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Nutrients
Volume 17
Issue 14
10.3390/nu17142316
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Review

Gut Microbiota in Women with Eating Disorders: A New Frontier in Pathophysiology and Treatment

by
Giuseppe Marano
1,2,*,
Sara Rossi
1,2,
Greta Sfratta
1,2,
Mariateresa Acanfora
1,2,
Maria Benedetta Anesini
1,2,
Gianandrea Traversi
3,
Francesco Maria Lisci
1,2,
Lucio Rinaldi
1,2,
Roberto Pola
4,
Antonio Gasbarrini
5,
Gabriele Sani
1,2,
Eleonora Gaetani
6,7,† and
Marianna Mazza
6,7,†
1
Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
2
Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
3
Unit of Medical Genetics, Department of Laboratory Medicine, Ospedale Isola Tiberina-Gemelli Isola, 00186 Rome, Italy
4
Section of Internal Medicine and Thromboembolic Diseases, Department of Internal Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
5
Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
6
Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
7
Unit of Internal Medicine, Cristo Re Hospital, 00167 Rome, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Nutrients 2025, 17(14), 2316; https://doi.org/10.3390/nu17142316 (registering DOI)
Submission received: 14 June 2025 / Revised: 6 July 2025 / Accepted: 7 July 2025 / Published: 14 July 2025
(This article belongs to the Section Clinical Nutrition)
Versions Notes

Abstract

Emerging evidence highlights the critical role of the gut microbiota in the development and progression of eating disorders (EDs), particularly in women, who are more frequently affected by these conditions. Women with anorexia nervosa, bulimia nervosa, and binge eating disorder exhibit distinct alterations in gut microbiota composition compared to healthy controls. These alterations, collectively termed dysbiosis, involve reduced microbial diversity and shifts in key bacterial populations responsible for regulating metabolism, inflammation, and gut–brain signaling. The gut microbiota is known to influence appetite regulation, mood, and stress responses—factors closely implicated in the pathogenesis of EDs. In women, hormonal fluctuations related to menstruation, pregnancy, and menopause may further modulate gut microbial profiles, potentially compounding vulnerabilities to disordered eating. Moreover, the restrictive eating patterns, purging behaviors, and altered dietary intake often observed in women with EDs exacerbate microbial imbalances, contributing to intestinal permeability, low-grade inflammation, and disturbances in neurotransmitter production. This evolving understanding suggests that microbiota-targeted therapies, such as probiotics, prebiotics, dietary modulation, and fecal microbiota transplantation (FMT), could complement conventional psychological and pharmacological treatments in women with EDs. Furthermore, precision nutrition and personalized microbiome-based interventions tailored to an individual’s microbial and metabolic profile offer promising avenues for improving treatment efficacy, even though these approaches remain exploratory and their clinical applicability has yet to be fully validated. Future research should focus on sex-specific microbial signatures, causal mechanisms, and microbiota-based interventions to enhance personalized treatment for women struggling with eating disorders.
Keywords: eating disorders; anorexia nervosa; bulimia nervosa; binge eating disorder; gut microbiota; pathophysiology; microbiota-targeted interventions; women eating disorders; anorexia nervosa; bulimia nervosa; binge eating disorder; gut microbiota; pathophysiology; microbiota-targeted interventions; women

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MDPI and ACS Style

Marano, G.; Rossi, S.; Sfratta, G.; Acanfora, M.; Anesini, M.B.; Traversi, G.; Lisci, F.M.; Rinaldi, L.; Pola, R.; Gasbarrini, A.; et al. Gut Microbiota in Women with Eating Disorders: A New Frontier in Pathophysiology and Treatment. Nutrients 2025, 17, 2316. https://doi.org/10.3390/nu17142316

AMA Style

Marano G, Rossi S, Sfratta G, Acanfora M, Anesini MB, Traversi G, Lisci FM, Rinaldi L, Pola R, Gasbarrini A, et al. Gut Microbiota in Women with Eating Disorders: A New Frontier in Pathophysiology and Treatment. Nutrients. 2025; 17(14):2316. https://doi.org/10.3390/nu17142316

Chicago/Turabian Style

Marano, Giuseppe, Sara Rossi, Greta Sfratta, Mariateresa Acanfora, Maria Benedetta Anesini, Gianandrea Traversi, Francesco Maria Lisci, Lucio Rinaldi, Roberto Pola, Antonio Gasbarrini, and et al. 2025. "Gut Microbiota in Women with Eating Disorders: A New Frontier in Pathophysiology and Treatment" Nutrients 17, no. 14: 2316. https://doi.org/10.3390/nu17142316

APA Style

Marano, G., Rossi, S., Sfratta, G., Acanfora, M., Anesini, M. B., Traversi, G., Lisci, F. M., Rinaldi, L., Pola, R., Gasbarrini, A., Sani, G., Gaetani, E., & Mazza, M. (2025). Gut Microbiota in Women with Eating Disorders: A New Frontier in Pathophysiology and Treatment. Nutrients, 17(14), 2316. https://doi.org/10.3390/nu17142316

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