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Hunger and satiety perception in patients with severe anorexia nervosa

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Objectives

Appetite is a subjective essential sense. In patients with severe anorexia nervosa (AN), controversy remains whether this sensation is altered. The objectives were to clarify, in patients with severe AN: (1) Whether the appetite changes during partial weight restoration, (2) Whether potential changes in appetite are related to (i) diagnostic subtype of AN, (ii) psychopharmacological treatment, (iii) disease duration, (iv) duration of hospitalization, and (v) baseline body mass index (BMI).

Methods

The study consisted of 39 patients, with a mean age of 23.7 ± 8 and an admission mean BMI of 13.1 ± 2.0 kg/m2. The patients were consecutively admitted to a specialized somatic nutrition unit between 2015 and 2016. They were asked to rate their hunger and satiety on a numeric visual analog scale (VAS), before and after a lunch meal at admission and at discharge in the same standardized environment. The patients could participate more than once if readmitted, resulting in a total of 119 observed meals. Data were analyzed in a regression model for repeated measures.

Results

At admission, changes in hunger and satiety perception were weak. After weight gain of 10.4% ± 8.5% within a median of 26 (IQR: 25) days, there was a slight increase in hunger perception, p = 0.049. However, there was no detectable change in satiety perception. There was no noticeable correlation between appetite change and psychopharmacological treatment, diagnostic subtype, BMI, duration of hospitalization, and disease duration.

Conclusion

Hospitalized patients with severe AN exhibit strikingly weak changes in hunger and satiety perception during standardized and supervised meals.

Level of evidence

Level IV, evidence obtained from multiple time series analysis.

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Acknowledgements

We thank Erik Christiansen for skilled statistic support and research nurse Kirsten Gitte Hansen for competent patient support during the meals.

Funding

This is a non-profit study, completely independent from commercial interests. The operating costs are very limited apart from the cost of the scholarship, which was supported by the Foundation of Psychiatry in southern Denmark.

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Authors and Affiliations

  1. Center for Eating Disorders, Odense University Hospital, Odense, Denmark

    Camilla Klastrup, Jacob Frølich, Laura Al-Dakhiel Winkler & René Klinkby Støving

  2. Endocrine Research Unit, Odense University Hospital, Odense, Denmark

    Camilla Klastrup, Jacob Frølich, Laura Al-Dakhiel Winkler & René Klinkby Støving

  3. Mental Health Services in the Region of Southern Denmark, Odense, Denmark

    Camilla Klastrup, Jacob Frølich, Laura Al-Dakhiel Winkler & René Klinkby Støving

  4. Clinical Institute, University of Southern Denmark, Odense, Denmark

    Camilla Klastrup, Jacob Frølich, Laura Al-Dakhiel Winkler & René Klinkby Støving

Authors
  1. Camilla Klastrup
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  2. Jacob Frølich
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  3. Laura Al-Dakhiel Winkler
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  4. René Klinkby Støving
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Contributions

RKS conceived the original idea, defined, and described the project as well as initiated data sampling. CK, JF, LAW, and RKS all contributed substantially to the analysis and interpretation of the data. CK wrote the first draft of the manuscript. CK, JF, LAW, and RKS all critically revised the manuscript for important intellectual content. All authors have provided approval of the final version to be published.

Corresponding author

Correspondence to René Klinkby Støving.

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The authors have nothing to declare.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from the participants.

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Klastrup, C., Frølich, J., Winkler, L.AD. et al. Hunger and satiety perception in patients with severe anorexia nervosa. Eat Weight Disord 25, 1347–1355 (2020). https://doi.org/10.1007/s40519-019-00769-7

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  • DOI: https://doi.org/10.1007/s40519-019-00769-7

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