Endocrine Abstracts

Background and aims: liraglutide belongs to glucagon-like peptide-1 receptor agonists (GLP-1 RA) and is widely used for diabetes type 2 (DT2) management as well as for obesity treatment. GLP-1 RA reduce body weight and suppress eating behavior by delaying gastric emptying and affecting arcuate nucleus in hypothalamus. Binge eating disorder (BED) is the most common eating disorder (ED) in individuals with obesity and DT2. BED is characterized by consuming large amounts of food with an associated sense of loss of control. A well-known appetite-stimulating hormone is ghrelin, secreted within the gastric mucosa. Some studies report about decreased ghrelin levels in obese, diabetic 2 patients as well as in individuals with BED. Our aim was to evaluate the effect of liraglutide on BED and ghrelin level after 3 months of administration in obese diabetic 2 patients.

Materials and methods: 75 individuals (mean age – 60.1±6.4 years; BMI - 33.4±3.6 kg/m²; history of diabetes<5 years) with DT2 were recruited into the study. After completing Binge eating scale (BES) 18 patients were screened positive for BED. 8 binge-eaters (1^st study group) started therapy with metformin and liraglutide 1.8 mg daily. Other 10 participants (2^nd study group) used metformin and SGLT-2 inhibitors as glucose-lowering therapy. Ghrelin level was assessed at the 1^st and 12^th week of the study.

Results: the 1^st study group which used dual therapy with liraglutide demonstrated greater weight loss compared to the 2^nd group (4.3±1.3 kg vs. 1.7±0.8 kg, p<0.05). BES-scoring improved in the 1^st study group and 3 participants (37,5%) were categorized into non-binge-eaters. Baseline ghrelin level in the liraglutide group (18.8±10.3 ng/ml) increased (24.9±10.8 ng/ml) significantly (P<0.05) but not in the 2^nd group.

Conclusion: liraglutide is effective and safe for the use in obese diabetic 2 individuals with BED. It reduces body weight and stabilizes eating behavior which makes them potential candidates for the application in diabetic 2 patients with BED. Changes in ghrelin level reflect the recovery of energy homeostasis due to weight loss.