Acute responses to opioidergic blockade as a biomarker of hedonic eating among obese women enrolled in a mindfulness-based weight loss intervention trial.
There are currently no commonly used or easily accessible 'biomarkers' of hedonic eating. Physiologic responses to acute opioidergic blockade, indexed by cortisol changes and nausea, may represent indirect functional measures of opioid-mediated hedonic eating drive and predict weight loss following a mindfulness-based intervention for stress eating. In the current study, we tested whether cortisol and nausea responses induced by oral ingestion of an opioidergic antagonist (naltrexone) correlated with weight and self-report measures of hedonic eating and predicted changes in these measures following a mindfulness-based weight loss intervention. Obese women (N = 88; age = 46.7 ± 13.2 years; BMI = 35.8 ± 3.8) elected to complete an optional sub-study prior to a 5.5-month weight loss intervention with or without mindfulness training. On two separate days, participants ingested naltrexone and placebo pills, collected saliva samples, and reported nausea levels. Supporting previous findings, naltrexone-induced cortisol increases were associated with greater hedonic eating (greater food addiction symptoms and reward-driven eating) and less mindful eating. Among participants with larger cortisol increases (+1 SD above mean), mindfulness participants (relative to control participants) reported greater reductions in food addiction symptoms, b = -0.95, SE(b) = 0.40, 95% CI [-1.74, -0.15], p = .021. Naltrexone-induced nausea was marginally associated with reward-based eating. Among participants who endorsed naltrexone-induced nausea (n = 38), mindfulness participants (relative to control participants) reported greater reductions in food addiction symptoms, b = -1.00, 95% CI [-1.85, -0.77], p = .024, and trended toward reduced reward-based eating, binge eating, and weight, post-intervention. Single assessments of naltrexone-induced cortisol increases and nausea responses may be useful time- and cost-effective biological markers to identify obese individuals with greater opioid-mediated hedonic eating drive who may benefit from weight loss interventions with adjuvant mindfulness training that targets hedonic eating.
UCSF Osher Center for Integrative Medicine.
Ashley E
AE
Mason
UCSF Department of Pediatrics.
Robert H
RH
Lustig
UCSF Center for Health and Community.|UC Berkeley School of Public Health.
Rashida R
RR
Brown
UCSF Osher Center for Integrative Medicine.
Michael
M
Acree
UCSF Department of Epidemiology and Biostatistics.
Peter
P
Bacchetti
UCSF Osher Center for Integrative Medicine.
Patricia J
PJ
Moran
UCSF Center for Health and Community.
Mary
M
Dallman
UCSF Department of Epidemiology and Biostatistics.
Barbara
B
Laraia
UCSF Center for Health and Community.
Nancy
N
Adler
UCSF Osher Center for Integrative Medicine.
Frederick M
FM
Hecht
UCSF Osher Center for Integrative Medicine.
Jennifer
J
Daubenmier
UCSF Osher Center for Integrative Medicine.|UCSF Center for Health and Community.
Elissa S
ES
Epel
D000328:Adult; D016739:Behavior, Addictive / Q000150:complications / Q000523:psychology; D056912:Binge-Eating Disorder / Q000517:prevention & control; D015992:Body Mass Index; D001835:Body Weight; D002032:Bulimia / Q000517:prevention & control; D004435:Eating / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008875:Middle Aged; D064866:Mindfulness; D009042:Motivation; D009271:Naltrexone / Q000009:adverse effects / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D009325:Nausea / Q000209:etiology*; D009765:Obesity / Q000188:drug therapy* / Q000378:metabolism / Q000523:psychology; D018847:Opioid Peptides / Q000378:metabolism; D011957:Receptors, Opioid / Q000378:metabolism; D012201:Reward; D013315:Stress, Psychological; D061217:Weight Reduction Programs / Q000379:methods
D009292:Narcotic Antagonists; D018847:Opioid Peptides; D011957:Receptors, Opioid; D009271:Naltrexone; D006854:Hydrocortisone
Cortisol; Hedonic eating; Mindfulness intervention; Naltrexone; Nausea