The Effect of Estrogen on Appetite

[ttweed@wildrockies.org (Tony Tweedale)]

Medscape Women's Health

>From Medscape Women's Health

The Effect of Estrogen on Appetite          Nori Geary, PhD

Abstract

Such eating disorders as anorexia nervosa, bulimia nervosa,
and binge eating disorder are associated with significant
morbidity and mortality in women. The etiology of these
disorders and the causes of women's increased vulnerability
to them remain obscure. The lack of understanding of the
biological bases of normal and abnormal human eating
behavior impedes development of effective pharmacologic
treatment for eating disorders. A review of basic research,
implicating estradiol in the physiologic control of eating in
laboratory animals, shows potential heuristic and
mechanistic significance for normal and disordered eating in
women. Furthermore, accumulating evidence indicates that
estradiol may decrease meal size by increasing the potency
of the satiating actions of some gut peptides, especially
cholecystokinin. These findings suggest there may be hope
for treatment through manipulation of estradiol's
interactions with both peripheral psychological and central
neural controls of eating. [Medscape Women's Health 3(6),
1998. © 1998 Medscape, Inc.]



Introduction

Dramatic differences exist between women and men in the
prevalence of disordered eating. In fact, more than 90% of
patients who meet the American Psychiatric Association's
(APA's) DSM-IV criteria for anorexia nervosa or bulimia
nervosa are women. In 1 study, the prevalence of moderate
obesity, defined as a weight 30% to 50% higher than normal,
was 11% for women versus 8% for men, a small but
significant difference.[1] Severe obesity (>50% above the
recommended weight) affects 4 times as many women (8%)
as men (2%). Several studies indicate that the APA's new
diagnostic category of binge eating disorder, which includes
persons who regularly eat huge meals without purging,
occurs in a substantial number of overweight persons; about
60% of binge eaters are women. An even larger percentage of
persons whose eating is influenced by the personality
construct known as cognitive restraint are women.
Furthermore, altered eating may be a part of the
symptomatology of other disorders occurring in women, such
as premenstrual syndrome. Thus, major clinical challenges
confront women who are affected by an eating disorder and
their physicians.

Why do these disorders occur more commonly in women?
Although there has been rapid progress in the last decade in
the analysis of the physiologic controls of eating in animals,
the potential contribution of physiologic factors to the
etiology and courses of these disorders remains obscure.
However, a wealth of data indicates that the
hypothalamic-pituitary-ovarian axis has significant effects
on eating in animals and that estradiol is a key link in
controlling eating in normally cycling adult females. These
findings have potential heuristic and mechanistic
significance for normal and disordered eating in women,
suggesting that manipulation of estradiol's effects on eating
may provide an opportunity for the development of
pharmacologic treatment.



continued...


Dr. Geary is Associate Research Professor, Department of
Psychiatry, Cornell University Medical College, and E. W.
Bourne Behavioral Research Laboratory, New York
Presbyterian Hospital-Cornell Medical College, White Plains,
N.Y.


  





 



Section 1 of 10



CONTENTS

Abstract & Introduction


Animal Studies of Estradiol

and Food Intake


Relationship of Estradiol to

Food Intake in Women


Role of Estradiol


The Meal as the Functional

Unit of Eating Behavior


The Physiology of Meals


Physiologic Mechanisms of

Estradiol's Effects on Eating


Estradiol and Indirect

Controls of Meal Size


Estradiol and the Direct

Control of Meal Size


Conclusion


References


EDITORIAL COMMENT


Editorial Comment by Chet

Zelasko, PhD


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SMART SEARCH KEYWORDS


Anorexia nervosa


Bulimia nervosa


Estrogen


Menopause


Obesity


RELATED SPECIALTIES


Pharmacotherapy


Women's Health


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