Anorexia and Autoimmunity: Challenging the Etiologic Constructs of Disordered Eating

* Abbreviations: PANDAS — : Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections PANS — : Pediatric Acute-onset Neuropsychiatric Syndrome Eating disorders, particularly anorexia and bulimia nervosa, have traditionally been viewed as arising from a conglomeration of psychological, biological, and sociocultural factors.1 Family and individual psychotherapy are mainstays of treatment, but not all youth respond to these interventions, leaving patients at increased risk of death from suicide or medical consequences of their disordered eating.1,2 The need for new and more effective treatments has prompted investigations into the role of immune function in anorexia and bulimia. Similar lines of research have proven fruitful for a variety of mood, psychotic, and neurodevelopmental disorders, which have been linked to immune dysfunction via epidemiologic, genetic, and immunologic studies.3 A few studies in adult populations have found that eating disorders and autoimmune disease each confer an increased risk for the other disorder, but the role that immune disturbances might play in the onset of eating disorders among youth remains largely unexplored.4,5 In “Eating Disorders, Autoimmune, and Autoinflammatory Disease,” Zerwas et al6 address these gaps in the literature by documenting bidirectional associations between autoimmune and/or autoinflammatory diseases and eating disorders in a large, population-based cohort study of … Address correspondence to Rebecca E. Hommer, MD, NIH/NIMH/SBP, 10 Center Dr, MSC 1255, Bethesda, MD 20892-1255. E-mail: rebecca.hommer{at}nih.gov