Anorexia Nervosa

An eating disorder that is characterized by the lack or loss of APPETITE, known as ANOREXIA. Other features include excess fear of becoming OVERWEIGHT; BODY IMAGE disturbance; significant WEIGHT LOSS; refusal to maintain minimal normal weight; and AMENORRHEA. This disorder occurs most frequently in adolescent females. (APA, Thesaurus of Psychological Index Terms, 1994)

Also Known As:

Networked: 2127 relevant articles (76 outcomes, 332 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Weight Gain
2.	Bulimia Nervosa
3.	Binge-Eating Disorder (Binge Eating Disorder)
4.	Eating Disorders (Eating Disorder)
5.	Obsessive-Compulsive Disorder (Disorder, Obsessive-Compulsive)

Experts

1.	Klibanski, Anne: 48 articles (09/2015 - 06/2002)
2.	Misra, Madhusmita: 37 articles (01/2015 - 08/2003)
3.	Miller, Karen K: 33 articles (09/2015 - 08/2003)
4.	Herzog, David B: 29 articles (08/2015 - 08/2003)
5.	Kaye, Walter H: 28 articles (08/2014 - 11/2002)
6.	Treasure, Janet: 17 articles (08/2014 - 04/2005)
7.	Monteleone, Palmiero: 16 articles (01/2016 - 12/2003)
8.	Lawson, Elizabeth A: 16 articles (09/2015 - 06/2007)
9.	Inui, Akio: 16 articles (09/2015 - 12/2004)
10.	Bulik, Cynthia M: 15 articles (10/2015 - 09/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Anorexia Nervosa:

1.	olanzapine (Zyprexa)FDA Link 11/01/2007 - "This paper was written with three main objectives in mind: to comment on some of the barriers impeding mental health research in general, to highlight challenges faced in the design and implementation of ED-specific studies, and to integrate personal insight into some of the many challenges that we have encountered during our experience with a randomized clinical trial examining the efficacy of olanzapine for the adjunctive treatment of youth with Anorexia Nervosa. " 03/01/2006 - "Several studies have shown that olanzapine is effective in weight restoration and maintenance for patients with anorexia nervosa (AN). " 10/01/2015 - "Olanzapine (OLZ), an atypical antipsychotic, can be effective in treating patients with restricting type anorexia nervosa who exercise excessively. " 03/01/2012 - "This case supports the need for adequately powered, controlled clinical trials to test the efficacy of olanzapine in adolescents presenting with anorexia nervosa." 04/01/2010 - "The aim of this study was to evaluate the efficacy of olanzapine in girls with anorexia nervosa, restricting subtype (ANr). "
2.	Fluoxetine (Prozac)FDA LinkGeneric 06/01/2003 - "Although fluoxetine appears to be promising for the treatment of patients with anorexia nervosa, further studies need to be performed with a larger sample size and/or better design." 06/01/2003 - "Studies conducted on the efficacy of fluoxetine in treating anorexia nervosa have conflicting results. " 05/01/2003 - "This study evaluated the efficacy of nutritional management with and without fluoxetine (FLX) in anorexia nervosa diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. " 06/01/1999 - "Limited research has been conducted on the treatment of anorexia nervosa, although preliminary studies suggest that psychotherapy and fluoxetine may be helpful in preventing relapse after weight restoration." 01/01/2004 - "Use of nutritional supplements to increase the efficacy of fluoxetine in the treatment of anorexia nervosa."
3.	Antipsychotic Agents (Antipsychotics)IBA 06/01/2007 - "Atypical antipsychotics may be beneficial in treating the core psychopathology of anorexia nervosa (AN). " 06/01/2012 - "Are antipsychotics effective for the treatment of anorexia nervosa? " 03/01/2005 - "A systematic review of clinical, neurobiological and functional neuroimaging findings of serotonergic and dopaminergic system activity in anorexia nervosa was conducted via MEDLINE, PsycINFO and EMBASE psychiatry databases, with a critical review of dysregulation of these systems as therapeutic targets for atypical antipsychotics, in context of evidence regarding the utility and efficacy of these medications in this syndrome. " 01/01/2014 - "There are currently few studies focusing on the efficacy of long-term atypical antipsychotics to treat anorexia nervosa in the pediatric population. " 08/01/2012 - "Antipsychotic agents in the treatment of anorexia nervosa: neuropsychopharmacologic rationale and evidence from controlled trials."
4.	Serotonin (5 Hydroxytryptamine)IBA 01/01/2004 - "Selective serotonin reuptake inhibitor (SSRI) medication does not appear to be effective in ill, malnourished anorexia nervosa (AN) patients. " 01/01/1999 - "Are serotonin selective reuptake inhibitors effective in underweight anorexia nervosa?" 05/01/2007 - "Many studies have found disturbances of serotonin (5-HT) activity in anorexia nervosa (AN). " 04/01/2006 - "In addition, clinical studies suggest a possible role for 5-HT in the etiology of anorexia nervosa. " 02/01/2006 - "Biochemical, genetic and imaging studies support the involvement of the serotonin (5-HT) system in anorexia nervosa. "
5.	HormonesIBA 01/01/1981 - "These data suggest that 1) the abnormal responses of some hormones to provocation tests observed in obese patients and patients with anorexia nervosa should be evaluated in consideration of changes in the DV and metabolic clearance of hormones in these conditions, and 2) in patients with anorexia nervosa changes in MCR and t 1/2 may reflect low metabolism of LRH." 01/01/2015 - "Whether these hormone pathways play etiologic roles with regard to anorexia nervosa behavioral types or are compensatory merits further study." 10/01/2010 - "Studies in patients with anorexia nervosa (AN) suggest an abnormal expression of appetite-regulating hormones. " 01/01/2002 - "The aim of this study was to assess the relationship between plasma LEP levels and nutritional state, secretion of hormones of the hypothalamic-pituitary axis, and personality traits in patients with anorexia nervosa (AN). " 12/01/1998 - "Hence, clinical studies pertaining to anorexia nervosa can serve to further elucidate the functions of this hormone in light of the unique features of this disorder. "
6.	Growth Hormone (Somatotropin)IBA 06/28/2013 - "The growth hormone (GH)–insulin-like growth factor-1 (IGF-1) axis is dramatically altered in patients with anorexia nervosa (AN). " 06/28/2013 - "Growth hormone level at admission and its evolution during refeeding are predictive of short-term outcome in restrictive anorexia nervosa." 01/01/2010 - "Fibroblast growth factor-21 may mediate growth hormone resistance in anorexia nervosa." 06/01/2008 - "Nadir growth hormone levels predicted height SD scores and predicted adult-height SD scores in controls but not in the girls with anorexia nervosa. " 12/01/2003 - "Alterations in growth hormone secretory dynamics in adolescent girls with anorexia nervosa and effects on bone metabolism."
7.	Serotonin Uptake Inhibitors (Serotonin Reuptake Inhibitors)IBA 01/01/2015 - "[A Case of Anorexia Nervosa with Chewing and Spitting Improved by Treatment with Selective Serotonin Reuptake Inhibitors]." 10/04/1997 - "Selective serotonin reuptake inhibitors in anorexia nervosa." 05/01/2005 - "Although selective-serotonin-reuptake-inhibitors (SSRI) have been of limited efficacy in the treatment of eating disorder psychopathology and comorbid symptoms of malnourished patients with anorexia nervosa (AN), there is recent data suggesting that SSRI may play a role in preventing relapse among weight-restored patients. " 09/01/2004 - "Animal studies have led to promising results; we might use medicine, such as serotonin reuptake inhibitors or opioid antagonists in the treatment of hyperactivity in anorexia nervosa." 03/01/2012 - "No studies have compared the response to selective serotonin reuptake inhibitors and atypical antipsychotics in anorexia nervosa. "
8.	erucylphosphocholineIBA 05/01/2007 - "The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on efficacy of treatment for anorexia nervosa (AN), harms associated with treatments, factors associated with treatment efficacy, and differential outcome by sociodemographic characteristics. " 04/01/2006 - "The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on efficacy of treatment for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), harms associated with treatments, factors associated with the treatment efficacy and with outcomes of these conditions, and whether treatment and outcomes for these conditions differ by sociodemographic characteristics. "
9.	LeptinIBA 01/01/2014 - "Inverse relationship between leptin increase and improvement in depressive symptoms in anorexia nervosa." 10/01/2010 - "The purpose of this study was to assess leptin levels and other biological variables in a population of anorexia nervosa patients. " 10/01/2009 - "Observational and interventional studies in humans with (complete) congenital leptin deficiency caused by mutations in the leptin gene or with relative leptin deficiency as seen in states of negative energy balance such as lipoatrophy, anorexia nervosa, or exercise-induced hypothalamic and neuroendocrine dysfunction have contributed to the elucidation of the pathophysiological role of leptin in these conditions and of the clinical significance of leptin administration in these subjects. " 06/15/2009 - "Results from studies in patients with anorexia nervosa (AN) showed an association between excessive physical activity (PA) and leptin. " 11/01/2006 - "Thus, interventional studies involving administration of recombinant leptin are required to fully clarify the physiologic and potentially therapeutic role of leptin in anorexia nervosa."
10.	Hydrocortisone (Cortisol)FDA LinkGeneric 12/01/2002 - "Treatment of the underlying adrenocortical insufficiency with cortisol supplements has been shown to be effective in five previously published cases of diagnosed anorexia nervosa." 12/01/2014 - "The aim of this study was to examine the features and changes of the cortisol awakening response (CAR) in patients with anorexia nervosa (AN) with severe and less severe symptoms over the course of inpatient treatment. " 01/01/2000 - "It is suggested that more sensitive profiling of cortisol levels throughout the circadian cycle may be useful in future studies of cognitive function in anorexia nervosa." 09/01/2015 - "In anorexia nervosa (AN), a low-BMI state, cortisol measures are elevated. " 11/01/2011 - "Changes in salivary cortisol levels as a prognostic predictor in children with anorexia nervosa."

Therapies and Procedures

1.	Enteral Nutrition (Feeding, Tube) 08/01/2007 - "Despite the high mortality rate in malnourished anorexia nervosa (AN) patients, very few trials have prospectively studied the efficacy of tube feeding. " 08/01/2007 - "A randomized trial on the efficacy of a 2-month tube feeding regimen in anorexia nervosa: A 1-year follow-up study." 12/01/2009 - "In the aim to explore the efficacy of tube feeding (TF) in ambulatory anorexia nervosa (AN) patients, we prospectively treated 60 AN patients by tube feeding (TF) at home, using a nasogastric tube. " 07/01/2003 - "Efficacy of voluntary nasogastric tube feeding in female inpatients with anorexia nervosa." 10/01/2007 - "We previously showed in an open study that nasogastric tube feeding (TF) reduced binges and purging in patients with anorexia nervosa. "
2.	Drug Therapy (Chemotherapy) 04/01/2008 - "For anorexia nervosa (AN), there are no pharmacotherapies of proven efficacy in either adults or youths. " 01/01/2014 - "Meta analysis on the efficacy of pharmacotherapy versus placebo on anorexia nervosa." 11/01/2007 - "To date, studies addressing the role of pharmacotherapy in the treatment of anorexia nervosa are limited, especially in childhood and adolescence. " 09/01/2011 - "Pharmacotherapy of anorexia nervosa: more questions than answers." 03/01/2007 - "Anorexia nervosa (AN) is a disorder that is difficult to treat with psycho- or pharmacotherapy. "
3.	Estrogen Replacement Therapy 12/01/2011 - "In contrast, transdermal estrogen replacement is effective in increasing bone accrual in adolescents with anorexia nervosa, although not to the extent seen in controls. " 08/01/2013 - "We hypothesized that physiologic estrogen replacement would ameliorate anxiety and improve eating attitudes without affecting body image in anorexia nervosa. " 08/01/2013 - "The impact of estrogen replacement on anxiety, eating attitudes, and body image has not been reported in anorexia nervosa. " 08/01/2013 - "Impact of physiologic estrogen replacement on anxiety symptoms, body shape perception, and eating attitudes in adolescent girls with anorexia nervosa: data from a randomized controlled trial." 10/01/2011 - "Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa."
4.	Nursing Care 10/01/2009 - "However, only limited evidence is available on what patients with anorexia nervosa themselves consider important and effective in terms of nursing care. " 02/01/2011 - "The purpose of this study was to discover which aspects of nursing care are most effective, according to nurses, in recovery of normal body weight in adolescents with anorexia nervosa. " 10/01/2009 - "The purpose of this study is to develop - from the patients' perspective - a tentative theoretical model explaining the effectiveness of inpatient nursing care of adolescents diagnosed with anorexia nervosa. " 04/11/1984 - "Nursing care study: anorexia nervosa." 10/09/1980 - "Nursing care study.--Anorexia nervosa: a daunting prospect."
5.	Deep Brain Stimulation 06/01/2013 - "In "Bedside to Bench", Eric Nestler discusses two trials of individuals with anorexia nervosa in which deep brain stimulation of different brain areas resulted in improvement of behavioral domains associated with the syndrome. " 04/20/2013 - "Subcallosal cingulate deep brain stimulation for treatment-refractory anorexia nervosa: a phase 1 pilot trial." 07/01/2015 - "We examined whether those with treatment refractory anorexia nervosa undergoing deep brain stimulation (DBS) of the subcallosal white matter (SCC) show: (1) altered anatomical SCC connectivity compared to healthy controls, (2) white matter microstructural changes, and (3) microstructural changes associated with clinically-measured affect. " 01/01/2014 - "Recently there has been emerging clinical and research interest in the application of deep brain stimulation (DBS) and repetitive transcranial magnetic stimulation (rTMS) to the treatment of anorexia nervosa (AN). " 01/01/2014 - "Targeting emotion circuits with deep brain stimulation in refractory anorexia nervosa."