ENDOCRINE FACTORS IN UNDERNUTRITION1

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Abstract
The similarity of the clinical picture in 3 cases of anorexia nervosa to that of hypophyseal cachexia is emphasized. Striking improvement was observed when caloric intake was increased. The literature is reviewed. Chronic undernutrition is evidently accompanied by structural and functional alterations in the hypophysis, thyroid, gonads, and adrenal. Many of the changes in undernutrition may be regarded as expressions of a protective mechanism to compensate for the reduced caloric intake, mediated principally through a reversible, functional limitation of pituitary activity. A concept of the pathogenesis of the clinical picture of anorexia nervosa is suggested. The changes, at least to a large extent, are reversible and may be corrected by re-feeding. The therapeutic use of endocrine preps. is usually unnecessary and, on theoretical considerations, may be contraindicated.