Associations of Stress and Appetite Hormones with Binge Eating in Females with Anorexia Nervosa after Weight Restoration: A Longitudinal Study.

Ya-Ke Wu,Jessica H Baker,Cynthia M Bulik,Kimberly A Brownley,Anna M Bardone-Cone

doi:10.3390/jpm11101020

Ya-Ke Wu, Jessica H Baker + Show 3 more

Open Access

https://doi.org/10.3390/jpm11101020

Copy DOI

Abstract

Binge eating is a transdiagnostic eating disorder symptom that can occur in patients with anorexia nervosa (AN), persisting after weight restoration, and impeding their recovery. However, little is known about the biological predictors of binge eating after AN weight restoration. The goals of this exploratory study of 73 females with AN were: (1) to examine changes in cortisol, the adrenocorticotropic hormone, norepinephrine, ghrelin (total and active), and leptin levels across the admission, discharge, and 3 months post-discharge from the inpatient AN weight restoration; and (2) to determine whether the target hormones were associated with objective or subjective binge eating (OBE or SBE). The participants completed the self-reported Eating Disorder Examination Questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory-II, and provided fasting whole blood samples for hormone assays. The results showed significant changes in body mass index (BMI), cortisol, total ghrelin, and leptin levels over the three time points. The cortisol levels at admission and discharge were significantly associated with the number of SBE episodes at 3 months post-discharge. Findings suggest the need to replicate and confirm the role of cortisol in predicting the emergence of SBE and uncover the mechanisms underlying SBE and cortisol to prevent SBE and its negative consequences.

Highlights

Anorexia nervosa (AN) is an eating disorder defined by a restriction of energy intake leading to a significantly low body weight [1]
No significant correlation was found between age, age of AN onset, anxiety, and depression, and the change in hormone levels with objective binge eating (OBE) or subjective binge eating (SBE) at 3 months post-discharge, and these variables were not included as covariates in the regression models
The present study explored the changes in stress and appetite hormones across inpatient admission, discharge, and 3 months post-discharge in females with AN, and how the admission and discharge levels of hormones and changes in these hormones related to OBE and SBE episodes after weight restoration

Summary

Introduction

Anorexia nervosa (AN) is an eating disorder defined by a restriction of energy intake leading to a significantly low body weight [1]. Patients with AN often display anxiety toward food, fear weight gain, and fail to recognize the seriousness of their low body weight [2]. Compared with patients with AN who do not binge eat, those who binge eat frequently experience more adverse consequences (e.g., increased food addiction and compulsive exercise) that may delay recovery and prolong the duration of illness [6,7,8,9]. Despite the potential consequences of binge eating on the treatment outcome and recovery, little is known about the prospective predictors of binge eating in patients with AN after weight restoration

Methods

Results

Discussion

Conclusion