Early intervention in anorexia nervosa could dramatically improve treatment outcomes, yet clinicians currently lack reliable biological tools to identify at-risk individuals or predict treatment response. This represents a critical gap in managing a disorder with one of the highest mortality rates among psychiatric conditions.
A comprehensive consensus review by the World Federation of Societies of Biological Psychiatry identified multiple biological markers associated with anorexia nervosa across clinical, molecular, cellular, neuroimaging, and neurophysiological domains. These include genetic and epigenetic factors, hormonal disruptions, immune system alterations, metabolic signatures, brain structural changes, and cardiac parameters. Some clinical and laboratory measures already serve as risk indicators in current practice, while molecular markers are advancing understanding of the disorder's underlying biological mechanisms and physical health consequences.
This systematic cataloguing represents important progress toward precision medicine approaches for eating disorders. However, the clinical utility remains constrained by significant methodological limitations. Most existing research relies on group-level comparisons rather than individual diagnostic accuracy studies. The field lacks crucial data on sensitivity, specificity, and prognostic value—the statistical measures necessary to translate research findings into reliable clinical tools. Without these validation studies, even promising biomarkers cannot yet guide treatment decisions or screening protocols. The consensus highlights this as a priority research direction, suggesting that while biological markers may eventually enable targeted early intervention and overcome treatment resistance, substantial additional work is needed to establish their practical clinical value for individual patients.