POSTPRANDIAL CHOLECYSTOKININ RELEASE AND GASTRIC-EMPTYING IN PATIENTSWITH BULIMIA-NERVOSA

This study was designed to investigate the biological underpinnings of the observed deficit in satiety in patients with bulimia nervosa. Eig ht women with bulimia nervosa and 10 age- and weight-matched control s ubjects consumed three laboratory meals consisting of 200, 400, and 60 0 g of a radiolabeled liquid meal. For 1 h after each meal, blood samp les were obtained at 10-min intervals for measurement of cholecystokin in concentration and gastric emptying was measured. Subjects also comp leted perceptual rating scales at 10-min intervals. Compared with cont rol subjects, patients with bulimia nervosa showed a blunting of postp randial cholecystokinin release, particularly with larger meal sizes, as well as delayed gastric emptying. Increasing meal size was associat ed with increased desire to binge eat in patients but not in control s ubjects. These data lend support to a model in which increased gastric capacity, perhaps resulting from replated binge eating, gives rise to delayed gastric emptying and blunted postprandial cholecystokinin rel ease, leading to an impaired satiety response, which tends to perpetua te the illness.