title: New Insights in Anorexia Nervosa.
abstract: Anorexia nervosa (AN) is classically defined as a condition in which an abnormally low body weight is associated with an intense fear of gaining weight and distorted cognitions regarding weight, shape, and drive for thinness. This article reviews recent evidences from physiology, genetics, epigenetics, and brain imaging which allow to consider AN as an abnormality of reward pathways or an attempt to preserve mental homeostasis. Special emphasis is put on ghrelino-resistance and the importance of orexigenic peptides of the lateral hypothalamus, the gut microbiota and a dysimmune disorder of neuropeptide signaling. Physiological processes, secondary to underlying, and premorbid vulnerability factors-the "pondero-nutritional-feeding basements"- are also discussed.
authors.affiliation: Centre Hospitalier Sainte-Anne (CMME)Paris, France; UMR-S 894, Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et NeurosciencesParis, France; Université Paris Descartes, Sorbonne Paris CitéParis, France.
authors.forename: Philip
authors.initials: P
authors.lastname: Gorwood
authors.affiliation: CB Maison de Solenn-Maison des Adolescents, Cochin Hospital Paris, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Blanchet-Collet
authors.affiliation: Institut National de la Santé et de la Recherche Médicale U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in BiomedicineRouen, France; Normandy UniversityCaen, France; University of RouenRouen, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Chartrel
authors.affiliation: Adolescents and Young Adults Psychiatry Department, Institut Mutualiste MontsourisParis, France; CESP, Institut National de la Santé et de la Recherche Médicale, Université Paris-Descartes, USPCParis, France; University Reims, Champagne-Ardenne, Laboratoire Cognition, Santé, Socialisation (C2S)-EA 6291Reims, France.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Duclos
authors.affiliation: Institut National de la Santé et de la Recherche Médicale U1073 IRIB Normandy UniversityRouen, France; Faculté de Médecine-PharmacieRouen, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Dechelotte
authors.affiliation: Université de Versailles Saint-Quentin-en-Yvelines, Institut National de la Santé et de la Recherche Médicale U1179, équipe Thérapeutiques Innovantes et Technologies Appliquées aux Troubles Neuromoteurs, UFR des Sciences de la Santé Simone VeilMontigny-le-Bretonneux, France; Département de Médecine (Unité de Nutrition), Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de ParisGarches, France.
authors.forename: Mouna
authors.initials: M
authors.lastname: Hanachi
authors.affiliation: Institut National de la Santé et de la Recherche Médicale U1073 IRIB Normandy University Rouen, France.
authors.forename: Serguei
authors.initials: S
authors.lastname: Fetissov
authors.affiliation: Adolescents and Young Adults Psychiatry Department, Institut Mutualiste MontsourisParis, France; CESP, Institut National de la Santé et de la Recherche Médicale, Université Paris-Descartes, USPCParis, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Godart
authors.affiliation: Université de Versailles Saint-Quentin-en-Yvelines, Institut National de la Santé et de la Recherche Médicale U1179, équipe Thérapeutiques Innovantes et Technologies Appliquées aux Troubles Neuromoteurs, UFR des Sciences de la Santé Simone VeilMontigny-le-Bretonneux, France; Département de Médecine (Unité de Nutrition), Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de ParisGarches, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Melchior
authors.affiliation: UMR-S 894, Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et NeurosciencesParis, France; Université Paris Descartes, Sorbonne Paris CitéParis, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Ramoz
authors.affiliation: Institut de Pharmacologie Moléculaire et Cellulaire, UMR6097, Centre National de la Recherche Scientifique Valbonne, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Rovere-Jovene
authors.affiliation: UMR-S 894, Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et NeurosciencesParis, France; Université Paris Descartes, Sorbonne Paris CitéParis, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Tolle
authors.affiliation: Université Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer Lille, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Viltart
authors.affiliation: UMR-S 894, Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et NeurosciencesParis, France; Université Paris Descartes, Sorbonne Paris CitéParis, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Epelbaum
keywords: autoantibodies; eating disorders; mental homeostasis; microbiota; reward system adaptations; susceptibility factors