Associations between reproductive hormonal milieus and binge eating: The roles of sex and hormonal contraceptive use

Sex - and its associated gonadal hormones - matters for binge eating (BE). On average, females report higher BE than males. Estradiol generally suppresses appetite, whereas progesterone opposes estradiol's action such that their combined presence represents a high-risk hormonal milieu for BE. Testosterone is thought to be associated with increased BE in females but appears protective in males. Hormonal contraceptives (HCs) provide a naturalistic means to study the relation between gonadal hormones and BE, as HCs vary in formulations and delivery. Oral contraceptive (OC) use has been linked to greater BE-related appetitive processes (e.g., food intake); however, the association with BE itself has not been studied, and research has overlooked hormonal variation across OCs. No study has systematically examined BE and hormonal intrauterine devices (IUDs), which differ in formulation and delivery from other HCs. We explored hormone-BE links in 401 human females (181 naturally cycling (NC); 152 OC users; 53 IUD users) and 159 males aged 18-44 years. ANCOVA tested differences in Binge Eating Scale (BES) summary scores across sex and HC groups (NC, OC, and IUD). Hierarchical linear regressions examined relations between OC hormone activities and BES summary scores. Analyses controlled for BMI and age. In this sample, females reported higher BE than males, but BE did not differ across HC groups or vary with OC hormonal activities. Null results may reflect true group-level similarities in BE or individual differences in vulnerability to hormonal exposures. Further research should replicate and extend these findings to other samples and using other methodologies.