A treatment for anorexia could be on the horizon

The cause of the eating disorder anorexia nervosa may have been identified, and with it, a possible cure, according to an international team of scientists.

More than a million people across the UK are thought to have an eating disorder, including anorexia. The condition often causes a distorted body image, meaning people believe they are overweight, leading them to try to keep their weight as low as possible.

It affects both men and women, although is most common in young women and teenage girls, and is the deadliest of all psychiatric disorders.

Now, scientists from Canada and France believe they may have discovered the brain mechanism behind anorexia.

Studying mice with anorexia-like behaviour, they found that a deficiency in the chemical acetylcholine has a negative impact on the brain’s reward system, leading to excess habit formation – linked to the compulsive self-starvation often seen in patients.

After identifying the imbalance, the team tried to correct it using donepezil, a medication known to increase the presence of acetylcholine in the brain – and the mice appeared to recover.

Senior author Dr Salah El Mestikawy said: ‘We found that it fully reversed the anorexia-like behaviour in mice, and we believe that it could potentially offer the first mechanism-based treatment of anorexia nervosa. 

‘In fact, we are already seeing its effects on some patients with the disease.’

Independent trials in Toronto and Montreal have shown positive results for ten patients with severe anorexia nervosa, three of whom are in full remission. The remaining seven have shown significant improvement.

Further trials, comparing patients taking donepezil with those taking a placebo, are due to start this year at Columbia University, Denver University and the Hôpital Sainte-Anne in Paris.

However, Dr El Mestikawy warned it could take many years for the drug to gain government approval and be used to treat anorexic patients.

In addition, the drug has gastrointestinal and muscular side-effects, so the team is working to develop a new compound with fewer problems.

But if that can be developed, and gain official approval, the team hopes it will help a wide range of patients.

‘We also suspect that other compulsive pathologies such as obsessive-compulsive disorders and addictions can also be improved by donepezil, so we are actively looking for collaboration with other psychiatrists around the world to explore the possibilities,’ said Dr El Mestikawy.