Association of cognitive restraint with ghrelin, leptin, and insulin levels in subjects who are not weight-reduced

Despite widespread efforts at weight loss, the prevalence of obesity continues to rise. Restrained eating is a pattern of attempted weight control characterized by cognitive restriction of food intake that has paradoxically been linked with overeating and/or weight gain. It is not known whether restrained eating is associated with abnormalities in appetite-regulating hormones, independent of its effects on body weight. To address this question, we assessed cognitive restraint using the Three-Factor Eating Questionnaire and obtained fasting measurements of ghrelin, leptin and insulin from 24 healthy, non-obese (body mass index (BMI) 19.7 to 29.6 kg/m2) adult subjects who were at a stable, lifetime maximum weight. We chose to study subjects at stable maximum weight to avoid the secondary effects of weight reduction on body-weight regulating hormones. Subjects were classified by cognitive restraint scale score into Low, Indeterminate, and High Restraint groups. Higher ghrelin levels were significantly associated with restraint in an unadjusted model (P = 0.004) and after adjustment for BMI (P = 0.007). No relationships were found between restraint scores and either leptin (P = 0.75) or insulin (P = 0.36). These findings show an orexigenic hormonal profile in restrained eaters, independent of changes in body weight.