Physiological and psychological responses to a glucose challenge in bulimia

Abstract

Twenty females meeting DSM‐III criteria for bulimia, and 12 age‐ and sex‐matched controls underwent a 60‐min intravenous glucose tolerance test. Blood samples were taken at −10, 0, 5, 10, 20, 30, 45, and 60 min after the glucose injection. At these times, subjects completed a mood rating scale [Profile of Mood States (POMS)] and a subjective self‐report questionnaire addressing both food cravings and thirst, as well as the urge to binge and subjective control over food intake. Blood levels of tryptophan, tyrosine, valine, leucine, phenylalanine, and isoleucine were measured at 0 and 60 min after the injection. Although equivalent at baseline, the blood glucose levels of bulimics at 5 min and insulin/glucagon ratio at 20, 30, and 45 min following injection were reduced in comparison to controls. Blood valine levels were also lower among the bulimic group. There were no differences between the bulimics and normal controls at baseline on subjective self‐report measures of urge to binge, control over food intake, carbohydrate (CHO) craving or fatigue. following the glucose injection, however, the observed physiological differences between the two groups were accompanied by increased subjective cravings for sweets and fruits, an enhanced urge to binge, and less subjective control over food intake for bulimics as compared with controls. The bulimics also reported increased fatigue in response to glucose, whereas controls reported feeling less fatigued. The results suggest that abnormal physiological responses to blood glucose are accompanied by alterations in both food cravings and mood, which may promote binging among bulimic patients.

Effects of eating behavior on mood: A review of the literature

“…Thayer (1987) has demonstrated that the initial effect of consumption of refined carbohydrates is an increase in energy but the longer term effect is one of increased fatigue and a decline in energy. This finding of increased feelings of fatigue following carbohydrate ingestion is supported by Blouin et al (1991) who revealed that feelings of fatigue as well as increased cravings for carbohydrate-rich Foods increased following a 25-gm glucose load but only in bulimics and not controls. This would suggest that, for a distressed group of individuals, a vicious cycle may be created where simple carbohydrates are consumed to obtain a temporary relief from feelings of dysphoria and fatigue.…”

Ovarian morphology and insulin sensitivity in women with bulimia nervosa

“…They found variable insulin sensitivity in women with anorexia nervosa and decreased insulin sensitivity in women with bulimia nervosa. Other workers, using indirect measures of insulin sensitivity, found no evidence of insulin resistance in bulimia nervosa (Hohlstein et al, 1986;Weingarten et al, 1988;Blouin et al, 1991). In this study, we have used a direct measure of insulin sensitivity and have confirmed that it is not altered in bulimia nervosa.…”

Carbohydrate, Memory, and Mood

“…By contrast, when subjective energy was found to increase after a sugar-containing drink, this occurred after 15, 30, 71 or 60 minutes. 72 Benton and Owens,71 who used by far the largest sample sizes in this area, commented that the short-term increase in reported energy seemed to be a robust phenomenon as they replicated the nding. It was, however, a small effect that would likely not be reproduced in a small sample size.…”

“…When a protein-rich meal such as turkey breast was compared with a carbohydrate-rich meal, the latter tended to result in subjects feeling less energetic. [66][67][68][69][70] Studies comparing the consumption of a sugar-containing drink and a calorie-free drink have produced equivocal ndings; two found increased subjective energy 71,72 and three others reported nonsigni cant ndings. [73][74][75] A major variable appears to be the time after consumption when mood was assessed.…”