Gender differences in patients with binge eating disorder

Baclofen reduces fat intake under binge-type conditions

The GABA-B agonist baclofen reduces drug self-administration in rats and has shown promise clinically in the treatment of substance abuse. Baclofen generally does not reduce food intake in non-binge feeding protocols. In this study, baclofen was tested in a fat-binge protocol. Thirty male rats were divided into three groups (B: binge; FM: fat-matched; C: chow). B received a bowl of vegetable shortening for 2 h on Monday, Wednesday, and Friday (MWF) and continuous access to powdered chow (regular chow) in all phases. FM had continuous access to a regular chow+shortening mixture (FM chow) that provided the same proportion of shortening and regular chow that the B rats consumed in all phases. In addition, FM had the following: phase 1: no separate bowl of shortening; phase 2: 2-h MWF access to a separate bowl of shortening; phase 3, daily 2-h access to a separate bowl of shortening; C rats had continuous access to the regular chow in all phases. In addition, C had the following: phase 1: no separate bowl of shortening; phase 2: 2-h MWF access to a separate bowl of shortening; in phase 3, daily 2-h access to a separate bowl of shortening. Baclofen (1.0, 1.8 mg/kg, i.p.) reduced shortening intake regardless of access condition. Baclofen had no effect on, or stimulated, FM and regular chow intake. These results demonstrate that baclofen can reduce fat intake in rats under binge-type conditions. Furthermore, these results indicate that bingeing, as modeled in our protocol, is different from other forms of food intake and may share similarities with substance abuse.

Gender comparisons in psychological characteristics of obese, binge eaters

OBJECTIVE

To investigate differences between male and female, obese binge eaters in levels of depression, anxiety and self-esteem. In addition, to make comparisons in these psychological characteristics, for both genders, between obese, binge eaters and obese nonbingers.

METHOD

Participants consisted of 48 female (26 binge eaters and 22 nonbingers) and 13 male (4 binge eaters and 9 nonbingers) outpatients in a hospital weight-loss program. Participants completed the following: Questionnaire on Eating and Weight Patterns--Revised, Beck Depression Inventory, Beck Anxiety Inventory and the Coopersmith Self-Esteem Inventory.

RESULTS

Females had a significantly higher level of depression (p<0.003) than males. No other significant gender differences were found. However significant differences between binge eaters and nonbingers were found, for both genders, in depression (p<0.0001) and anxiety (p<0.008) with the binge eaters having higher scores than the nonbingers, and in self-esteem (p<0.0001) with the binge eaters having lower scores than the nonbingers.

CONCLUSION

Females have higher levels of depression compared to males, but no gender differences were found in anxiety or self-esteem. In both genders, binge eaters have higher levels of depression and anxiety and lower levels of self-esteem compared to nonbingers.

Correlates of body image dissatisfaction in treatment-seeking men and women with binge eating disorder

OBJECTIVE

We examined body image dissatisfaction (BID) in patients with binge eating disorder (BED).

METHOD

Six predictors were considered in 343 consecutive treatment-seeking BED patients (76 men, 267 women): body mass index (BMI), age onset of overweight childhood teasing about weight or size childhood teasing about general appearance, depression, and self-esteem.

RESULTS

Women reported higher BID than men. In women, depression, self-esteem, and childhood teasing about weight or size jointly accounted for 28.4% of the variance in BID. In men, depression, self-esteem, and BMI jointly accounted for 47.4% of the variance in BID.

DISCUSSION

Findings highlight gender differences and the importance of adult psychological functioning (depression and self-esteem) for predicting BID in treatment-seeking men and women with BED.

Binge eating and self-esteem predict body image dissatisfaction among obese men and women seeking bariatric surgery

OBJECTIVE

We examined body image dissatisfaction (BID) in extremely obese men and women seeking bariatric surgery.

METHODS

The following predictors of BID were examined in a consecutive series of 260 (44 men and 216 women) gastric bypass candidates: gender, ethnicity, body mass index (BMI), age at onset of overweight, childhood maltreatment, binge eating, depression, and self-esteem.

RESULTS

Women reported significantly higher levels of BID than men. Stepwise multiple regression analyses revealed that gender, binge eating, and self-esteem levels accounted for 41% of the variance in BID. In predicting BID levels separately by gender, binge eating and self-esteem accounted for 56% of the variance among men and for 33% of the variance among women.

DISCUSSION

Among bariatric surgery candidates, women reported significantly higher BID than men. Our findings suggest the importance of binge eating and lower self-esteem for understanding BID in both men and women who are extremely obese.

Binge eating and psychological distress in ethnically diverse undergraduate men and women

Binge eating symptomatology affects African Americans and Caucasians at similar rates. Moreover, compared to anorexia nervosa (AN) and bulimia nervosa (BN), binge eating and BED are more evenly distributed across genders. Undergraduates are likely to be affected by binge eating, yet, relatively few studies have investigated this behavior and its correlates in college samples. This study examined the influence of alexithymia, depression, and anxiety on binge eating among ethnically diverse undergraduates. Results indicated that these variables significantly predicted eating symptomatology among Caucasian and African American women but not among Caucasian men. Further, among Caucasian women, depression was the only unique predictor of eating pathology. In contrast, anxiety was the only unique predictor of disordered eating in African American women. There were no differences between Caucasians and African Americans in severity of disordered eating symptomatology; however, in both ethnic groups, women reported greater eating pathology than men. Eating disorders of all types may be more prevalent among African American undergraduates than previously thought. These results highlight the need to study binge eating and its correlates in this traditionally underserved group.

Gender differences in compensatory behaviors, weight and shape salience, and drive for thinness

Gender differences in compensatory behaviors, weight and shape salience, and drive for thinness have rarely been examined in nonclinical samples. The present study examines gender differences in a sample of 1111 male and 1510 female twins responding to a questionnaire on eating attitudes and behaviors. Logistic regression using generalized estimating equations (GEE) tested the extent to which gender could be predicted from compensatory behaviors, weight and shape salience, and drive for thinness. The results indicated that use of compensatory behaviors predicted female gender for all except exercise and "other," where no gender differences were found. Greater importance of weight and shape also predicted female gender, as did drive for thinness. Findings with respect to exercise use and "other" compensatory behaviors have nosological implications for the eating disorders, especially as regards eating disorders in males. These findings suggest that both the nature and function of compensatory behaviors may differ by gender.

Eating disorders

Eating disorders are an important cause of physical and psychosocial morbidity in adolescent girls and young adult women. They are much less frequent in men. Eating disorders are divided into three diagnostic categories: anorexia nervosa, bulimia nervosa, and the atypical eating disorders. However, the disorders have many features in common and patients frequently move between them, so for the purposes of this Seminar we have adopted a transdiagnostic perspective. The cause of eating disorders is complex and badly understood. There is a genetic predisposition, and certain specific environmental risk factors have been implicated. Research into treatment has focused on bulimia nervosa, and evidence-based management of this disorder is possible. A specific form of cognitive behaviour therapy is the most effective treatment, although few patients seem to receive it in practice. Treatment of anorexia nervosa and atypical eating disorders has received remarkably little research attention.

Weight and eating concerns in outpatient men and women being treated for substance abuse

This study examined the specific features of weight and eating concerns, and explored gender differences, in a racially diverse group of outpatients (45 men and 39 women) currently being treated for substance abuse but abstinent from substance use. Overweight was prevalent and similarly distributed across gender: 60% of the men and 69% of the women were overweight. Most of the overweight participants did not identify themselves as such. No significant gender differences were observed in terms of the behavioural features of eating disorders: 8% of the men and 11% of the women reported binge eating on at least one day per week; inappropriate weight compensatory behaviours were reported by 8% of the men vs 16% of the women, but the women had significantly higher attitudinal scores than the men. Our findings suggest that, in patients recovering from substance abuse, overweight and features of eating disorders are common in both men and women, and occur in poor and minority groups.

Eating and body image disturbances in adolescent psychiatric inpatients: gender and ethnicity patterns

OBJECTIVE

To examine gender and ethnicity patterns in eating and body image disturbances in adolescents hospitalized in a psychiatric facility.

METHOD

Participants comprised 715 inpatients who completed the Millon Adolescent Clinical Inventory. Gender (317 males, 398 females), ethnicity (553 Caucasians, 77 Latinõ Americans, 85 African Americans), and Gender x Ethnicity interactions in the features of eating disorders and body image disturbance were explored in the study group.

RESULTS

Eating-related disturbances at diagnostic threshold were infrequent but participants' reported rates of specific features and symptoms were not. Overall, a significantly higher proportion of females than males reported features of eating and body image disturbances. The three ethnic groups differed significantly in their reports of body image disturbances but not in their endorsement of features of eating disorders. Post-hoc comparisons revealed that a significantly higher proportion of Caucasian participants reported body image concerns than did African American and Latinõ American participants who did not differ significantly from one another. Significant Gender x Ethnicity interactions were observed, with Caucasian females endorsing higher rates of features of eating disorders and body image disturbances than African American and Latinõ American females.

DISCUSSION

In adolescent psychiatric inpatients, although Caucasian females report the highest rates of the features of eating and body image disturbances, such concerns are not uncommon in males and in minorities.