The interplay of gut microbiota and eating disorders: exploring potential links and treatment implications

Background: Eating Disorders (EDs), including Binge Eating Disorder (BED), Bulimia Nervosa (BN), Anorexia Nervosa (AN), Avoidant/Restrictive Food Intake Disorder (ARFID), and Other Specified Feeding or Eating Disorders (OSFED), manifest as complex psychiatric conditions. Recent evidence suggests a pivotal role of the gut microbiota in their pathophysiology. This review explores the intricate connections between gut microbiota and EDs, focusing on BED, BN, AN, ARFID, and OSFED. Examining distinct microbial profiles, antibiotic usage implications, and therapeutic interventions such as probiotics and fecal microbiota transplantation, it provides valuable insights into potential modifications of the gut microbiome for innovative ED management. Materials and Methods: The manuscript was drafted as per the SANRA guidelines. The included literature was reviewed by the authors as per the analytical framework mentioned in detailed. Objectives: The manuscript intends to explore gut microbiota changes in Eating Disorders, identify biomarkers, evaluate interventions for therapeutic insights, and enhance understanding for innovative management. Results: The results revealed unique gut microbiota signatures in diverse Eating Disorders (BED, BN, AN, ARFID, OSFED), showcasing altered levels of specific bacteria and concentrations of ClpB. Elevated Anaerostipes, Bifidobacterium, and Roseburia, alongside reduced Akkermansia, Desulfovibrio, and Intestinimonas, characterized BED. For BN, increased Bifidobacterium and decreased Odoribacter were observed. AN exhibited elevated Methanobrevibacter smithii and reduced anaerobes. ARFID displayed a distinctive microbiota profile. Therapeutic interventions, such as probiotics and fecal microbiota transplantation, exhibited potential in ameliorating symptoms across different Eating Disorders, suggesting novel avenues for targeted interventions in ED management.