BACKGROUND: Over the past decades, a substantial increase in the prevalence of eating disorders (ED) has been noticed. In the treatment of ED priority is justifiably given to psychosocial interventions. However, it is well known that centrally acting drugs can significantly affect appetite and food consumption.
AIM: The aim of this review is to analyze and summarize the available neurobiological data on the mechanisms of central regulation of eating behavior as a rationale for pharmacological strategies for appetite modulation in ED.
METHODS: The authors have carried out a narrative review of scientific papers published from 2013 to 2023. The studies presented in the PubMed and Web of Science electronic databases were analyzed. Relevant studies were included regardless of their design. Descriptive analysis was used to summarize the information obtained.
RESULTS: Neurobiological mechanisms of central regulation of eating behavior are reviewed. Pharmacological strategies for appetite modulation in ED based on neurobiological and clinical data are discussed. The influence of age on efficacy and safety of pharmacotherapy is also discussed, with an emphasis on adolescence.
CONCLUSIONS: The progress in neurobiological understanding of the mechanisms of central regulation of appetite reveals the opportunities for new pharmacotherapeutic approaches aimed at changing the patterns of eating behavior. Obviously, treatment of ED is a much broader problem and cannot be reduced to the correction of food consumption. Nevertheless, at certain stages of treatment, drug-induced modulation of appetite can play an important role among multi-targeted biological and psychosocial interventions. Translation of neurobiological data into clinical practice requires a large number of clinical studies to confirm the long-term efficacy and safety of pharmacotherapeutic approaches and to develop personalized algorithms for the treatment of various forms of ED in different age groups.