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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Hebebrand, Johannes, Antel, Jochen, von Piechowski, Linda, Kiewert, Cordula, Stüve, Burkhard, & Gradl-Dietsch, Gertraud (2023). Case report: Rapid improvements of anorexia nervosa and probable myalgic encephalomyelitis/chronic fatigue syndrome upon metreleptin treatment during two dosing episodes.. Frontiers in psychiatry. https://doi.org/10.3389/fpsyt.2023.1267495
BibTeX
@article{mecfsatlas-hebebrand-2023-case-report,
author = {Hebebrand, Johannes and Antel, Jochen and von Piechowski, Linda and Kiewert, Cordula and Stüve, Burkhard and Gradl-Dietsch, Gertraud},
title = {Case report: Rapid improvements of anorexia nervosa and probable myalgic encephalomyelitis/chronic fatigue syndrome upon metreleptin treatment during two dosing episodes.},
journal = {Frontiers in psychiatry},
year = {2023},
doi = {10.3389/fpsyt.2023.1267495},
note = {PubMed: 38025476},
url = {https://www.mecfsatlas.com/evidence/hebebrand-2023-case-report},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/hebebrand-2023-case-report
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