Physiological model-based machine learning for classifying patients with binge-eating disorder (BED) from the Oral Glucose Tolerance Test (OGTT) curve

Background and objective: Binge eating disorder (BED) is the most frequent eating disorder, often confused with obesity, with which it shares several characteristics. Early identification could enable targeted therapeutic interventions. In this study, we propose a hybrid pipeline that, starting from plasma glucose data acquired during the Oral Glucose Tolerance Test (OGTT), allows us to classify the two types of patients through computational modeling and artificial intelligence. Methods: The proposed hybrid pipeline integrates a classical mechanistic model of delayed differential equations (DDE) that describes glucose–insulin dynamics with machine learning (ML) methods. Ad hoc techniques, including structural identifiability analysis, have been employed for refining and evaluating the mathematical model. Additionally, a dedicated pipeline for identifying and optimizing model parameters has been applied to obtain reliable estimates. Robust feature extraction and classifier selection processes were developed to ensure the optimal choice of the best-performing classifier. Results: By leveraging parameters estimated from the mechanistic model alongside easily obtainable patient information (such as glucose levels at 30 and 120 min post-OGTT, glycated hemoglobin (Hb1Ac), body mass index (BMI), and waist circumference), our approach facilitates accurate classification of patients, enabling tailored therapeutic interventions. Conclusion: Initial findings, focusing on correctly categorizing patients with BED based on metabolic data, demonstrate promising outcomes. These results suggest significant potential for refinement, including exploration of alternative mechanistic models and machine learning algorithms, to enhance classification accuracy and therapeutic strategies.