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Morning and afternoon appetite and gut hormone responses to meal and stress challenges in obese individuals with and without binge eating disorder

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Eating late in the day is common, and stress can induce eating. Little is understood about how time of day and stress interact to affect appetite and thereby body weight. These may be particularly important influences in binge eaters, who tend to binge in the evening, and in response to stress.


Obese participants with (n=16) and without (n=16) Binge Eating Disorder (BED) participated in two identical test protocols beginning either in the morning or the afternoon (AM condition/PM condition), each following an 8 h fast. For each protocol they first received a standardized liquid meal (9:00am/4:00pm), then a stress test (Socially-Evaluated Cold Pressor Test, 11:10am/6:1pm), then a multi-item ad libitum buffet meal (11:40am/6:40pm), while rating appetite and stress and having blood drawn for hormone measures.


Appetite at baseline was greater in the PM than AM condition (higher hunger, lower fullness). Following the liquid meal, AUC values for hunger and ghrelin were greater, and AUC values for PYY lower, in the PM than AM condition. Only those with BED showed lower fullness AUC in the PM condition, as well as a pattern of higher initial PM and lower initial AM ghrelin. Following the stress test, cortisol and ghrelin increased in both the AM and PM conditions, but higher ghrelin AUC and lower cortisol AUC were observed in the PM condition. Again, only participants with BED showed lower fullness AUC in the PM condition. Buffet meal intake was similar across groups and conditions, but those with BED reported greater loss of control and binge resemblance than those without.


Afternoon/evening may be a high-risk period for overeating, particularly when paired with stress exposure, and for those with binge eating.

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Author information

Author notes

    • S Carnell
    •  & C Grillot

    *Joint first authors


  1. Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD

    • S Carnell
  2. Department of Psychology, Florida State University, Tallahassee, FL

    • C Grillot
  3. Mt Sinai St Luke’s Hospital, Icahn School of Medicine at Mt Sinai, New York, NY

    • T Ungredda
    • , S Ellis
    • , N Mehta
    •  & A Geliebter
  4. Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark

    • J Holst
  5. Department of Psychiatry, Icahn School of Medicine at Mt Sinai, New York, NY

    • A Geliebter
  6. Department of Psychology, Touro College and University System, New York, NY

    • A Geliebter


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Corresponding author

Correspondence to S Carnell.