Recent Developments in the Treatment of Anorexia Nervosa

Anorexia Nervosa (AN) is a psychiatric, eating disorder characterised by three core symptoms, (a) the persistent restriction of eating leading to significantly low body weight relatively to health norms, (b) an intense fear of gaining weight or of becoming fat, or persistent related behaviours, even though one is underweight and (c) disturbance in the way one’s body weight or shape is experienced, undue influence of body shape and weight on self-regard, or persistent lack of recognition of the seriousness of the current low body weight (DSM-V, 2013).

AN is associated with more deaths than any other mental disorder. Unfortunately, its cause is unknown and there is currently no evidence-based treatment. Research on animals has been used to try to study the role of chemical messengers in the brain, such as dopamine and serotonin, that may affect how patients experience their need and desire for food, as well as their fears of gaining weight. Unfortunately, the results are currently mixed. In this context, a recent development is the study of a different chemical called ‘oxytocin’. Oxytocin is known as a ‘peptide’ that has a well-recognized role in the body. It acts as a hormone helping lactation, pregnancy and parenting. In recent years it has also been understood that oxytocin also acts like a messenger in the brain, influencing a range of social behaviors, including trust, empathy, and sensitive parenting. Although, recent research shows that the effects of oxytocin are more nuanced than previously thought (Bartz et al., 2011), a group of researchers has recently explored the potential of using ‘intranasal’ oxytocin, that is oxytocin that can be safely administered by the nose, to treat AN.

The study conducted in South Korea in collaboration with researchers in London, UK, found that intranasal oxytocin as compared to placebo led 31 women with AN to pay less attention to images of food and fatter body shapes. The researchers suggested that oxytocin may thus be able to reduce these patients usual, obsessional focus on eating and body shape. However, it is important to note that oxytocin had no effect on the amount of juice consumed in either the AN or the control group of the study. Moreover, before we can conclude that oxytocin can be used to treat AN, we will need different kind of studies to be conducted, in which oxytocin is administered for longer periods of time and food intake, weight, body image distortions and other relevant facets of AN are carefully studied.
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American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing

Kim Y, Kim C, Cardi V, et al. Intranasal oxytocin attenuates attentional bias for eating and fat shape stimuli in patients with anorexia nervosa. Psychoneuroendocrinology, Volume 44, June 2014, Pages 133-142.

Bartz JA, Zaki J, Bolger N, Ochsner KN. Social effects of oxytocin in humans: context and
person matter. Trends Cogn Sci 2011; 15:301–9.