A consequence of starvation stress is that all the endocrine axes are altered in AN, leading to protein- and energy preserving adaptation. Thus, in particular, increased levels of cortisol is well described in both AN and in patients with primary affective disorders. Depression/anxiety and cognitive impairment is also a well-described side effect of pharmacological treatment with corticosteroids and is well-known symptoms in excess endogenous cortisol production (mb. Cushing). Moreover, neuroanatomical animal studies indicate that cortisol per se has neurotoxic properties and may play a pathogenic role in affective disorders and anxiety. There is preliminary experimental evidence that pharmacological cortisol synthesis inhibition may have therapeutic efficacy in depression. However, so far this is not investigated in AN. In one study, it was found that cortisol levels correlated positively with anxiety and depression.