Eating Disorders and the Intestinal Microbiota: Mechanisms of Energy Homeostasis and Behavioral Influence

Glenny, Elaine M.; Bulik-Sullivan, Emily C.; Tang, Quyen; Bulik, Cynthia M.; Carroll, Ian M.

doi:10.1007/s11920-017-0797-3

Cited by 53 publications

(48 citation statements)

References 82 publications

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“…Furthermore, physical anxiety can include interoceptive experiences involving gastrointestinal distress, which can impact feelings of hunger and fullness. Recent reviews of the relationship between gastrointestinal symptoms and eating disorders highlight the potential for complex and reciprocal relationships between eating disorder, anxiety, and gastrointestinal symptoms (Conviser, Fisher, & McColley, ; Norris et al., ), which may be mediated by variations in gut microbiota (Glenny, Bulik‐Sullivan, Tang, Bulik, & Carroll, ; Kleiman et al., ).…”

Section: Discussionmentioning

confidence: 99%

Anxiety disorder symptoms at age 10 predict eating disorder symptoms and diagnoses in adolescence

Schaumberg

Zerwas

Goodman

et al. 2018

Child Psychology Psychiatry

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Background: Cross-sectional associations between anxiety disorders and eating disorders (EDs) have been well documented; however, limited research has examined whether symptoms of anxiety disorders are prospectively associated with EDs. Identifying these longitudinal associations can aid in discerning relationships among eating and anxiety disorders and point toward a mechanistic understanding of developmental psychopathology. This study investigated the prospective associations between parent-reported anxiety in mid-childhood (age 10) and childreported ED behaviors and disorders in adolescence (at ages 14 and 16 years) in a population-based sample. Methods: Participants were individuals enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based, prospective study of women and their children; 7,767 children whose parents provided data at age 10 were included in current analyses. An exploratory factor analysis identified latent anxiety factors at age 10, followed by a path analysis that evaluated associations between these factors and eating disorder symptoms and cognitions at age 14. Results: Parent-reported anxiety symptoms at age 10 yielded 5 factors: obsessive-compulsive disorder (OCD) symptoms related to symmetry and checking (Factor 1); OCD symptoms associated with aversion to dirt and germs (Factor 2); physical anxiety symptoms (Factor 3); worries (Factor 4); and social phobia symptoms (Factor 5). Factors 3 and 4 showed the most consistent, positive associations with a range of ED symptoms at age 14. Factor 3 predicted diagnosis of bulimia nervosa by age 16 (OR = 1.11, p = .007), whereas Factor 4 predicted diagnoses of anorexia nervosa (OR = 1.10, p = .01) and disordered eating by age 16 (OR = 1.08, p = .001). Conclusions: Results indicate that symptoms of generalized anxiety in middle childhood may predict adolescentonset ED symptoms and ED diagnoses.Anxiety-related symptoms at age 10 and eating disorder symptoms during adolescence were examined in a population-based, epidemiological sample of children.Worries and physical anxiety at age 10 predict eating disorder symptoms and diagnoses in adolescence.Clinicians should be attentive to weight fluctuations and eating concerns among anxious children. Childhood worries about physical symptoms might predispose to eating and body related worries that can convert into full blown ED.

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Section: Discussionmentioning

confidence: 99%

Anxiety disorder symptoms at age 10 predict eating disorder symptoms and diagnoses in adolescence

Schaumberg

Zerwas

Goodman

et al. 2018

Child Psychology Psychiatry

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“…Recently, the prospective role of Fecal Microbiota Transplant (FMT) was evaluated in the management of ED. To date, only promising preclinical studies about the positive effects of microbiota restoration on mood disorders are available [140][141][142]; for this reason, future studies should focus on the possibility of translating these results in human studies.…”

Section: Gut Microbiotamentioning

confidence: 99%

Eating Disorders and Gastrointestinal Diseases

et al. 2019

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Eating disorders (ED) are frequently associated with a wide range of psychiatric or somatic comorbidities. The most relevant ED are anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorders (BED). Patients with ED exhibit both upper and lower gastrointestinal (GI) symptoms. Evidence of alterations throughout the GI tract in ED will be analyzed given the role of the GI tract in food intake and its regulation. It remains a matter of debate whether GI disorders are inherent manifestations of ED or the results of malnutrition occurring from ED. Moreover, recent clinical studies have highlighted the growing role of intestinal microbiota in the pathogenesis of ED, making it possible to hypothesize a modulation of intestinal microbiota as a co-adjuvant to standard therapy. The aim of this review is to analyze the link between ED and GI diseases and to present, where known, the potential key factors underlying these conditions. Conclusions: The presence of GI disorders should be investigated in patients with ED. Screening for ED should also be encouraged in individuals seeking treatment for unexplained GI complaints to better address therapeutic issues that surround these difficult medical conditions. Nutrients 2019, 11, 3038 3 of 17 ED can be associated with anxiety or mood disorders; insomnia; as well as somatic complications such as cardiac alterations, hormonal imbalances and also a wide range of gastrointestinal (GI) symptoms [3].Prevalence estimate of lifetime AN is 0.8% [4]. The overall incidence rate of AN is around 7 per 100,000 persons; however, it is higher in 15-19 year old girls reaching 109.2 cases per 100,000. The incidence is increasing in Italy and other Western countries probably due to earlier diagnosis or earlier onset [5,6].The prevalence of BN is 0.28% [4]. The highest incidence rate of BN is 300 per 100,000 persons in women aged between 16 and 20 [7], although the age at onset is decreasing [5].BED are described in 0.85% of the population [4,8] and are frequently associated with medical comorbidities, especially obesity and its complications such as Type II diabetes mellitus, hypertension, and dyslipidemia [9]. Furthermore, BED may occur in a subset ranging from 27% to 47% in severely obese persons undergoing bariatric surgery [10].The previous edition of DSM (DSM-IV) [11], classified as "Eating Disorders Not Otherwise Specified (EDNOS)", is the ED that does not satisfy all the diagnostic criteria for AN or BN. Previously, EDNOS contained a huge and varied group of individuals and was the most commonly diagnosed ED. However, the DSM-V revised this ED type and called it "Other Specified Feeding or Eating Disorder" (OSFED). Moreover, the DSM-V introduced the definition of Avoidant/restrictive food intake disorder (ARFID) that was distinct from AN and BN in that there is no body image disturbance [2].The first description of AN in the 19th century revealed that the sufferers' reasons for self-starvation generally were strictly connected to inappetence, feelings of fullness and abdominal ...

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“…Heterogeneity: I 2 = 87%, τ 2 = 703.4575, p < 0.01 Barja−Fernandez et al 2015Boland et al 2001Curatola et al 2004Delporte et al 2003Franssila−Kallunki et al 1991Heilbronn et al 2007Karczewska−Kupczewska et al 2010Kaválková et al 2012Krízová et al 2008Lejoyeux et al 1996Matzkin et al (all) 2006Matzkin et al (all) 2007Misra et al 2006Mordasini et al 1977Nestel et al 1974Nova et al 2008Omodei et al 2015Rigaud et al 2009 191.4 199.0 167.6 186.0 189.5 205.0 162.4 174.6 295.4 185.6 282.3 191.4 191.3 144.7 265.0 318.8 208.2 171.7 190.0 199.5 204.2 184.8 162.6 197.8 201.1 189.5 192 Furthermore, some studies suggest increased absorption of exogenous cholesterol indicated by higher concentrations of the phytosterol campesterol and beta-sitosterol-steroids derived from plantsin individuals with AN (Zák et al, 2003;Zák et al, 2005), and potentially, these changes in absorption may be influenced by alterations in gut microbiota (Glenny, Bulik-Sullivan, Tang, Bulik, & Carroll, 2017;Schwensen, Kan, Treasure, Hoiby, & Sjogren, 2018). Increased endogenous cholesterol synthesis seems to be unlikely in individuals suffering from AN (Feillet et al, 2000;Weinbrenner et al, 2004;Zák et al, 2003;Zák et al, 2005).…”

Section: Random Effects Modelmentioning

confidence: 99%

Increased lipid and lipoprotein concentrations in anorexia nervosa: A systematic review and meta‐analysis

Hussain

Hübel

Hindborg

et al. 2019

Intl J Eating Disorders

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Objective: Alterations in blood lipid concentrations in anorexia nervosa (AN) have been reported; however, the extent, mechanism, and normalization with weight restoration remain unknown. We conducted a systematic review and a meta-analysis to evaluate changes in lipid concentrations in acutely-ill AN patients compared with healthy controls (HC) and to examine the effect of partial weight restoration. Method: A systematic literature review and meta-analysis (PROSPERO: CRD42017078014) were conducted for original peer-reviewed articles. Results: Forty-eight studies were eligible for review; 33 for meta-analyses calculating mean differences (MD). Total cholesterol (MD = 22.7 mg/dL, 95% CI = 12.5, 33.0), high-density lipoprotein (HDL; MD = 3.4 mg/dL, CI = 0.3, 7.0), low-density lipoprotein (LDL; MD = 12.2 mg/dL, CI = 4.4, 20.1), triglycerides (TG; MD = 8.1 mg/dL, CI = 1.7, 14.5), and apolipoprotein B (Apo B; MD = 11.8 mg/dL, CI = 2.3, 21.2) were significantly higher in acutely-ill AN than HC. Partially weight-restored AN patients had higher total cholesterol (MD = 14.8 mg/dL, CI = 2.1, 27.5) and LDL (MD = 16.1 mg/dL, CI = 2.3, 30.0). Pre-versus post-weight restoration differences in lipid concentrations did not differ significantly. Discussion: We report aggregate evidence for elevated lipid concentrations in acutely-ill AN patients compared with HC, some of which persist after partial weight restoration. This could signal an underlying adaptation or dysregulation not fully reversed by weight restoration. Although concentrations differed between AN and HC, most lipid concentrations remained within the reference range and metaanalyses were limited by the number of available studies. ResumenObjetivo: En la anorexia nervosa (AN) han sido reportadas alteraciones en las concentraciones de lípidos sanguíneos; sin embargo, la extensión, mecanismo y normalización con la restauración del peso continúa aún desconocida. Hicimos una revisión sistemática y meta-análisis para evaluar los cambios en las concentraciones de lípidos

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Eating Disorders and the Intestinal Microbiota: Mechanisms of Energy Homeostasis and Behavioral Influence

Cited by 53 publications

References 82 publications

Anxiety disorder symptoms at age 10 predict eating disorder symptoms and diagnoses in adolescence

Anxiety disorder symptoms at age 10 predict eating disorder symptoms and diagnoses in adolescence

Eating Disorders and Gastrointestinal Diseases

Increased lipid and lipoprotein concentrations in anorexia nervosa: A systematic review and meta‐analysis

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