SPOTLIGHT
A new conceptual model for anorexia nervosa: A role for connective tissue?
Dennis Gibson MD,
Philip S. Mehler MD,
Corresponding Author
Dennis Gibson MD
ACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, Denver, Colorado, USA
Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
Correspondence
Dennis Gibson, ACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, 723 Delaware St, Denver, CO 80204, USA.
Email: [email protected]
Contribution: Conceptualization, Writing - original draft
Search for more papers by this authorPhilip S. Mehler MD
ACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, Denver, Colorado, USA
Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
Eating Recovery Center, Denver, Colorado, USA
Contribution: Writing - review & editing
Search for more papers by this authorDennis Gibson MD,
Philip S. Mehler MD,
Corresponding Author
Dennis Gibson MD
ACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, Denver, Colorado, USA
Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
Correspondence
Dennis Gibson, ACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, 723 Delaware St, Denver, CO 80204, USA.
Email: [email protected]
Contribution: Conceptualization, Writing - original draft
Search for more papers by this authorPhilip S. Mehler MD
ACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, Denver, Colorado, USA
Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
Eating Recovery Center, Denver, Colorado, USA
Contribution: Writing - review & editing
Search for more papers by this authorFirst published: 19 February 2024
Action Editor: Ata Ghaderi
Abstract
The etiology of anorexia nervosa (AN) remains to be fully elucidated, and current theories also fail to account for the direct effect of starvation on the health of the organs and tissues, specifically the connective tissue present in most organs of the body. Individuals with hereditary disorders of connective tissue manifest with clinical symptoms that overlap with AN, as the abnormal connective tissue also contributes to many of the other extra-articular manifestations of these hereditary disorders. This article hypothesizes that a similar pathophysiology may also contribute to the clinical presentation of AN. Therefore, a better understanding is needed to elucidate: (1) the relationship between abnormal connective tissue and AN, (2) the impact of starvation toward the development of abnormal connective tissue and how this manifests clinically, (3) the etiology of autonomic nervous system changes contributing to the dysautonomia in AN, and (4) how the sensory signals sent from potentially abnormal connective tissue to the central nervous system impact interoception in AN. A conceptual model incorporating abnormal connective tissue is provided.
Public Significance
The etiology of AN remains poorly understood and current theories fail to account for the direct impact of starvation on the health of the organs and tissues of the body. There is significant clinical overlap between AN and hereditary connective tissue disorders. This paper attempts to provide a new conceptual model for AN in which abnormal connective tissue contributes to the underlying pathogenesis.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
Data sharing is not applicable to this article as no new data were created or analyzed in this study.
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