Dysbiosis in Anorexia Nervosa: restrictive diets' impact and the role of gastrointestinal microbiota in improving patients' care

Abstract

Anorexia Nervosa is the psychiatric disease with the highest mortality rate. Despite its severity, this disorder remains poorly understood, with only moderately effective treatment and frequent relapse. Emerging evidence on both the communication between gastrointestinal microbiota and the brain, through the gut-brain axis, and its influence on weight, anxiety and depression makes the gut microbiota an enticing potential target for novel therapeutic approaches. Using PubMed, a literature research was conducted to obtain English-written articles about the relationship between the gastrointestinal microbiota and Anorexia Nervosa. Thus, the present narrative review exposes the current state of knowledge on both the composition and the role of intestinal microbiota in AN, analyses the impact of dietary changes in this ecosystem and highlights the potential therapeutic applications of gut microbiota modulation, particularly in what concerns the reduction of discomfort during refeeding. Even though restoring the equilibrium of intestinal microbiota looks promising, the investigation in this field is currently in its beginning, with only a few studies on dysbiosis reporting inconsistent results and making further investigation crucial. Thus, this narrative review aims to congregate the current knowledge on the topic to guide future investigation advances.