Dysfunctional Eating Behaviour and Leptin in Middle-Aged Women: Role of Menopause and a History of Anorexia Nervosa

Abstract

BACKGROUND: Weight gain is common as women approach mid-life. Reduced levels of leptin, an anorexigenic hormone, may facilitate this. Studies in middle-aged women with obesity have shown that dysfunctional eating behaviour, such as restrained eating, is linked to lower leptin. Furthermore, states of low oestradiol signalling, as are found in post-menopause or anorexia nervosa, have been found to impact leptin levels. The aim of this study was to investigate, for the first time, how different aspects of dysfunctional eating, menopausal status, and a history of anorexia nervosa relate to leptin levels in normalweight middle-aged women. METHODS: A total of N = 57 women were recruited. Thirty-one were postmenopausal, and 27 had a history of anorexia nervosa. Dysfunctional eating behaviour was measured by the Three-Factor Eating Questionnaire, which contains three subscales: susceptibility/responsiveness to hunger, restraint, and disinhibition. Body composition was assessed by bioelectrical impedance analysis. A fasting blood sample was obtained to determine leptin. RESULTS: Controlling for age, body mass index, and fat mass, susceptibility/responsiveness to hunger was positively associated with leptin ( = 0.267, p = 0.031), whereas restrained eating ( = -0.183, p = 0.079) and a history of anorexia nervosa ( = -0.221, p = 0.059) were, by trend, negatively associated with leptin. Neither disinhibited eating nor menopausal status was related to leptin. CONCLUSIONS: Leptin may decline as a response to repeated states of a negative energy balance. A possible implication is that mid-life weight management should avoid extreme changes in eating behaviour and instead focus on the macronutrient composition of diet and physical activity. Further, longitudinal enquiries are warranted to investigate these relationships.

Premature menopause and autoimmune primary ovarian insufficiency in two international multi-center cohorts

“…A U-shaped relationship between BMI and the risk of earlier menopause has been shown in previous studies ( 7 , 8 , 40 ). Underweight associated with malnutrition, over-exercising and chronic illness can cause premature menopause due to hypothalamic-pituitary deficiency ( 8 , 41 , 42 , 43 ). Because of a relatively low number of underweight women in this study we did not have enough power to address this issue.…”