# Biobehavioral Prediction of Illness Trajectory in Bulimic Syndromes

> **NIH NIH R01** · FLORIDA STATE UNIVERSITY · 2020 · $395,541

## Abstract

Bulimic syndromes (BN-S) are characterized by large out-of-control binge episodes, span the three DSM-5
eating disorder categories of anorexia nervosa-binge purge subtype (ANbp), bulimia nervosa (BN), and binge
eating disorder (BED), and vary considerably in illness severity and course. Our long-term objectives are to
identify biobehavioral predictors of illness trajectory in BN-S so that treatments may be developed to address
key factors influencing the severity and course of binge eating. The specific aims of this study are to test a
model in which weight suppression (WS) leads to deficient circulating leptin, which contributes to blunted
postprandial glucagon-like peptide 1 (GLP-1) response, which causes alterations in the RDoC core constructs
of approach motivation and sustained responsiveness to reward, which then contribute to BN-S severity and
maintenance. WS (the difference between an individual's highest weight and current weight) has emerged as
one key predictor of severity and maintenance of BN-S, and investigators have posited a biobehavioral
mechanism for this association. Yet, no study has evaluated how the biological consequences of WS may
contribute to alterations in RDoC core constructs proposed to contribute to binge eating. Our model posits that
the same set of physiological consequences of WS contribute to binge eating by 1) increasing drive/motivation
to consume food (approach motivation), and 2) decreasing ability for food consumption to lead to a state of
satiation/satisfaction (sustained responsiveness to reward). Approach motivation will be measured both
behaviorally as breakpoint on progressive ratio tasks for food and non-food reinforcers and by self-report.
Sustained responsiveness to reward (satiation) will be measured both behaviorally as food intake in an ad lib
meal and by self-report. Participants (N=320) with BN-S and non-eating disorder controls, ranging in BMI from
16 to 35 kg/m2, will be assessed for WS, leptin, GLP-1 response to a fixed meal, approach motivation, ability to
achieve satiation in an ad lib meal, self-report measures of core constructs, and binge eating at baseline, 6-,
and 12-month follow-up, to produce the first study of biobehavioral predictors of illness trajectory in BN-S
transdiagnostically. Examining the integration of approach motivation and satiation through the same set of
physiological mechanisms represents a major innovation as it translates cutting-edge research in basic science
to understand clinical phenomena in BN-S. If differences in illness trajectory across ANbp, BN, and BED are
attributable to the underlying dimension of WS, this will fundamentally alter conceptualization of BN-S from
three eating disorder categories to one eating disorder. If findings support biobehavioral distinctions across the
BMI range, this would provide important information in what treatments would work in whom. Moreover, our
focus on factors that are modifiable via behavioral and pharmacological inte...

## Key facts

- **NIH application ID:** 9913584
- **Project number:** 5R01MH111263-05
- **Recipient organization:** FLORIDA STATE UNIVERSITY
- **Principal Investigator:** Pamela K. Keel
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $395,541
- **Award type:** 5
- **Project period:** 2016-08-05 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9913584

## Citation

> US National Institutes of Health, RePORTER application 9913584, Biobehavioral Prediction of Illness Trajectory in Bulimic Syndromes (5R01MH111263-05). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/9913584. Licensed CC0.

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