2022 Volume 62 Issue 1 Pages 57-64
This article reviews the pathogenesis and psychosomatic correlates of anorexia nervosa (AN), one of the most common endocrine psychosomatic disorders. The hypothalamic-pituitary-adrenal (HPA) axis is a major component of the stress system, and the HPA axis is activated by the effects of starvation in AN. The hypothalamic-pituitary-gonadal axis and the growth hormone-insulin-like growth factor-1 axis are also abnormal in AN. Furthermore, feeding-regulation hormones, cytokines, and the autonomic nervous system are altered in AN. Recently, functional brain imaging analysis and findings from gut microbiota studies have provided new insights into the cognitive and behavioral features of AN. AN is classified as a psychiatric disorder with a core pathology of desire for thinness and fear of weight gain. However, the bio-psycho-social perspective is important for understanding the pathogenesis of AN. It is expected that further elucidation of the pathological mechanisms of AN will be achieved through the development and integration of each research field.
