This paper is only available as a PDF. To read, Please Download here.
Abstract
Bulimia patients claim to crave sweets and since as clinical evidence suggests that
the food consumed during eating binges often contains large amounts of carbohydrates,
hormones involved in carbohydrate metabolism might be affected in bulimia. We therefore
performed a 4-hr glucose tolerance test (GTT), using 100 g oral glucose and inquired
about attitudes toward sweets. Thirteen female patients, with a mean age of 23.3 years,
who had had bulimia from 3 to 7 years but whose binge-eating/vomiting behavior was
largely controlled at the time of testing, were compared to 14 age-matched healthy
female controls with a mean age of 24.4 years. All bulimic patients and most controls
had liked sweets as children and still liked sweets. Significantly more bulimic patients
than controls stated they overate on sweets and avoided sweets. Glucose utilization
and the insulin, glucagon, growth hormone (GH), and pancreatic poloypeptide (PP) response
curves in the bulimic patients were within the normal range. Fasting plasma levels
of glucose, insulin, glucagon, GH, cortisol, free fatty acids (FFA), and PP were not
different from controls. There was a trend in bulimic patients to have lower plasma
FFA levels and higher plasma cortisol levels during the GTT than controls. The findings
suggest that, given body weight maintenance and adequate nutrition, patients with
bulimia nervosa have normal glucose tolerance and normal hormonal responses following
an oral glucose load.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Biological PsychiatryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Diagnostic and Statistical Manual of Mental Disorders.ed 3. American Psychiatric Association, Washington, DC1980
- Depression Inventory.Center for Cognitive Therapy, Philadelphia1978
- An improved assay with 4-(2-thiazolylazo)-resorcinol for non-esterified fatty acids in biological fluids.Clin Chim Acta. 1980; 104: 53-63
- Acute effect of psychologic stimuli upon plasma non-esterifed fatty acid level.Proc Soc Exp Biol Med. 1959; 100: 503-504
- Psychologic and neural regulation of growth hormone secretion.Psychosom Med. 1972; 34: 45-61
- Rapid increase of plasma unesterified fatty acids in man during fear.J Psychosom Res. 1959; 4: 5-9
- Weight loss, cortisol levels, and dexamethasone suppression in major depressive disorder.Acta Psychiatr Scand. 1987; 75: 243-250
- Interpretation of the glucose tolerance test. The necessity of a standard preparatory diet.Am J Med Sci. 1940; 199: 555-564
- Fractional and partial hypopituitarism in anorexia nervosa.Hormone Res. 1972; 3: 105-118
- Gastric inhibitory polypeptide (GIP) in anorexia nervosa.Int J Eating Dis. 1985; 4: 597-604
- A relation between non-esterified fatty acids in plasma and the metabolism of glucose.J Clin Invest. 1956; 35: 150-154
- The Eating Attitudes Test: An index of the symptoms of anorexia nervosa.Psychol Med. 1979; 9: 273-279
- Development and validation of a multi-dimensional eating disorder inventory for anorexia nervosa and bulimia.Int J Eating Dis. 1983; 2: 15-34
- The regulation of growth hormone secretion.in: Ganong WF Martini L Frontiers in Neuroendocrinology. Oxford University Press, New York1969: 141-182
- Unesterified fatty acid in human blood plasma. II. The transport function of unesterified fatty acid.J Clin Invest. 1957; 36: 810-815
- Neuroendocrine abnormalities in bulimia.Am J Psychiatry. 1983; 140: 559-563
- Predominance of renal and absence of hepatic metabolism of pancreatic polypeptide in the dog.Am J Physiol. 1983; 245: E171-E177
- Effects of low-carbohydrate diet and diabetes mellitus on plasma concentrations of glucose, non-esterified fatty acid, and insulin during oral glucose-tolerance tests.Lancet. 1963; 1: 790-794
- Satiety and taste in eating disorders.in: Disorders of Eating Behavior. A Psychoneuroendocrine Approach. Advances in Biosciences. vol 60. Pergamon Press, New York1986: 199-203
- Dietetic factor determining glucose tolerance and sensitivity to insulin of healthy men.Clin Sci. 1935; 2: 67-94
- Oral glucose tolerance in bulimia.Int J Eating Dis. 1986; 5: 157-160
- Plasma insulin and growth hormone during 22-hour fasts and after graded glucose loads in six healthy adults.J Endocrinol. 1968; : 10297-10311
- On the volume of distribution of glucose in man.Acta Endocrinol. 1957; 25: 335-344
- Taste experience and the development of a dietary preference for sweet in humans: Ethnic and cultural variations in early taste experience.(Washington, DC)in: DHEW publication no (NIH) 77–1068. 1977
- Heterogeneity of plasma glucagon: Patterns in patients with chronic renal failure and diabetes.J Clin Endocrinol Metab. 1976; 42: 173-176
- The plasma sugar, free fatty acid, cortisol and growth hormone response to insulin and the comparison of this procedure with other tests of pituitary and adrenal function. II. In patients with hypothalamic or pituitary dysfunction or anorexia nervosa.J Clin Invest. 1966; 45: 437-449
- Pancreatic polypeptide: A review.Arch Surg. 1981; 116: 1256-1264
- Plasma growth hormone levels in chronic starvation in man.Nature. 1965; 208: 686-687
- Blood sugar studies in abnormal mental states.J Ment Sci. 1931; 77: 525-548
- Metabolic and endocrine investigations in women of normal weight with the bulimia syndrome.Biol Psychiatry. 1983; 18: 355-365
- Monitored binge eating behavior in patients with bulimia.Int J Eating Dis. 1985; 4: 177-184
- Frequency and duration of binge-eating episodes in patients with bulimia.Am J Psychiatry. 1981; 138: 835-836
- Immunoassay of insulin: Two antibody systems. Plasma insulin levels of normal subdiabetic and diabetic rats.Diabetes. 1963; 12: 115
- Simplified, partially automated method for radioimmunoassay of human thyroid-stimulating, growth, luteinizing and follicle stimulating hormones.J Lab Clin Med. 1967; 70: 973-979
- Brain metabolism during fasting.J Clin Invest. 1967; 46: 1589-1595
- Metabolic and endocrine indices of starvation in bulimia: A comparison with anorexia nervosa.Psychiatry Res. 1985; 15: 33-39
- The relationship between glucose tolerance, body weight, and clinical state.J Mental Sci. 1958; 104: 1079-1092
- Physiological roles of ketone bodies as substrates and signals in mammalian tissues.Physiol Rev. 1980; 60: 143-187
- Vagal, cholinergic regulation of pancreatic polypeptide secretion.J Clin Invest. 1978; 61: 781-789
- Altered insulin response to a balanced test meal in bulimic patients.Int J Eating Dis. 1987; 6: 551-556
- Effects of drugs on clinical laboratory test.Clin Chem. 1975; 21: 1D-432D
Article info
Publication history
Received in revised form:
December 21,
1987
Received:
October 16,
1987
We thank the patients and control subjects for their participation and gratefully acknowledge the technical assistance of Leslie Jabine, Nancy Staples, Julie Moreschi, and Barbara Brown.Footnotes
☆Supported in part by NIMH Grants ROI MIH35585 and ROI MH40623-01.
Identification
Copyright
© 1988 Published by Elsevier Inc.
