Abstract
Energy balance is controlled by various long- and short-term regulatory mechanisms that influence food intake and energy expenditure. The central nervous system carries out this regulation in cooperation with many peripheral regulatory elements (hormones, neuropeptides of the gastrointestinal tract, adipose tissue, and microbiome) that interact. Generally, feeding and appetite are regulated by the dynamic interplay of homeostatic, hedonic, and cognitive (learning, inhibitory, top-down self-control) neurocircuits. Homeostatic regulation of the appetite is located mainly in the hypothalamus. Central and peripheral factors affecting food intake contribute to a complex network of hypothalamic signaling with the appetite-inhibitory and appetite-stimulatory circuits, which oppose each other. Disruption of hypothalamic homeostatic balance and a disbalance in hedonic (reward system) and cognitive (inhibitory) neurocircuits contribute to a variety of extremes in eating behavior and eating disorders. However, imbalances in any single factor involved in feeding regulation cannot explain the complexity of regulatory pathways or the multiple individual developmental factors that are thought to be associated with eating disorders. The importance of the interplay between diets, brain neurocircuits, and hypothalamus energy homeostasis must be clarified under normal and pathological conditions. Some alterations in the abundance of neuropeptides normalize after recovery in patients with anorexia nervosa (AN) or bulimia nervosa (BN), suggesting that malnutrition can cause transitional disturbances. However, imbalances do not normalize in others, and, for example, those with AN or BN often fail to reverse imbalances linked to their illness, and disease symptoms can persist long after weight recovery.
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The study was supported by the Ministry of Health of the Czech Republic, grant nr. NU20-04-00088, NU22-04-00010 and NU23-04-00381.
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Prochazkova, P., Roubalova, R., Papezova, H. (2023). Central Modulators of Appetite in Eating Disorders. In: Robinson, P., Wade, T., Herpertz-Dahlmann, B., Fernandez-Aranda, F., Treasure, J., Wonderlich, S. (eds) Eating Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-97416-9_112-1
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