In the recent article, Eating Disorder and Metabolism in Narcoleptic Patients, it was shown that the energy balance of narcoleptic individuals was impaired compared to healthy individuals.
It had been long reported by doctors that their narcoleptic patients tended to be overweight compared to other patients, and that patients tended to have a higher BMI (body mass index) “regardless of whether they were treated with drugs increasing appetite, and regardless of whether they had cataplexy.” More importantly, not only are narcoleptics more overweight than the “healthy” control population, but they are also more overweight than their family members, suggesting that the etiology of obesity and narcolepsy extends beyond a familial predisposition to be a little bit thicker.
In the hypothalamus, hypocretin neurons are found in the region of the brain called the feeding center, and when it was found that narcoleptics have a reduction in hypocretin-producing neurons in the brain, it was then suggested that metabolic functioning may also be impaired. In the paper reviewed here, the authors set out to determine energy expenditure in more than 500 narcoleptic patients. Some patients had cataplexy, while some did not, but all were not taking any treatments at the time of the study for their narcolepsy.
Overall, they found that:
1) Narcoleptics tended to have a higher median BMI. That is to say, we narcos are usually fatter.
2) Narcoleptics have lower rest energy expenditure. This means that, when not moving, we burn calories at a lower basal rate than non-narcoleptics.
3) Typical, but not atypical narcoleptic patients tended to eat less. In the study, they separated narcoleptics with cataplexy (“typical”) and those without (“atypical”) and found that typical patients ate less than “healthy controls.” While there was no food intake difference between typical and atypical narcoleptics, overweight narcoleptic patients ate 1/2 as much as narcoleptic patients with a healthy weight.
4) Narcoleptic patients demonstrate a higher rate of eating disorders, particularly bulemia. Narcoleptic patients tended to demonstrate impaired eating behaviors, including the use of binge eating to control daytime sleepiness. There was no difference between typical and atypical narcoleptic patients, and they found that 1/2 of narcoleptic patients suffered from a mild form of eating disorder.