7. mai 2016

Leptin changes in recovery.

In the malnourished, underweight anorexic, leptin levels are typically very low, due to low fat reserves. Usually, leptin levels reach normal levels during weight restoration. However, when weight is gained too quickly, leptin levels rise too quickly and may exceed the normal range. As a result, it becomes increasingly difficult for the patient to eat, often interfering with the refeeding process.

Low leptin plays a significant role in many of the physical complications and behaviors that are typically associated with anorexia nervosa; amenorrhea, hypothyroidism, hypercortisolism, osteopenia, immune changes, and increased physical activity.

Although there are other endocrine changes that contribute to osteopenia, low leptin levels appear to play a significant role.
Individuals with anorexia nervosa, often experience a compromised immune system. This could also be due, in part to low leptin levels although most of the compromised immunity is due to increased cortisol levels.  Cortisol is the hormone that we associate with stress.  Patients who are gaining weight too rapidly, are under considerably more stress, and may also be experiencing increased cortisol levels.

The lower the leptin levels, the more drive there is to exercise excessively, which causes more weight loss or less weight gain. One study demonstrated that patients reported a decreased feeling of restlessness or hyperactivity (need to exercise) as leptin increased during the refeeding/weight restoration phase of treatment.http://www.eatingdisorderpro.com/2012/08/24/why-rapid-weight-gain-decreases-treatment-success-rates/

In some studies, weight regain in individuals with anorexia nervosa increased leptin concentrations much more rapidly than in weight-matched controls, which may contribute to early satiation and a possibly increased metabolic rate. If this is confirmed in future studies, it may be one of the factors that frustrate attempts to achieve and maintain a more normal weight in individuals afflicted with anorexia nervosa.http://eatingdisordersreview.com/nl/nl_edr_13_5_1.html




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