title: Appetite-regulating hormones cortisol and peptide YY are associated with disordered eating psychopathology, independent of body mass index.
abstract: OBJECTIVE
  Disordered eating occurs in women at both weight extremes of anorexia nervosa (AN) and obesity. Cortisol, peptide YY (PYY), leptin, and ghrelin are hormones involved in appetite and feeding behavior that vary with weight and body fat. Abnormal levels of these hormones have been reported in women with AN, functional hypothalamic amenorrhea (HA), and obesity. The relationship between appetite-regulating hormones and disordered eating psychopathology is unknown. We therefore studied the relationship between orexigenic and anorexigenic hormones and disordered eating psychopathology in women across a range of weights.
  
  
  METHODS
  A cross-sectional study of 65 women, 18-45 years: 16 with AN, 12 normal-weight with HA, 17 overweight or obese, and 20 normal-weight in good health.
  
  
  METHODS
  Two validated measures of disordered eating psychopathology, the Eating Disorders Examination-Questionnaire (EDE-Q) and Eating Disorders Inventory-2 (EDI-2), were administered. Fasting PYY, leptin, and ghrelin levels were measured; cortisol levels were pooled from serum samples obtained every 20 min from 2000 to 0800 h.
  
  
  RESULTS
  Cortisol and PYY levels were positively associated with disordered eating psychopathology including restraint, eating concerns, and body image disturbance, independent of body mass index (BMI). Although leptin levels were negatively associated with disordered eating psychopathology, these relationships were not significant after controlling for BMI. Ghrelin levels were generally not associated with EDE-Q or EDI-2 scores.
  
  
  CONCLUSIONS
  Higher levels of cortisol and PYY are associated with disordered eating psychopathology independent of BMI in women across the weight spectrum, suggesting that abnormalities in appetite regulation may be associated with specific eating disorder pathologies.
authors.affiliation: Neuroendocrine Unit, Bulfinch 457B Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. ealawson@partners.org
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Lawson
authors.forename: Kamryn T
authors.initials: KT
authors.lastname: Eddy
authors.forename: Daniel
authors.initials: D
authors.lastname: Donoho
authors.forename: Madhusmita
authors.initials: M
authors.lastname: Misra
authors.forename: Karen K
authors.initials: KK
authors.lastname: Miller
authors.forename: Erinne
authors.initials: E
authors.lastname: Meenaghan
authors.forename: Janet
authors.initials: J
authors.lastname: Lydecker
authors.forename: David
authors.initials: D
authors.lastname: Herzog
authors.forename: Anne
authors.initials: A
authors.lastname: Klibanski
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001828:Body Image; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D001068:Feeding and Eating Disorders / Q000097:blood* / Q000175:diagnosis; D005260:Female; D054439:Ghrelin / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D020738:Leptin / Q000097:blood; D008875:Middle Aged; D019894:Peptide YY / Q000097:blood*; D011863:Radioimmunoassay; D011795:Surveys and Questionnaires
chemical_list: D054439:Ghrelin; D020738:Leptin; D019894:Peptide YY; D006854:Hydrocortisone