An empirical examination of appetite hormones and cognitive and behavioral bulimic symptomatology
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ORIGINAL ARTICLE
An empirical examination of appetite hormones and cognitive and behavioral bulimic symptomatology Emily K. Presseller1,2 · Kelsey E. Clark1,2 · Caroline Fojtu1,2 · Adrienne S. Juarascio1,2 Received: 8 June 2020 / Accepted: 3 September 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose Existing literature has demonstrated that appetite hormones are frequently dysregulated in individuals with bulimicspectrum eating disorders (BN-EDs). Although dysregulations in appetite hormones may maintain BN-EDs, very limited research has examined the association between dysregulated appetite hormones and cognitive and behavioral bulimic symptoms. We hypothesized that greater frequency of behavioral symptoms and severity of cognitive symptoms of BN-EDs would correlate with greater dysregulation in appetite hormones. Methods The association between ghrelin, cortisol, leptin, GLP-1, and amylin levels and eating pathology was examined in treatment-seeking adults with BN-EDs (N = 33). Participants completed bloodwork to assess fasting blood hormone levels and bulimic symptoms were measured by the Eating Disorder Examination. Pearson partial correlations were run to examine the association between hormone levels and eating pathology, controlling for BMI. Results Contrary to hypotheses, none of the appetite hormones tested were significantly associated with frequency of behavioral ED symptoms (p range = 0.13–0.97, negligible to small effect sizes). Global eating pathology was positively associated with leptin (p = 0.03) and negatively associated with GLP-1 (p = 0.03) and amylin (p = 0.04), with medium effect sizes. Post hoc analyses indicated significantly stronger associations between appetite hormones and cognitive eating pathology than between appetite hormones and frequency of binge eating [GLP-1 (p = 0.02) and amylin (p = 0.02)] or compensatory behaviors [leptin (p = 0.03), GLP-1 (p = 0.02), and amylin (p = 0.04)]. Conclusion In individuals with BN-EDs, appetite hormones may be more strongly associated with cognitive symptoms than behavioral symptoms. Level of evidence Level V, cross-sectional descriptive study. Keywords Appetite hormones · Bulimia nervosa · Binge eating · Neuroendocrinology
Introduction Individuals with bulimia nervosa (BN) and other bulimicspectrum eating disorders often engage in irregular eating patterns (e.g., eating large quantities of food during bingeeating episodes, going long periods of time without eating, purging) that may lead to dysregulations in metabolic hormones impacting appetite and body weight. Appetite hormones are signaling molecules and can roughly be divided * Emily K. Presseller [email protected] 1
Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA 19104, USA
Department of Psychology, Drexel University, Philadelphia, PA, USA
2
into two broad categories (with some caveats, see Begg, Woods [1] for a full review of the function of appetite hormones): (1) hormones that stimulate appetite and promote in
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