Anorexia nervosa: diagnostic, therapeutic, and risk biomarkers in clinical practice

Biomarkers are essential for clinical risk management in anorexia nervosa (AN).Biomarkers can inform decisions regarding AN treatment at specific steps during the therapeutic cycle.Biomarker research will help to define subgroups of people with AN and guide decisions on individually tailored therapies, including psychotherapy.Anti-hypothalamus autoantibodies, cytokines, and metabolically relevant hormones such as insulin and leptin may be novel future drug targets for the treatment of AN.Pharmacogenetic testing and therapeutic drug monitoring are available for research and clinical application in AN, but they are usually not utilized in clinical practice. In anorexia nervosa (AN), measurable biological parameters can inform the process of treating patients. Such biomarkers include established laboratory parameters as well as a range of potential future biomarkers, including genetic, metabolomic, microbiomic, endocrine, immunological, hematological, electrophysiological, and neuroimaging parameters. In this opinion article we discuss how these biomarkers can support diagnosic and therapeutic processes at specific steps during the AN treatment cycle, that is, the diagnosis, diagnostic specification, risk management, choice of therapy, therapy monitoring, and treatment review. History-taking, physical and neuropsychological examination, clinical observation, and judgment about treatment success by the patient, their carers, and members of the multidisciplinary team are essential to interpret laboratory and imaging data appropriately and to assess the full clinical picture. In anorexia nervosa (AN), measurable biological parameters can inform the process of treating patients. Such biomarkers include established laboratory parameters as well as a range of potential future biomarkers, including genetic, metabolomic, microbiomic, endocrine, immunological, hematological, electrophysiological, and neuroimaging parameters. In this opinion article we discuss how these biomarkers can support diagnosic and therapeutic processes at specific steps during the AN treatment cycle, that is, the diagnosis, diagnostic specification, risk management, choice of therapy, therapy monitoring, and treatment review. History-taking, physical and neuropsychological examination, clinical observation, and judgment about treatment success by the patient, their carers, and members of the multidisciplinary team are essential to interpret laboratory and imaging data appropriately and to asse