{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:26:42Z","timestamp":1790288802083,"version":"4.1.0"},"reference-count":84,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathophysiology"],"abstract":"<jats:p>Anorexia nervosa (AN) remains a challenging condition in psychiatric management and its pathogenesis is not yet fully understood. An imbalance in the gut microbiota composition may contribute to its pathophysiology. This review aims to explore the link between the human gut microbiota and AN (objective 1) or refeeding syndrome in AN (objective 2). The online databases MEDLINE and PsycINFO were searched for relevant studies. A total of 14 studies met the inclusion and exclusion criteria and only answered objective 1. A total of 476 AN patients, 554 healthy-weight (HC) controls, and 0 patients with other psychiatric disorders were included. Compared to HC, there were consistently reduced abundances of Faecalibacterium prausnitzii and Roseburia inulinivorans, and increased Methanobrevibacter smithii, in AN patients. Changes in alpha diversity were inconsistent, while beta diversity increased in four of six studies. Our model suggests that an imbalance in gut microbiota composition leads to reduced short-chain fatty acids, contributing to a proinflammatory state in AN, which is also common in other psychiatric comorbidities. Microbial changes may also contribute to the semistarvation state through endocrine changes and altered energy utilization.<\/jats:p>","DOI":"10.3390\/pathophysiology31010006","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T06:12:58Z","timestamp":1707286378000},"page":"68-88","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Gut Microbiome Changes in Anorexia Nervosa: A Comprehensive Review"],"prefix":"10.3390","volume":"31","author":[{"given":"Wendi","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Melbourne, Parkville, Melbourne 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhath","family":"Kodancha","sequence":"additional","affiliation":[{"name":"Unit of Psychiatry, Western Health, Melbourne 3021, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7329-8264","authenticated-orcid":false,"given":"Soumitra","family":"Das","sequence":"additional","affiliation":[{"name":"Unit of Psychiatry, Western Health, Melbourne 3021, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"k2179","DOI":"10.1136\/bmj.k2179","article-title":"Role of the gut microbiota in nutrition and health","volume":"361","author":"Valdes","year":"2018","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1848158","DOI":"10.1080\/19490976.2020.1848158","article-title":"Gut Bacteroides species in health and disease","volume":"13","author":"Zafar","year":"2021","journal-title":"Gut Microbes"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1038\/nature11234","article-title":"Structure, function and diversity of the healthy human microbiome","volume":"486","author":"Huttenhower","year":"2012","journal-title":"Nature"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jpsychires.2016.07.019","article-title":"Transferring the blues: Depression-associated gut microbiota induces neurobehavioural changes in the rat","volume":"82","author":"Kelly","year":"2016","journal-title":"J. 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