title: A new biomarker of hedonic eating? A preliminary investigation of cortisol and nausea responses to acute opioid blockade.
abstract: Overweight and obese individuals differ in their degree of hedonic eating. This may reflect adaptations in reward-related neural circuits, regulated in part by opioidergic activity. We examined an indirect, functional measure of central opioidergic activity by assessing cortisol and nausea responses to acute opioid blockade using the opioid antagonist naltrexone in overweight/obese women (mean BMI=31.1±4.8) prior to the start of a mindfulness-based intervention to reduce stress eating. In addition, we assessed indices of hedonic-related eating, including eating behaviors (binge eating, emotional eating, external eating, restraint) and intake of sweets/desserts and carbohydrates (Block Food Frequency); interoceptive awareness (which is associated with dysregulated eating behavior); and level of adiposity at baseline. Naltrexone-induced increases in cortisol were associated with greater emotional and restrained eating and lower interoceptive awareness. Naltrexone-induced nausea was associated with binge eating and higher adiposity. Furthermore, in a small exploratory analysis, naltrexone-induced nausea predicted treatment response to the mindfulness intervention, as participants with more severe nausea at baseline maintained weight whereas those with little or no nausea responses tended to gain weight. These preliminary data suggest that naltrexone-induced cortisol release and nausea may help identify individuals who have greater underlying food reward dependence, which leads to an excessive drive to eat. Future research is needed to confirm this finding and to test if these markers of opioidergic tone might help predict success in certain types of weight management programs.
authors.affiliation: Osher Center for Integrative Medicine, Department of Medicine, University of California, San Francisco, United States. Electronic address: Jennifer.daubenmier@ucsf.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Daubenmier
authors.affiliation: Department of Pediatrics, University of California, San Francisco, United States.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Lustig
authors.affiliation: Osher Center for Integrative Medicine, Department of Medicine, University of California, San Francisco, United States.
authors.forename: Frederick M
authors.initials: FM
authors.lastname: Hecht
authors.affiliation: Department of Psychology, Indiana State University, United States.
authors.forename: Jean
authors.initials: J
authors.lastname: Kristeller
authors.affiliation: Department of Psychiatry, University of California, San Francisco, United States.
authors.forename: Josh
authors.initials: J
authors.lastname: Woolley
authors.affiliation: Department of Human Biology, Maastricht University, The Netherlands.
authors.forename: Tanja
authors.initials: T
authors.lastname: Adam
authors.affiliation: Department of Physiology, University of California, San Francisco, United States.
authors.forename: Mary
authors.initials: M
authors.lastname: Dallman
authors.affiliation: Department of Psychiatry, University of California, San Francisco, United States.
authors.forename: Elissa
authors.initials: E
authors.lastname: Epel
mesh_terms: D050154:Adiposity / Q000502:physiology; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D015992:Body Mass Index; D002032:Bulimia / Q000523:psychology; D003430:Cross-Sectional Studies; D004435:Eating / Q000523:psychology*; D002149:Energy Intake; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008875:Middle Aged; D009271:Naltrexone / Q000494:pharmacology*; D009292:Narcotic Antagonists / Q000494:pharmacology; D009325:Nausea / Q000097:blood / Q000503:physiopathology*; D009765:Obesity / Q000523:psychology; D050177:Overweight / Q000523:psychology; D011957:Receptors, Opioid / Q000378:metabolism; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D009292:Narcotic Antagonists; D011957:Receptors, Opioid; D009271:Naltrexone; D006854:Hydrocortisone
keywords: Cortisol; Food addiction; Hedonic eating; Naltrexone; Nausea; Obesity