Phosphatidylcholine containing long chain omega-3 fatty acids: A treatment adjunct for patients with anorexia nervosa?

Background: Anorexia nervosa (AN) is a serious mental disorder with a high mortality rate and often a chronic course. In contrast to many other common mental disorders, there is no drug therapy approved for AN. Methods: We performed a narrative literature review to consider whether a choline-containing molecule, such as phosphatidylcholine (PC), with an omega (Ȧ)-3 long chain polyunsaturated fatty acid (LCPUFA) could be a potential future medicinal treatment for AN. Results: Choline and LCPUFAs have individually shown benefit for mental health. Case series and pilot studies suggest Ȧ-3 LCPUFAs may be effective in eating disorders. However, pharmacodynamic and pharmacokinetic considerations suggest a greater benefit from the combination of both components. Conclusion: The combination of a choline-containing molecule with an Ȧ-3 LCPUFA may be clinically effective and well tolerated. This idea is supported by the current literature on the role of inflammation, the microbiome, the gut-brain-axis, hormonal, neurotransmitter and intracellular signalling, and on the structure and fluidity of nerve cells membranes in patients with AN.