What Is the Relationship Between Ghrelin and Eating Disorders?
Introduction:
Ghrelin, commonly referred to as the “hunger hormone,” is a 28-amino acid peptide that has many important roles in human digestion including regulation of growth hormone release, enhancement of appetite, and increase of food intake (1). This gut-derived peptide could play an extremely important role in the altered eating behaviors of patients with eating disorders. Increased fasting plasma ghrelin levels have been consistently reported in underweight patients with anorexia nervosa. Circulating levels of this hormone have also been found to be enhanced in symptomatic bulimic patients, while also being blunted in response to balanced meals (4).
Because of ghrelin’s effect on appetite and its suggested role in eating disorders, this research will aim to investigate ghrelin’s relationship with anorexia nervosa (AN) and bulimia nervosa (BN). The following paper will determine exactly how these eating disorders influence ghrelin regulation or how ghrelin levels may influence the eating disorders themselves. This paper will examine ghrelin’s functions, the two eating disorders, and what that relationship precisely is by examining ghrelin’s metabolic actions as well as two clinical trials that explore its role in bulimia nervosa and anorexia nervosa.
Metabolic Basis Ghrelin has many roles in the body’s metabolism, one of which is serving as the natural ligand for the growth hormone secretagogue receptor.
Scientifically, it has been proven that one should not make long-term decisions while hungry. Students at the University of Gothenburg in Sweden studied whether or not it is smart to make a decision when you are ravenous. A hormone that is made in the gastrointestinal tract, called ghrelin enhanced this study. Ghrelin is released when your body is searching for food as energy. When you are no longer hungry, the manufacturing of ghrelin halts. Ghrelin is also associated with drug and alcohol intake. Tests were developed to demonstrate how this happens through living organisms, the researchers at the University of Gothenburg examined rats. Although rats are not humans, they can display human-like behaviors. When an extra amount of ghrelin was inserted into the rat, they went against their regular impulses. They would gain a
Incidences of Anorexia Nervosa have appeared to increase sharply in the USA, UK and western European countries since the beginning of the 60s (Gordon, 2001). The increasing prevalence of the disease has led the World Health Organisation to declare eating disorders a global priority area within adolescent mental health (Becker et al. 2011). Anorexia has in many ways become a modern epidemic (Gordon, 2000) and with a mortality rate of 10% per decade (Gorwood et al. 2003), the highest of any mental disorder (Bulik et al. 2006), it is an epidemic that social and biological scientists have been working tirelessly to understand.
Eating disorder is the abnormal eating behavior that would negatively impact one’s health, emotions and ability to function in important areas of life. Eating disorders include several categories: binge eating disorder, which means people eat large amount in a short period, anorexia nervosa which people eat very little, bulimia nervosa which people eat a lot and then try to rid themselves of food, pica which people eat non-food items, rumination disorder means people regurgitate food, avoidant food intake means that people have a lack of interest in food, and other specified eating disorders (ANAD). There is believed to be no single cause for eating disorders, as all the biological, psychological, and sociocultural factors contribute to this illness. Studies have shown that specific chromosomes may be associated with bulimia and anorexia (NY times). Eating disorders may also be caused by imbalance of serotonin and dopamine which explain why people who have anorexia
The two most common eating disorders are bulimia nervosa and anorexia nervosa. Both disorders, primarily affect young women, therefore the majority of the research on eating disorders has been done with women subjects. The onset of bulimia is between adolescence and early adulthood while the onset of anorexia is between early and late adolescence. Not only is the onset different but the disorders are unique. Bulimia nervosa is characterized by loss of control over eating which leads to food binges. These episodes are interspersed with episodes of purging, such as vomiting or laxative abuse, to keep weight down. The goal of anorexia is also to keep weight down , but to a
Eating disorders affect millions of men and women every day. Bulimia nervosa, anorexia nervosa, and binge eating disorder are three main types of eating disorders that can have detrimental consequences on the human body. These eating disorders not only deteriorate one’s body, but also eradicate the mind. “Inherent to anorexia nervosa and bulimia nervosa are a plethora of medical complications which correlate with the severity of weight loss or the frequency and mode of purging” (Mehler, 2015).
Bailer et al (1970) compared serotonin activity in recovering anorexia suffers and healthy controls. They found significantly higher activity in the women that were recovering from anorexia, the highest levels found in those women with the highest anxiety levels. This also provides support for AN having a biological cause, in this case an imbalance of neurotransmitters.
Anorexia Nervosa is the condition when an individual abstains from food in order to lose weight or prevent more weight gain. In the Diagnostic and Statistical Manual of Mental Disorders IV(DSM-IV) there are four aspects of criteria to be diagnosed with anorexia: a refusal to maintain weight above what is minimally normal for one’s age and height, and extreme fear of weight gain, distorted body image, and (in females) having amenorrhea(missing three or more consecutive menstrual cycles.)(DSM-IV, 2000:589) Anorexia not only affects weight, but also alters bone growth, neurotransmitters and hormones in the brain, and electrolytes.
It is probable that most people think about food than any other thing throughout their life time. It is funny to realize that even some people think about the next meal while they are having their current meal. Fresh fleshy fruit can stimulate a craving for food even when a person is on a full stomach. It is true that people and all living things require nutrition to survive. However, some eating cravings are just not normal. This is due to various hunger simulation reasons. The motivation to eat is propagated by more than just the need for body nourishment. The hunger motivation influences are, thus, either internal or external.
Each year millions of people in the United States develop serious and often fatal eating disorders. More than ninety percent of those are adolescent and young women. The consequences of eating disorders are often severe--one in ten end in death from either starvation, cardiac arrest, or suicide. Due to the recent awareness of this topic, much time and money has been attributed to eating disorders. Many measures have been taken to discover leading causes and eventual treatment for those suffering from anorexia. (http://www.kidsource.com/kidsource ...er.html#Causes of Eating Disorders) )
There was a study conducted in 2005 that used rats and PET scans in order to better understand the neurological aspects of anorexia. (Barbarich-Marsteller, Marsteller, Alexoff, Fowler, & Dewey, 2005) They wanted to see if chronic food restriction would decrease 2-deoxy-2-fluoro-D-glucose (FDG) they were comparing this to the cerebral glucose hypometabolism in people who had anorexia nervosa. (Barbarich-Marsteller et al., 2005) For this study, the researchers used nine female rats that were six to seven weeks old. They allowed the rats one week to get accustomed to their new home and then during the second week the rats were randomly assigned to one of two groups. The control group had as much food as they wanted for twenty-five days, but the group that was having their food restricted received forty percent of the food they had eaten during the first week until they had lost thirty percent of their body weight. . (Barbarich-Marsteller et al., 2005) The researchers then tried to get the rats to maintain this weight. As another factor of this study, only the food restricted group had free range to a running wheel. . (Barbarich-Marsteller et al.,
According to the DSM-5, eating disorders are characterized by a persistent disturbance of eating–related behavior that results in non-normative eating patterns which leads to impaired physical and psychosocial functioning, (American Psychiatric Association, 2013). Bulimia Nervosa is an eating disorder characterized by recurrent episodes of binge eating with inappropriate compensatory behaviors to prevent weight gain. Binge eating is described as eating an amount of food definitely larger than normal with a sense of lack of control. Compensatory behaviors include misuse of laxatives, self-induced vomiting, diuretics, fasting and excessive exercise, (Comer, 2014) . Another key feature is
Garfinkel and Garner did another study on biological causes for anorexia. They discovered that anorexia sufferers had a disturbed hypothalamus. This could mean that there is a link between the hypothalamus and eating disorders. However not everyone with anorexia have a hypothalamus dysfunction.
In our Western society, we have several different types of eating dysfunction, all of which are unique and tragic in their own right. Despite their individuality, however, they all have several overlapping symptoms that are key to their classification and severity. For Bulimia Nervosa (BN) and Binge Eating Disorder (BED), one of the core features is binge eating, which can be defined objectively by number of calories eaten in a given time or subjectively by the feelings of the binger. Binge eating has many different aspects that are of interest to scientists and clinicians alike. One of those interests has to do with the reduction of this symptom among populations being treated for their respective disorder. Because both
Anorexia Nervosa is a fairly common and very consequence psychiatric disorder that affects a person’s desire to consume nutrients because they believe that they are overweight. Women are more likely then men to develop this specific disorder and teenagers aged 15 to 19 are at the highest risk of anyone (Berends, Van Meijel, & Van Elburg, 2012). Individual’s affected by Anorexia Nervosa Disorder will refuse to maintain a healthy body weight for their size and instead will starve themselves in an attempt to loose weight. The lack of nutrients within their body and lack of fats left after starving themselves affects not only their physical functioning but also their psychological functioning. There has been much advancement in developing treatment for individuals affected by Anorexia Nervosa. Treatment typically consists of careful monitoring of the individual’s food intake, their weight, BMI, and their psychological state. However relapse is extremely common after full treatment occurs. It is estimated that 30-50% of individuals who are treated for Anorexia Nervosa will relapse, with the likelihood of relapse decreasing to almost zero two years after discharge (Berends, Van Meijel, & Van Elburg, 2012). Determining if an individual is going through relapse has been broken down into six key symptoms:
There are multiple ways to be guided to an eating disorder other than the media. “Eating behavior is a complex process controlled by the neuroendocrine system of which the Hypothalamus-pituitary-adrenal-axis (HPA axis) is a major component” (News Medical). Psychological research is very important to patients who have an eating disorder. Throughout the research in the paper, researchers have come to a conclusion that some of the qualities in the brain a person has a certain level