A critical analysis of eating disorders and the gut microbiome
Open accessAbstract
The gut microbiota, also known as our “second brain” is an exciting frontier of research across a multitude of health domains. Gut microbes have been implicated in feeding behaviour and obesity, as well as mental health disorders including anxiety and depression, however their role in the development and maintenance of eating disorders (EDs) has only recently been considered. EDs are complex mental health conditions, shaped by a complicated interplay of factors. Perhaps due to an incomplete understanding of the etiology of EDs, treatment remains inadequate with affected individuals likely to face many relapses. The gut microbiota may be a missing piece in understanding the etiology of eating disorders, however more robust scientific inquiry is needed in the field before concrete conclusions can be made. In this spotlight paper, we critically evaluate what is known about the bi-directional relationship between gut microbes and biological processes that are implicated in the development and maintenance of EDs, including physiological functioning, hormones, neurotransmitters, the central nervous system, and the immune system. We outline limitations of current research, propose concrete steps to move the field forward and, hypothesize potential clinical implications of this research. Plain English summary: Our gut is inhabited by millions of bacteria which have more recently been referred to as “our second brain”. In fact, these microbes are thought to play a role in ED behaviour, associated anxiety and depression, and even affect our weight. Recent research has dove into this field with promising findings that have the potential to be applied clinically to improve ED recovery. The present paper discusses what is known about the gut microbiome in relation to EDs and the promising implications that leveraging this knowledge, through fecal microbiome transplants, probiotics, and microbiome-directed supplemental foods, could have on ED treatment.
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Accumulating evidence suggests that the microbiota influences the regulation of appetite, eating behavior, common mental illnesses, immunity, and emotional states.
“Accumulating evidence suggests that the microbiota influences the regulation of appetite, eating behavior, common mental illnesses, immunity, and even emotional states [89,90].”
From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [89]
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- Authors
- Terry, S. M., Barnett, J. A., & Gibson, D. L.
- Affiliations
- University of British Columbia, Okanagan Campus (CA)
- University of British Columbia (CA)
- Corresponding author
- Gibson, Deanna L.
- Venue
- Journal of Eating Disorders
- Published
- 2022-11-03
- Volume
- 10
- Issue
- 1
- Pages
- 154-154
- ISSN
- 2050-2974 (ISSN-L)
- PMC
- PMC9635068
- OpenAlex
- W4308183909
- Cited by
- 40
- References
- 64
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 13 · 2023: 7
- FWCI
- 7.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Eating Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Natural Sciences and Engineering Research Council of Canada,Canada
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- eating disorders, gut microbiota, gut-brain axis, etiology of eating disorders, anxiety, depression, obesity, neurotransmitters, hormones, immune system, fecal microbiota transplantation, probiotics, eating disorder treatment
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