Cortisol,Hunger, and Desire to Binge Eat Following a Cold Stress Test in Obese Women with Binge Eati

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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-Dec66(6)876-81.

Nick Bello ED Journal Club
05-Dec-2008
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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

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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.

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HPA Axis and dexamethasone test (DST)
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Cold Pressor Test (CPT)
Life, December 1955
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Hypothesis

• Obese women with BED compared with non-BED
• Increase CORT after CPT
• More hungry and desire to binge eat after CPT
• Less CORT suppression after DST

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Methods (Participants)

• Obese women (n38) 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

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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 (n11)
non-BED (n11)
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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 _at_ 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

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Procedures (More)

• DST (third day)
• 1 mg oral dexamethasone _at_ 11 pm
• Blood drawn _at_ 8am for CORT

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Results
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Results
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Results
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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

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Results
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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

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Results