Binge eating and binge drinking: an integrative review

Intermittent access to a nutritionally complete high-fat diet attenuates alcohol drinking in rats

Binge eating disorder and alcohol use disorder (AUD) frequently co-occur in the presence of other psychiatric conditions. Data suggest that binge eating engages similar behavioral and neurochemical processes common to AUD, which might contribute to the etiology or maintenance of alcoholism. However, it is unclear how binge feeding behavior and alcohol intake interact to promote initiation or maintenance of AUD. We investigated the impact of binge-like feeding on alcohol intake and anxiety-like behavior in male Long Evans rats. Rats received chow (controls) or extended intermittent access (24h twice a week; Int-HFD) to a nutritionally complete high-fat diet for six weeks. Standard rodent chow was available ad-libitum to all groups and food intake was measured. Following HFD exposure, 20.0% ethanol, 2.0% sucrose intake and endocrine peptide levels were evaluated. Anxiety-like behavior was measured using a light-dark (LD) box apparatus. Rats in the Int-HFD group displayed a binge-like pattern of feeding (alternations between caloric overconsumption and voluntary caloric restriction). Surprisingly, alcohol intake was significantly attenuated in the Int-HFD group whereas sugar consumption was unaffected. Plasma acyl-ghrelin levels were significantly elevated in the Int-HFD group, whereas glucagon-like peptide-1 levels did not change. Moreover, rats in the Int-HFD group spent more time in the light side of the LD box compared to controls, indicating that binge-like feeding induced anxiolytic effects. Collectively, these data suggest that intermittent access to HFD attenuates alcohol intake through reducing anxiety-like behavior, a process potentially controlled by elevated plasma ghrelin levels.

Do parental traumatic experiences have a role in the psychological functioning of early adolescents with binge eating disorder?

PURPOSE

Few studies have addressed the psychological characteristics of adolescents with binge eating disorder (BED). No research has focused on the psychological functioning of these adolescents' parents or on the prevalence of traumatic experiences among them.

METHODS

In this study, 202 adolescents aged 11-13 and their parents were recruited from mental health clinics to complete the youth self-report (YSR), the response evaluation measure for youth (REM-71), the Toronto Alexithymia Scale (TAS-20), the Symptom Check-List (SCL-90-R), and the traumatic experience checklist (TEC).

RESULTS

Female adolescents scored higher than males on withdrawal, internalizing problems, dissociation, and somatization subscales. Boys scored higher than girls on externalizing problems and acting out subscales. Maternal depression predicted withdrawal and dissociation in female adolescents. Maternal sexual abuse predicted social problems in males and self-destructive behaviors in females. Paternal physical abuse predicted delinquent behavior and acting out in males.

CONCLUSIONS

Our data suggest that parental traumatic experiences play a role in their offspring's mental health; the data also showed different psychopathological configurations in male and female adolescents with BED and their parents, suggesting the development of prevention and treatment polices specific to gender.

Night eating syndrome: How to treat it?

Summary Night eating syndrome (NES) is characterized by caloric intake ≥ 25% of total daily after dinner and/or by two or more weekly nocturnal awakenings accompanied by food ingestion. Causes of NES are not entirely clear and seem to involve a desynchronization between the circadian rhythms of food ingestion and sleep, resulting in a delayed pattern of food intake. Estimates of the prevalence of NES in the general population are around 1.5%, and although much higher frequencies have been described in obese individuals, a causal relationship between NES and obesity is not clearly established. Since the first NES reports, several treatment modalities have been proposed, although, in many cases, the evidence is still insufficient and there is no consensus on the ideal approach. In order to conduct a critical review of proposed treatments for NES since its original description, a systematic search of articles published in journals indexed in Medline/Pubmed database in the period 1955-2015 was performed. Seventeen articles addressing non-pharmacological and pharmacological therapies met the selection criteria. Based on the articles analyzed, we conclude that serotonergic agents and psychological interventions, particularly cognitive behavioral therapy, have been shown to be effective for the treatment of NES. A combination of non-pharmacological and pharmacological therapies must be considered in future studies on the treatment of these patients.

The prevalence of binge eating disorder and its relationship to work and classroom productivity and activity impairment

OBJECTIVE

The study aimed to determine the prevalence of binge eating disorder on university campus, its associations with health risk factors, and its associations with work and classroom productivity and activity impairment, adjusted for health risk factors.

PARTICIPANTS

The study was conducted at a public midwestern university in the United States and involved 1,165 students.

METHODS

Data were collected online, using preestablished instruments. Descriptive, chi-square, correlation, and robust multiple regression tests were used.

RESULTS

About 7.8% of the participants were assessed as having binge eating disorder. Binge eating disorder was more common among obese students than nonobese students. Associations were found between moderate binge eating disorder and classroom productivity and daily activity impairment; however, sleep duration and physical activity were the strongest predictors.

CONCLUSIONS

University students are at risk of binge eating disorder. Interventions with this population should include education, screening, and clinical consultation when warranted.

Differential motivational profiles following adolescent sucrose access in male and female rats

Adolescents are the highest consumers of sugar sweetened drinks. Excessive consumption of such drinks is a likely contributor to the development of obesity and may be associated with enduring changes in the systems involved in reward and motivation. We examined the impact of daily sucrose consumption in young male and female rats (N=12 per group) across the adolescent period on the motivation to perform instrumental responses to gain food rewards as adults. Rats were or were not exposed to a sucrose solution for 2 h each day for 28 days across adolescence [postnatal days (P) 28-56]. They were then trained as adults (P70 onward) to lever press for a palatable 15% cherry flavored sucrose reward and tested on a progressive ratio (PR) schedule to assess motivation to respond for reinforcement. Female rats exposed to sucrose had higher breakpoints on the PR schedule than controls, whereas male rats exposed to sucrose had lower breakpoints than controls. These results show that consumption of sucrose during adolescence produced sex-specific behavioral changes in responding for sucrose as adults.

The Elaborated Intrusion Theory of desire: a 10-year retrospective and implications for addiction treatments

INTRODUCTION

Ten years after the publication of Elaborated Intrusion (EI) Theory, there is now substantial research into its key predictions. The distinction between intrusive thoughts, which are driven by automatic processes, and their elaboration, involving controlled processing, is well established. Desires for both addictive substances and other desired targets are typically marked by imagery, especially when they are intense. Attention training strategies such as body scanning reduce intrusive thoughts, while concurrent tasks that introduce competing sensory information interfere with elaboration, especially if they compete for the same limited-capacity working memory resources.

CONCLUSION

EI Theory has spawned new assessment instruments that are performing strongly and offer the ability to more clearly delineate craving from correlated processes. It has also inspired new approaches to treatment. In particular, training people to use vivid sensory imagery for functional goals holds promise as an intervention for substance misuse, since it is likely to both sustain motivation and moderate craving.

The role of sensation seeking and motivations for eating in female and male adolescents who binge eat

OBJECTIVES

Although different personality traits have been associated with the onset and maintenance of binge eating, the role of sensation seeking is still not well documented. The aim of the present study was to investigate the role of sensation seeking and motivations for eating in male and female adolescents who binge eat.

METHODS

336 adolescents (196 boys and 140 girls, mean age 17.48) completed a survey composed of Binge Eating Scale, Motivation for Eating Scale, and Brief Sensation Seeking Scale.

RESULTS

Our results showed that for female adolescents, binge eating was significantly correlated with age, body mass index (BMI), Environmental and Emotional Eating. Hierarchical multiple regression analysis indicated that BMI was a significant positive predictor of binge eating; Emotional and Physical Eating accounted for 34% of the variance. For male adolescents, binge eating was significantly correlated with age, BMI, Boredom susceptibility, Experience seeking, environmental, Social and Emotional Eating. The most significant variables that contribute to binge symptoms, were age and BMI (that accounted for 16% of the variance), Experience seeking and Boredom susceptibility (11%) and emotional eating (18%).

CONCLUSIONS

Our results provided support for emotional motivations as significant triggers for binge eating behavior in both male and female adolescents. Although two sensation seeking dimensions were significant predictors of binge eating in males, sensation seeking was not associated to binge eating in the female subsample.

Binge drinking and eating problems in Russian adolescents

BACKGROUND

Binge drinking may be linked to problematic eating behavior, although as yet, little research has been conducted on this association. The objective of this study was to examine the relationship between binge drinking and eating problems in Russian adolescents.

METHODS

Data were drawn from the Social and Health Assessment, a cross-sectional school-based survey of 6th to 10th grade students (aged 12 to 17 years old) carried out in Arkhangelsk, Russia. Information was collected on various eating problems (worries about weight, feeling fat, excessive eating, fasting and excessive exercise, and purging behaviors) and binge drinking (5 or more drinks in a row). Logistic regression analysis was used to examine the relationship between binge drinking and eating problems.

RESULTS

Among the 2,488 adolescents included in the statistical analysis, nearly 50% of girls expressed worries about their weight, while 35.0 and 41.5% of adolescent boys and girls reported excessive eating, respectively. The prevalence of purging behaviors (vomiting/using laxatives) was, however, much lower among both sexes (females—2.6%; males—3.3%). In a regression model adjusted for demographic factors and depressive symptoms, among girls, binge drinking was associated with 5 of the 6 eating problems with odds ratios (ORs) ranging from 1.21 (upset about weight gain) to 1.68 (excessive eating). For boys, binge drinking was linked to feeling overweight (OR: 1.47, confidence interval [CI]: 1.20 to 1.81) and vomiting/used laxatives (OR: 4.13, CI: 1.58 to 10.80).

CONCLUSIONS

Many adolescents in Russia report problematic eating attitudes and behaviors, and eating problems are associated with binge drinking. More research is now needed in this setting to better understand adolescent eating problems and their association with alcohol misuse, so that contextually suitable interventions can be implemented to reduce these behaviors and mitigate their potentially detrimental effects.

Exploring the concept of eating dyscontrol in severely obese patients candidate to bariatric surgery

Eating dyscontrol constitutes a potential negative predictor for the outcome of treatment strategies for obese patients. The aim of this study was to examine the qualitative characteristics of eating dyscontrol in obese patients who engage in binge eating (BE) compared with those who do not (NBE), and to analyse the relationship between eating dyscontrol and axis-I, axis-II, spectrum psychopathology using instruments that explore mood, panic-agoraphobic, social-phobic, obsessive-compulsive and eating disorders spectrum psychopathology (SCI-MOODS-SR, SCI-PAS-SR, SCI-SHY-SR, SCI-OBS-SR, SCI-ABS-SR). This was a cross-sectional study involving a clinical sample of adult obese patients with severe obesity (average body mass index = 45 ± 8 kg m(-2) ) and candidate to bariatric surgery who were recruited between November 2001 and November 2010 at the Obesity Center of the Endocrinology Unit, University Hospital of Pisa. All participants completed a face-to-face interview, including a diagnostic assessment of axes-I and II mental disorders (using the Structured Clinical Interview for Manual of Mental Disorders, fourth edition [SCID]-I and SCID-II) and filled out self-report spectrum instruments. Among obese patients not affected by BE, eating dyscontrol was highly represented. Indeed, 39.7% (N = 177) of subjects endorsed six or more items of the Anorexia-Bulimia Spectrum Self-Report, lifetime version domain exploring this behaviour. The cumulative probability of having axis-I, axis-II and a spectrum condition disorder increased significantly with the number of eating dyscontrol items endorsed. In both BE and NBE obese subjects, eating dyscontrol may represent an independent dimension strongly related to the spectrum psychopathology and axes I/II disorders. A systematic screening for eating dyscontrol symptoms by means of self-report spectrum instruments may be valuable to assign specific treatment strategies.

Neuronal correlates of risk-seeking attitudes to anticipated losses in binge drinkers

BACKGROUND

Abnormal decision making under risk is associated with a number of psychiatric disorders. Here, we focus on binge drinkers (BD), characterized by repeated episodes of heavy alcohol intoxication. Previous studies suggest a decreased sensitivity to aversive conditioning in BD. Here, we asked whether BD might be characterized by enhanced risk seeking related to decreased sensitivity to the anticipation of negative outcomes.

METHODS

Using an anticipatory risk-taking task (40 BD and 70 healthy volunteers) and an adapted version of this task for functional magnetic resonance imaging (21 BD and 21 healthy volunteers), we assessed sensitivity to reward and loss across risk probabilities.

RESULTS

In the behavioral task, BD showed a higher number of risky choices in high-risk losses. In the neuroimaging task, the high-risk attitude in the loss condition was associated with greater activity in dorsolateral prefrontal, lateral orbitofrontal, and superior parietal cortices in BD. Explicit exposure of BD to the probability and magnitude of loss, via introduction of feedback, resulted in a subsequent decrease in risky choices. This change in risk attitude in BD was associated with greater activity in inferior frontal gyrus, which also correlated with the percentage of decrease in risky choices after feedback presentation, suggesting a possible role for cognitive control toward risk-seeking attitudes.

CONCLUSIONS

Our findings suggest that a decrease in sensitivity to the anticipation of high-risk negative outcomes might underlie BD behavior. Presentation of explicit feedback of probability and loss in BD can potentially modify risk-taking attitudes, which have important public health implications and suggest possible therapeutic targets.

The overlap between binge eating disorder and substance use disorders: Diagnosis and neurobiology

BACKGROUND AND AIMS

Binge eating disorder (BED) is a relatively common condition, especially in young adult females, and is characterized by chronic over-consumption of food resulting in embarrassment, distress, and potential health problems. It is formally included as a disorder in DSM-5 for the first time, an acknowledgement to its debilitating nature. This article explores the overlap between binge eating disorder and substance use disorders (SUD).

METHODS

The bibliographic search was a computerized screen of PubMed databases from January 1990 to the present. Binge eating disorder, substance use disorder, binging, obesity, food addiction, comorbidity, dopamine, opioid, serotonin, glutamate, and pharmacological treatment were the keywords used in searching.

RESULTS

BED shares similar phenomenology to SUD, including significant urges to engage in binging episodes, resulting in distress and impairment. Similar neurobiological pathways are found in both BED and SUD and medications based on similar neurobiology have been examined for both disorders. A subset of individuals with BED may have a "food addiction", but there is no clinical agreement on the meaning of "food addiction". Exploring the relationship between BED and obesity may also shed light on the extent to which BED can be viewed as an addiction.

CONCLUSIONS

Overall, nascent research regarding BED and SUD suggests an overlap between these disorders, but there are discrepancies between these two disorders that need further exploration.

The relationship between trait impulsivity, negative affective states, and urge for nonsuicidal self-injury: a daily diary study

Theories of nonsuicidal self-injury (NSSI) and impulsivity suggest that individuals with high levels of negative urgency (e.g., those with a propensity to act rashly while experiencing negative affect) should experience the urge to engage in NSSI during negative affect states. However, previous research has not directly tested these predictions. This study used a daily diary methodology in a sample of individuals who engaged in NSSI in the last year. Participants completed self-report measures of trait impulsivity and subsequently made daily ratings of negative affect, sadness, guilt, and urge to engage in NSSI for 14 days. Our results indicated that for individuals high in negative urgency, daily sadness, but not guilt or general negative affect, was a positive predictor of urge to engage in NSSI. Meanwhile, for those low in negative urgency, sadness was unrelated to NSSI urge. Implications for theories of NSSI and treatment are discussed.

Binge eating and binge drinking behaviors: individual differences in adolescents' identity styles

Considering the significant negative consequences that are directly related to binge eating and drinking behaviors, many studies have explored the reasons why adolescents engage in them. This study examined the differences in the development, maintenance, and co-occurrence of "binge" behaviors associated with adolescent's identity style and the level of commitment. One thousand four hundred Italian adolescents completed self-report measures assessing binge behaviors and identity styles. Overall, results show that diffused adolescents were more likely to be engaged in binge eating and binge drinking behaviors than others, validating the idea that the achievement of a consolidated ego identity is important for enhancing well-being.

Alcohol consumption patterns and body weight

BACKGROUND/AIMS

The impact of alcohol on health depends on both the total amount ingested per week and the drinking pattern. Our goal was to assess the relationship between drinking occasions and anthropometric indicators of adiposity.

METHODS

For this cross-sectional study, 7,855 men aged 50-59 years were recruited between 1991 and 1993 in France. Clinical and anthropometric data were obtained in a standardized clinical examination by trained staff. Alcohol intake was assessed by a questionnaire recording daily consumption of each type of alcohol during a typical week.

RESULTS

75% of the participants drank alcohol daily (264.7 ml per week). For a given total alcohol intake and after adjustment of confounders, the number of drinking episodes was inversely correlated with body mass index (p < 0.0001) and waist circumference (p < 0.0001). The odds ratio (95% confidence interval) for obesity was 1.8 (1.3-2.4) for occasional (1-2 days/week) and 1.6 (1.2-2.1) for frequent drinkers (3-5 days/week) compared with daily drinkers. This correlation was less pronounced in moderate (<140 ml/week) than intermediate consumers (140-280 ml/week). In heavy consumers (>280 ml/week), the intake was almost always daily. The results were similar for wine and beer consumption.

CONCLUSION

Our findings suggest that drinking occasion is a risk indicator of obesity independent of total alcohol intake.

Out of control? Inhibition processes in eating disorders from a personality and cognitive perspective

OBJECTIVE

The present study examined the role of "a breakdown in inhibition" as a mechanism to explain differences in impulsivity between restrictive and bingeing/purging eating disorders (ED). Two types of inhibition (i.e., executive and reactive inhibition) were assessed by means of personality and neuropsychological tests.

METHOD

Forty-eight female in patients with ED completed the Effortful Control Scale, the BISBAS scales, and a set of neuropsychological tests.

RESULTS

The results showed that executive inhibition measures were able to differentiate restrictive from bingeing/purging ED subtypes. Patients with ED and bingeing/purging behavior scored significantly lower on the Effortful Control Scale, needed more time to finish the Trail Making Test/STROOP, and showed more reaction time variability on the Go No-Go task. We did not find significant associations between personality and neuropsychological measures of executive/reactive inhibition.

DISCUSSION

Insight in the breakdown of inhibition in bingeing/purging patients can increase our understanding of impulse-control disorders and guide the development of tools to improve effortful control.

Interdisciplinary lifestyle therapy improves binge eating symptoms and body image dissatisfaction in Brazilian obese adults

INTRODUCTION: Obesity is related to numerous negative consequences for physical and mental health. It is often associated with the presence of binge eating disorder, body image dissatisfaction, and general psychopathology. OBJECTIVE: To assess the effects of an interdisciplinary lifestyle therapy on binge eating symptoms, depression, anxiety, body dissatisfaction, and quality of life in obese adults. METHODS: A total of 49 obese adults (body mass index = 37.35±5.82 kg/m²; age = 44.14±10.00 years) participated in a weight-loss program for 6 months. Symptoms suggestive of binge eating, body dissatisfaction, depression, anxiety, and quality of life were measured using self-reported questionnaires. Food intake was assessed using a 3-day dietary record. Data were analyzed using analysis of variance (ANOVA). RESULTS: ANOVA results showed a reduction in binge eating symptoms and in body dissatisfaction results. Depression and anxiety symptoms also decreased, and an increase was observed in quality of life scores. After therapy, a significant improvement was observed in dietary patterns, as well as significant weight loss. A positive correlation was found between variation of anxiety symptoms and lipid intake. Binge eating symptoms were associated with anxiety symptoms and body image dissatisfaction, and body image dissatisfaction correlated positively with anxiety symptoms in males only. In females, a positive correlation was observed between depression and binge eating symptoms. CONCLUSION: The interdisciplinary therapy was effective in promoting positive physical and psychological changes and in improving the quality of life of obese adults.