CLPB and Anxiety: These authors claim that a dysbiosis involving an increase in these bacteria would cause the segregation of ClpB affecting the aetiology of AN either by (a) a direct effect on the peripheral satiety routes -increasing PYY [25, 26], or centrally through MC4R [27]; or (b) an indirect effect from the formation of anti-ClpB IgG antibodies cross-reactive with α-MSH that would form immune complexes, activating chronically the central MC4R receptor and inducing increased satiety and anxiety, or both.