The Relationship Between Food Craving, Appetite-Related Hormones and Clinical Parameters in Bipolar Disorder

Abstract

Obesity and weight gain in bipolar disorder (BD) have multifactorial underlying causes such as medication side effects, atypical depressive symptomatology, genetic variants, and disturbances in the neuro-endocrinal system. Therefore, we aim to explore the associations between food craving (FC), clinical parameters, psychotropic medication, and appetite-related hormones. In this cross-sectional investigation, 139 individuals with BD and 93 healthy controls (HC) completed the food craving inventory (FCI). In addition, blood samples (including leptin and acylated ghrelin) were analyzed and sociodemographic and anthropometric data were collected. Individuals with BD reported higher frequencies of total FC as well as craving for fat and fast food than HC. Additionally, we found a significant negative correlation between FC and ghrelin levels in BD. Smokers with BD reported significantly more craving for high fat foods than non-smokers. Age was significantly associated with FC independent of group. Individuals with BD taking olanzapine and quetiapine reported higher frequencies of craving for sweet food, while patients currently taking lithium reported less total FC compared to those without lithium therapy. Likewise, patients currently taking valproate reported less total FC and less craving for sweets than those not taking valproate. FC appears to be of clinical relevance in individuals with BD. Contrary to previous data, this does not seem to be a female phenomenon only and might encompass more than the specific craving for carbohydrates. Although due to the cross sectional design, causality cannot be determined, the association between depressive symptomatology and fast food craving warrants further research.

Comparison of executive dysfunction, proinflammatory cytokines, and appetite hormones between first-episode and multiple-episode bipolar disorders

“…However, previous research has shown contradictory results regarding ghrelin levels of patients with BD. Rosso et al 25 observed that ghrelin levels were lower in patients with BD than in healthy controls, whereas Platzer et al 26 and Tunçel et al 27 reported no difference in ghrelin levels between patients with BD and healthy controls. However, Tunçel et al 27 observed that patients with BD had significantly higher ghrelin levels during euthymic episodes than during manic episodes after treatment.…”

Leptin—A Potential Bridge between Fat Metabolism and the Brain’s Vulnerability to Neuropsychiatric Disorders: A Systematic Review

“…The involvement of central circuits in the expression of LepRls sheds light on the integration of metabolism as a contributing factor for feeding and stress-related neuropsychiatric disorders [ 95 , 96 , 97 , 98 ]. The function of leptin in the CNS requires fine-tuning of LepRls signaling throughout the neuroendocrine axes, which is a coadjutant in the physiopathology of these disorders.…”

Characterizing eating behavioral phenotypes in mood disorders: a narrative review

“…(2) Presence of food cravings: Individuals with BD report more frequent food cravings, mostly for foods high in fat, sodium and refined carbohydrates. In addition, the presence of more frequent food cravings in BD is associated with increased depressive symptoms and negatively correlates with ghrelin levels (Platzer et al, 2020).…”

“… Presence of food cravings: Individuals with BD report more frequent food cravings, mostly for foods high in fat, sodium and refined carbohydrates. In addition, the presence of more frequent food cravings in BD is associated with increased depressive symptoms and negatively correlates with ghrelin levels (Platzer et al, 2020 ). Excessive consumption of highly palatable foods: Palatable foods are known to activate the brain's reward circuitry similarly to drugs of abuse and dopamine signaling impacts both food intake and mood (Singh, 2014 ).…”

“…One study indicated that individuals with BD taking olanzapine or quetiapine reported increased food cravings, specifically for sweet foods. In contrast, individuals taking valproate or lithium demonstrated fewer food cravings (Platzer et al, 2020 ). Despite this, mood stabilizers have also been repeatedly linked to weight gain (El-Khatib et al, 2007 ; Martin, Han, Anton, Greenway, & Smith, 2009 ).…”