Detection of Self-Induced Vomiting in Eating Disorders Through Oral Microbiota Profiling

Detection of Self-Induced Vomiting in Eating Disorders Through Oral Microbiota Profiling | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Detection of Self-Induced Vomiting in Eating Disorders Through Oral Microbiota Profiling Cristina M Diaz-Perdigones, Zaida Agüera, Cristina Artero, Isabel Baenas, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8046238/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Eating disorders (EDs) are severe psychiatric conditions frequently associated with purging behaviors such as self-induced vomiting, which can cause serious medical complications. Saliva is an accessible biofluid reflecting oral and systemic health and may provide biomarkers of purging. This study examined whether salivary microbiota profiles are linked to vomiting frequency in EDs. Methods We conducted a case–control study including 27 women with EDs (24 bulimia nervosa; 3 OSFED–purging subtype) and 27 age and sex matched healthy controls (HC). Saliva was collected one week after admission to the Eating Disorders Unit of Barcelona and analyzed with 16S rRNA sequencing. Diversity indices, core microbiome, differential abundance, and functional predictions (PICRUSt2) were assessed. Results The ED group reported a mean vomiting frequency of 4.3 ± 4.9 episodes per week, a mean BMI of 26.3 ± 6.1 kg/m², and an EDI-2 total score of 122.7 ± 32. Beta diversity significantly differed between ED and HC microbiota (PERMANOVA unweighted p = .044; weighted p = .001). Actinomyces and Bulleidia were enriched in EDs, whereas Veillonella and Oribacterium were depleted. Vomiting frequency correlated positively with Actinomyces, Granulicatella , and Bulleidia , and negatively with Eikenella . Functional analyses indicated shifts in pathways related to secondary metabolite biosynthesis and carbohydrate degradation. Conclusions ED patients engaging in vomiting show distinct salivary microbiota signatures, with specific taxa correlating to purging severity. Saliva-based microbiome profiling may represent a potential novel biomarker, by means of non-invasive tool, for early detection and monitoring of purging behaviors in EDs. Eating disorders self-induced vomiting salivary microbiota and non-invasive diagnosis Full Text Additional Declarations No competing interests reported. Supplementary Files additionalfile.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8046238","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":546286645,"identity":"320c4af8-839d-4a92-8226-ede17fe77596","order_by":0,"name":"Cristina M Diaz-Perdigones","email":"","orcid":"","institution":"Hospital Clínico Universitario Virgen de la Victoria","correspondingAuthor":false,"prefix":"","firstName":"Cristina","middleName":"M","lastName":"Diaz-Perdigones","suffix":""},{"id":546286646,"identity":"7e93f326-b0e6-4fc8-b6b0-f1ccd9bea159","order_by":1,"name":"Zaida Agüera","email":"","orcid":"","institution":"Facultat 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Profiling","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Eating disorders, self-induced vomiting, salivary microbiota and non-invasive diagnosis","lastPublishedDoi":"10.21203/rs.3.rs-8046238/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8046238/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eEating disorders (EDs) are severe psychiatric conditions frequently associated with purging behaviors such as self-induced vomiting, which can cause serious medical complications. Saliva is an accessible biofluid reflecting oral and systemic health and may provide biomarkers of purging. This study examined whether salivary microbiota profiles are linked to vomiting frequency in EDs.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe conducted a case\u0026ndash;control study including 27 women with EDs (24 bulimia nervosa; 3 OSFED\u0026ndash;purging subtype) and 27 age and sex matched healthy controls (HC). Saliva was collected one week after admission to the Eating Disorders Unit of Barcelona and analyzed with 16S rRNA sequencing. Diversity indices, core microbiome, differential abundance, and functional predictions (PICRUSt2) were assessed.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe ED group reported a mean vomiting frequency of 4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.9 episodes per week, a mean BMI of 26.3\u0026thinsp;\u0026plusmn;\u0026thinsp;6.1 kg/m\u0026sup2;, and an EDI-2 total score of 122.7\u0026thinsp;\u0026plusmn;\u0026thinsp;32. Beta diversity significantly differed between ED and HC microbiota (PERMANOVA unweighted p\u0026thinsp;=\u0026thinsp;.044; weighted p\u0026thinsp;=\u0026thinsp;.001). Actinomyces and \u003cem\u003eBulleidia\u003c/em\u003e were enriched in EDs, whereas \u003cem\u003eVeillonella\u003c/em\u003e and \u003cem\u003eOribacterium\u003c/em\u003e were depleted. Vomiting frequency correlated positively with Actinomyces, \u003cem\u003eGranulicatella\u003c/em\u003e, and \u003cem\u003eBulleidia\u003c/em\u003e, and negatively with \u003cem\u003eEikenella\u003c/em\u003e. Functional analyses indicated shifts in pathways related to secondary metabolite biosynthesis and carbohydrate degradation.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eED patients engaging in vomiting show distinct salivary microbiota signatures, with specific taxa correlating to purging severity. Saliva-based microbiome profiling may represent a potential novel biomarker, by means of non-invasive tool, for early detection and monitoring of purging behaviors in EDs.\u003c/p\u003e","manuscriptTitle":"Detection of Self-Induced Vomiting in Eating Disorders Through Oral Microbiota Profiling","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-18 23:28:07","doi":"10.21203/rs.3.rs-8046238/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"65c34940-8692-44b4-ae81-66d43ea6810a","owner":[],"postedDate":"November 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-09T22:38:26+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-18 23:28:07","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8046238","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8046238","identity":"rs-8046238","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}