Cited by 26Eating Disorders and BehaviorsRegulation of Appetite and ObesityHypothalamic control of reproductive hormones

The importance of the hypothalamo-pituitary-adrenal axis as a therapeutic target in anorexia nervosa

Bou Khalil, Rami, Souaiby, Lama, Farès, Nassim·2017·Physiology & Behavior

Abstract

Anorexia nervosa (AN) is an eating disorder, mainly affecting women, with a lifetime prevalence of about 1%, that can run a chronic course. While an effective pharmacotherapy is lacking, it is hypothesized that the progesterone and type II glucocorticoid receptor antagonist mifepristone (RU486) might be useful, as it is well known that the hypothalamo-pituitary-adrenal axis (HPA) is activated in AN. Even if secondary to the eating disorder, an active HPA axis may contribute to maintaining the neuroendocrine, emotional and behavioral effects observed in AN. More specifically, it is suggested that the HPA axis interacts with limbic structures, including the insular and prefrontal cortices, to uphold the changes in interoceptive and emotional awareness seen in AN. As such, it is proposed that mifepristone (RU486) reverses these effects by acting on these limbic regions. In conclusion, the theoretical efficacy of mifepristone (RU486) in improving symptoms of AN should be tested in randomized clinical trials.

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Crossref · 10.1016/j.physbeh.2016.12.035

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Authors
Bou Khalil, R., Souaiby, L., & Farès, N.
Affiliations
Saint Joseph University (LB)
Venue
Physiology & Behavior
Publisher
Elsevier BV
Published
2017-03
Volume
171
Pages
13-20
ISSN
0031-9384 (ISSN-L)
OpenAlex
W2567082966
Cited by
26
References
115
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 6 · 2019: 3 · 2018: 4 · 2017: 1
FWCI
0.40
Type
journal article
Language
en
Open access
closed
Locations
  • Physiology & Behavior (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords
anorexia nervosa, hypothalamic-pituitary-adrenal axis, mifepristone, RU486, progesterone, limbic system, insula, prefrontal cortex, interoception, emotional awareness, neuroendocrine dysfunction, pharmacotherapy
MeSH terms
Animals, Anorexia Nervosa, Hormone Antagonists, Humans, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Mifepristone

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