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Role of Ghrelin in the Pathophysiology of Eating Disorders

Implications for Pharmacotherapy

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Abstract

Ghrelin is the only known circulating orexigenic hormone. It increases food intake by interacting with hypothalamic and brainstem circuits involved in energy balance, as well as reward-related brain areas. A heightened gutbrain ghrelin axis is an emerging feature of certain eating disorders such as anorexia nervosa and Prader-Willi syndrome. In common obesity, ghrelin levels are lowered, whereas post-meal ghrelin levels remain higher than in lean individuals. Agents that interfere with ghrelin signalling have therapeutic potential for eating disorders, including obesity. However, most of these drugs are only in the preclinical phase of development. Data obtained so far suggest that ghrelin agonists may have potential in the treatment of anorexia nervosa, while ghrelin antagonists seem promising for other eating disorders such as obesity and Prader-Willi syndrome. However, large clinical trials are needed to evaluate the efficacy and safety of these drugs.

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Acknowledgements

The work leading to this review has received funding from the European Community’s Seventh Framework Programme (FP7/2007-2013 Neurofast under grant agreement no. 245009).

The authors declared no conflict of interest.

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Authors and Affiliations

  1. Utrecht Research Group Eating Disorders, Utrecht, The Netherlands

    Sebastian Cardona Cano &  Roger A. H. Adan

  2. Parnassia Bavo Psychiatric Institute, The Hague, The Netherlands

    Sebastian Cardona Cano

  3. Rintveld Centre for Eating Disorders, Altrecht Mental Health Institute, Zeist, The Netherlands

    Sebastian Cardona Cano &  Roger A. H. Adan

  4. Department of Neuroscience and Pharmacology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Universiteitsweg 100, 3584, CG Utrecht, The Netherlands

    Myrte Merkestein &  Roger A. H. Adan

  5. Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden

    Karolina P. Skibicka & Suzanne L. Dickson

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Cano, S.C., Merkestein, M., Skibicka, K.P. et al. Role of Ghrelin in the Pathophysiology of Eating Disorders. CNS Drugs 26, 281–296 (2012). https://doi.org/10.2165/11599890-000000000-00000

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