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The goal was to understand BMI\u2010independent leptin alterations and their potential as biomarkers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>PubMed and <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link> were searched for studies reporting serum leptin in AN, BN, BED, or recovered EDs. A multilevel network meta\u2010analysis using a linear mixed\u2010effects meta\u2010regression model, adjusting for BMI, sex, and assay type, was performed on 146 studies (5048 patients, 3525 controls).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant differences in leptin levels were found across EDs. AN patients exhibited the lowest leptin levels, while BED patients had the highest. BN and recovered AN patients had leptin levels similar to AN, significantly lower than HCs. BMI, sex, and assay type were significant covariates. The model accounted for heterogeneity due to diagnostic criteria, assay types, and study\u2010level differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Leptin levels in EDs are significantly altered beyond BMI effects, suggesting disease\u2010specific factors. These findings support leptin's potential as a biomarker for ED staging and prognosis. 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