Infections and Drugs to Treat Them Tied to Eating Disorders in Teens

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A new study adds to growing evidence that immune system dysfunction and altered gut microbes may contribute to the development of eating disorders.

When Cynthia Bulik started studying eating disorders back in the early 1980s, what she read in the scientific literature clashed with what she saw in the clinic. At the time, theories about the causes of these conditions were focused primarily on explanations based on family dynamics and sociocultural factors.

These descriptions could not explain how, despite dangerously low body weights, patients with eating disorders were often “hyperactive and said they felt well, and only started feeling poorly when we nourished them,” says Bulik, who is currently a professor at both the University of North Carolina and the Karolinska Institute in Sweden. “I became convinced that there had to be something biological going on.”

Since then, a growing body of research has confirmed Bulik’s observations. Cases of individuals developing rapid alterations in eating behaviors after various infections — the first of which emerged nearly a century ago — have built up over decades. For example, symptoms of eating disorders often occur in pediatric acute-onset neuropsychiatric syndrome (PANS), a condition in which children experience sudden behavioral changes, typically after a streptococcal infection. In addition, over the last few years, several large-scaleepidemiological investigations based on data from population registers in Scandinavia — compiled by Bulik and others — have linked eating disorders and autoimmune diseases, including Crohn’s, celiac and type 1 diabetes.

Now, Bulik and her colleagues have tied exposure to infections during childhood to an increased risk of developing eating disorders in a large, population-based examination.

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