Study supports utilizing weight history assessment for eating disorders and shows pivotal role of GLP-1 in link between weight loss and binge eating severity
A groundbreaking study from Florida State University has uncovered the biological and behavioral consequences of weight loss that underlie binge eating in women with bulimia nervosa and related syndromes.
Led by Pamela Keel, Robert O. Lawton Distinguished Professor in FSU’s Department of Psychology, the study reveals the roles of the hormones leptin and GLP-1 (glucagon-like peptide 1) for understanding excessive food intake in binge eating among women.
“When somebody loses weight, they put themselves in this ‘psychobiological bind,’” Keel said. “We live in a culture that values weight loss, so psychologically, you’re motivated to keep the weight off. But biologically, your body is not designed to maintain that weight loss. Caught between a desire to be thin and strong urges to eat more food, weight suppression could trap people in cycles of bingeing and purging.”
WHY IT MATTERS
The study highlights the concept of weight suppression — the difference between a person’s highest and current weight — and how it affects hormone levels.
The researchers found that greater weight suppression is associated with reduced levels of leptin, and lower leptin was further associated with reduced release of the naturally occurring hormone GLP-1 after eating. Both hormones play key roles in appetite regulation.
Leptin, primarily released from fat tissue, signals the brain about the body’s energy reserves, while GLP-1, secreted by the intestinal tract in response to food intake, helps signal the brain when enough food has been consumed. The study showed that lower GLP-1 response was associated with needing to eat more food to feel satiated, which was linked to more severe binge episodes.
“Prior to this research, the middle of the equation – GLP-1 and satiation deficits – was completely missing, and that missing part is crucial for advancing treatment for bulimia and related disorders,” Keel said.
IMPLICATIONS FOR TREATMENT
The research underscores the importance of assessing weight history in addition to current weight in patients with eating disorders and shows that drugs that affect GLP-1 receptor agonists, initially approved by the FDA for type 2 diabetes and, more recently, for weight loss, could have potential applications in managing binge eating.
“Our study offers novel insights as the first project to link biological consequences of weight loss, namely lower leptin and reduced GLP-1, to eating larger amounts of food, which is a core feature of binge eating,” said co-author Lindsay Bodell, a professor in the Department of Psychology at Western University in Ontario, Canada. “These findings point to new directions for treatment, offering hope to those affected by eating disorders.”
The article also discusses the need for further investigation of GLP-1 medication misuse as an eating disorder symptom and describes cognitive-behavioral therapy as a first-line treatment for bulimia and related disorders.
The study included nearly 400 women with various weights with a range of eating disorders involving recurrent binge eating as well as women without eating disorders. This approach was designed to identify mechanisms underlying binge eating across diagnoses of anorexia, bulimia, binge-eating disorder and other specified feeding and eating disorders to have the broadest impact possible.
FUNDING AND MORE INFORMATION
This research was funded by a $2.1 million grant from the National Institute of Mental Health, part of the National Institutes of Health, to investigate biobehavioral predictors of bulimia. Additional support was provided by Florida State University through an award from the U.S. Department of Education Higher Education Emergency Relief Fund.
For more information about Keel’s research, visit her lab’s website. For more about FSU’s Department of Psychology, visit psychology.fsu.edu.