Regulating Satiety in Bulimia Nervosa: The Role of Cholecystokinin


  • Sandy Hannon-Engel PhD(c), RN, CS

    Corresponding author
    1. Sandy Hannon-Engel, PhD(c), RN, CS, is a doctoral candidate, Psychiatric/Mental Health Department, Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA.
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PURPOSE:  Individuals with bulimia nervosa (BN) report altered perceptions in hunger, fullness, and satiety. This article reviews the role of cholecystokinin (CCK), a satiety-producing hormone, in the regulation of binge eating in those who suffer from BN.

CONCLUSION:  Studies have shown that CCK is decreased in individuals with BN when compared with healthy controls. Decreased CCK functioning may contribute to impaired satiety and thus binge eating in this patient population. Depending on the macronutrient composition of food choices, CCK release can be differentially influenced. For instance, protein is a potent stimulator of a CCK response. Eating more protein-rich meals increases the release of CCK, increasing satiety and ending a meal.

PRACTICE IMPLICATIONS:  Knowledge of CCK functioning and the utility of manipulating the macronutrient composition of meals may inform standard behavioral treatment strategies for those who suffer from BN.