This paper reviews the recent progress in the understanding of the neurobiology of the
eating disorders. The analysis of the biochemical abnormalities present in the patients with
bulimia nervosa indicates the decrease of central
serotonin and noradrenalin activity, elevation of the levels of cerebrospinal fluid
peptide YY, alterations of the endogenous
opioids and also reduction of peripheral
cholecystokinin levels. As these studies were performed on patients who were actively binging and purging it is conceivable that the above abnormalities can results from a pathological feeding pattern. It is also suggested that the reduction of central serotoninergic activity is the stable, trait-related dysregulation of
neurotransmitter system activity. In patients with
anorexia nervosa the endocrine disturbances of the hypothalamic-pituitary-ovarian and hypothalamic-pituitary-adrenal axes were thoroughly studied. Underweight
anorectic patients have been found to have elevations of cerebrospinal fluid level of
neuropeptide Y,
corticotropin releasing hormone and
vasopressin as well as reductions of
beta-endorphin and
oxytocin level. However, most of the
neuropeptide alterations normalize following weight recovery. The only exception is a persistent increase of central
serotonin activity postulated to be responsible for the
obsessive-compulsive personality traits and disturbed eating behaviors found in these patients.