroides vulgatus reversed compulsive behavior but failed to exert any substantial effect on body weight. Collectively, these results indicate that AN-specific dysbiosis may contribute to both poor weight gain and mental disorders in patients with AN.

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