Department of Psychology, Florida State University, USA.
Department of Psychology, University of Western Ontario, Canada.
Physiol Behav. 2019 Sep 1;208:112565. doi: 10.1016/j.physbeh.2019.112565. Epub 2019 May 30.
Recent research indicates that weight suppression (WS: defined as the difference between highest lifetime and current weight) prospectively predicts illness trajectory across eating disorders characterized by binge eating, including AN binge-purge subtype (ANbp), bulimia nervosa (BN), and binge eating disorder (BED), collectively referred to as bulimic eating disorders. Through a series of studies, we have developed a model to explain the link between WS and illness trajectory in bulimic eating disorders. Our model posits that WS contributes to reduced circulating leptin, which leads to reduced postprandial glucagon-like peptide 1 (GLP-1) response. Diminished leptin and GLP-1 function contribute to alterations in two reward-related constructs in the Research Domain Criteria (RDoC): reward value/effort and reward satiation. Respectively, these changes increase drive/motivation to consume food and decrease ability for food consumption to lead to a state of satiation/satisfaction. Combined, these alterations increase risk for experiencing large, out-of-control binge-eating episodes. The following review presents evidence that contributed to the development of this model as well as preliminary findings from an on-going project funded to test this model.
最近的研究表明，体重抑制（WS：定义为最高终生体重与当前体重之间的差异）前瞻性地预测了以暴食为特征的各种进食障碍的疾病轨迹，包括 AN 暴食-清泻型（ANbp）、神经性贪食症（BN）和暴食障碍（BED），统称为贪食性进食障碍。通过一系列研究，我们已经开发出一种模型来解释 WS 与贪食性进食障碍疾病轨迹之间的联系。我们的模型假设，WS 导致循环瘦素减少，进而导致餐后胰高血糖素样肽 1（GLP-1）反应减少。瘦素和 GLP-1 功能的减弱导致了研究领域标准（RDoC）中两个与奖励相关的结构的改变：奖励价值/努力和奖励满足感。分别而言，这些变化增加了进食的驱动力/动机，并减少了食物摄入导致满足/满意状态的能力。综合起来，这些变化增加了经历大的、无法控制的暴食发作的风险。以下综述介绍了有助于该模型发展的证据，以及正在进行的项目的初步发现，该项目旨在测试该模型。
