Problematic avoidant/restrictive eating in adults with functional dyspepsia: the role of endogenous oxytocin and glucagon-like peptide 1

PROJECT SUMMARY/ABSTRACT Functional dyspepsia (FD) is a chronic gastrointestinal functional/motility disorder that affects up to 12% of US adults with significant morbidity and healthcare costs, and limited treatment options. Detrimental eating-related medical consequences are frequent in FD, with a level of food avoidance/restriction meeting criteria for avoidant/restrictive food intake disorder (ARFID) in up to 40% of adults with FD. However, the biological mechanisms of problematic avoidant/restrictive eating in FD have been underexplored and could inform behavioral and biological intervention targets. The parent K23-Patient-Oriented Research Career Development award addresses this research gap by using an innovative, multi-disciplinary approach to examine the mechanistic role of problematic avoidant/restrictive eating in FD and the potential benefit of a behavioral intervention that exposes patients with FD to increased food volume/variety. Our team’s uncontrolled pilot data suggest that the behavioral treatment can improve FD. In the parent K23-supported studies, Dr. Burton-Murray is studying anorexigenic cholecystokinin and peptide YY as candidate mechanisms of ARFID in FD that may be modifiable. The R03 is a discrete, well-defined project that will expand the K23 research objectives with the evaluation of two additional candidate anorexigenic hormones, oxytocin and glucagon-like peptide 1 (GLP-1). Biospecimens are collected from two parent K23-supported studies—an observational cross-sectional study and a pilot feasibility randomized controlled trial of a behavioral treatment. As the first evaluation to our knowledge of endogenous oxytocin and GLP-1 in FD the study aims to: (1) identify if oxytocin and GLP-1 are additional biomarkers associated with problematic avoidant/restrictive eating in adults with FD, and (2) characterize preliminary candidate mechanisms of action in a behavioral treatment for adults with FD and ARFID. The R03 study aims complement Dr. Burton-Murray’s K23 training objectives in examining endocrine regulation of appetite in FD. Findings from the proposed project will support Dr. Burton Murray’s K-to-R transition as an independent R01-funded researcher, informing candidate appetite hormones to investigate as mechanisms of action in a behavioral treatment for FD in a next-step R01.