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Special Updated Research on Eating Disorders: Medical Perspectives

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 45986

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Special Issue Editors

Prof. Dr. Yael Latzer

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Guest Editor

1. School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel
2. Rambam Medical Center, Eating Disorders Institution, Haifa 3109601, Israel
Interests: eating disorders and women; eating and sleeping disorders; night eating syndrome; psychopathology and family in EDs; identifying at-risk groups and prevention of EDs in adolescent Israeli subgroups (Arabs, ultraorthodox, and more); religiosity, spirituality and EDs; culturally sensitive treatment.

Prof. Dr. Daniel Stein

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Guest Editor

1. Director, Ambulatory Service for Children and Adolescents with Eating Disorders, Pediatric Psychosomatic Department Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel
2. Director, Eating Disorders Unit, Department of Psychiatry, “Maaynei Hayeshuah” Medical Center, Bnei Brak, Israel
3. Full Professor (Clinical, Emeritus), Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Interests: eating disorders; suicide; psychological therapies; child and adolescent psychiatry

Dr. Itay Tokatly Latzer

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Guest Editor

1. Lecturer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
2. Pediatric Neurology and Child Development Institute, The Dana-Dwek Children’s Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
Interests: pediatric neurology; child development; disordered eating; child and adolescent medicine

Special Issue Information

Dear Colleagues,

Eating disorders (EDs) are currently considered among the most prevailing public health problems, reaching an epidemic proportion in many Western countries. Nevertheless, symptoms and syndromes of self-starvation are not a new, modern phenomenon. They first appeared in the clinical descriptions of anorexia by Gull and Lasegue in the 19th century, and since then have been observed for more than 1500 years, being interpreted in each era according to prevailing beliefs and cultural norms (Witztum, Stein and Latzer, 2005). EDs, particularly anorexia nervosa (AN)—the most studied ED—were originally conceptualized as of sociocultural (Stice, Shupak-Neuberg, Shaw, Stein, 1994), psychodynamic (Mushat, 1982), or psychosomatic origin (Minuchin, Roseman, Baker 1978). However, they are currently considered to be mainly induced and maintained by a host of genetic, neurobiological, and neurocognitive influences (Keel and Klump, 2003; Kaye et al., 2013; Roberts et al., 2010, 2013; Brownell and Walsh, 2017). In that sense, rather than being associated first and foremost to eating-related, dieting, and body image disturbances, EDs—particularly anorexia nervosa—are currently considered to represent mind- or brain-related illnesses (Kaye et al., 2013).

According to the latest classification of the DSM, the DSM-5 (2013), ED diagnoses currently include anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorders (BEDs), and other specified eating and feeding disorders (OS-FEDs). On the one hand, this latter category includes a variety of maladaptive eating-related attitudes and behaviors that do not reach the severity of full-blown AN, BN, and BED (Hoek and van Hoeken, 2003), but are distinct from mere dieting in having the potential to induce significant morbidity. Furthermore, almost half of individuals with these EDs may progress to the full syndrome within several years (Fairburn and Harrison, 2003). On the other hand, the OS-FED category includes “non-classical” EDs such as orthorexia (a maladaptive concern about the healthiness of consumed ingredients) or avoidant restrictive food intake disorder (ARFID), a reduction in the amount and diversity of food that starts in childhood and is not related to dieting or body image disturbances (DSM-5, 2013).

Prof. Dr. Yael Latzer
Prof. Dr. Daniel Stein
Dr. Itay Tokatly Latzer
Guest Editors

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Keywords

eating disorders
adolescent
medical complication
psychopharmacology
NES, Israel
dissociation
bariatric
interpersonal

Published Papers (13 papers)

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13 pages, 272 KiB

Open AccessArticle

Sleep Quality and Eating Disorder-Related Psychopathologies in Patients with Night Eating Syndrome and Binge Eating Disorders

by Orna Tzischinsky, Itay Tokatly Latzer, Sigal Alon and Yael Latzer

J. Clin. Med. 2021, 10(19), 4613; https://doi.org/10.3390/jcm10194613 - 08 Oct 2021

Cited by 7 | Viewed by 2787

Abstract

Night eating syndrome (NES) is an eating disorder (ED) characterized by nocturnal ingestion (NI), evening hyperphagia, morning anorexia, as well as mood and sleep disturbances. This study compared subjective and objective sleep quality and ED-related psychopathologies in patients seeking treatment for ED. Method: The sample was composed of 170 women, aged 18–68, who were referred for an ED assessment from 2011 to 2020. The participants were divided into three subgroups: NES-NI only (n = 30), NES+ binge eating (BE) (including binge eating disorders or bulimia nervosa (n = 52), and BE-only (n = 88). The measures consisted of a psychiatric evaluation, objective sleep monitoring measured by an actigraph for 1 week, a subjective sleep self-report, and ED-related psychopathology questionnaires. Results: Objective sleep monitoring revealed significant group differences, with higher sleep efficiency in participants with BE-only and longer sleep durations for the NES-NI only group. Subjectively, the BE-only group described a significantly lower sleep quality than either the NES-NI only or the NES+BE groups. ED-related psychopathology was lower in the NES-NI-only group. A stepwise linear regression revealed that general psychopathology (the brief symptom inventory total score) was a significant predictor of subjective sleep quality. Conclusion: NES-NI-only was correlated with less psychopathology, but with more subjective and objective sleep disturbances. These results lend weight to the supposition that NES lies on a continuum of ED psychopathologies, and that NES-NI-only appears to be a separate entity from NES+BE and BE-only in terms of its psychopathology. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

16 pages, 1173 KiB

Open AccessArticle

Dissociation and Suicidality in Eating Disorders: The Mediating Function of Body Image Disturbances, and the Moderating Role of Depression and Anxiety

by Yael Doreen Lewis, Shirley Kapon, Adi Enoch-Levy, Amit Yaroslavsky, Eliezer Witztum and Daniel Stein

J. Clin. Med. 2021, 10(17), 4027; https://doi.org/10.3390/jcm10174027 - 06 Sep 2021

Cited by 6 | Viewed by 3033

Abstract

In patients with eating disorders (EDs), elevated dissociation may increase the risk of suicide. Bodily related disturbances, depression, and anxiety may intervene in the association between dissociation and suicidality. In this study we aimed to examine the influence of bodily related disturbances, depression, anxiety, severity of ED symptoms, body mass index (BMI), and type and duration of the ED on the relationship between elevated dissociation and elevated suicidality. The study included 172 inpatients: 65 with anorexia nervosa restricting type, 60 with anorexia nervosa binge/purge type, and 37 with bulimia nervosa. Participants were assessed using self-rating questionnaires for dissociation, suicidality, bodily related parameters, and severity of ED symptomatology, depression, and anxiety. We found that dissociation and suicidality were directly associated. In addition, depression and anxiety moderated the mediating role of body image parameters in the association between increased dissociation and increased suicidality. Thus, only in inpatients with high depression and anxiety, i.e., above the median range, body image disturbances were found to mediate the association between dissociation and suicidality. ED-related parameters did not moderate these relationships. Our study demonstrates that in inpatients with EDs, increased dissociation may be significantly associated with increased suicidality, both directly and via the intervening influence of body image, depression, and anxiety. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

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14 pages, 289 KiB

Open AccessArticle

Validation of the Eating Disorder Examination Questionnaire in Danish Eating Disorder Patients and Athletes

by Mia Beck Lichtenstein, Lauge Haastrup, Karen Krogh Johansen, Jacob B. Bindzus, Pia Veldt Larsen, René Klinkby Støving, Loa Clausen and Jakob Linnet

J. Clin. Med. 2021, 10(17), 3976; https://doi.org/10.3390/jcm10173976 - 02 Sep 2021

Cited by 14 | Viewed by 3978

Abstract

The Eating Disorder Examination Questionnaire (EDE-Q) is a gold standard questionnaire to identify eating disorder symptoms but has not yet been validated in Danish. The scale consists of four theoretical constructs of disordered eating: Restraint eating, Eating concerns, Shape concerns and Weight concerns. However, the four-factor structure has been difficult to replicate across cultures. This study aimed to examine the factor structure and psychometric properties of the EDE-Q in Danish. The study consisted of four samples (aged 15–70): Patients with anorexia, bulimia and unspecified eating disorders (n = 101), patients with symptoms of binge-eating disorder (n = 300), recreational athletes (n = 404), and elite athletes (n = 526). Depending on the analysis performed, participants had to complete the EDE-Q, the SCOFF questionnaire for eating disorders or the Binge Eating Disorders Questionnaire. In accordance with international research, we found no evidence for a four-factor structure in the EDE-Q among patients or among athletes. But our results showed significant, positive associations between EDE-Q and SCOFF, BED-Q and MDI in all samples. We conclude that the internal structure of EDE-Q is low, while construct validity is high, making EDE-Q useful as an instrument to identify individuals with eating disorder symptoms, including recreational, and elite athletes. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

18 pages, 712 KiB

Open AccessArticle

Short-Term Outcome of Inpatient Treatment for Adolescents with Anorexia Nervosa Using DSM-5 Remission Criteria

by Dunja Mairhofer, Michael Zeiler, Julia Philipp, Stefanie Truttmann, Tanja Wittek, Katrin Skala, Michaela Mitterer, Gabriele Schöfbeck, Clarissa Laczkovics, Julia Schwarzenberg, Gudrun Wagner and Andreas Karwautz

J. Clin. Med. 2021, 10(14), 3190; https://doi.org/10.3390/jcm10143190 - 20 Jul 2021

Cited by 10 | Viewed by 3048

Abstract

This study evaluated the short-term outcome of a multimodal inpatient treatment concept for adolescents with anorexia nervosa (AN). In this prospective observational study, a cohort of 126 female adolescents with AN (age range: 11–17, mean age: 14.83) was longitudinally followed from admission to discharge (average duration of stay: 77 days). We used gold-standard clinical interviews and self-report data, as well as DSM-5 remission criteria, to evaluate the treatment outcome. From admission to discharge, body-mass-index (BMI) significantly improved by 2.6 kg/m². Data from clinical interviews and self-reports yielded similar improvements in restraint eating and eating concerns (large effects). Lower effects were observed for variables assessing weight/shape concerns and drive for thinness. At discharge, 23.2% of patients showed full remission of AN, 31.3% partial remission, and 45.5% no remission according to DSM-5 criteria. Differences in remission groups were found regarding AN severity, age at admission, and use of antidepressant medication. Living with both parents, longer duration of inpatient treatment and the use of antipsychotic medication were significantly associated with higher BMI change. The findings provide evidence for the short-term effectiveness of our inpatient treatment concept. We recommend using DSM-5 based remission criteria to evaluate the treatment outcome to improve the comparability of studies. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

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10 pages, 664 KiB

Open AccessArticle

Understanding Uncontrolled Eating after Bariatric Surgery: The Role of Excessive Skin and Body Image Shame

by Marta de Lourdes, Luísa Cerqueira, Ana Pinto-Bastos, João Marôco, Lara Palmeira, Isabel Brandão, Ana Rita Vaz and Eva Conceição

J. Clin. Med. 2021, 10(13), 2967; https://doi.org/10.3390/jcm10132967 - 01 Jul 2021

Cited by 3 | Viewed by 2137

Abstract

Excess skin and disordered eating behaviors are referred to as some of the major negative consequences of bariatric surgery as well as body image shame. This study sought to explore how discomfort with excessive skin, body image shame, psychological distress, eating-related psychopathology, and negative urgency interact to understand uncontrolled eating among woman submitted to bariatric surgery. A cross-sectional sample of 137 women was evaluated postoperatively through self-report questionnaires assessing discomfort with excess skin, body image shame, eating-related psychopathology, negative urgency, and uncontrolled eating in a hospital center in the north of Portugal. Pearson correlations and Structural Equation Modeling (SEM) were performed. Body image shame mediated the relationship between discomfort with excess skin and eating-related psychopathology. In turn, the relationship between eating-related psychopathology and uncontrolled eating was mediated by negative urgency. This study highlights the impact of excess skin and body image shame on eating behavior post-bariatric-surgery. Considering the proven impact of uncontrolled eating on weight-loss results post-surgery, understanding the mechanisms underlying this problem is highly important. Our findings provide helpful insight for multidisciplinary teams committed to providing care to bariatric patients struggling with body image and eating difficulties. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

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7 pages, 215 KiB

Open AccessArticle

Bodyweight Measures and Lifestyle Habits in Individuals with Multiple Sclerosis and Moderate to Severe Disability

by Moran Livne-Margolin, Itay Tokatly Latzer, Orit Pinhas-Hamiel, Gil Harari and Anat Achiron

J. Clin. Med. 2021, 10(10), 2083; https://doi.org/10.3390/jcm10102083 - 12 May 2021

Cited by 6 | Viewed by 1468

Abstract

Multiple sclerosis (MS) is a chronic disease marked by progressive disability and decreased mobility over time. We studied whether individuals with MS of higher disability levels will be more overweight/obese as a result of their immobility and/or recurrent steroid treatments. In a prospective study, 130 individuals with MS and significant disability were classified according to the Expanded Disability Status Scale (EDSS) score as belonging to four groups: EDSS 3.0–4.0 (n = 31, 24%), EDSS 4.5–5.5 (n = 24, 18%), EDSS = 6.0 (n = 44, 34%) and EDSS ≥ 6.5 (n = 31, 24%). Medical history, body mass index (BMI), waist circumference and the level of engagement in physical activity were obtained. The mean ± standard error age was 55.8 ± 0.5 years, disease duration 18.2 ± 1.0 years and EDSS score 5.5 ± 0.1. Disease duration, the number of steroid courses per disease duration, weight, BMI and physical activity did not differ according to the four disability groups. The mean waist circumference increased significantly with increased severity of EDSS, p = 0.03. Increased disability in individuals with MS was not correlated with disease duration, lifestyle habits or overweight/obesity. However, increased disability was associated with central obesity. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

12 pages, 262 KiB

Open AccessArticle

Explanatory Factors for Disease-Specific Health-Related Quality of Life in Women with Anorexia Nervosa

by Laura Al-Dakhiel Winkler, Claire Gudex, Mia Beck Lichtenstein, Michael Ejnar Røder, Carol E. Adair, Jan Magnus Sjögren and René Klinkby Støving

J. Clin. Med. 2021, 10(8), 1592; https://doi.org/10.3390/jcm10081592 - 09 Apr 2021

Cited by 4 | Viewed by 1850

Abstract

A better understanding of explanatory factors for disease-specific health-related quality of life (HRQoL) in anorexia nervosa (AN) could help direct treatment providers to aspects of the most relevance for patient wellbeing and recovery. We aimed to investigate whether factors associated with HRQoL are the same for women with AN and normal-weight controls. The participants in this study were women with AN recruited from specialized eating disorder centers in Denmark and healthy, normal-weight controls invited via online social media. Participants completed online questionnaires on medical history, disease-specific HRQoL (Eating Disorders Quality of Life Scale, EDQLS) and generic HRQoL (SF-36), eating disorder symptomatology, depression, psychological wellbeing, and work and social adjustment. Questionnaires were fully completed by 211 women with AN (median age 21.7 years) and 199 controls (median age 23.9 years). Women with AN had poorer scores on all measures, i.e., worse HRQoL, psychological health, and work/social functioning. Eating disorder symptomatology affected EDQLS score in both groups, but poorer HRQoL in women with AN was also significantly associated with worse scores on bulimia, maturity fears, depression, vitality, and with older age. The factors investigated together explained 79% of the variance in EDQLS score. Management of disordered self-assessment and thought processes may be of particular importance to women with AN. Greater emphasis on these aspects alongside weight gain could enhance patient–clinician alliance and contribute to better treatment outcomes. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

20 pages, 1356 KiB

Open AccessArticle

Comparison of Interview to Questionnaire for Assessment of Eating Disorders after Bariatric Surgery

by Inbal Globus, Harry R. Kissileff, Jeon D. Hamm, Musya Herzog, James E. Mitchell and Yael Latzer

J. Clin. Med. 2021, 10(6), 1174; https://doi.org/10.3390/jcm10061174 - 11 Mar 2021

Cited by 2 | Viewed by 2090

Abstract

The Eating Disorder Examination Interview Bariatric Surgery Version (EDE-BSV) assesses eating pathology after bariatric surgery but requires significant training and time to administer. Consequently, we developed a questionnaire format called the Eating Disorders After Bariatric Surgery Questionnaire (EDABS-Q). This study evaluates the consistency of responsiveness between the two formats. After surgery, 30 patients completed the EDE-BSV and EDABS-Q in a restricted randomized design. Patient reported behavior for each item which was converted to a score following the Eating Disorder Examination-Questionnaire (EDE-Q) scoring scheme. Responses fell into three distributions: (1) dichotomous, (2) ordinal, or (3) unimodal. Distributions of items were not different between the two formats and order did not influence response. Tests of agreement (normal approximation of the binomial test) and association (χ² analyses on binary data and spearman rank order correlations on ordinal items) were performed. Percent concordance was high across items (63–100%). Agreement was significant in 31 of 41 items (Bonferroni-P < 0.001). Association was significant in 10 of 21 in χ²–appropriate items (Bonferroni-P < 0.002), and the ordinal items had highly significant correlations between formats (Bonferroni-P < 0.0125). The EDABS-Q is an adequate substitute for the EDE-BSV and may be useful for research and clinical evaluation of eating pathology after bariatric surgery. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

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13 pages, 545 KiB

Open AccessArticle

A Retrospective Analysis Evaluating the Outcome of Parenteral Nutrition in the Treatment of Anorexia Nervosa in Korea

by Jeong-Kyung Ko, You-Kyung Lee, Jong Chun Na, Dong-Yeon Kim and Youl-Ri Kim

J. Clin. Med. 2020, 9(11), 3711; https://doi.org/10.3390/jcm9113711 - 19 Nov 2020

Cited by 2 | Viewed by 2032

Abstract

The objective of this study was to investigate the clinical efficacy of parenteral nutrition (PN) as supplemental feeding for patients with anorexia nervosa (AN). This study was conducted by reviewing the medical records of patients with AN who were hospitalized at a non-specialized ward. A total of 129 patients with AN were recruited, consisting of 67 patients received PN with oral refeeding and 62 patients received oral refeeding alone. We compared the weight gain at discharge and after discharge between the groups. As a result, at admission, the patients given supplementary PN had lower body mass indices and lower caloric intake than the patients without PN. The mean duration of PN was 8.5 days, which amounted to about a third of the average hospital stay with no difference between the groups. Both groups had similar weight gains during hospitalization, but the patients with PN had higher weight gains than the patients without PN at one and three months after discharge. In conclusion, the results suggest that supplementary PN in the early stage of refeeding might initiate weight gain in AN when nasogastric tube feeding is not possible. Randomized controlled trials are needed to be further tested of PN in treatment of AN. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

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Review

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16 pages, 7303 KiB

Open AccessReview

Review of Ireland’s First Year of the COVID-19 Pandemic Impact on People Affected by Eating Disorders: ‘Behind Every Screen There Was a Family Supporting a Person with an Eating Disorder’

by Harriet Parsons, Barry Murphy, Deirbhile Malone and Ingrid Holme

J. Clin. Med. 2021, 10(15), 3385; https://doi.org/10.3390/jcm10153385 - 30 Jul 2021

Cited by 14 | Viewed by 7562

Abstract

Irish society went into one of the most stringent lockdowns in March 2020 due to the COVID-19 pandemic, and barring a few weeks, remains highly restricted at time of writing. This has produced a wide range of challenges for those affected by eating disorders, as well as treatment services and Bodywhys, The Eating Disorders Association of Ireland. Current research indicates that COVID-19 has impacted across three key areas—the experience of those with an eating disorder, the experience of service provision, and the impact on the family situation. Drawing on monitoring and evaluation data gathered by Bodywhys, this paper details the challenges faced by those affected by eating disorders in Ireland and how the organisation responded to these challenges, providing support in various forms to people with eating disorders and their families. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

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15 pages, 317 KiB

Open AccessReview

A Comprehensive Review of Complications and New Findings Associated with Anorexia Nervosa

by Leah Puckett, Daniela Grayeb, Vishnupriya Khatri, Kamila Cass and Philip Mehler

J. Clin. Med. 2021, 10(12), 2555; https://doi.org/10.3390/jcm10122555 - 09 Jun 2021

Cited by 26 | Viewed by 6933

Abstract

Anorexia nervosa is a complex and deadly psychiatric disorder. It is characterized by a significant degree of both co-occurring psychiatric diseases and widespread physiological changes which affect nearly every organ system. It is important for clinicians to be aware of the varied consequences of this disorder. Given the high rate of mortality due to AN, there is a need for early recognition so that patients can be referred for appropriate medical and psychiatric care early in the course of the disorder. In this study, we present a comprehensive review of the recent literature describing medical findings commonly encountered in patients with AN. The varied and overlapping complications of AN affect pregnancy, psychological well-being, as well as bone, endocrine, gastrointestinal, cardiovascular, and pulmonary systems. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

16 pages, 2967 KiB

Open AccessReview

Repetitive Negative Thinking and Eating Disorders: A Meta-Analysis of the Role of Worry and Rumination

by Sara Palmieri, Giovanni Mansueto, Simona Scaini, Gabriele Caselli, Walter Sapuppo, Marcantonio M. Spada, Sandra Sassaroli and Giovanni Maria Ruggiero

J. Clin. Med. 2021, 10(11), 2448; https://doi.org/10.3390/jcm10112448 - 31 May 2021

Cited by 17 | Viewed by 4311

Abstract

The role of worry and rumination in eating disorders (EDs) is controversial. This meta-analysis of the literature is aimed at clarifying the relationship between repetitive negative thinking (RNT) and EDs. In accordance with the PRISMA criteria, a comprehensive search of the literature was conducted on PubMed and PsycInfo from inception to March 2021. Search terms: “eating disorder/anorexia/bulimia/binge eating disorder” AND “worry/rumination/brooding/repetitive thinking”. A manual search of reference lists was also run. Forty-three studies were included. RNT was found to be associated with anorexia, bulimia, and binge eating disorder. A moderating effect was found for “presence/absence ED diagnosis” and “subtype of ED symptom”. ED patients showed higher RNT than the general population. No differences were observed for age or between worry and rumination in the magnitude of their association with EDs. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

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12 pages, 2151 KiB

Open AccessReview

From Desire to Dread—A Neurocircuitry Based Model for Food Avoidance in Anorexia Nervosa

by Guido K. W. Frank

J. Clin. Med. 2021, 10(11), 2228; https://doi.org/10.3390/jcm10112228 - 21 May 2021

Cited by 7 | Viewed by 3323

Abstract

Anorexia nervosa is a severe psychiatric illness associated with food avoidance. Animal models from Berridge et al. over the past decade showed that environmental ambience, pleasant or fear inducing, can trigger either appetitive (desire) or avoidance (dread) behaviors in animals via frontal cortex, nucleus accumbens dopamine D1 and D2 receptors, and hypothalamus. Those mechanisms could be relevant for understanding anorexia nervosa. However, models that translate animal research to explain the psychopathology of anorexia nervosa are sparse. This article reviews animal and human research to find evidence for whether this model can explain food avoidance behaviors in anorexia nervosa. Research on anorexia nervosa suggests fear conditioning to food, activation of the corticostriatal brain circuitry, sensitization of ventral striatal dopamine response, and alterations in hypothalamic function. The results support the applicability of the animal neurocircuitry derived model and provide directions to further study the pathophysiology that underlies anorexia nervosa. Full article

(This article belongs to the Special Issue Special Updated Research on Eating Disorders: Medical Perspectives)

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