Abstract
Anorexia nervosa, bulimia nervosa, and binge eating disorder are eating disorders with common clinical and psychological features, potentially shared mechanisms, significant morbidity and, at least for anorexia nervosa, a high mortality rate. Among the numerous risk factors involved, the importance of a genetic vulnerability has been demonstrated, and the heritability, in the broad sense, has being estimated to be between 50 and 70%. Studies have thus focused on different candidate genes.
Serotonin transmission and regulation has been extensively studied with regard to its role in core mechanisms such as feeding and fasting, but also in different clinical characteristics of eating disorders. The serotonin transporter (5-HTT), encoded by the SLC6A4 gene, may also have an important role in eating disorders, as its availability is decreased in patients with bulimia nervosa and binge eating disorder. The promoter region contains a functional insertion/deletion polymorphism with two common alleles that have been designated the short (*S) and long (*L) alleles. The frequency of the SLC6A4*S allele has been assessed in four independent samples of patients with anorexia nervosa, but gave discrepant results. A meta-analysis was performed, which showed that the *S allele could represent a moderate but significant risk factor that increases the risk of anorexia nervosa (odds ratio [OR] = 1.38, 95% confidence interval [CI] 1.16–1.72).
Eating disorders are treated using different types of psychotherapy and pharmacotherapy with antidepressants; serotonin reuptake inhibitors being the most frequently prescribed. High doses of selective serotonin reuptake inhibitors (SSRIs) are usually prescribed in eating disorders. The prevalence of non-responders (roughly one out of two), and the presence of a functional genetic polymorphism in the promotor region of SLC6A4, emphasizes the potential utility of psychopharmacogenetics in prescribing SSRIs in the treatment of patients with weight-restored anorexia nervosa. Information about genetic variations of cytochrome P450 could also facilitate pharmacotherapy by preventing the administration of high doses in poor metabolizers and identify rapid metabolizes who may require higher doses for efficacy. SLC6A4 genotyping would allow physicians to individualize selective serotonin reuptake therapy for their patients.
Similar content being viewed by others
References
Fairburn CG, Harrison PJ. Eating disorders. Lancet 2003 Feb 1; 361(9355): 407–16
Sullivan PF. Mortality in anorexia nervosa. Am J Psychiatry 1995 Jul; 152(7): 1073–4
Keel PK, Dorer DJ, Eddy KT, et al. Predictors of mortality in eating disorders. Arch Gen Psychiatry 2003 Feb; 60(2): 179–83
Fairburn CG, Walsh BT. Atypical eating disorders (eating disorder not otherwise specified). In: Fairburn CG, Brownell KD, editors. Eating disorders and obesity: a comprehensive handbook. 2nd ed. New York: Guilford Press, 2002: 171–7
Kinzl JF, Traweger C, Trefalt E, et al. Binge eating disorder in males: a population-based investigation. Eat Weight Disord 1999 Dec; 4(4): 169–74
Striegel-Moore RH, Dohm FA, Kraemer HC, et al. Eating disorders in white and black women. Am J Psychiatry 2003 Jul; 160(7): 1326–31
Fairburn CG, Welch SL, Doll HA, et al. Risk factors for bulimia nervosa: a community-based case-control study. Arch Gen Psychiatry 1997 Jun; 54(6): 509–17
Fairburn CG, Doll HA, Welch SL, et al. Risk factors for binge eating disorder: a community-based, case-control study. Arch Gen Psychiatry 1998 May; 55(5): 425–32
Fairburn CG, Cowen PJ, Harrison PJ. Twin studies and the etiology of eating disorders. Int J Eat Disord 1999 Dec; 26(4): 349–58
Fairburn CG, Cooper Z, Doll HA, et al. Risk Factors for Anorexia Nervosa: three integrated case-control comparisons. Arch Gen Psychiatry 1999 May; 56(5): 468–76
Kipman A, Gorwood P, Mouren-Siméoni MC, et al. Genetic factors in anorexia nervosa. Eur Psychiatry 1999; 14: 189–98
Strober M, Freeman R, Lampert C, et al. Controlled family study of anorexia nervosa and bulimia nervosa: evidence of shared liability and transmission of partial syndromes. Am J Psychiatry 2000 Mar; 157(3): 393–401
Kortegaard LS, Hoerder K, Joergensen J, et al. A preliminary population-based twin study of self-reported eating disorder. Psychol Med 2001 Feb; 31(2): 361–5
Wade TD, Bulik CM, Neale M, et al. Anorexia nervosa and major depression: shared genetic and environmental risk factors. Am J Psychiatry 2000 Mar; 157(3): 469–71
Walters EE, Kendler KS. Anorexia nervosa and anorexic-like syndromes in a population-based female twin sample. Am J Psychiatry 1995; 152: 64–71
Klump KL, Miller KB, Keel PK, et al. Genetic and environmental influences on anorexia nervosa syndromes in a population-based twin sample. Psychol Med 2001 May; 31(4): 737–40
Holland AJ, Hall A, Murray R, et al. Anorexia nervosa: a study of 34 pairs of twins and one set of triplets. Br J Psychiatry 1984; 145: 414–9
Ben-Dor DH, Laufer N, Apter A, et al. Heritability, genetics and association findings in anorexia nervosa. Isr J Psychiatry Relat Sci 2002; 39(4): 262–70
Rutherford J, McGuffin P, Katz RJ, et al. Genetic influences on eating attitudes in a normal female twin population. Psychol Med 1993 May; 23(2): 425–36
Bulik CM, Sullivan PF, Kendler KS. Heritability of binge-eating and broadly defined bulimia nervosa. Biol Psychiatry 1998 Dec 15; 44(12): 1210–8
Kendler KS, MacLean C, Neale M, et al. The genetic epidemiology of bulimia nervosa. Am J Psychiatry 1991 Dec; 148(12): 1627–37
Wade T, Martin NG, Neale MC, et al. The structure of genetic and environmental risk factors for three measures of disordered eating. Psychol Med 1999 Jul; 29(4): 925–34
Kendler KS, Walters EE, Neale MC, et al. The structure of the genetic and environmental risk factors for six major psychiatric disorders in women: phobia, generalized anxiety disorder, panic disorder, bulimia, major depression, and alcoholism. Arch Gen Psychiatry 1995 May; 52(5): 374–83
Rowe R, Pickles A, Simonoff E, et al. Bulimic symptoms in the Virginia Twin Study of Adolescent Behavioral Development: correlates, comorbidity, and genetics. Biol Psychiatry 2002 Jan 15; 51(2): 172–82
Bulik CM, Sullivan PF, Kendler KS. Genetic and environmental contributions to obesity and binge eating. Int J Eat Disord 2003 Apr; 33(3): 293–8
Wade TD, Bulik CM, Sullivan PF, et al. The relation between risk factors for binge eating and bulimia nervosa: a population-based female twin study. Health Psychol 2000 Mar; 19(2): 115–23
Gorwood P, Bouvard M, Mouren-Siméoni MC, et al. Genetics of anorexia nervosa: a review of candidate genes. Psychiatr Genet 1998; 8(1): 1–12
Hinney A, Remschmidt H, Hebebrand J. Candidate gene polymorphisms in eating disorders. Eur J Pharmacol 2000 Dec 27; 410(2–3): 147–59
Brewerton TD. Toward a unified theory of serotonin dysregulation in eating and related disorders. Psychoneuroendocrinology 1995; 20(6): 561–90
Goodwin GM, Fairburn CG, Cowen PJ. Dieting changes serotonergic function in women, not men: implications for the aetiology of anorexia nervosa? Psychol Med 1987 Nov; 17(4): 839–42
Cowen PJ, Clifford EM, Walsh AE, et al. Moderate dieting causes 5-HT2C receptor supersensitivity. Psychol Med 1996 Nov; 26(6): 1155–9
Kaye WH, Barbarich NC, Putnam K, et al. Anxiolytic effects of acute tryptophan depletion in anorexia nervosa. Int J Eat Disord 2003 Apr; 33(3): 257–67
Brewerton TD, Mueller EA, Lesem MD, et al. Neuroendocrine responses to m-chlorophenylpiperazine and L-tryptophan in bulimia. Arch Gen Psychiatry 1992 Nov; 49(11): 852–61
Levitan RD, Kaplan AS, Joffe RT, et al. Hormonal and subjective responses to intravenous meta-chlorophenylpiperazine in bulimia nervosa. Arch Gen Psychiatry 1997 Jun; 54(6): 521–7
Jimerson DC, Wolfe BE, Metzger ED, et al. Decreased serotonin function in bulimia nervosa. Arch Gen Psychiatry 1997 Jun; 54(6): 529–34
McBride PA, Anderson GM, Khait VD, et al. Serotonergic responsivity in eating disorders. Psychopharmacol Bull 1991; 27(3): 365–72
Brewerton TD, Brandt HA, Lesem MD, et al. Serotonin in major psychiatric disorders. Washington, DC: American Psychiatric Press, 1990: 153–84
Hadigan CM, Walsh BT, Buttinger C, et al. Behavioral and neuroendocrine responses to metaCPP in anorexia nervosa. Biol Psychiatry 1995 Apr 15; 37(8): 504–11
Monteleone P, Brambilla F, Bortolotti F, et al. Prolactin response to d-fen-fluramine is blunted in people with anorexia nervosa. Br J Psychiatry 1998 May; 172: 439–42
O’Dwyer AM, Lucey JV, Russell GF. Serotonin activity in anorexia nervosa after long-term weight restoration: response to D-fenfluramine challenge. Psychol Med 1996 Mar; 26(2): 353–9
Ward A, Brown N, Lightman S, et al. Neuroendocrine, appetitive and behavioural responses to d-fenfluramine in women recovered from anorexia nervosa. Br J Psychiatry 1998 Apr; 172: 351–8
Young SN, Smith SE, Pihl RO, et al. Tryptophan depletion causes a rapid lowering of mood in normal males. Psychopharmacology (Berl) 1985; 87(2): 173–7
Smith KA, Fairburn CG, Cowen PJ. Symptomatic relapse in bulimia nervosa following acute tryptophan depletion. Arch Gen Psychiatry 1999 Feb; 56(2): 171–6
Weltzin TE, Fernstrom JD, McConaha C, et al. Acute tryptophan depletion in bulimia: effects on large neutral amino acids. Biol Psychiatry 1994 Mar 15; 35(6): 388–97
Weltzin TE, Fernstrom MH, Fernstrom JD, et al. Acute tryptophan depletion and increased food intake and irritability in bulimia nervosa. Am J Psychiatry 1995 Nov; 152(11): 1668–71
Kaye WH, Gendall KA, Fernstrom MH, et al. Effects of acute tryptophan depletion on mood in bulimia nervosa. Biol Psychiatry 2000 Jan 15; 47(2): 151–7
Favaro A, Caregaro L, Burlina AB, et al. Tryptophan levels, excessive exercise, and nutritional status in anorexia nervosa. Psychosom Med 2000 Jul–Aug; 62(4): 535–8
Kaye WH, Ebert MH, Raleigh M, et al. Abnormalities in CNS monoamine metabolism in anorexia nervosa. Arch Gen Psychiatry 1984 Apr; 41(4): 350–5
Demitrack MA, Heyes MP, Altemus M, et al. Cerebrospinal fluid levels of kynurenine pathway metabolites in patients with eating disorders: relation to clinical and biochemical variable. Biol Psychiatry 1995 Apr 15; 37(8): 512–20
Gerner RH, Cohen DJ, Fairbanks L, et al. CSF neurochemistry of women with anorexia nervosa and normal women. Am J Psychiatry 1984 Nov; 141(11): 1441–4
Kaye WH, Gwirtsman HE, George DT, et al. CSF 5-HIAA concentrations in anorexia nervosa: reduced values in underweight subjects normalize after weight gain. Biol Psychiatry 1988 Jan 1; 23(1): 102–5
Kaye WH, Ballenger JC, Lydiard RB, et al. CSF monoamine levels in normal-weight bulimia: evidence for abnormal noradrenergic activity. Am J Psychiatry 1990 Feb; 147(2): 225–9
Jimerson DC, Lesem MD, Kaye WH, et al. Low serotonin and dopamine metabolite concentrations in cerebrospinal fluid from bulimic patients with frequent binge episodes. Arch Gen Psychiatry 1992 Feb; 49(2): 132–8
Bjorntorp P. Neuroendocrine abnormalities in human obesity. Metabolism 1995 Feb; 44 (2 Suppl. 2): 38–41
Kaye WH, Greeno CG, Moss H, et al. Alterations in serotonin activity and psychiatric symptoms after recovery from bulimia nervosa. Arch Gen Psychiatry 1998 Oct; 55(10): 927–35
Marazziti D, Macchi E, Rotondo A, et al. Involvement of serotonin system in bulimia. Life Sci 1988; 43(25): 2123–6
Weizman R, Carmi M, Tyano S, et al. High affinity [3H]imipramine binding and serotonin uptake to platelets of adolescent females suffering from anorexia nervosa. Life Sci 1986 Mar 31; 38(13): 1235–42
Goldbloom DS, Hicks LK, Garfinkel PE. Platelet serotonin uptake in bulimia nervosa. Biol Psychiatry 1990 Oct 1; 28(7): 644–7
Okamoto Y, Okamoto Y, Kagaya A, et al. Serotonin-induced platelet calcium mobilization is enhanced in bulimia nervosa but not in anorexia nervosa. Biol Psychiatry 1995 Aug 15; 38(4): 274–6
Robinson PH, Checkley SA, Russell GF. Suppression of eating by fenfluramine in patients with bulimia nervosa. Br J Psychiatry 1985 Feb; 146: 169–76
Blouin AG, Blouin JH, Perez EL, et al. Treatment of bulimia with fenfluramine and desipramine. J Clin Psychopharmacol 1988 Aug; 8(4): 261–9
Russel GFM, Checkley SA, Feldman J, et al. A controlled trial of d-fenfluramine in bulimia nervosa. Clin Neuropharmacol 1996; 11(S1) 51: 107–15
Fahy TA, Eisler I, Russell GF. A placebo-controlled trial of d-fenfluramine in bulimia nervosa. Br J Psychiatry 1993 May; 162: 597–603
Tauscher J, Pirker W, Willeit M, et al. [123I]beta-CIT and single photon emission computed tomography reveal reduced brain serotonin transporter availability in bulimia nervosa. Biol Psychiatry 2001 Feb 15; 49(4): 326–32
Tammela LI, Rissanen A, Kuikka JT, et al. Treatment improves serotonin transporter binding and reduces binge eating. Psychopharmacology (Berl). Epub 2003 May 27
Hinney A, Barth N, Ziegler A, et al. Serotonin transporter gene-linked polymorphic region: allele distributions in relationship to body weight and in anorexia nervosa. Life Sci 1997; 61(21): PL 295–303
Sundaramurthy D, Pieri LF, Gape H, et al. Analysis of the serotonin transporter gene linked polymorphism (5-HTTLPR) in anorexia nervosa. Am J Med Genet 2000 Feb 7; 96(1): 53–5
Di Bella DD, Catalano M, Cavallini MC, et al. Serotonin transporter linked polymorphic region in anorexia nervosa and bulimia nervosa. Mol Psychiatry 2000 May; 5(3): 233–4
Fumeron F, Betoulle D, Aubert R, et al. Association of a functional 5-HT transporter gene polymorphism with anorexia nervosa and food intake. Mol Psychiatry 2001 Jan; 6(1): 9–10
Ioannidis J, Ntzani E, Trikalinos T, et al. Replication validity of genetic association studies. Nat Genet 2001; 29: 306–9
Woolf B. On estimating the relation between blood group and disease. Ann Hum Genet 1955; 19: 251–3
Matsushita S, Nakamura T, Nishiguchi N, et al. Association of serotonin transporter regulatory region polymorphism and abnormal eating behaviors. Mol Psychiatry 2002; 7(6): 538–40
Urwin RE, Bennetts BH, Wilcken B, et al. Investigation of epistasis between the serotonin transporter and norepinephrine transporter genes in anorexia nervosa. Neuropsychopharmacology 2003 Jul; 28(7): 1351–5
Gorwood P. Genetic association studies in behavioral neuroscience. In: Cruzio W, Gerlai R, editors. Molecular genetic techniques for behavioural neuroscience. Amsterdam: Elsevier, 1999: 113–21
Gelernter J, Cubells JF, Kidd JR, et al. Population studies of polymorphisms of the serotonin transporter protein gene. Am J Med Genet 1999 Feb 5; 88(1): 61–6
Risch N, Merikangas K. The future of genetic studies of complex human diseases. Science 1996 Sep 13; 273(5281): 1516–7
American Psychiatric Association. Practice guideline for eating disorders. Am J Psychiatry 1993; 150: 212–28
Mayer LE, Walsh BT. The use of selective serotonin reuptake inhibitors in eating disorders. J Clin Psychiatry 1998; 59Suppl. 15: 28–34
Ferguson JM. Treatment of an anorexia nervosa patient with fluoxetine [letter]. Am J Psychiatry 1987 Sep; 144(9): 1239
Gwirtsman HE, Guze BH, Yager J, et al. Fluoxetine treatment of anorexia nervosa: an open clinical trial. J Clin Psychiatry 1990 Sep; 51(9): 378–82
Attia E, Haiman C, Walsh BT, et al. Does fluoxetine augment the inpatient treatment of anorexia nervosa? Am J Psychiatry 1998 Apr; 155(4): 548–51
Ferguson CP, La Via MC, Crossan PJ, et al. Are serotonin selective reuptake inhibitors effective in underweight anorexia nervosa? Int J Eat Disord 1999 Jan; 25(1): 11–7
Kaye WH, Weltzin TE, Hsu LK, et al. An open trial of fluoxetine in patients with anorexia nervosa. J Clin Psychiatry 1991 Nov; 52(11): 464–71
Strober M, Freeman R, DeAntonio M, et al. Does adjunctive fluoxetine influence the post-hospital course of restrictor-type anorexia nervosa?: a 24-month prospective, longitudinal follow-up and comparison with historical controls. Psychopharmacol Bull 1997; 33(3): 425–31
Kaye WH, Nagata T, Weltzin TE, et al. Double-blind placebo-controlled administration of fluoxetine in restricting- and restricting-purging-type anorexia nervosa. Biol Psychiatry 2001 Apr 1; 49(7): 644–52
Fichter MM, Leibl C, Kruger R, et al. Effects of fluvoxamine on depression, anxiety, and other areas of general psychopathology in bulimia nervosa. Pharmacopsychiatry 1997 May; 30(3): 85–92
Hudson JI, McElroy SL, Raymond NC, et al. Fluvoxamine in the treatment of binge-eating disorder: a multicenter placebo-controlled, double-blind trial. Am J Psychiatry 1998 Dec; 155(12): 1756–62
Frank GK, Kaye WH, Marcus MD. Sertraline in underweight binge eating/purging-type eating disorders: five case reports. Int J Eat Disord 2001 May; 29(4): 495–8
Calandra C, Gulino V, Inserra L, et al. The use of citalopram in an integrated approach to the treatment of eating disorders: an open study. Eat Weight Disord 1999 Dec; 4(4): 207–10
Bacaltchuk J, Hay P. Antidepressants versus placebo for people with bulimia nervosa. Cochrane Database Syst Rev 2001; (4): CD003391
Kaye W, Gendall K, Strober M. Serotonin neuronal function and selective serotonin reuptake inhibitor treatment in anorexia and bulimia nervosa. Biol Psychiatry 1998 Nov 1; 44(9): 825–38
Fluoxetine Bulimia Nervosa Collaborative Study Group. Fluoxetine in the treatment of bulimia nervosa: a multicenter, placebo-controlled, double-blind trial. Arch Gen Psychiatry 1992 Feb; 49(2): 139–47
Ricca V, Mannucci E, Mezzani B, et al. Fluoxetine and fluvoxamine combined with individual cognitive-behaviour therapy in binge eating disorder: a one-year follow-up study. Psychother Psychosom 2001 Nov–Dec; 70(6): 298–30
Romano SJ, Halmi KA, Sarkar NP, et al. A placebo-controlled study of fluoxetine in continued treatment of bulimia nervosa after successful acute fluoxetine treatment. Am J Psychiatry 2002 Jan; 159(1): 96–102
Goldstein DJ, Wilson MG, Ascroft RC, et al. Effectiveness of fluoxetine therapy in bulimia nervosa regardless of comorbid depression. Int J Eat Disord 1999 Jan; 25(1): 19–27
Fichter MM, Leibl K, Rief W, et al. Fluoxetine versus placebo: a double-blind study with bulimic inpatients undergoing intensive psychotherapy. Pharmacopsychiatry 1991 Jan; 24(1): 1–7
Goldbloom DS, Olmsted M, Davis R, et al. A randomized controlled trial of fluoxetine and cognitive behavioral therapy for bulimia nervosa: short-term outcome. Behav Res Ther 1997 Sep; 35(9): 803–11
Beumont PJ, Russell JD, Touyz SW, et al. Intensive nutritional counselling in bulimia nervosa: a role for supplementation with fluoxetine? Aust N Z J Psychiatry 1997 Aug; 31(4): 514–24
Walsh BT, Wilson GT, Loeb KL, et al. Medication and psychotherapy in the treatment of bulimia nervosa. Am J Psychiatry 1997 Apr; 154(4): 523–31
Arnold LM, McElroy SL, Hudson JI, et al. A placebo-controlled, randomized trial of fluoxetine in the treatment of binge-eating disorder. J Clin Psychiatry 2002 Nov; 63(11): 1028–33
Marcus MD, Wing RR, Ewing L, et al. A double-blind, placebo-controlled trial of fluoxetine plus behavior modification in the treatment of obese binge-eaters and non-binge-eaters. Am J Psychiatry 1990 Jul; 147(7): 876–81
Bertelsen KM, Venkatakrishnan K, Von Moltke LL, et al. Apparent mechanism-based inhibition of human CYP2D6 in vitro by paroxetine: comparison with fluoxetine and quinidine. Drug Metab Dispos 2003 Mar; 31(3): 289–93
Wang JH, Liu ZQ, Wang W, et al. Pharmacokinetics of sertraline in relation to genetic polymorphism of CYP2C19. Clin Pharmacol Ther 2001 Jul; 70(1): 42–7
Steimer W, Muller B, Leucht S, et al. Pharmacogenetics: a new diagnostic tool in the management of antidepressive drug therapy. Clin Chim Acta 2001 Jun; 308(1–2): 33–41
Brosen K. Drug-metabolizing enzymes and therapeutic drug monitoring in psychiatry. Ther Drug Monit 1996 Aug; 18(4): 393–6
Agundez JA, Ledesma MC, Ladero JM, et al. Prevalence of CYP2D6 gene duplication and its repercussion on the oxidative phenotype in a white population. Clin Pharmacol Ther 1995 Mar; 57(3): 265–9
Smeraldi E, Zanardi R, Benedetti F, et al. Polymorphism within the promoter of the serotonin transporter gene and antidepressant efficacy of fluvoxamine. Mol Psychiatry 1998 Nov; 3(6): 508–11
Kim DK, Lim SW, Lee S, et al. Serotonin transporter gene polymorphism and antidepressant response. Neuroreport 2000 Jan 17; 11(1): 215–9
Pollock BG, Ferrell RE, Mulsant BH, et al. Allelic variation in the serotonin transporter promoter affects onset of paroxetine treatment response in late-life depression. Neuropsychopharmacology 2000 Nov; 23(5): 587–90
Zanardi R, Serretti A, Rossini D, et al. Factors affecting fluvoxamine antidepressant activity: influence of pindolol and 5-HTTLPR in delusional and nondelusional depression. Biol Psychiatry 2001 Sep 1; 50(5): 323–30
Yu YW, Tsai SJ, Chen TJ, et al. Association study of the serotonin transporter promoter polymorphism and symptomatology and antidepressant response in major depressive disorders. Mol Psychiatry 2002; 7(10): 1115–9
Rausch JL, Johnson ME, Fei YJ, et al. Initial conditions of serotonin transporter kinetics and genotype: influence on SSRI treatment trial outcome. Biol Psychiatry 2002 May 1; 51(9): 723–32
Yoshida K, Ito K, Sato K, et al. Influence of the serotonin transporter gene-linked polymorphic region on the antidepressant response to fluvoxamine in Japanese depressed patients. Prog Neuropsychopharmacol Biol Psychiatry 2002 Feb; 26(2): 383–6
Gorwood P, Batel P, Adès J, et al. Serotonin transporter gene polymorphisms, alcoholism and suicidal behaviour. Biol Psychiatry 2002; 48(4): 259–64
Lotrich FE, Pollock BG, Ferrell RE. Polymorphism of the serotonin transporter: implications for the use of selective serotonin reuptake inhibitors. Am J Pharmacogenomics 2001; 1(3): 153–64
Heils A, Teufel A, Petri S, et al. Allelic variation of human serotonin transporter gene expression. J Neurochem 1996; 66: 2621–4
Acknowledgements
This work was supported by grants from EC Framework V (Factors in Healthy Eating) and INRA/INSERM (4M406D). ## The author has no conflict of interest directly relevant to the content of this review.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gorwood, P. Eating Disorders, Serotonin Transporter Polymorphisms and Potential Treatment Response. Am J Pharmacogenomics 4, 9–17 (2004). https://doi.org/10.2165/00129785-200404010-00002
Published:
Issue Date:
DOI: https://doi.org/10.2165/00129785-200404010-00002