{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:11:45Z","timestamp":1788498705937,"version":"build-2803163510"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cushing\u2019s disease (CD) is characterized by chronic hypercortisolism and is associated with persistent metabolic, psychological, and neurocognitive disturbances. While metabolic consequences are well described, the impact of disease activity and remission on eating behavior remains insufficiently explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to compare multidimensional eating behavior patterns among patients with active Cushing\u2019s disease, patients in biochemical remission, and healthy controls, and to examine their associations with cortisol biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this cross-sectional study, 74 participants were enrolled, including patients with active CD (n = 21), patients in remission (n = 32), and age-, sex-, and BMI-matched healthy controls (n = 21). Eating behavior was assessed using validated questionnaires: the Night Eating Questionnaire (NEQ), Emotional Appetite Questionnaire (EMAQ), Three-Factor Eating Questionnaire\u2013Revised 18 (TFEQ-R18), Mindful Eating Questionnaire (MEQ), and Dutch Eating Behavior Questionnaire (DEBQ). Group differences were analyzed using Kruskal\u2013Wallis tests followed by Dunn\u2019s\n                      <jats:italic>post-hoc<\/jats:italic>\n                      comparisons with Bonferroni correction. Associations between eating behavior scores and cortisol parameters were evaluated using Spearman correlation analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Active Cushing\u2019s disease was associated with higher night eating (NEQ; p &amp;lt; 0.001) and greater emotional and situational eating compared with remission and healthy controls (EMAQ total; p &amp;lt; 0.001). Positive emotion and situation subscales were higher in active disease (both p = 0.008), whereas negative total scores differed significantly only between active disease and healthy controls (p = 0.014). Mindful eating was reduced in both patient groups versus controls (MEQ total; p &amp;lt; 0.001), with active disease showing higher disinhibition (p = 0.002), greater interference (p &amp;lt; 0.001), and lower conscious nutrition (p = 0.016). Remission patients demonstrated partial but incomplete behavioral recovery. Late-night salivary cortisol correlated with MEQ interference (r = 0.5, p = 0.01), and cortisol levels after the 1-mg DST correlated with DEBQ emotional eating (r = 0.5, p = 0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cushing\u2019s disease is associated with marked alterations in eating behavior, particularly during active disease, including increased night eating, emotional susceptibility, and reduced mindful regulation. Although partial improvement occurs after remission, residual behavioral disturbances persist. These findings underscore the importance of integrating behavioral assessment into the long-term management of Cushing\u2019s disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1726118","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T05:16:23Z","timestamp":1770009383000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["From hypercortisolism to remission: impact of Cushing\u2019s disease on eating patterns"],"prefix":"10.3389","volume":"17","author":[{"given":"Merve","family":"Korkmaz Yilmaz","sequence":"first","affiliation":[{"name":"Department of Endocrinology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huseyin","family":"Sehit Burhan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Health Sciences, Basaksehir Cam and Sakura City Hospital","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebnem","family":"Burhan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mutlu","family":"Niyazoglu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital","place":["Istanbul, T\u00fcrkiye"]},{"name":"University of Health Sciences, Pituitary Disorders Research Center","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esra","family":"Hatipoglu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital","place":["Istanbul, T\u00fcrkiye"]},{"name":"University of Health Sciences, Pituitary Disorders Research Center","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.11305","article-title":"Cushing\u2019s syndrome","volume":"330","author":"Newell-Price","year":"1999","journal-title":"Clin Med (Lond)."},{"key":"B2","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1210\/er.2013-1048","article-title":"The treatment of Cushing\u2019s disease","volume":"36","author":"Pivonello","year":"2015","journal-title":"Endocr Rev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.eprac.2025.10.012","article-title":"Cushing\u2019s syndrome: clinical spectrum, diagnosis, and treatment","volume":"30","author":"Ragnarsson","year":"2019","journal-title":"Neurosurg Clin N Am"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/0006-3223(92)90079-F","article-title":"Depression and cognitive impairment in Cushing\u2019s syndrome","volume":"32","author":"Starkman","year":"1981","journal-title":"Arch Intern Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2015.00129","article-title":"Neuropsychiatric disorders in Cushing\u2019s syndrome","volume":"9","author":"Pivonello","year":"2015","journal-title":"Front Neurosci"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13056","article-title":"Psychiatric and neurocognitive consequences of endogenous hypercortisolism","volume":"288","author":"Piasecka","year":"2020","journal-title":"J Intern Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-017-0735-z","article-title":"Neuropsychiatric symptoms in Cushing\u2019s syndrome","volume":"19","author":"Resmini","year":"2016","journal-title":"Pituitary."},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2013.03.014","article-title":"Emotional, external, and restrained eating: Eating behavior and obesity","volume":"67","author":"Snoek","year":"2012","journal-title":"Appetite."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2009.12.004","article-title":"Night eating and obesity","volume":"54","author":"Nolan","year":"2017","journal-title":"Int J Obes"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2004.11.004","article-title":"Chronic stress and comfort foods: self-medication and abdominal obesity","volume":"19","author":"Dallman","year":"2005","journal-title":"Brain Behav Immun"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2007.04.011","article-title":"Stress, eating and the reward system","volume":"91","author":"Adam","year":"2007","journal-title":"Physiol Behav"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2011.04182.x","article-title":"Ghrelin and leptin in endocrine disease","volume":"76","author":"Lawson","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.8.7758","article-title":"Leptin and cortisol interactions in humans","volume":"86","author":"Ghizzoni","year":"2012","journal-title":"Obes (Silver Spring)."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2007.08.008","article-title":"Relationship between stress, eating behavior, and obesity","volume":"23","author":"Torres","year":"2007","journal-title":"Nutrition."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2021.101505","article-title":"Body image and quality of life in Cushing\u2019s syndrome","volume":"35","author":"Bride","year":"2011","journal-title":"Endocrine."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-022-00654-2","article-title":"Comorbidity of major depression and eating disorders","volume":"10","author":"Patten","year":"2001","journal-title":"Can J Psychiatry"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2019-01054","article-title":"Health-related quality of life in Cushing\u2019s syndrome","volume":"104","author":"Resmini","year":"2009","journal-title":"Pituitary."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-1945","article-title":"Eating behaviors in Cushing\u2019s syndrome: residual alterations after cure","volume":"97","author":"Ragnarsson","year":"2014","journal-title":"Eur J Endocrinol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.17925\/EE.2015.11.01.34","article-title":"Persistent morbidity in cured Cushing\u2019s syndrome: a concern for long-term care","volume":"11","author":"Huguet","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2009.74","article-title":"Psychometric evaluation of the three-factor eating questionnaire-R18","volume":"33","author":"Cappelleri","year":"2009","journal-title":"Int J Obes"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1037\/t65383-000","article-title":"Development and validation of the mindful eating questionnaire","volume":"109","author":"Framson","year":"2009","journal-title":"J Am Diet Assoc"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-015-0690-1","article-title":"A prospective study of appetite and food craving in 30 patients with Cushing\u2019s disease","volume":"19","author":"Geer","year":"2016","journal-title":"Pituitary."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2016.00021","article-title":"Glucocorticoid regulation of food-choice behavior in humans: evidence from cushing\u2019s syndrome","volume":"10","author":"Moeller","year":"2016","journal-title":"Front Neurosci"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2017.05.010","article-title":"Decreased prefrontal functional brain response during memory testing in women with Cushing\u2019s syndrome in remission","volume":"82","author":"Ragnarsson","year":"2017","journal-title":"Psychoneuroendocrinology."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(99)00203-6","article-title":"Decrease in cortisol reverses human hippocampal atrophy following treatment of Cushing\u2019s disease","volume":"46","author":"Starkman","year":"1999","journal-title":"Biol Psychiatry"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2231","article-title":"Verbal and visual memory performance and hippocampal volumes, measured by 3-Tesla magnetic resonance imaging, in patients with Cushing\u2019s syndrome","volume":"97","author":"Resmini","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13539","article-title":"Glucocorticoids, stress and eating: The mediating role of appetite-regulating hormones","volume":"24","author":"Kuckuck","year":"2023","journal-title":"Obes Rev"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.eatbeh.2007.03.007","article-title":"The Night Eating Questionnaire (NEQ): psychometric properties of a measure of severity of the Night Eating Syndrome","volume":"9","author":"Allison","year":"2008","journal-title":"Eat Behav."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.5455\/apd.39829","article-title":"The reliability and validity of Turkish version of the Night Eating Questionnaire in psychiatric outpatient population","volume":"15","author":"Atasoy","year":"2014","journal-title":"Anadolu Psikiyatri Dergisi (Anatolian Journal of Psychiatry)"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2009.12.004","article-title":"Emotional Appetite Questionnaire (EMAQ): construct validity and relationship with BMI","volume":"54","author":"Geliebter","year":"2010","journal-title":"Appetite"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.5455\/JCBPR.44046","article-title":"The Emotional Appetite Questionnaire (EMAQ)\u2019s reliability and validity and relationship with body mass index and emotional schemas","author":"Demirel","year":"2014","journal-title":"J Cogn Behav Psychother Res"},{"key":"B32","doi-asserted-by":"crossref","DOI":"10.1038\/sj.ijo.0801442","article-title":"Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women","volume":"24","author":"Karlsson","year":"2000","journal-title":"Int J Obes Relat Metab Disord"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980021000574","article-title":"Turkish version of the Three-Factor Eating Questionnaire-51 for obese individuals: a validity and reliability study","volume":"24","author":"K\u00fc\u00e7\u00fckerd\u00f6nmez","year":"2021","journal-title":"Public Health Nutr"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.5455\/JCBPR.250644","article-title":"Adaptation study of the Mindful Eating Questionnaire (MEQ) into Turkish","volume":"5","author":"K\u00f6se","year":"2016","journal-title":"J Cogn Behav Psychother Res"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(198602)5:2<295::AID-EAT2260050209>3.0.CO;2-T","article-title":"The Dutch Eating Behaviour Questionnaire (DEBQ) for assessment of restrained, emotional and external eating behaviour","volume":"5","author":"Van Strien","year":"1986","journal-title":"Int J Eat Disord"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2011.01.025","article-title":"Psychometric properties of Turkish version of Dutch Eating Behaviour Questionnaire (DEBQ): Preliminary results","volume":"56","author":"Bozan","year":"2011","journal-title":"Appetite"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1726118\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T05:16:24Z","timestamp":1770009384000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1726118\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,2]]},"references-count":36,"alternative-id":["10.3389\/fendo.2026.1726118"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1726118","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,2]]},"article-number":"1726118"}}