The effect of intranasal insulin on appetite and mood in women with and without obesity: an experimental medicine study

Elizabeth Schneider, Maartje S. Spetter, Elizabeth Martin, Elizabeth Sapey, Kay Por Yip, Konstantinos N. Manolopoulos, Abd A. Tahrani, Jason M. Thomas, Michelle Lee, Manfred Hallschmid, Pia Rotshtein, Colin T. Dourish, Suzanne Higgs*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Background/Objectives: Intranasal (IN) administration of insulin decreases appetite in humans, but the underlying mechanisms are unclear, and it is unknown whether IN insulin affects the food intake of women with obesity. Subjects/Methods: In a double-blind, placebo-controlled, crossover design, participants (35 lean women and 17 women with obesity) were randomized to receive 160 IU/1.6 mL of IN insulin or placebo in a counterbalanced order in the post prandial state. The effects of IN insulin on cookie intake, appetite, mood, food reward, cognition and neural activity were assessed. Results: IN insulin in the post prandial state reduced cookie intake, appetite and food reward relative to placebo and these effects were more pronounced for women with obesity compared with lean women. IN insulin also improved mood in women with obesity. In both BMI groups, IN insulin increased neural activity in the insula when viewing food pictures. IN insulin did not affect cognitive function. Conclusions: These results suggest that IN insulin decreases palatable food intake when satiated by reducing food reward and that women with obesity may be more sensitive to this effect than lean women. Further investigation of the therapeutic potential of IN insulin for weight management in women with obesity is warranted.

Original languageEnglish
Pages (from-to)1319-1327
Number of pages9
JournalInternational Journal of Obesity
Issue number7
Early online date9 Apr 2022
Publication statusPublished - Jul 2022

Bibliographical note

Funding Information:
Funding for this work was provided by BBSRC Grant UK awarded to SH grant number: BB/N008847/1 and supported by the NIHR funded Birmingham Clinical Research Facility. The BBSRC/NIHR had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The behavioural results of this study have been previously presented in poster format at the American College of Neuropsychopharmacology conference in 2019 and the European College of Neuropsychopharmacology conference in 2020. We would like to thank Nina Avitable, Jennie Gavin, Hafwen Thornhill, Saleema Islam, Dr Ross Wilson, and Nina Salman for their invaluable assistance with data collection.

Competing interests:
AAT reports grants from Novo Nordisk, personal fees from Novo Nordisk, non-financial support from Novo Nordisk, personal fees from Eli Lilly, non-financial support from Eli Lilly, personal fees from Janssen, personal fees from AstraZeneca, non-financial support from AstraZeneca, non-financial support from Impeto medical, non-financial support from Resmed, non-financial support from Aptiva, personal fees from Boehringer Ingelheim, non-financial support from Boehringer Ingelheim, personal fees from Bristol Myers Squibb, nonfinancial support from Bristol Myers Squibb, personal fees from NAPP, non-financial support from NAPP, personal fees from Merck Sharp & Dohme, non-financial support from Merck Sharp & Dohme, personal fees from Nestle, personal fees from Gilead, grants from Sanofi, and personal fees from Sanofi outside the submitted work. AAT is currently an employee of Novo Nordisk. This work was performed before AAT became a Novo Nordisk employee. Novo Nordisk had no role in this study. CTD is a Director and Co-Owner of P1vital Limited and a Director and Co-Owner of P1vital Products Limited. All other authors declare no competing interests.

Publisher Copyright:
© 2022, The Author(s).


  • Feeding behaviour
  • Translational research
  • Appetite
  • Insulin/pharmacology
  • Obesity
  • Double-Blind Method
  • Humans
  • Biomedical Research
  • Female
  • Administration, Intranasal
  • Energy Intake

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism


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