# A twin study of exogenous hormone exposure and risk for binge eating

> **NIH NIH R01** · MICHIGAN STATE UNIVERSITY · 2021 · $664,132

## Abstract

PROJECT SUMMARY
Extant animal and human data show that ovarian hormones are critical neurobiological risk factors for binge
eating in women. Natural increases in these hormones across the menstrual cycle substantially increase risk
for binge eating via hormonally induced increases in genetic risk. These data have significantly advanced
etiological models and our understanding of the female predominance in eating disorder risk. However, this
increased knowledge comes with an urgent public health responsibility. In the US today, 1 in 3 women take
contraceptives that contain combinations of hormones that mimic the riskiest milieus for binge eating (i.e.,
combined oral contraceptives (COCs) containing both estrogen and progesterone).The relatively commonplace
prescription of COCs may substantially increase risk for binge eating in women, particularly in those who are
genetically vulnerable to eating disorders. This possibility underscores the urgent need to examine COC
effects on binge eating to inform women's health practices and avert a potentially dangerous (and chronic)
path toward eating disorders in unsuspecting young women. The goal of the proposed project is to use a multi-
method (behavioral genetic, neuroendocrine), longitudinal twin study to document the effects of COCs on
phenotypic and genetic risk for binge eating in women. If COCs increase phenotypic risk for binge eating in
women, then there should be significantly higher rates of binge eating in twins using COCs than their non-
using co-twins (a population-level, between-subject effect) and substantial increases in binge eating when
COC users transition from inactive to active pills (an individual-level, within-subject effect). Moreover, if COCs
influence binge eating through genetic mechanisms, then there should be significantly increased genetic risk in
twins taking COCs (a population-level, between-subject effect) and substantial increases in genetic effects
when COC users transition from inactive to active pills (an individual-level, within-subject effect). We will
examine all of these hypotheses in a large sample of female twins (N = 1,000) assessed daily for 45 days
using multiple measures of binge eating and related phenotypes. Notably, the proposed project would directly
address NIH directives to enhance Rigor and Reproducibility through its validation of cross-sectional findings
(e.g., increased binge eating in COC twins vs. their non-using co-twins) with longitudinal data (i.e., increased
binge eating when transitioning from inactive to active pills) within a twin study design that substantially
minimizes confounders and selection factors into COC use. The inferential power gained from these multi-level
analyses has the potential to significantly advance public health policy and necessitate a re-thinking of basic
assumptions about COC prescriptions and use. The clinical implications of our findings run the gamut from
requiring physicians to screen for personal and family hi...

## Key facts

- **NIH application ID:** 10098341
- **Project number:** 5R01MH111715-05
- **Recipient organization:** MICHIGAN STATE UNIVERSITY
- **Principal Investigator:** Kelly L Klump
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $664,132
- **Award type:** 5
- **Project period:** 2017-03-01 → 2024-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10098341

## Citation

> US National Institutes of Health, RePORTER application 10098341, A twin study of exogenous hormone exposure and risk for binge eating (5R01MH111715-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10098341. Licensed CC0.

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