Hebebrand Johannes, Seitz Jochen, Matthews Abigail
Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Essen (AöR), University of Duisburg-Essen, Essen, Germany.
Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Int J Eat Disord. 2025 Jan;58(1):162-167. doi: 10.1002/eat.24313. Epub 2024 Oct 26.
Because premorbid BMI strongly predicts the amount of weight loss in anorexia nervosa (AN)/atypical AN, we hypothesize that weight loss triggers both disorders by inducing the endocrine adaptation to starvation.
We propose research to capture the onset of AN/atypical AN following intentional, otherwise behaviorally motivated, or unintentional weight loss in relationship to premorbid weight.
We propose retrospective and prospective studies to examine the temporal development of symptoms in AN/atypical AN. Given a greater frequency of weight loss behaviors in individuals with high BMIs, patients with intentionally driven weight loss should demonstrate a higher mean weight loss and greater premorbid weight and shape concerns. Practice guidelines necessitate weight gain for AN recovery, yet how weight gain induces improvements is unspecified and warrants systematic elucidation. Finally, we highlight implications for the current conceptualization of genetic and environmental contributors of AN/atypical AN in twin and molecular genetic studies.
We propose separating the starvation-induced mechanisms relevant for AN/atypical AN development from the reasons/mechanisms inherent to weight loss.
由于病前体重指数能有力地预测神经性厌食症（AN）/非典型AN的体重减轻量，我们推测体重减轻通过诱导对饥饿的内分泌适应而引发这两种疾病。
我们提议开展研究，以了解在与病前体重相关的有意、受其他行为驱使或无意的体重减轻后AN/非典型AN的发病情况。
我们提议进行回顾性和前瞻性研究，以检查AN/非典型AN症状的时间发展情况。鉴于高体重指数个体中体重减轻行为更为频繁，有意减肥的患者应表现出更高的平均体重减轻以及对病前体重和体型更大的担忧。实践指南要求通过增加体重来促进AN的康复，但体重增加如何带来改善尚不清楚，需要进行系统阐释。最后，我们强调了在双胞胎和分子遗传学研究中，当前对AN/非典型AN的遗传和环境因素概念化的影响。
我们提议将与AN/非典型AN发展相关的饥饿诱导机制与体重减轻所固有的原因/机制区分开来。
