Bulimics, lower leptin levels, wanting to conceive.

Dr. Rosedale,
Thank you for your great work. A study found that bulimics and
recovered bulimics have low leptin levels compared to a control group of
non-bulimics. My wife has a history of bulimia. Her BMI is about 19
(maybe a bit lower). Would you suspect that her leptin levels are low, as this study found? If so, what diet would you recommend she follow to bring
her leptin levels to a healthy range? She would likely classify herself as
a "sugar burner" as opposed to a fat burner, although she has been
introducing more healthy fats into her diet lately and she has been eating
much more nutrient dense foods such as grass fed liver and pastured eggs.
We have a 2 year old daughter and hope to conceive again soon. Also, can low BMI individuals be leptin resistant? Can leptin levels be
too low? If so, how do you raise them safely?
Thank you for considering my question.

The vast majority of studies confuse leptin levels with leptin signaling, not taking in to account leptin resistance, making most of them invalid. However, in this case it sounds like it might be valid since many bulimics have a very low fat percentage and therefore would have low leptin. This may have nothing to do with causing their bulimia, however. If low leptin is contributory to an inability to property ovulate then raising leptin by increasing fat percentage, preferably by increasing fat and oil intake, or leptin injections might be helpful (one of the few beneficial uses of exogenous leptin use). If your wife is a sugar burner because she is eating a lot of sugar and sugar forming foods, she would be much better off cutting these out and embracing the diet of high fat, low carb, moderate protein which will over time help with sugar and food cravings, and improve leptin signaling.

Best of health.

Dr. Ron