Bridging appetite and emotional dynamics: the oxytocinergic system as a therapeutic axis in feeding and eating disorders

Feeding and eating disorders represent some of the most devastating and paradoxical conditions in medicine, where the biological drive to survive collides with altered motivation, affect, and reward. Although neurobiological and metabolic research has substantially advanced our understanding of feeding and eating disorders, mechanism-driven therapeutic options remain limited. The oxytocinergic network has gained increasing attention for its dual capacity to regulate energy balance and socio-emotional processing. In this review, we systematically integrate preclinical and clinical evidence to position oxytocin as a unifying tunable axis across feeding and eating disorders. We critically synthesize current knowledge on the oxytocinergic system as a pivotal interface linking appetite regulation, reward circuitry, stress responsivity, and social cognition. By combining mechanistic findings from animal models of restrictive feeding, binge-like behavior, and activity-based anorexia with translational and clinical evidence in anorexia nervosa, binge eating disorder, and obesity, we provide a cohesive framework that bridges metabolic and affective dimensions of these conditions and highlights novel therapeutic opportunities. Across clinical populations, oxytocinergic alterations emerge as shaped by the phenotype, nutritional status, illness chronicity, and oxytocin receptor genetic/epigenetic variability, with partial dissociation between peripheral and central effects. Convergent animal and translational studies position oxytocin as a circuit-level modulator of feeding-reward-stress integration, although current intranasal approaches yield modest and domain-specific clinical effects. Conceptualizing the oxytocinergic system as an integrator of metabolic and affective signaling strengthens its positioning as a pharmacological target and supports the development of precision-guided oxytocinergic interventions in feeding and eating disorders.