Clinical trial

Investigation of the Mechanisms of the Gut-brain Axis in Binge Eating and Obesity.

Opening soon · Phase 1 · 1 countries · Registry ID NCT06823557

Opening soonPhase 1Interventional

What this study is about

Binge Eating Disorder (BED) is a recently recognized eating disorder, characterized by recurrent episodes of overeating with a loss of control. Highly comorbid with obesity, BED is associated with poor outcomes in weight loss treatments and presents unique challenges due to its distinct neuro-psycho-biological mechanisms, which remain poorly understood. The Microbiota-Gut-Brain Axis (MGBA) is a bidirectional communication system linking the gut microbiota with the central nervous system, that plays a critical role in regulating appetite, mood, and eating behavior. Dysregulations in MGBA may contribute to the development and maintenance of BED, offering a novel framework for understanding its complex mechanisms and identifying new therapeutic targets. Psychobiotics -pre-, pro-, or symbiotics that modulate the microbiota- emerge as a promising treatment strategy to address BED symptoms by influencing MGBA activity. The goal of this randomized clinical trial (RCT) is to investigate the role of psychobiotics in modulating the gut-brain axis and improving binge eating in adults, with a particular focus on evaluating these effects independently of obesity status. This project stands out for its comprehensive approach to understanding BED, integrating psychological, neurofunctional, hormonal, and microbiota factors that contribute to this complex disorder. The main questions it aims to answer are: * What specific alterations in the MGBA pathways are associated with BED? * Can psychobiotic supplementation effectively reverse microbiota alterations and modulate MGBA activity, ultimately improving BED symptoms? Researchers will compare participants receiving psychobiotics to those receiving a look-alike substance that contains no drug (a placebo) to evaluate whether psychobiotics impact endocrine hormones, neurofunction, psychological and behavioral factors related to eating regulation, and BED symptoms. Participants will: * Undergo an assessment protocol that includes microbiota sampling, blood tests for hormone analysis, neurofunctional evaluations, and psychological/behavioral assessments before and after the psychobiotics/ placebo intervention. * Take psychobiotics or a placebo daily for 12 weeks and receive well-being monitoring * Participate in follow-up visits three months after the intervention to monitor changes in BED symptoms and related parameters.

A promising-looking record is not the same as confirmed eligibility. The study team must review the full criteria and current recruitment status.

Basic eligibility

Age20 Years to 45 Years
SexAll
Healthy volunteersAccepted
ConditionBinge Eating Disorder, Obesity

Full registry criteria

Inclusion Criteria: * Portuguese adults (25 with normal weight; 25 with obesity only (30 ≤ BMI \< 40) and BED; 54 with BED) * Residents in Portugal for the past 10 years Exclusion Criteria: * Significant weight loss (\>5% of body weight) in the past 2 years * Antibiotic use in the past 6 months * History of surgery or medical/psychiatric diseases * Pregnant or breastfeeding * History of drug use or dependence * Use of medications that impact weight * Have metal implants or pacemakers

Treatments and study arms

Psychobiotic treatment

Dietary Supplement

The dietary supplementation will follow established guidelines, recommending an intake of 16 g of prebiotic per day, distributed across three meals, for a duration of 12 weeks.

Placebo treatment

Other

The control group will receive identical packaging that matches the experimental treatment in taste and appearance and will follow the same guidelines for consuming the placebo. For ethical reasons, after the end of the RCT, the control group will be given the option to receive the same prebiotic supplement.

Primary outcomes

Gut Microbiota outcomes - Gut-Bacteria CompositionChange measures: baseline and end of treatment at 12 weeks

Stool samples from each participant will be fermented by the prebiotic to allow direct comparison of individual alterations in vitro and in vivo of the microbiome. Changes in gut-bacteria composition and its adhesion into the mucus layer will be analyzed.

Gut Microbiota outcomes - Molecules released by the gut-bacteriaChange measures: baseline and end of treatment at 12 weeks

Stool samples from each participant will be fermented by the prebiotic to allow direct comparison of individual alterations in vitro and in vivo of the microbiome. Molecules released by the bacteria, including short-chain fatty acids (SCFA), lipopolysaccharides (LPS), gamma-aminobutyric acid (GABA), dopamine, and serotonin, which modify host metabolism and central regulation of appetite directly via vagal stimulation or indirectly through immune-neuroendocrine mechanisms, will be traced during fermentations.

Psycho-behavioral outcomes - Three Factor Eating Questionnaire-21Change measures: baseline, end of treatment at 12 weeks and follow-up at 12 weeks post-treatment.

Three Factor Eating Questionnaire-21 (TFEQ-21): assesses psychopathology and behaviors related to eating disorders, generating 3 subscales: emotional eating; compulsive eating; restraint eating.

Psycho-behavioral outcomes - Eating Expectancy InventoryChange measures: baseline, end of treatment at 12 weeks and follow-up at 12 weeks post-treatment.

\- The Eating Expectancy Inventory (EEI): evaluates cognitive expectations regarding eating

Psycho-behavioral outcomes - Negative urgency subscaleChange measures: baseline, end of treatment at 12 weeks and follow-up at 12 weeks post-treatment.

Negative urgency subscale from the Urgency, Premeditation, Perseverance, and Sensation Seeking scales (UPPS): assesses the tendency to act rashly/impulsively when experiencing negative emotions.

Psycho-behavioral outcomes - Difficulties in Emotion Regulation ScaleChange measures: baseline, end of treatment at 12 weeks and follow-up at 12 weeks post-treatment.

Difficulties in Emotion Regulation Scale (DERS): self-report measure developed to assess difficulties in emotional dysregulation.

Psycho-behavioral outcomes - Distress Tolerance ScaleChange measures: baseline, end of treatment at 12 weeks and follow-up at 12 weeks post-treatment.

The Distress Tolerance Scale (DTS): scale that assesses ability to experience, tolerate, and function in a context of emotional distress

Neurofunctioning outcomes - Default mode networkChange measures: baseline and end of treatment at 12 weeks

Neurofunctioning will be assessed through rs-fMRI. Specifically, we aim to compare the resting-state networks (RSNs), such as the default mode network (DMN), the salience network (SN), the meso/paralimbic network (MPN), and the executive network (EN) across the three groups. The DMN is involved in self-referential processing, which includes monitoring the external environment as well as physical and emotional states.

Study locations

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Center for Psychology at University of Porto🇵🇹 Porto, Paranhos, Portugal
Center for Psychology at University of PortoContact