New research presented at the Federation of European Neuroscience Societies Forum and conducted by scientists at France’s INSERM identifies changes in the hunger-regulating hormone ghrelin and its antagonist LEAP2 in patients undergoing refeeding for anorexia nervosa. The study tracks biochemical shifts during treatment and six months later, a period when relapse and hospital readmission are common.
Study design and primary findings
The research followed 30 women diagnosed with anorexia nervosa, aged 18 to 60, who entered a four-month specialized refeeding program. Blood samples were collected before treatment, at the end of the program and again six months later. Investigators measured circulating levels of ghrelin — a stomach-derived peptide associated with hunger signaling — and LEAP2, a liver-expressed peptide that antagonizes ghrelin’s effects.
"[Anorexia nervosa] is characterized by self-imposed food restriction, often accompanied by hyperactivity, which together can lead to severe undernutrition and potentially life-threatening consequences," the presenter from INSERM said, noting the disorder's high mortality and the lack of effective pharmacological treatments.
The team reports patterns in these hormones that could reflect metabolic adaptations to undernutrition and to nutritional rehabilitation. Because relapse rates remain high — with roughly 40 percent of hospitalized patients readmitted within six months in prior reports — researchers say biomarkers that track metabolic recovery could prove clinically useful.
Why ghrelin and LEAP2 matter
Ghrelin rises in many people to signal meal initiation, but its role in anorexia nervosa has been uncertain: is it a response to starvation, an ineffective hunger signal, or part of the pathophysiology that sustains restriction and activity? LEAP2, described as a ghrelin antagonist, modifies ghrelin signaling and might therefore influence appetite, energy balance and behavioral responses to refeeding. The INSERM investigators propose that the ghrelin–LEAP2 axis deserves attention as a potential target for interventions.
Clinical and research implications
- Potential biomarkers: Serial measurement of ghrelin and LEAP2 could help distinguish metabolic recovery from merely restored caloric intake.
- Therapeutic targets: Modulators of ghrelin signaling, including LEAP2-related compounds, might offer a biological avenue to support existing psychological and nutritional treatments.
- Follow-up care: Tracking hormonal changes after discharge could flag patients at elevated risk for relapse and prompt earlier intervention.
The study presentation emphasized that no drugs are currently approved specifically for anorexia nervosa and that standard care remains nutritional rehabilitation combined with multidisciplinary therapy. Investigators caution that these findings are preliminary: the dataset is modest and further work is required to determine causation, clinical utility and whether interventions that alter ghrelin or LEAP2 change outcomes.
| Measure | Value |
|---|---|
| Participants | 30 women |
| Age range | 18–60 years |
| Treatment duration | 4 months (refeeding program) |
| Follow-up | 6 months post-treatment |
Experts in eating disorders not involved in the work have previously noted that understanding metabolic drivers of sustained restriction and relapse is critical to improving long-term outcomes. The INSERM team hopes their ghrelin–LEAP2 observations will spur larger studies that can test whether modifying this hormonal axis reduces relapse or supports weight restoration and psychological recovery.
For clinicians and policymakers, the message is cautious optimism: biochemical markers may augment existing care pathways, but translation into approved treatments will require rigorous clinical trials. Until then, multidisciplinary approaches focused on nutrition, psychiatric care and close post-discharge monitoring remain the standard for a disorder with significant mortality and a high burden of relapse.
