The World Federation of Societies of Biological Psychiatry (WFSBP) has reached consensus on candidate biomarkers for anorexia nervosa and published a statement.
Lead author on the consensus statement is Dr Hubertus Himmerich, Clinical Reader at the King's IoPPN, consultant psychiatrist at the South London and Maudsley NHS Foundation Trust and part of the NIHR Maudsley BRC's theme on obesity and eating disorders. Professor Janet Treasure (Professor of Adult Psychiatry, IoPPN), Dr Johanna L. Keeler (Visiting Lecturer, IoPPN), Rebecca Morris (NIHR BRC PhD student) and Namrata Dhopatkar (NIHR pre-doctoral fellow) have also been key contributors and co-authors of this WFSBP consensus statement.
In the document scientists have listed and explained the various biological clues that help to better understand anorexia nervosa. Among these are physical signs like body weight and heart health, clinical laboratory parameters such as white blood cells, molecular, e.g. genetic markers, brain-related markers such as the brain's volume, as well as smart phone data to track behaviour.
The international task force consisted of 53 leading eating disorders experts from Africa, Asia, Australia, Europe, and the Americas, and was led by Dr Hubertus Himmerich.
Increasing awareness of biological factors in anorexia
In recent years, there has been an increasing recognition of the biological factors related to anorexia nervosa and the physical health consequences of it. For the first time the WFSBP task force has suggested a comprehensive list of biomarkers so those working in eating disorders can assess and further research these factors.
This consensus statement synthesizes current research on the biological markers of anorexia nervosa. A robust body of evidence - spanning genetics, epigenetics, gastroenterology, endocrinology, and neuroscience-strongly supports a biological basis for the disorder. This paper examines the clinical significance of the processes that synthesize fat metabolism, the gut microbiome, and antibodies produced by the immune system which errouneously target hormones that regulate appetite. Finally, it outlines strategic directions for future biological research in the field.
Dr Hubertus Himmerich
Key insights from the statement
Some of the key findings included and discussed in the statement were:
- Genetic research that supports the view that anorexia nervosa is both a psychiatric and a metabolic disorder.
- Epigenetic research demonstrating a correlation between anorexia nervosa and disruption in the balance of cholesterol and synthesis of fats, impaired signal transduction across cellular membranes, and diseases of connective tissue.
- Studies showing disturbances in the microbiome, changes in the production of antibodies and the abnormal secretion of molecules that regulate the activity of the immune system all play a significant role in the development of anorexia nervosa.
- Smartphones offer a valuable approach to record useful digital biomarkers for diagnostic and therapeutic purposes.
Through this consensus statement and the work that will arise from it, the authors hope that biological markers will be able to help doctors detect anorexia early and provide more personalised, more targeted and safer treatments.
World Federation of Societies of Biological Psychiatry (WFSBP) consensus statement on candidate biomarkers for anorexia nervosa by Himmerich, H. et al was published in the World Journal of Biological Psychiatry.
