[Food addiction]

Food addiction is a common term used in everyday language by obese patients. Although the neurobiological evidence points to some similarities between addictive mechanisms and the consumption of certain foods, this diagnosis is not yet officially recognized. After a brief history of food addiction compared to other eating disorders, we review the neurobiological processes underlying this concept. A food addiction assessment tool is presented and discussed with the current literature and new classifications of the DSM-5. The concept of food addiction needs to be rethought and requires further research.

A new look at the science of weight control: how acceptance and commitment strategies can address the challenge of self-regulation

The current manuscript proposes an acceptance-based, self-regulation framework for understanding the challenge of weight maintenance and describes how this framework can be integrated into the behavioral treatment of obesity. According to this framework, intrinsic drives to consume palatable, high-calorie food interact with a modern environment in which high calorie foods are easily accessible. This combination produces a chronic desire to eat unhealthy foods that exists in opposition to individuals' weight control goals. Similarly, low energy expenditure requirements reduce physical activity. We suggest that individuals vary in their responsivity to cues that motivate overeating and sedentary behavior, and that those higher in responsivity need specialized self-regulatory skills to maintain healthy eating and exercise behaviors. These skills include an ability to tolerate uncomfortable internal reactions to triggers and a reduction of pleasure, behavioral commitment to clearly-defined values, and metacognitive awareness of decision-making processes. So-called "acceptance-based" interventions based on these skills have so far proven efficacious for weight control, especially for those who are the most susceptible to eating in response to internal and external cues (as predicted by the model). Despite the current empirical support for the postulated model, much remains to be learned including whether acceptance-based interventions will prove efficacious in the longer-term.

External Eating as a Predictor of Cue-reactivity to Food-related Virtual Environments

The objective of this study was to assess the association between external eating style and food craving experienced during exposure to food cues in virtual reality (VR) environments in both clinical and non-clinical samples. According to the externality theory, people with external eating experience higher reactivity when exposed to food cues, which in turn increases the probability of overeating. Forty patients with eating disorders (23 with bulimia nervosa and 17 with binge eating disorder) and 78 undergraduate students were exposed to 10 different food cues in four VR environments (kitchen, dining room, bedroom, and café). After 30 seconds of exposure to each VR environment, food craving was assessed using a visual analog scale. External, emotional and restrictive eating styles were also assessed using the DEBQ. The results showed a strong association between external eating and cue-elicited food craving. After controlling for the presence of eating disorder diagnosis, external eating was the best predictor of reported food craving. The results lend support to the externality theory but highlight the need for further research in specific patterns of functioning in patients with bulimia nervosa and binge eating disorder.

Association between MC4R rs17782313 polymorphism and overeating behaviors

BACKGROUND/OBJECTIVES

Melanocortins have a crucial role in appetite and weight regulation. Although the melanocortin 4 receptor (MC4R) gene has been repeatedly linked to obesity and antipsychotic-induced weight gain, the mechanism behind how it leads to this effect in still undetermined. The goal of this study was to conduct an in-depth and sophisticated analysis of MC4R polymorphisms, body mass index (BMI), eating behavior and depressed mood.

SUBJECTS/METHODS

We genotyped 328 individuals of European ancestry on the following MC4R markers based on the relevant literature on obesity and antipsychotic-induced weight gain: rs571312, rs17782313, rs489693, rs11872992, and rs8087522. Height and weight were measured, and information on depressed mood and overeating behaviors was obtained during the in-person assessment.

RESULTS

BMI was associated with rs17782313 C allele; however, this finding did not survive correction for multiple testing (P = 0.018). Although rs17782313 was significantly associated with depressed mood and overeating behaviors, tests of indirect effects indicated that emotional eating and food cravings, rather than depressed mood, uniquely accounted for the effect of this marker and BMI (n = 152).

CONCLUSIONS

To our knowledge, this is the first study to investigate the link between MC4R rs17782313, mood and overeating behavior, as well as to demonstrate possible mechanisms behind MC4R's influence on body weight. If replicated in a larger sample, these results may have important clinical implications, including potential for the use of MC4R agonists in the treatment of obesity and disordered eating.

Risk factors across the eating disorders

This study sought to examine risk and onset patterns in anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Women with AN (n=71), BN (n=66), BED (n=160) and non-psychiatric controls (n=323) were compared retrospectively on risk factors, symptom onset, and diagnostic migration. Eating disorder groups reported greater risk exposure than non-psychiatric controls. AN and BED differed on premorbid personality/behavioral problems, childhood obesity, and family overeating. Risk factors for BN were shared with AN and BED. Dieting was the most common onset symptom in AN, whereas binge eating was most common in BN and BED. Migration between AN and BED was rare, but more frequent between AN and BN and between BN and BED. AN and BED have distinct risk factors and onset patterns, while BN shares similar risk factors and onset patterns with both AN and BED. Results should inform future classification schemes and prevention programs.

Microcystin-LR induced thyroid dysfunction and metabolic disorders in mice

There is growing evidence that microcystins (MCs) act as hazardous materials and can disrupt the endocrine systems of animals. However, the response of thyroid function and the related energy metabolism following MCs exposure is still unknown. In the present study, mice were injected intraperitoneally (i.p.) with doses of either 5 or 20 μg/kg MC-LR for 4 weeks. We report, for the first time, that mice exposed to 20 μg/kg MC-LR showed disrupted glucose, triglyceride and cholesterol metabolism with obvious symptoms of hyperphagia, polydipsia, and weight loss. The circulating thyroid hormone (TH) levels in mice following MC-LR exposure were detected. Significantly increased free triiodothyronine (FT3) and decreased free thyroxin (FT4) were largely responsible for the physiological aberrations and metabolic disorders observed in mice after the 20 μg/kg MC-LR exposure. Increased expression of TH receptor (Trα) and mTOR expression in the brain after the 20 μg/kg MC-LR exposure suggests that the increased FT3 enhanced mTOR signaling subsequently led to hyperphagia and elevated energy expenditure in mice. Furthermore, several genes involved in glucose homeostasis and lipid metabolism, which have been identified affected by TH, were also differentially expressed after MC-LR exposure. The above results clearly showed that mice exposed to MC-LR experienced thyroid dysfunction and its downstream functional changes, and are useful to better understand the endocrine toxicity of MC-LR to mammals or even humans.

Ecological momentary assessment of environmental and personal factors and snack food intake in African American women

This study examined contributions of environmental and personal factors (specifically, food availability and expense, daily hassles, self-efficacy, positive and negative affect) to within-person and between-person variations in snack food intake in 100 African American women. Participants were signaled at random five times daily for seven days to complete a survey on a study-provided smartphone. Women reported consuming snack foods at 35.2% of signals. Easier food availability accounting for one's usual level was associated with higher snack food intake. Being near outlets that predominately sell snacks (e.g., convenience stores), while accounting for one's usual proximity to them, was associated with higher snack food intake. Accounting for one's usual daily hassle level, we found that on days with more frequent daily hassles snack food intake was higher. The positive association between within-person daily hassles frequency and snack food intake was stronger when foods were easily available. Public and private policies to curb ubiquitous food availability and mobile health interventions that take into account time-varying influences on food choices and provide real-time assistance in dealing with easy food availability and coping with stressors may be beneficial in improving African American women's day to day food choices.

Food addiction in the light of DSM-5

The idea that specific kind of foods may have an addiction potential and that some forms of overeating may represent an addicted behavior has been discussed for decades. In recent years, the interest in food addiction is growing and research on this topic lead to more precise definitions and assessment methods. For example, the Yale Food Addiction Scale has been developed for the measurement of addiction-like eating behavior based on the diagnostic criteria for substance dependence of the fourth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). In 2013, diagnostic criteria for substance abuse and-dependence were merged, thereby increasing the number of symptoms for substance use disorders (SUDs) in the DSM-5. Moreover, gambling disorder is now included along SUDs as a behavioral addiction. Although a plethora of review articles exist that discuss the applicability of the DSM-IV substance dependence criteria to eating behavior, the transferability of the newly added criteria to eating is unknown. Thus, the current article discusses if and how these new criteria may be translated to overeating. Furthermore, it is examined if the new SUD criteria will impact future research on food addiction, for example, if "diagnosing" food addiction should also be adapted by considering all of the new symptoms. Given the critical response to the revisions in DSM-5, we also discuss if the recent approach of Research Domain Criteria can be helpful in evaluating the concept of food addiction.

Eating behavior in Portuguese higher education students: the effect of social desirability

OBJECTIVES

The aim of this study was to relate social desirability with eating behavior dimensions among higher education students in Portugal, and to assess the effect of social desirability on the association between pairs of eating behavior dimensions.

METHODS

Data from 266 higher education students (62.8% women) aged between 18 and 27 y were evaluated. Social desirability and several eating behavior dimensions (emotional and external eating, flexible and rigid restraint, binge eating, and eating self-efficacy) were assessed.

RESULTS

In both women and men, social desirability showed negative associations with emotional, external, and binge eating, and positive associations with eating self-efficacy. For the majority of the correlations, the control for social desirability led to a decrease in the strength of the association: Social desirability showed a greater effect on the associations between external and binge eating, external eating and eating self-efficacy, binge eating and eating self-efficacy, and emotional and external eating.

CONCLUSION

This study demonstrated that social desirability should be considered when assessing the dimensions of eating behavior, namely eating self-efficacy and dimensions related to overeating.

Expression profile of hypothalamic neuropeptides in chicken lines selected for high or low residual feed intake

The R(+) and R(-) chicken lines have been divergently selected for high (R(+)) or low (R(-)) residual feed intake. For the same body weight and egg production, the R(+) chickens consume 40% more food than their counterparts R(-) lines. In the present study we sought to determine the hypothalamic expression profile of feeding-related neuropeptides in these lines maintained under fed or food-deprived conditions. In the fed condition, the suppressor of cytokine signaling 3 (SOCS3) was 17-fold lower (P<0.05) and the ghrelin receptor was 7-fold higher (P<0.05) in R(+) compared to R(-) chicken lines. The hypothalamic expression of the other studied genes remained unchanged between the two lines. In the fasted state, orexigenic neuropeptide Y and agouti-related peptide were more responsive, with higher significant levels in the R(+) compared to R(-) chickens, while no significant differences were seen for the anorexigenic neuropeptides pro-opiomelanocortin and corticotropin releasing hormone. Interestingly, C-reactive protein, adiponectin receptor 1 and ghrelin receptor gene expression were significantly higher (12-, 2- and 3-folds, respectively), however ghrelin and melanocortin 5 receptor mRNA levels were lower (4- and 2-folds, P=0.05 and P=0.03, respectively) in R(+) compared to R(-) animals. We identified several key feeding-related genes that are differently expressed in the hypothalamus of R(+) and R(-) chickens and that might explain the difference in feed intake observed between the two lines.

Expression of gastrointestinal nesfatin-1 and gastric emptying in ventromedial hypothalamic nucleus- and ventrolateral hypothalamic nucleus-lesioned rats

AIM: To determine the expression levels of gastrointestinal nesfatin-1 in ventromedial hypothalamic nucleus (VMH)-lesioned (obese) and ventrolateral hypothalamic nucleus (VLH)-lesioned (lean) rats that exhibit an imbalance in their energy metabolism and gastric mobility.

METHODS: Male Wistar rats were randomly divided into a VMH-lesioned group, a VLH-lesioned group, and their respective sham-operated groups. The animals had free access to food and water, and their diets and weights were monitored after surgery. Reverse transcription-polymerase chain reaction and immunostaining were used to analyse the levels of NUCB2 mRNA and nesfatin-1 immunoreactive (IR) cells in the stomach, duodenum, small intestine, and colon, respectively. Gastric emptying was also assessed using a modified phenol red-methylcellulose recovery method.

RESULTS: The VMH-lesioned rats fed normal chow exhibited markedly greater food intake and body weight gain, whereas the VLH-lesioned rats exhibited markedly lower food intake and body weight gain. NUCB2/nesfatin-1 IR cells were localised in the lower third and middle portion of the gastric mucosal gland and in the submucous layer of the enteric tract. Compared with their respective controls, gastric emptying was enhanced in the VMH-lesioned rats (85.94% ± 2.27%), whereas the VLH lesions exhibited inhibitory effects on gastric emptying (29.12% ± 1.62%). In the VMH-lesioned rats, the levels of NUCB2 mRNA and nesfatin-1 protein were significantly increased in the stomach and duodenum and reduced in the small intestine. In addition, the levels of NUCB2 mRNA and nesfatin-1 protein in the VLH-lesioned rats were decreased in the stomach, duodenum, and small intestine.

CONCLUSION: Our study demonstrated that nesfatin-1 level in the stomach and duodenum is positively correlated with body mass. Additionally, there is a positive relationship between gastric emptying and body mass. The results of this study indicate that gastrointestinal nesfatin-1 may play a significant role in gastric mobility and energy homeostasis.

Behavioral characterization of the hyperphagia synphilin-1 overexpressing mice

Synphilin-1 is a cytoplasmic protein that has been shown to be involved in the control of energy balance. Previously, we reported on the generation of a human synphilin-1 transgenic mouse model (SP1), in which overexpression of human synphilin-1 resulted in hyperphagia and obesity. Here, behavioral measures in SP1 mice were compared with those of their age-matched controls (NTg) at two time points: when there was not yet a group body weight difference (“pre-obese”) and when SP1 mice were heavier (“obese”). At both time points, meal pattern analyses revealed that SP1 mice displayed higher daily chow intake than non-transgenic control mice. Furthermore, there was an increase in meal size in SP1 mice compared with NTg control mice at the obese stage. In contrast, there was no meal number change between SP1 and NTg control mice. In a brief-access taste procedure, both “pre-obese” and “obese“ SP1 mice displayed concentration-dependent licking across a sucrose concentration range similar to their NTg controls. However, at the pre-obese stage, SP1 mice initiated significantly more trials to sucrose across the testing sessions and licked more vigorously at the highest concentration presented, than the NTg counterparts. These group differences in responsiveness to sucrose were no longer apparent in obese SP1 mice. These results suggest that at the pre-obese stage, the increased trials to sucrose in the SP1 mice reflects increased appetitive behavior to sucrose that may be indicative of the behavioral changes that may contribute to hyperphagia and development of obesity in SP1 mice. These studies provide new insight into synphilin-1 contributions to energy homeostasis.

Eating on impulse: the relation between overweight and food-specific inhibitory control

OBJECTIVE

Consistent with the idea that impulsivity increases vulnerability to temptations of tasty high caloric food, less effective response inhibition is associated with overeating, overweight, and obesity. However, inefficient response inhibition mainly affects eating behavior when strong motivational urges to consume palatable food are simultaneously present. This study, therefore, examined whether overweight is associated specifically with inefficient response inhibition of food-related responses rather than with a general response inhibition deficiency.

METHODS

Eighty-seven female participants (age: M = 26.17, SD = 10.9; body mass index (BMI: kg/m²): M = 22.28, SD = 4.34, range 13.86-39.86) performed both a Stop-Signal task with general stimuli to measure general response inhibition ability, and a Stop-Signal task with food-related pictures to measure ability to inhibit responses to food pictures.

RESULTS

As expected, a higher BMI was associated with decreased inhibitory control over food-related responses. There was no association between BMI and general response inhibition.

CONCLUSIONS

Overweight is not characterized by a general tendency to react impulsively, but instead by impulsive responding toward palatable food. The implication is that weight loss interventions need to focus on decreasing food-specific impulsivity rather than on reducing general impulsivity.

Overeating phenotypes in overweight and obese children

The purpose of this study was to identify overeating phenotypes and their correlates in overweight and obese children. One hundred and seventeen treatment-seeking overweight and obese 8-12year-old children and their parents completed the study. Children completed an eating in the absence of hunger (EAH) paradigm, the Eating Disorder Examination interview, and measurements of height and weight. Parents and children completed questionnaires that evaluated satiety responsiveness, food responsiveness, negative affect eating, external eating and eating in the absence of hunger. Latent profile analysis was used to identify heterogeneity in overeating phenotypes in the child participants. Latent classes were then compared on measures of demographics, obesity status and nutritional intake. Three latent classes of overweight and obese children were identified: High Satiety Responsive, High Food Responsive, and Moderate Satiety and Food Responsive. Results indicated that the High Food Responsive group had higher BMI and BMI-Z scores compared to the High Satiety Responsive group. No differences were found among classes in demographics or nutritional intake. This study identified three overeating phenotypes, supporting the heterogeneity of eating patterns associated with overweight and obesity in treatment-seeking children. These finding suggest that these phenotypes can potentially be used to identify high risk groups, inform prevention and intervention targets, and develop specific treatments for these behavioral phenotypes.

Diurnal cortisol pattern, eating behaviors and overweight in low-income preschool-aged children

This study examined, among children, the associations among chaos in the home, diurnal cortisol patterns, eating behaviors and being overweight. Participants included 331 low-income children aged 3-4years. Mean salivary cortisol-intercept (representing morning peak, 60min since waking) and cortisol-slope (representing diurnal decline after peak) were calculated using mixed models from samples obtained across 3days. Parents reported chaos in the home by questionnaire and responded to the Children's Eating Behavior Questionnaire, generating subscales Food Responsiveness (FR), Emotional Overeating (EO), Enjoyment of Food (EF), and Satiety Responsiveness (SR). Body mass index was categorized as overweight vs. not. Path analysis evaluated associations among chaos, cortisol patterns, eating behaviors, and weight status. Children living in more chaotic homes had lower morning cortisol levels, consistent with "hypocortisolism" reported among individuals who have experienced significant allostatic load as a result of substantial early life chronic stress. Among girls, the hypocortisolism pattern predicted a higher likelihood of being overweight both directly and mediated through reduced Satiety Responsiveness; in boys, the association of the hypocortisolism pattern with being overweight was mediated entirely through Emotional Overeating. In summary, our results provide support for the conceptual model that psychosocial stress contributes to hypocortisolism, which contributes directly to a higher likelihood of being overweight in girls, and indirectly through reduced Satiety Responsiveness in girls and through increased Emotional Overeating in boys.

Psychosocial stress induces hyperphagia and exacerbates diet-induced insulin resistance and the manifestations of the Metabolic Syndrome

Stress and hypercaloric food are recognized risk factors for obesity, Metabolic Syndrome (MetS) and Type 2 Diabetes (T2D). Given the complexity of these metabolic processes and the unavailability of animal models, there is poor understanding of their underlying mechanisms. We established a model of chronic psychosocial stress in which subordinate mice are vulnerable to weight gain while dominant mice are resilient. Subordinate mice fed a standard diet showed marked hyperphagia, high leptin, low adiponectin, and dyslipidemia. Despite these molecular signatures of MetS and T2D, subordinate mice fed a standard diet were still euglycemic. We hypothesized that stress predisposes subordinate mice to develop T2D when synergizing with other risk factors. High fat diet aggravated dyslipidemia and the MetS thus causing a pre-diabetes-like state in subordinate mice. Contrary to subordinates, dominant mice were fully protected from stress-induced metabolic disorders when fed both a standard- and a high fat-diet. Dominant mice showed a hyperphagic response that was similar to subordinate but, unlike subordinates, showed a significant increase in VO2, VCO2, and respiratory exchange ratio when compared to control mice. Overall, we demonstrated a robust stress- and social status-dependent effect on the development of MetS and T2D and provided insights on the physiological mechanisms. Our results are reminiscent of the effect of the individual socioeconomic status on human health and provide an animal model to study the underlying molecular mechanisms.

Self-efficacy beliefs and eating behavior in adolescent girls at-risk for excess weight gain and binge eating disorder

OBJECTIVE

To examine the relationship between self-related agency beliefs and observed eating behavior in adolescent girls with loss of control (LOC) eating.

METHOD

One-hundred eleven adolescent girls (14.5 ± 1.7 years; BMI: 27.1 ± 2.6 kg/m(2)) were administered the General Self-Efficacy Scale and the Weight Efficacy Lifestyle Questionnaire (WEL). Adolescents then participated in a laboratory test meal.

RESULTS

Greater general and eating self-efficacy were associated with fewer episodes of LOC eating. General self-efficacy was inversely related to total intake at the meal (p < .01). Only the WEL availability subscale score, but not the other WEL subscales, was inversely related to total energy, snack, and dessert intake (ps < 0.05).

DISCUSSION

General self-related agency beliefs may be important in relation to energy consumption. Among girls susceptible to disordered eating and obesity, the domain-specific belief in one's ability to refrain from eating when food is widely available may be especially salient in determining overeating in the current food environment. Further research is therefore needed to assess the predictive validity of these beliefs on eating and weight outcomes.

Hyperphagia among patients with Bardet-Biedl syndrome

BACKGROUND

The importance of hyperphagia as a cause for energy imbalance in humans with Bardet-Biedl syndrome (BBS) has not been established. We therefore compared hyperphagic symptoms in patients with BBS vs. controls.

METHODS

We studied 13 patients with BBS and 23 non-syndromic controls with similar age, sex and body mass index (BMI) z-score. A 13-item hyperphagia questionnaire was completed by patients' parents/guardians.

RESULTS

Total hyperphagia questionnaire score was higher in BBS than controls (27.6 ± 9.0 vs. 19.1 ± 7.9, P = 0.005). Behaviour and drive subscales were higher for BBS than controls (12.5 ± 4.1 vs. 7.8 ± 3.2, P = 0.001, and 11.2 ± 4.1 vs. 8.3 ± 3.8, P = 0.04, respectively); severity was not significantly different between groups (3.8 ± 1.5 vs. 3.0 ± 1.3, P = 0.072). After adjustment for demographic variables and BMI z-score, total and behaviour subscale scores remained significantly different between groups, suggesting food-seeking activity, rather than preoccupation with food may be the main hyperphagic feature among patients with BBS.

CONCLUSION

Appetite dysregulation may contribute to obesity in BBS.

Characterization of a novel genetically obese mouse model demonstrating early onset hyperphagia and hyperleptinemia

Obesity is a critical risk factor for the development of metabolic syndrome, and many obese animal models are used to investigate the mechanisms responsible for the appearance of symptoms. To establish a new obese mouse model, we screened ∼13,000 ICR mice and discovered a mouse demonstrating spontaneous obesity. We named this mouse "Daruma" after a traditional Japanese ornament. Following the fixation of the genotype, these animals exhibited obese phenotypes according to Mendel's law of inheritance. In the Daruma mouse, the leptin receptor gene sequence carried two base mutations that are good candidates for the variation(s) responsible for the obese phenotype. The Daruma mice developed characteristic visceral fat accumulation at 4 wk of age, and the white adipose and liver tissues exhibited increases in cell size and lipid droplets, respectively. No histological abnormalities were observed in other tissues of the Daruma mice, even after the mice reached 25 wk of age. Moreover, the onset of impaired leptin signaling was early and manifested as hyperleptinemia and hyperinsulinemia. Pair feeding completely inhibited obesity, although these mice rapidly developed hyperphagia and obesity followed by hyperleptinemia when pair feeding ceased and free-access feeding was permitted. Therefore, the Daruma mice exhibited unique characteristics and may be a good model for studying human metabolic syndrome.

A comparison of the accuracy of self-reported intake with measured intake of a laboratory overeating episode in overweight and obese women with and without binge eating disorder

PURPOSE

Research has demonstrated significant underreporting of food intake in obese individuals with and without binge eating disorder (BED). An improved understanding of the accuracy of self-reported food intake is central to diagnosis of eating disorders and monitoring response to treatment. The purpose was to: (1) confirm those with BED consume significantly more kilocalories (kcal) than overweight/obese controls when instructed to overeat in the laboratory and (2) compare dietary recall data with measured intake.

METHODS

Fifteen women fulfilling BED criteria and 17 controls participated in an overeating episode and completed a 24-h dietary recall.

RESULTS

BED participants consumed significantly more kilocalories according to both methodologies. The BED group self-reported 90% of the measured intake compared to 98% for the control group. Mean differences between the methods indicated that on average both groups underreported intake; however, the mean difference between methods was significantly greater in the BED group.

CONCLUSIONS

Findings confirm that those with BED consume significantly more than controls during a laboratory binge and controls tended to be more accurate in recalling their intake 24 h later.

Secretive food concocting in binge eating: test of a famine hypothesis

OBJECTIVE

Food concocting, or making strange food mixtures, is well documented in the famine and experimental semistarvation literature and appears anecdotally in rare descriptions of eating disorder (ED) patients but has never been scientifically investigated. Here we do so in the context of binge-eating using a "famine hypothesis of concocting."

METHOD

A sample of 552 adults varying in binge eating and dieting traits completed a Concocting Survey created for this study. Exploratory ED groups were created to obtain predictions as to the nature of concocting in clinical populations.

RESULTS

Binge eating predicted the 24.6% of participants who reported having ever concocted but dietary restraint, independently, even after controlling for binge eating, predicted its frequency and salience. Craving was the main motive. Emotions while concocting mirrored classic high-arousal symptoms associated with drug use; while eating the concoctions were associated with intensely negative/self-deprecating emotions. Concocting prevalence and salience was greater in the anorexia > bulimia > BED > no ED groups, consistent with their respectively incrementing dieting scores.

DISCUSSION

Concocting distinguishes binge eating from other overeating and, consistent with the famine hypothesis, is accounted for by dietary restraint. Unlike its adaptive function in famine, concocting could worsen binge-eating disorders by increasing negative effect, shame, and secrecy. Its assessment in these disorders may prove therapeutically valuable.

Social anxiety and disordered overeating: an association among overweight and obese individuals

OBJECTIVE

The study objectives were to evaluate the relationship between social anxiety, binge eating, and emotional eating in overweight and obese individuals and to evaluate the relationship between weight and social anxiety.

METHODS

Using an internet based survey, overweight and obese men and women (n=231; mean age=36.0±12.8; mean BMI=33.7 kg/m(2)±6.7) completed several self-report measures including: social anxiety, social physique anxiety, binge eating, and emotional eating. The relationships among variables were evaluated using Spearman's correlations, ANOVAs, and linear and logistic regression equations.

RESULTS

Clinically significant levels of social anxiety were reported in 59% of participants, and binge eating disorder criteria were met by 13%. Social anxiety was significantly associated with binge eating (r=.36; OR=1.06, CI=1.02-1.10) and emotional eating (r=.46; β=0.36), but was not associated with restrained eating. The association between social physique anxiety and emotional and binge eating did not remain significant in regression equations. BMI was associated with binge eating (r=.19) but not emotional eating. Level of social anxiety was not significantly higher among extremely obese participants, compared to overweight and obese participants.

CONCLUSIONS

In this study, social anxiety was associated with binge eating and emotional eating in overweight and obese men and women. When appropriate, interventions could address social anxiety as a barrier to normative eating patterns and weight loss.

The clinical obesity maintenance model: an integration of psychological constructs including mood, emotional regulation, disordered overeating, habitual cluster behaviours, health literacy and cognitive function

Psychological distress and deficits in executive functioning are likely to be important barriers to effective weight loss maintenance. The purpose of this paper is twofold. First, in the light of recent evidence in the fields of neuropsychology and obesity, particularly on the deficits in the executive function in overweight and obese individuals, a conceptual and theoretical framework of obesity maintenance is introduced by way of a clinical obesity maintenance model (COMM). It is argued that psychological variables, that of habitual cluster Behaviors, emotional dysregulation, mood, and health literacy, interact with executive functioning and impact on the overeating/binge eating behaviors of obese individuals. Second, cognizant of this model, it is argued that the focus of obesity management should be extended to include a broader range of maintaining mechanisms, including but not limited to cognitive deficits. Finally, a discussion on potential future directions in research and practice using the COMM is provided.