Anorexia Nervosa

Leptin levels in restricting and purging anorectics

International Journal of Eating Disorders
By Philip S. Mehler, MD, FACP, FAED, CEDS


Patients with anorexia nervosa of the restricting (AN-R) and purging (AN-P) subtypes were studied to determine if there was a differential effect on leptin levels. It was hypothesized that the AN-P subgroup would have elevated leptin compared to the AN-R subgroup. Fasting plasma and anthropormorphic measurements were collected from 8 women with AN-R and 5 with AN-P. Eleven women served as controls. Overall, the plasma leptin correlated with body mass index (BMI; R = 0.432, p < .05). The AN-P subgroup had elevated leptin compared to the AN-R subgroup (3.8 +/- 0.8 vs. 1.5 +/- 0.2 ng/ml, p < .05) despite similar BMI (16.0 +/- 0.5 vs. 14.8 +/- 0.8 kg/m2). Additionally, the AN-P subgroup had similar plasma leptins as controls (3.8 +/- 0.8 vs. 3.6 +/- 0.1) despite different BMI (16.0 +/- 0.5 vs. 20.2 +/- 0.2, p < .001). Cortisol in the AN-P subgroup trended to be higher than in the restricting anorectics (21.8 +/- 3.0 vs. 15.6 +/- 1.3, p = .06). In AN, leptin was elevated in AN-P vs. AN. This may be due to increased glucocorticoid stimulation of leptin.

Written by

Philip S. Mehler, MD, FACP, FAED, CEDS

Dr. Philip S. Mehler began his career at Denver Health more than 35 years ago and was formerly its Chief of Internal Medicine and then Denver Health’s Chief Medical Officer (CMO) until he was promoted…

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