Binge eating disorder is associated with lower glucose levels three hours after an oral glucose tolerance test

Introduction: Binge-eating disorder (BED) is characterized by regularly and compulsively eating large amounts of food, often rapidly, and to the point of discomfort or pain. The exact cause of BED is still unknown, but it is currently attributed to a combination of sychological, behavioral, and environmental influences. The aim of this study has been to assess any association of BED with metabolic disorders, specifically glucose metabolism. Methods: 1166 non-diabetic obese subjects were retrospectively selected among those who had undergone a 3-hour-OGTT and a psychological assessment including psychometric tests as part of the routine patients accessing our obesity center undergo for initial evaluation. The patients were divided in two groups depending on the presence or absence of BED. Subjects with other eating disorders with no binge eating pattern were excluded from this study. Results: Patients with a diagnosis of BED were 150, and 868 obese subjects with no eating disorder were selected as control. BMI and HOMA IR were not significantly different between the two groups. The area under the curve (AUC) of glucose and insulin after an oral glucose load were not significantly different, but glucose at 3 hours was significantly lower (p<.0001) and insulin significantly higher (p = .005) in BED patients compared to control subjects. Conclusion: Although OGTT is no longer recognized as a tool to assess for reactive hypoglycemia, these preliminary results may suggest that low postprandial glucose levels possibly caused by an abnormal insulin secretion could lie at the root of BED by acting as a possible trigger of binge eating. These data need to be further confirmed by specifically designed studies.