Insulin response in bulimia nervosa as a marker of nutritional depletion

Russell, Janice; Hooper, Michael J.; Hunt, Glenn E.

doi:10.1002/(sici)1098-108x(199611)20:3<307::aid-eat10>3.0.co;2-x

Cited by 21 publications

(3 citation statements)

References 16 publications

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“…In bulimia nervosa patients with unstable weight and with binge‐eating and frequent vomiting, a blunted insulin response to a glucose load was found. On the other hand, in these patients who were treated successfully by abstaining from binge‐eating and vomiting for 4 weeks, there was a similar insulin response to that seen in normal controls (Russell et al ., 1996). These findings suggest that both abnormal eating behaviour and nutritional depletion may be the cause of the results found in AN‐BP, and that abstaining from binge‐eating and vomiting may be important for inpatient treatment of AN‐BP patients.…”

Section: Discussionmentioning

confidence: 68%

Eating pattern and the effect of oral glucose on ghrelin and insulin secretion in patients with anorexia nervosa

Tanaka

Tatebe

Nakahara

et al. 2003

Clinical Endocrinology

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Section: Discussionmentioning

confidence: 68%

Eating pattern and the effect of oral glucose on ghrelin and insulin secretion in patients with anorexia nervosa

Tanaka

Tatebe

Nakahara

et al. 2003

Clinical Endocrinology

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“…Results from prior studies of insulin in BN are mixed and largely suggest that insulin may not be a major influence on the pathophysiology of BN (Johnson, Jarrell, Chupurdia, & Williamson, ; Naessén et al, ; Russell, Hooper, & Hunt, ; Schweiger et al, ). Our results also found no significant difference in insulin release between BN and control participants but did suggest greater sensitivity to the effects of insulin in both BN and PD.…”

Section: Discussionmentioning

confidence: 99%

Preliminary examination of insulin and amylin levels in women with purging disorder

Maske

Williams

Keel

2020

Intl J Eating Disorders

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Objective: This preliminary study explored whether differences in meal-stimulated insulin or amylin release are linked to altered ingestive behaviors in individuals with bulimia nervosa (BN) or purging disorder (PD).Method: Women with BN (n = 15), PD (n = 16), or no eating disorder (n = 18) underwent structured clinical interviews and assessments of gut hormone and subjective responses to a fixed test meal. Multilevel model analyses were used to explore whether gut hormone responses contribute to subjective responses to the test meal and whether these associations differed by group.Results: Insulin and amylin levels significantly increased following the test meal.Women with PD showed greater insulin release compared to those with BN, but not controls. Multilevel models support significant group X insulin interactions predicting subjective ratings of nausea and urge to vomit, with a stronger association between higher insulin responses and higher nausea and urge to vomit in women with PD and BN. Amylin responses did not differ by group.Conclusion: Increased sensitivity to the effects of insulin on nausea and urge to vomit may be linked to purging in both PD and BN. Differences in postprandial insulin levels may be linked to purging behavior in the absence versus presence of binge eating. K E Y W O R D Samylin, bulimia nervosa, insulin, purging disorder, self-induced vomiting

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“…Studies using non‐CGM technology and CGM have evaluated glucose and insulin responses in individuals with B‐EDs. The vast majority of the literature to date suggests that measures of glucose, insulin, glucagon, and thyroid function are generally within normal limits during standard test meals (Monteleone et al., 2000; Russell et al., 1996; Schweiger et al., 1987) and in free‐living conditions (Presseller et al., 2022; Uotani et al., 2022). It is likely that meal detection algorithms using similar features as those among healthy populations could be developed to detect episodes of eating in individuals with B‐EDs.…”

Section: Introduction and Aimsmentioning

confidence: 99%

Continuous glucose monitoring as an objective measure of meal consumption in individuals with binge‐spectrum eating disorders: A proof‐of‐concept study

Presseller,

Parker,

Zhang

et al. 2024

Euro Eating Disorders Rev

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ObjectiveGoing extended periods of time without eating increases risk for binge eating and is a primary target of leading interventions for binge‐spectrum eating disorders (B‐EDs). However, existing treatments for B‐EDs yield insufficient improvements in regular eating and subsequently, binge eating. These unsatisfactory clinical outcomes may result from limitations in assessment and promotion of regular eating in therapy. Detecting the absence of eating using passive sensing may improve clinical outcomes by facilitating more accurate monitoring of eating behaviours and powering just‐in‐time adaptive interventions. We developed an algorithm for detecting meal consumption (and extended periods without eating) using continuous glucose monitor (CGM) data and machine learning.MethodAdults with B‐EDs (N = 22) wore CGMs and reported eating episodes on self‐monitoring surveys for 2 weeks. Random forest models were run on CGM data to distinguish between eating and non‐eating episodes.ResultsThe optimal model distinguished eating and non‐eating episodes with high accuracy (0.82), sensitivity (0.71), and specificity (0.94).ConclusionsThese findings suggest that meal consumption and extended periods without eating can be detected from CGM data with high accuracy among individuals with B‐EDs, which may improve clinical efforts to target dietary restriction and improve the field's understanding of its antecedents and consequences.

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Insulin response in bulimia nervosa as a marker of nutritional depletion

Cited by 21 publications

References 16 publications

Eating pattern and the effect of oral glucose on ghrelin and insulin secretion in patients with anorexia nervosa

Eating pattern and the effect of oral glucose on ghrelin and insulin secretion in patients with anorexia nervosa

Preliminary examination of insulin and amylin levels in women with purging disorder

Continuous glucose monitoring as an objective measure of meal consumption in individuals with binge‐spectrum eating disorders: A proof‐of‐concept study

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