Hebebrand, Johannes, Antel, Jochen, von Piechowski, Linda et al. · Frontiers in psychiatry · 2023 · DOI
This case report describes a 17-year-old boy who had both anorexia nervosa (an eating disorder) and probable ME/CFS (a condition causing extreme fatigue and pain after exertion). He was treated with a medication called metreleptin for short periods. Notably, the treatment appeared to improve not only his eating disorder symptoms but also his ME/CFS symptoms like fatigue and post-exertional muscle pain. This raises the possibility that metreleptin might help people with ME/CFS, especially those who have also lost significant weight.
ME/CFS comorbid with anorexia nervosa is rare, making this observation clinically noteworthy. The potential dual benefit of metreleptin—improving both psychiatric and somatic ME/CFS symptoms—suggests an underexplored therapeutic avenue. This report may prompt researchers to investigate the role of leptin dysregulation in ME/CFS pathophysiology and stimulate discussion about metabolic interventions.
This case report cannot prove that metreleptin causes symptom improvement; temporal association does not establish causation, and natural recovery or placebo effect cannot be excluded. The brief treatment periods and lack of controls mean long-term efficacy, optimal dosing, and safety in ME/CFS populations remain unknown. Generalization to the broader ME/CFS population is inappropriate given the unique comorbidity and single-subject design.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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