Doing what we can to help eating disorders.

I don't know Jean Forney, a Phd student and AED (Academy for Eating Disorders) member studying eating disorders, but she has some very interesting ideas. She recently contacted me requesting I do a blog post on her research. Better yet, I thought--you can do it! I wasn't just passing the buck, but preferred to give her the opportunity to describe her proposal. 

One step in the right direction.
Measuring hormone levels to help predict eating disorder recovery (keep reading for the full description) is not simply about determining how long your eating disorder will last. It may offer insights about biological causes of eating disorders and ultimately to treatments for bulimia, binge eating disorder and purging disorder. 

I post this to offer hope--to show what young researchers are exploring to better understand eating disorders and help the path to recovery. And to offer you an opportunity to personally support the research (see her link at the end). 

The Importance of Physiological Research to Help Eating Disorder Treatment
By K. Jean Forney, M.S.

Eating is both a biological and psychological process. Deciding what to eat, when to eat, etc. - it’s governed by both our mind and our biological make-up. In trying to understand and treat eating disorders, more and more research is focusing on physiological processes to help supplement what we know about the role of the mind and psychological factors in eating disorders.
Two hormones involved in eating come to mind: cholecystokinin (CCK) and leptin. CCK is released from the gut during digestion. It sends a signal to the brain that says “Hey, I’m full!” and leads you to stop eating. Multiple studies have found that CCK is released more slowly in individuals with bulimia nervosa, an eating disorder characterized by binge eating and purging, compared to individuals without an eating disorder. In contrast, the CCK response appears to be normal in individuals with purging disorder, an eating disorder characterized by purging in the absence of binge eating. This led the authors who conducted the study to conclude that delayed CCK response is likely related to binge eating. 
Problematically, when you look at people at one point of time, you do not know if dysregulated CCK response occurred before the eating disorder started, or if it is a consequence of the eating disorder, or a combination of the two.  It also means that we do not know if a dysregulated CCK response makes someone more likely to binge eat and keeps the eating disorder perpetuating itself over time.
The other hormone I mentioned was leptin. Leptin is a hormone secreted from fat tissue. It is sometimes called an “adipostat” because it tells the body how much fat tissue it has. When leptin levels are too low, the brain is told to eat more via a network of neurons, neurotransmitters, and other hormones, and people become more hungry. Leptin levels appear to be lower in people with bulimia nervosa and purging disorder compared to people without eating disorders, and some authors have found that leptin levels are associated with duration of illness. That is, the lower the leptin levels, the longer someone has been ill. It makes you wonder if lower leptin somehow contributes to the eating disorder lasting longer, or if having an eating disorder causes lower leptin levels.
To answer that question, you need to study people at multiple time points.
I am running a study that will see how CCK and leptin levels predict eating disorder remission over time. Multiple women with bulimia nervosa and purging disorder have already participated in studies and had their CCK and leptin levels measured through blood draws. I will be interviewing these women, on average, 10 years after they had their blood drawn. Then, we will have some information as to whether or not these disruptions influence how likely someone is to recover from their eating disorder. This is part of a larger study looking at the long-term outcome of purging disorder and comparing it to bulimia nervosa.
Why does this matter? Well, the more we know about the processes that keep eating disorders going, the better interventions we can develop. Perhaps by treating both the body and the mind, we can help people have healthier, happier lives, free from the distress and impairment that eating disorders cause.

To read more about my study or to donate to help support the study, please see my website are some of the articles I gathered this information from, for your interest:
 Keel PK, Wolfe BE, Liddle RA, De Young KP, Jimerson DC. Clinical features and physiological response to a test meal in purging disorder and bulimia nervosa. Arch Gen Psychiatry. 2007;64(9):1058-1066. PMID: 17768271 Monteleone P, Martiadis V, Colurcio B, Maj M. Leptin secretion is related to chronicity and severity of the illness in bulimia nervosa. Psychosom Med. 2002;64(6):874-879. PMID: 12461192 Jimerson DC, Wolfe BE, Carroll DP, Keel PK. Psychobiology of purging disorder: Reduction in circulating leptin levels in purging disorder in comparison with controls. Int J Eat Disord. 2010;43(7):584-588. PMCID: 2891937
Expect another post from me soon!  And please share any thoughts about Jean's research here. Your voice really matters! Lori

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