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

Trial statusNot yet recruiting
Trial phasePhase 1
Trial typeInterventional
Biological sexAll
Age20-45
SponsorUniversidade do Porto

About this trial

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.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

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

Disqualifiers

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

Trial design

Design model

Parallel

Treatments tested in this trial

  • 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 intervention

    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.

Treatment groups

104 Participants
are divided into 2 treatment groups
Group A: Psychobiotic groupExperimental treatment 1 intervention
Group B: Control groupPlacebo comparator 1 intervention

Trial outcomes

Primary outcomes

1

Gut Microbiota outcomes - Gut-Bacteria Composition

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.

Time frame
Change measures: baseline and end of treatment at 12 weeks
2

Gut Microbiota outcomes - Molecules released by the gut-bacteria

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.

Time frame
Change measures: baseline and end of treatment at 12 weeks
3

Psycho-behavioral outcomes - Three Factor Eating Questionnaire-21

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

Time frame
Change measures: baseline, end of treatment at 12 weeks and follow-up at 12 weeks post-treatment.
4

Psycho-behavioral outcomes - Eating Expectancy Inventory

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

Time frame
Change measures: baseline, end of treatment at 12 weeks and follow-up at 12 weeks post-treatment.

Secondary outcomes

1

Eating Disorder Examination

Eating Disorder Examination (EDE): semi-structured clinical interview for the diagnosis of binge eating disorder

Time frame
baseline moment

Other outcomes

Sponsors and contacts

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Universidade do Porto

Lead sponsor

University of Minho

Collaborator

Braga Hospital

Collaborator

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