Binge-eating disorder, characterized by binge meals without purging afterward, is found in about 30% of obese individuals seeking treatment.
Dr Geliebter and colleagues ascertained abnormalities in hormones influencing appetite in binge-eating disorder, especially ghrelin, an appetite-stimulating peptide, which was expected to be elevated.
The research team made measurements of plasma insulin, leptin, glucagon, cholecystokinin, and ghrelin.
The team also took measures of glucose following an overnight 12-hour fast, prior to and after ingestion from 0 to 5 min of a nutritionally complete liquid meal of 1254 kJ.
The glucose measures were taken at 08h30, at 15, 0, 5, 15, 30, 60, 90, and 120 minutes.
|Binge-eating disorder subjects, compared to nonbinge eating subjects, had lower baseline ghrelin concentrations|
|Journal of Nutrition|
The investigators obtained appetite ratings including hunger and fullness.
An acetaminophen tracer was used to assess gastric emptying rate.
The researchers included 3 groups of comparably obese women of which 12 were nonbinge eating normals, 14 were subthreshold binge-eating disorder, and 11 had binge-eating disorder.
The researchers found that the binge-eating disorder subjects, compared to nonbinge eating subjects, had lower baseline ghrelin concentrations prior to the meal.
The binge-eating subjects also had a lower area under the curve, with lower levels at 5, 15, 30, 90, and 120 min, and a smaller decline in ghrelin postmeal.
The investigative team observed that the other blood values did not differ among groups, and neither did gastric emptying rate nor ratings of fullness.
The team then randomly assigned 5 subjects with binge-eating disorder to treatment with cognitive-behavior therapy and diet and 4 to a wait-list control.
The research team noted that baseline ghrelin and area under the curve increased, across both conditions, in which most subjects stopped binge eating.
Dr Geliebter concludes, “The lower fasting and postmeal plasma ghrelin levels in binge-eating disorder are consistent with lower ghrelin levels in obese compared to lean individuals and suggests downregulation by binge eating.”