Disruptions in appetite-regulating hormones may contribute to the development and/or maintenance of avoidant/restrictive food intake disorder (ARFID). No study has previously assessed fasting levels of orexigenic ghrelin or anorexigenic peptide YY (PYY), nor their trajectory in response to food intake among youth with ARFID across the weight spectrum. We measured fasting and postprandial (30, 60, 120 minutes post-meal) levels of ghrelin and PYY among 127 males and females with full and subthreshold ARFID (n = 95) and healthy controls (HC; n = 32). We used latent growth curve analyses to examine differences in the trajectories of ghrelin and PYY between ARFID and HC. Fasting levels of ghrelin did not differ in ARFID compared to HC. Among ARFID, ghrelin levels declined more gradually than among HC in the first hour post meal (p =.005), but continued to decline between 60 and 120 minutes post meal, whereas HC plateaued (p =.005). Fasting and PYY trajectory did not differ by group. Findings did not change after adjusting for BMI percentile (M(SD) ARFID = 37(35); M(SD) HC = 53(26); p =.006) or calories consumed during the test meal (M(SD) ARFID = 294(118); M(SD) HC = 384 (48); p <.001). These data highlight a distinct trajectory of ghrelin following a test meal in youth with ARFID. Future research should examine ghrelin dysfunction as an etiological or maintenance factor of ARFID.
Competing Interests: Declaration of Competing Interest Drs. Thomas and Eddy receive royalties from Cambridge University Press for the sale of their book, Cognitive- Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder: Children, Adolescents, and Adults. Drs. Thomas, Eddy and Becker receive royalties from Cambridge University Press for the sale of their book The Picky Eater’s Recovery Book: Overcoming Avoidant/Restrictive Food Intake Disorder. Drs. Lawson and Misra receive royalties from UpToDate. Dr. Lawson was on the scientific advisory board and has/had a financial interest in OXT Therapeutics, a company that developed oxytocin-based therapeutics for metabolic disease; and receives research funding from Tonix Pharmaceuticals. Dr. Misra reports receiving personal fees from AbbVie, Ipsen, and Sanofi. Dr. Breithaupt reports receiving personal fees from Otsuka Pharmaceutical. Drs. Burton Murray and Thomas receive royalties from Oxford University Press for her forthcoming book on rumination syndrome. No other authors declare competing interests.
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