Blunted cortisol response to stress in patients with eating disorders: Its association to bulimic features

Eur Eat Disord Rev. 2018 May;26(3):207-216. doi: 10.1002/erv.2581. Epub 2018 Feb 21.


Objective: Clinical research on cortisol response to stress in patients with eating disorders has provided controversial and even contradictory results. As this might be the consequence of the inclusion in the studies of heterogeneous clinical populations, 3 highly selected samples were studied.

Methods: Dexamethasone suppression test was performed on 15 restricting anorexia nervosa patients without history of bulimia nervosa (BN), 17 BN patients with normal weight and no history of anorexia nervosa, and 22 healthy controls. Three days later, the Trier Social Stress Test was applied, and 8 saliva samples were collected along the trial for cortisol assessment.

Results: When the patients were considered as a single group, a slightly blunted cortisol response to stress was observed, but when the 3 groups were considered separately, the blunted response was observed only in the BN patients.

Discussion: The results support the association between blunted cortisol response and bulimic features.

Keywords: Trier Social Stress Test; cortisol; eating disorders; hypothalamus-pituitary-adrenal axis; stress.

MeSH terms

  • Adult
  • Anorexia Nervosa* / metabolism
  • Bulimia
  • Bulimia Nervosa* / metabolism
  • Humans
  • Hydrocortisone* / metabolism
  • Saliva
  • Stress, Psychological


  • Hydrocortisone