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Examining the biological causes of eating disorders to inform treatment strategies

Nature Reviews Neuroscience volume 26, pages 554–570 (2025)Cite this article

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Abstract

Despite their prevalence, eating disorders (EDs) are under-researched and often misunderstood. A recent focus of research on the biological underpinnings of EDs has helped to reframe our understanding of their origins, but there remain a lack of effective treatment options, high rates of relapse and, unfortunately, high mortality and morbidity. In this Review, we highlight the many facets of normal and pathological feeding behaviour and body weight regulation and suggest that these provide a framework with which to develop integrative methods to study, and ultimately treat, EDs. We propose that a better understanding of the biological causes of ED, and their crucial interactions with psychological and environmental factors, is necessary to progress the field. This can be achieved through a combination of preclinical and clinical investigations, which provide complementary information on these highly complex disorders. In the era of individualized medicine and with the advent of artificial intelligence tools that allow the amalgamation of multimodal data, we hope that a better understanding of the biology of EDs may hold the answer to effectively overcoming the debilitating effects of these conditions.

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Fig. 1: Multiple systems control feeding and eating.
Fig. 2: The self-perpetuating cycle of eating disorders.
Fig. 3: Using animal models to investigate causal mechanisms in eating disorders.
Fig. 4: Data-driven approaches towards individualized treatments.

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Acknowledgements

C.J.F. received financial support from the National Health and Medical Research Council (NHMRC) of Australia (GTN 2001722 and GTN 2011334).

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Authors and Affiliations

  1. Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia

    Claire J. Foldi

  2. InsideOut Institute, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia

    Kristi R. Griffiths

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Glossary

Adiposity

The extent of body fat accumulation, typically quantified as the mass or proportion of adipose tissue relative to total body mass, serving as an index of energy storage and metabolic health.

Anorexigenic hormones

Hormones that suppress appetite and reduce food intake by signalling satiety to the brain.

Case–control studies

Observational studies that compare individuals with a specific condition or disease (cases) with those without it (controls) to identify factors associated with the outcome.

Cognitive control

The mental ability to regulate thoughts and actions in accordance with internal goals, including processes such as attention, inhibition and working memory.

Epigenetic mechanisms

Molecular processes — such as DNA methylation, histone modifications and non-coding RNA activity — that stably alter gene expression without changing the underlying DNA sequence.

Face validity

The extent to which a test or measure appears, on the surface, to assess what it is intended to measure.

Genome-wide association studies

(GWASs). Studies that scan the entire genome to identify genetic variants associated with specific traits or diseases in a population.

Gut–brain axis

The bidirectional communication network linking the gastrointestinal tract and the central nervous system, involving neural, hormonal and immune pathways.

Neuroendocrine signalling

The process by which neurons communicate with endocrine cells to regulate physiological functions through the release of hormones into the bloodstream.

Orexigenic hormones

Hormones that stimulate appetite and increase food intake by acting on brain regions involved in hunger regulation.

Psychological therapies

Structured interventions aimed at improving mental health by addressing thoughts, emotions and behaviours through techniques such as cognitive behavioural therapy and counselling.

Psychosocial factors

Social and psychological influences that affect an individual’s behaviour, mental health and well-being.

Reward

A positive stimulus or outcome that reinforces behaviour by activating brain circuits associated with pleasure andmotivation.

State-based factors

Temporary internal conditions or circumstances, such as mood or physiological status, that influence behaviour or cognition at a given moment.

Trait-based factors

Stable, enduring characteristics or qualities of an individual that influence behaviour and cognition over time.

Transdiagnostic

Processes or factors that apply across multiple distinct mental health disorders rather than being specific to one diagnosis.

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Foldi, C.J., Griffiths, K.R. Examining the biological causes of eating disorders to inform treatment strategies. Nat. Rev. Neurosci. 26, 554–570 (2025). https://doi.org/10.1038/s41583-025-00940-3

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  • DOI: https://doi.org/10.1038/s41583-025-00940-3

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