Undernutrition and pituitary function: relevance to the pathophysiology of some neuroendocrine alterations of anorexia nervosa

Introduction Interest in anorexia nervosa (AN) has grown remarkably in recent years, the surge of interest in public attention probably reflecting an increase in the incidence of the disease. Recent studies have found, in fact, that AN may affect as many as 0·8% of particularly susceptible groups, such as middle-class, late-adolescent girls (Culberg & Engstrom-Lindberg, 1988). From a clinical viewpoint the disease is characterized by an autoinduced starvation due to a relentless and pathological pursuit of thinness, a distortion of body image, unusual food-related behaviours and amenorrhoea. In the disease, psychological, biological, familial and sociocultural factors are thought to be important for the development and expression of the behavioural aberrations, even though the relative contribution of each factor may be different among a heterogenous population of subjects. Among the biological abnormalities which characterize AN, a major role is that taken by the neuroendocrine abnormalities and a major issue has been