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Dreier, Melissa

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Dreier, Melissa

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    Elevated Fasting Satiety-Promoting Cholecystokinin (CCK) in Avoidant/Restrictive Food Intake Disorder Compared to Healthy Controls
    (Physicians Postgraduate Press, Inc, 2022-07-11) Burton Murray, Helen; Becker, Kendra; Harshman, Stephanie; Breithaupt Langston, Lauren; Kuhnle, Megan; Dreier, Melissa; Hauser, Kristine; Freizinger, Melissa; Eddy, Kamryn; Misra, Madhusmita; Kuo, Braden; Micali, Nadia; Thomas, Jennifer; Lawson, Elizabeth
    Objective: Avoidant/restrictive food intake disorder (ARFID) is characterized by food avoidance or dietary restriction not primarily motivated by body weight/shape concerns. Individuals with ARFID can report early satiation, post-prandial fullness, and high inter-meal satiety, but whether these symptoms are related to differences in the biology underlying appetite regulation is unknown. In male and female children and adolescents, we hypothesized that fasting levels of cholecystokinin (CCK), a satiety hormone, would be elevated in participants with ARFID (full or subthreshold) versus healthy controls (HC). Within the ARFID group, we also explored the relations of CCK with weight status, subjective appetite ratings, and ARFID severity and phenotypes. Methods: 125 participants (83 full/subthreshold ARFID and 42 HC, ages 10-23 years; 59% female) underwent fasting blood draws for CCK, completed self-report measures assessing subjective state and trait appetite ratings, and completed a semi-structured interview assessing ARFID severity. Results: Fasting CCK was higher in full/subthreshold ARFID versus HC with a large effect (F(1)=25.0, p<.001, ηp2=.17), controlling for age, sex, and BMI percentile. Within the ARFID group, CCK was not significantly related to BMI percentile, subjective appetite ratings, or ARFID characteristic measures. Conclusion: CCK may contribute to etiology and/or maintenance of ARFID, as children/adolescents with heterogeneous presentations of avoidant/restrictive eating appear to show elevated fasting levels compared to healthy youth. Further research is needed to understand relations between CCK and appetite, weight, and eating behavior in ARFID.