Outcome in anorexia nervosa remains poor and a new way of looking at this condition is therefore needed. To this aim, we review the effects of food restriction and starvation in humans. It is suggested that body weight remains stable and relatively low when the access to food requires a considerable amount of physical activity. In this condition, the human homeostatic phenotype, body fat content is also low and as a consequence, the synthesis and release of brain neurotransmitters are modified. As an example, the role of neuropeptide Y is analyzed in rat models of this state. It is suggested that the normal behavioral role of neuropeptide Y is to facilitate the search for food and switch attention from sexual stimuli to food. Descriptive neuroendocrine studies on patients with anorexia nervosa have not contributed to the management of the patients and the few studies in which hormones have been administered have, at best, reversed an endocrine consequence secondary to starvation. In a modified framework for understanding the etiology and treatment of anorexia nervosa it is suggested that the condition emerges because neural mechanisms of reward and attention are engaged. The neural neuropeptide Y receptor system may be involved in the maintenance of the behavior of eating disorder patients because the localization of these receptors overlaps with the neural systems engaged in cue-conditioned eating in limbic and cortical areas. The eating behavior of patients with anorexia nervosa, and other eating disorders as well, is viewed as a cause of the psychological changes of the patients. Patients are trained to re-learn normal eating habits using external support and as they do, their symptoms, including the psychological symptoms, dissolve.

中文翻译：

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神经性厌食症的行为神经内分泌学和治疗

神经性厌食症的结果仍然很差，因此需要一种新的方法来看待这种情况。为此，我们回顾了食物限制和饥饿对人类的影响。建议当获得食物需要大量体力活动时，体重保持稳定且相对较低。在这种情况下，人体稳态表型、体脂肪含量也很低，因此，大脑神经递质的合成和释放会发生改变。例如，在这种状态的大鼠模型中分析了神经肽 Y 的作用。这表明神经肽Y的正常行为作用是促进寻找食物并将注意力从性刺激转移到食物上。对神经性厌食症患者的描述性神经内分泌研究并没有对患者的管理做出贡献，而少数使用激素的研究充其量只能逆转继发于饥饿的内分泌后果。在用于理解神经性厌食症的病因和治疗的修改框架中，建议这种情况的出现是因为奖励和注意力的神经机制参与其中。神经神经肽 Y 受体系统可能参与维持进食障碍患者的行为，因为这些受体的定位与边缘和皮层区域从事线索条件进食的神经系统重叠。神经性厌食症患者的饮食行为，以及其他饮食失调症，被视为导致患者心理变化的原因。患者接受培训，通过外部支持重新学习正常的饮食习惯，当他们这样做时，他们的症状，包括心理症状，就会消失。