A proposed model of bulimic behavior: Effect on plasma insulin, noradrenalin, and cortisol levels

The purpose of this single case study of a bulimic patient was to replicate and incorporate certain elements of bulimic behavior, namely fasting, carbohydrate loading, vomiting, and binge eating, into the glucose tolerance test in order to observe the effects of these modifications on plasma insulin, noradrenalin, and cortisol. The most striking finding was that of potentiation of insulin secretion in response to a glucose load most marked after the subject had engaged in binging and vomiting. The results support the hypothesis that engagement in bulimic behaviors induces higher plasma insulin levels and that this precipitates a behavioral vicious cycle with associated mood changes. Other applications of this experimental model are discussed.