Metabolic bioenergy homeostatic disruption: a cause of anorexia nervosa

We believe anorexia nervosa is the result of a disruption in bioenergy home ostasis induced by lipid dysregulation. This disruption has two major deter minants: (1) a biological predisposition to primary multihormonal disharmon y linked to post-pubertal growth and development; and (2) an acquired abnor mal lipid-induced loop operation precipitated by inappropriate diet. We pre sent a step-by-step model describing the cascade of disorders that culminat es in anorexia nervosa: defective digestion and absorption of essential fat ty acids; diversion of lipids from adipose cells into bloodstream; defectiv e carbohydrate and lipid metabolism which modifies the blood brain barrier; neuroendocrine membrane alteration causing severe endocrine impairment; ch anges in the negative feedback mechanism which escalate the body's use of b ioenergy; derangement of the appetite center which causes a constant sensat ion of satiety; replacement of the correct body image with the premorbid on e that encourages poor judgement concerning food intake and self-support. T he loop-like nature of this mechanism perpetuates the disease. (C) 2001 Har court Publishers Ltd.