Reprinted from Eating Disorders Review
July/August 2006 Volume 17, Number 4
©2006 Gürze Books
Decreases in estradiol (E2) and increases in progesterone (PRO) may intensify binge eating, according to the results of a study of ovarian hormones and binge eating in bulimia nervosa (BN). As reported by Drs. Pamela Keel, Crystal Edler, and Susan Lipson at the AED Conference, symptom fluctuations in BN are related to menstrual cycle phase, and ovarian hormone function is a prime candidate for unraveling the neurobiological mechanisms of binge eating.
A Small Controlled Study
The researchers examined daily changes in ovarian hormones and binge eating in two groups: 9 women with DSM-IV-diagnosed BN and 9 regularly menstruating controls without BN. Women in both groups collected saliva samples and recorded their moods and bulimic symptoms for 35 days. E2 and PRO were measured by radioimmunoassay.
Women with BN reported higher levels of depression, impulsivity, restraint, disinhibition, and hunger compared with controls. However, mean E2 and PRO levels did not differ between the two groups. The same proportion of controls and BN patients failed to show a preovulatory E2 peak, indicative of disrupted hormonal cycles. The researchers used within-subject analyses of associations between ovarian hormones and binge eating separately for women with BN with expected hormone profiles (BN-E) and those with disrupted hormone levels (BN-D).
Fluctuations Noted among BN Patients
Significant positive associations between daily fluctuations in negative affect and binge frequency were found in BN-E and BN-D groups, and both groups showed a significant positive association between PRO and binge frequency (controlling for E2 and mood). A significant negative association between E2 and binge frequency (controlling for PRO and mood) occurred only in the BN-E group.
In women with predictable hormone profiles, cyclical changes in ovarian hormones are dictated by the female reproductive system and can’t be attributed to the presence or absence of disordered eating. The authors’ results are consistent with those reported from experimental animal studies and suggest that decreases in E2 and increases in PRO may drive increases in binge eating in women with BN.