cortisol,hunger, and desire to binge eat following a cold stress test in obese women with binge...
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Cortisol,Hunger, and Desire to Binge Eat Following a Cold
Stress Test in Obese Women with Binge Eating Disorder
Gluck ME, Geliebter A, Hung J, and Yahav E.
Psychosom Med. 2004 Nov-Dec;66(6):876-81.
Nick Bello
ED Journal Club 05-Dec-2008
Introduction
Binge eating disorder (BED) Frequent and regular intake large amount of food
twice a week for 6 months Sense of “loss of control” over eating No inappropriate compensatory behaviors BED is 2% of the nonpatient general community ~ 30% obese people seeking medical treatment
Introduction (continue)
Stress and binge eating Stress and negative affect precursors to binge
eating Cortisol is the major hormonal component to
stress response. Exogenous glucocorticoids induce obesity by
increasing food intake. Elevated cortisol levels associated with energy
intake in health individuals.
HPA Axis and dexamethasone test (DST)
Cold Pressor Test (CPT)
Life, December 1955
Hypothesis
Obese women with BED compared with non-BED
1. Increase CORT after CPT
2. More hungry and desire to binge eat after CPT
3. Less CORT suppression after DST
Methods (Participants)
Obese women (n=38) were recruited by local advertisements
Exclusion Criteria Significant health problem other than obesity Unstable weight (± 5%) for the past 3 months Dieting or smoking current or in the past 3 months Most prescribed medication or substance abuse
within the past 6 months Pregnant or lactating, not oral contraceptives
Methods (Participants)
Inclusion Criteria PE (medical history, ECG and blood tests) Questionnaire on Eating and Weight Patterns BED if they met the full criteria of DSM IV Non-BED if they denied episodes of overeating
BED (n=11) non-BED (n=11)
Procedures Body Composition (first day)
Waist and hip circumferences (WHR) % Body Fat by underwater weighing
Psychological Scales Zung Depression Rating Scales
CPT ( second day) 12 hour fast and then a fixed meal First blood draw @ 8-9 am Immersed non-dominant hand in 2 min of 0° C ice water Rated Pain, Stress, Hunger and Desire to Binge Eat Blood draws at –10 , 0, 5,15, 30, 45 and 60 min Blood pressure and heart rate
Procedures (More)
DST (third day) 1 mg oral dexamethasone @ 11 pm Blood drawn @ ~8am for CORT
Results
Results
Results
Results Insulin
No differences DST
No difference between BED and non-BED BED compared with morning CORT relative
greater reduction VAS Ratings
BED had greater AUC hunger, desire to binge eat, pain, stress
Results
Results Sympathetic Activity
No Differences Correlations
AUC for CORT was correlated w/ AUC pain AUC for Stress was correlated w/ AUC “desire to
binge eat” and Pain AUC Pain was correlated Hunger and “desire to
binge eat”
Results