Acute Stressors Reduce Neural Inhibition to Food Cues and Increase Eating Among Binge Eating Disorder Symptomatic Women

Abstract

Stressors can trigger binge-eating but researchers have yet to consider their effects on both neural responses to food cues and food consumption among those at risk. In this experiment, we examined the impact of acute stressors on neural activation to food images and subsequent food consumption within binge-eating disorder (BED) and non-eating disordered control groups. Eighteen women meeting DSM-IV BED criteria and 26 women serving as non-eating disordered controls were randomly assigned to unpleasant stressor (painful cold pressor test (CPT) followed by negative performance feedback) or less unpleasant stressor (non-painful sensory discrimination task followed by positive performance feedback) conditions. Subsequently, they were scanned with functional magnetic resonance imaging (fMRI) while viewing food and neutral images. After the scans, participants completed a self-report battery in an environment conducive to snacking. During exposure to food images, BED-symptomatic women in the unpleasant stressor condition reported more liking of high calorie food images and showed less activation in one inhibitory area, the hippocampus, compared to controls in this condition. BED-symptomatic women exposed to unpleasant stressors also consumed more chocolate than any other group during the post-scan questionnaire completion. Crucially, reduced hippocampal activation to high calorie food images predicted more chocolate consumption following fMRI scans within the entire sample. This experiment provides initial evidence suggesting unpleasant acute stressors contribute to reduced inhibitory region responsiveness in relation to external food cues and later food consumption among BED-symptomatic women.

Systematic review of the effects of acute stress in binge eating disorder

“…Finally, a study by Lyu & Jackson () used a different method of inducing stress. Participants in Lyu and Jackson's study were randomly assigned to the CPT or a non‐stressful control condition, before ad libitum consumption of chocolate was assessed.…”

“…In BED, initial eating rate was higher and deceleration lower in stress compared to non-stress; in NBED, initial eating rate decreased and deceleration increased with stress. Frequency of spoonfuls was higher in BED compared to NBED irrespective of condition (P < 0.02) Finally, a study by Lyu & Jackson (2016) used a different method of inducing stress. Participants in Lyu and Jackson's study were randomly assigned to the CPT or a non-stressful control condition, before ad libitum consumption of chocolate was assessed.…”

“…Four studies included in this review reported direct measures of food intake following an acute stressor in individuals with BED (Klatzkin et al, 2016;Laessle & Schulz, 2009;Lyu & Jackson, 2016;Schulz & Laessle, 2012; Table 5). Laessle & Schulz (2009) assessed ad libitum food intake in participants with or without BED, following a stressful or non-stressful task.…”

“…Sub-group analyses-BED: Calorie intake negatively correlated with dietary restraint (P < 0.05); NBED-Ob: Calories poured positively associated with post-stress hunger (P < 0.05); NBED-NW: Calories poured negatively associated with HR and cortisol changes (Ps ≤ 0.05), and positively associated with post-stress hunger (P < 0.01). Lyu & Jackson (2016) BED ( 37.0 (5.5) 36.9 (6.1)…”

“…At the behavioural level, one study suggested enhanced overall food intake during stress in individuals with BED compared to healthy controls (Lyu & Jackson, 2016), while two studies demonstrated differences in initial eating rate and deceleration of eating rate during stress (Laessle & Schulz, 2009;Schulz & Laessle, 2012). As the initial eating rate and deceleration are thought to be associated with eating motivation and satiety (Guss & Kissileff, 2000;Elfhag et al, 2003;Laessle & Schulz, 2009), it is possible that these differences drive over-eating outside of the laboratory setting.…”