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Altered regional homogeneity and efficient response inhibition in restrained eaters. Neuroscience 2014; 266:116-26. [PMID: 24513387 DOI: 10.1016/j.neuroscience.2014.01.062] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 01/24/2014] [Accepted: 01/30/2014] [Indexed: 12/29/2022]
Abstract
Restrained eaters (REs) characterized by less efficient response inhibition are at risk for future onset of binge eating and bulimic pathology. Previous imaging studies investigating REs have been based on task-related functional magnetic resonance imaging (fMRI) and little is known about resting-state neural activity underlying restrained eating. To illuminate this issue, we investigated resting-state fMRI differences between REs (n=22) and unrestrained eaters (UREs) (n=30) using regional homogeneity (ReHo) analysis, which measures the temporal synchronization of spontaneous fluctuations. Samples were equated on body mass index (BMI) and caloric deprivation levels (i.e., 14±2.1h since last evening meal) before undergoing fMRI. Correlation analyses were performed between the ReHo index of identified regions and response inhibition based on stop-signal reaction time (SSRT) within each sample. Compared with UREs, REs showed more ReHo in brain regions associated with food reward (i.e., orbitofrontal cortex (OFC), dorsal-lateral prefrontal cortex (dlPFC)), attention (i.e., lingual gyrus, cuneus, inferior parietal lobule) and somatosensory functioning (i.e., paracentral lobule, anterior insula). In addition, ReHo values for the left dlPFC and left anterior insula, respectively, were negatively and positively correlated with SSRT among REs but not UREs. In concert with previous studies, these results suggest altered local synchronization may help to explain why dieting to maintain or lose weight often fails or increases risk for binge eating among REs.
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Panchaud Cornut M, Szymanski J, Marques-Vidal P, Giusti V. Identification of psychological dysfunctions and eating disorders in obese women seeking weight loss: cross-sectional study. Int J Endocrinol 2014; 2014:356289. [PMID: 24737999 PMCID: PMC3967633 DOI: 10.1155/2014/356289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 01/16/2014] [Accepted: 02/06/2014] [Indexed: 01/14/2023] Open
Abstract
Objective. The aim of this study is to analyse associations between eating behaviour and psychological dysfunctions in treatment-seeking obese patients and identify parameters for the development of diagnostic tools with regard to eating and psychological disorders. Design and Methods. Cross-sectional data were analysed from 138 obese women. Bulimic Investigatory Test of Edinburgh and Eating Disorder Inventory-2 assessed eating behaviours. Beck Depression Inventory II, Spielberger State-Trait Anxiety Inventory, form Y, Rathus Assertiveness Schedule, and Marks and Mathews Fear Questionnaire assessed psychological profile. Results. 61% of patients showed moderate or major depressive symptoms and 77% showed symptoms of anxiety. Half of the participants presented with a low degree of assertiveness. No correlation was found between psychological profile and age or anthropometric measurements. The prevalence and severity of depression, anxiety, and assertiveness increased with the degree of eating disorders. The feeling of ineffectiveness explained a large degree of score variance. It explained 30 to 50% of the variability of assertiveness, phobias, anxiety, and depression. Conclusion. Psychological dysfunctions had a high prevalence and their severity is correlated with degree of eating disorders. The feeling of ineffectiveness constitutes the major predictor of the psychological profile and could open new ways to develop screening tools.
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Affiliation(s)
- Maude Panchaud Cornut
- Service of Endocrinology, Diabetes and Metabolism, University Hospital CHUV, rue du Bugnon, 1011 Lausanne, Switzerland
| | - Jennifer Szymanski
- Service of Endocrinology, Diabetes and Metabolism, University Hospital CHUV, rue du Bugnon, 1011 Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Institute of Social and Preventive Medicine, University Hospital CHUV, rue du Bugnon, 1011 Lausanne, Switzerland
| | - Vittorio Giusti
- Service of Endocrinology, Diabetes and Metabolism, University Hospital CHUV, rue du Bugnon, 1011 Lausanne, Switzerland
- Département de Médecine, Hôpital Intercantonal de la Broye, 1470 Estavayer-le-Lac, Switzerland
- *Vittorio Giusti:
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Pacanowski CR, Senso MM, Oriogun K, Crain AL, Sherwood NE. Binge eating behavior and weight loss maintenance over a 2-year period. J Obes 2014; 2014:249315. [PMID: 24891946 PMCID: PMC4033559 DOI: 10.1155/2014/249315] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 04/12/2014] [Accepted: 04/15/2014] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate the relationship between binge eating behavior and weight loss maintenance over a two-year period in adults. DESIGN Secondary data analysis using the Keep It Off study, a randomized trial evaluating an intervention to promote weight loss maintenance. PARTICIPANTS 419 men and women (ages: 20 to 70 y; BMI: 20-44 kg/m2) who had intentionally lost ≥10% of their weight during the previous year. MEASUREMENTS Body weight was measured and binge eating behavior over the past 6 months was reported at baseline, 12 months and 24 months. Height was measured at baseline. RESULTS Prevalence of binge eating at baseline was 19.4% (n = 76). Prevalence of binge eating at any time point was 30.1% (n = 126). Although rate of weight regain did not differ significantly between those who did or did not report binge eating at baseline, binge eating behavior across the study period (additive value of presence or absence at each time point) was significantly associated with different rates of weight regain. CONCLUSION Tailoring weight loss maintenance interventions to address binge eating behavior is warranted given the prevalence and the different rates of weight regain experienced by those reporting this behavior.
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Affiliation(s)
- Carly R. Pacanowski
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN 55454, USA
- *Carly R. Pacanowski:
| | - Meghan M. Senso
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN 55454, USA
- HealthPartners Institute for Education and Research, 8170 33rd Avenue South, Bloomington, MN 55425, USA
| | - Kristin Oriogun
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN 55454, USA
| | - A. Lauren Crain
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN 55454, USA
- HealthPartners Institute for Education and Research, 8170 33rd Avenue South, Bloomington, MN 55425, USA
| | - Nancy E. Sherwood
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN 55454, USA
- HealthPartners Institute for Education and Research, 8170 33rd Avenue South, Bloomington, MN 55425, USA
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Bailey AP, Parker AG, Colautti LA, Hart LM, Liu P, Hetrick SE. Mapping the evidence for the prevention and treatment of eating disorders in young people. J Eat Disord 2014; 2:5. [PMID: 24999427 PMCID: PMC4081733 DOI: 10.1186/2050-2974-2-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 12/13/2013] [Indexed: 12/31/2022] Open
Abstract
ABSTRACT Eating disorders often develop during adolescence and young adulthood, and are associated with significant psychological and physical burden. Identifying evidence-based interventions is critical and there is need to take stock of the extant literature, to inform clinical practice regarding well-researched interventions and to direct future research agendas by identifying gaps in the evidence base. AIM To investigate and quantify the nature and distribution of existing high-quality research on the prevention and treatment of eating disorders in young people using evidence mapping methodology. METHOD A systematic search for prevention and treatment intervention studies in adolescents and young adults (12-25 years) was conducted using EMBASE, PSYCINFO and MEDLINE. Studies were screened and mapped according to disorder, intervention modality, stage of eating disorder and study design. Included studies were restricted to controlled trials and systematic reviews published since 1980. RESULTS The eating disorders evidence map included 197 trials and 22 systematic reviews. Prevention research was dominated by trials of psychoeducation (PE). Bulimia nervosa (BN) received the most attention in the treatment literature, with cognitive behavioural therapy (CBT) and antidepressants the most common interventions. For anorexia nervosa (AN), family based therapy (FBT) was the most studied. Lacking were trials exploring treatments for binge eating disorder (BED) and eating disorder not otherwise specified (EDNOS). Relapse prevention strategies were notably absent across the eating disorders. CONCLUSIONS Despite substantial literature devoted to the prevention and treatment of eating disorders in young people, the evidence base is not well established and significant gaps remain. For those identified as being at-risk, there is need for prevention research exploring strategies other than passive PE. Treatment interventions targeting BED and EDNOS are required, as are systematic reviews synthesising BN treatment trials (e.g., CBT, antidepressants). FBTs for AN require investigation against other validated psychological interventions, and the development of relapse prevention strategies is urgently required. By systematically identifying existing interventions for young people with eating disorders and exposing gaps in the current literature, the evidence map can inform researchers, funding bodies and policy makers as to the opportunities for future research.
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Affiliation(s)
- Alan P Bailey
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10, Parkville, Melbourne, Victoria 3052, Australia ; Centre of Excellence in Youth Mental Health, headspace National Youth Mental Health Foundation Ltd, Level 2, South Tower, 485 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Alexandra G Parker
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10, Parkville, Melbourne, Victoria 3052, Australia ; Centre of Excellence in Youth Mental Health, headspace National Youth Mental Health Foundation Ltd, Level 2, South Tower, 485 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Lauren A Colautti
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10, Parkville, Melbourne, Victoria 3052, Australia ; Centre of Excellence in Youth Mental Health, headspace National Youth Mental Health Foundation Ltd, Level 2, South Tower, 485 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Laura M Hart
- Melbourne School of Population Health, The University of Melbourne, Level 3, 207 Bouverie Street, Melbourne, Victoria 3010, Australia
| | - Ping Liu
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10, Parkville, Melbourne, Victoria 3052, Australia ; Centre of Excellence in Youth Mental Health, headspace National Youth Mental Health Foundation Ltd, Level 2, South Tower, 485 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Sarah E Hetrick
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10, Parkville, Melbourne, Victoria 3052, Australia ; Centre of Excellence in Youth Mental Health, headspace National Youth Mental Health Foundation Ltd, Level 2, South Tower, 485 La Trobe Street, Melbourne, Victoria 3000, Australia
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Schreiber LRN, Odlaug BL, Grant JE. The overlap between binge eating disorder and substance use disorders: Diagnosis and neurobiology. J Behav Addict 2013; 2:191-8. [PMID: 25215200 PMCID: PMC4154572 DOI: 10.1556/jba.2.2013.015] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 08/19/2013] [Accepted: 08/20/2013] [Indexed: 01/03/2023] Open
Abstract
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.
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Affiliation(s)
| | | | - Jon E. Grant
- ,
Corresponding author. Jon E. Grant Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine; 5841 S. Maryland Avenue, Chicago, IL 60637, USAE-mail: E-mail:
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Rosenberger PH, Dorflinger L. Psychosocial factors associated with binge eating among overweight and obese male veterans. Eat Behav 2013; 14:401-4. [PMID: 23910790 DOI: 10.1016/j.eatbeh.2013.06.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 04/11/2013] [Accepted: 06/07/2013] [Indexed: 12/25/2022]
Abstract
The study's primary objective is to compare psychosocial characteristics of overweight/obese male Veterans who report binge eating with those who do not report binge eating. Participants include 111 overweight/obese male Veterans who completed questionnaires assessing binge eating, depression, stress, body image, self-efficacy for healthy eating and physical activity, and barriers to physical activity. Of the study sample, 25.2% are classified as binge eaters. Binge eating status is not significantly associated with age, race/ethnicity, weight, or BMI. Binge eating is associated with higher scores on measures of depression, barriers to exercise, self-classified weight, and lower self-efficacy for both healthy eating and exercise, but is not associated with body satisfaction or recent stress. Findings suggest that a sizable minority of overweight/obese male Veterans engage in binge eating. Depressive symptoms, self-efficacy, and perceived barriers all significantly predicted binge eating. These findings have implications both for identification of overweight/obese men at risk for binge eating disorder as well as for weight loss treatment in the Veteran population.
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57
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Grant JE, Schreiber LRN, Odlaug BL. Phenomenology and treatment of behavioural addictions. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2013; 58:252-9. [PMID: 23756285 DOI: 10.1177/070674371305800502] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Behavioural addictions are characterized by an inability to resist an urge or drive resulting in actions that are harmful to oneself or others. Behavioural addictions share characteristics with substance and alcohol abuse, and in areas such as natural history, phenomenology, and adverse consequences. Behavioural addictions include pathological gambling, kleptomania, pyromania, compulsive buying, compulsive sexual behaviour, Internet addiction, and binge eating disorder. Few studies have examined the efficacy of pharmacological and psychological treatment for the various behavioural addictions, and therefore, currently, no treatment recommendations can be made.
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Affiliation(s)
- Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
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58
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Wildermuth SA, Mesman GR, Ward WL. Maladaptive eating patterns in children. J Pediatr Health Care 2013; 27:109-19. [PMID: 23414976 DOI: 10.1016/j.pedhc.2011.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 07/22/2011] [Accepted: 07/26/2011] [Indexed: 11/25/2022]
Abstract
Given the increasing frequency of obesity and related maladaptive eating patterns in pediatric populations, health care professionals in a variety of settings must find ways to treat persons who are obese and have maladaptive eating patterns. The authors summarized literature related to binge eating disorder, boredom eating, emotional eating, and night eating syndrome and developed educational handouts designed for children/adolescents and their families who present with these eating problems. These educational handouts may be used by primary care physicians, psychologists, psychiatrists, nurses, and other specialists in medical settings. They are free for use in educational purposes, with permission from the authors, but are not intended to replace appropriate health care and follow-up.
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59
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Trace SE, Thornton LM, Root TL, Mazzeo SE, Lichtenstein P, Pedersen NL, Bulik CM. Effects of reducing the frequency and duration criteria for binge eating on lifetime prevalence of bulimia nervosa and binge eating disorder: implications for DSM-5. Int J Eat Disord 2012; 45:531-6. [PMID: 21882218 PMCID: PMC3235235 DOI: 10.1002/eat.20955] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2011] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We assessed the impact of reducing the binge eating frequency and duration thresholds on the diagnostic criteria for bulimia nervosa (BN) and binge eating disorder (BED). METHOD We estimated the lifetime population prevalence of BN and BED in 13,295 female twins from the Swedish Twin study of Adults: Genes and Environment employing a range of frequency and duration thresholds. External validation (risk to cotwin) was used to investigate empirical evidence for an optimal binge eating frequency threshold. RESULTS The lifetime prevalence estimates of BN and BED increased linearly as the frequency criterion decreased. As the required duration increased, the prevalence of BED decreased slightly. Discontinuity in cotwin risk was observed in BN between at least four times per month and at least five times per month. This model could not be fit for BED. DISCUSSION The proposed changes to the DSM-5 binge eating frequency and duration criteria would allow for better detection of binge eating pathology without resulting in a markedly higher lifetime prevalence of BN or BED.
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Affiliation(s)
- Sara E. Trace
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Tammy L. Root
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Suzanne E. Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Nancy L. Pedersen
- Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA,Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA,Correspondence to: Dr. Bulik, Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7160, 101 Manning Drive, Chapel Hill, NC 27599-7160, Voice: (919) 843 1689 Fax: (919) 843 8802,
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60
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Carrard I, Linden MV, Golay A. Comparison of Obese and Nonobese Individuals with Binge Eating Disorder: Delicate Boundary Between Binge Eating Disorder and Non-Purging Bulimia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2012; 20:350-4. [DOI: 10.1002/erv.2174] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Isabelle Carrard
- Therapeutic Education Service for Chronic Diseases; University Hospitals of Geneva; Geneva; Switzerland
| | - Martial Van Linden
- Cognitive Psychopathology and Neuropsychology Unit; University of Geneva; Geneva; Switzerland
| | - Alain Golay
- Therapeutic Education Service for Chronic Diseases; University Hospitals of Geneva; Geneva; Switzerland
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61
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Stress-induced laboratory eating behavior in obese women with binge eating disorder. Appetite 2012; 58:457-61. [DOI: 10.1016/j.appet.2011.12.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 12/07/2011] [Accepted: 12/12/2011] [Indexed: 11/19/2022]
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Dingemans AE, van Furth EF. Binge Eating Disorder psychopathology in normal weight and obese individuals. Int J Eat Disord 2012; 45:135-8. [PMID: 22170025 DOI: 10.1002/eat.20905] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2010] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Although Binge Eating Disorder (BED) is associated with obesity and unstable weight and the diagnosis was originally predicated with the obese in mind, obesity is not a criterion for BED. In fact, BED is not uncommon in nonobese individuals. The aim of this study was to compare the psychopathology of obese (BMI >30) and nonobese individuals (BMI < 30) with BED. METHOD Within a group of 174 individuals diagnosed with BED, 51 (29%) were classified as nonobese and 123 (71%) as obese. The Eating Disorder Examination (EDE) and Beck Depression Inventory (BDI) were administered to assess eating disorder psychopathology and depressive symptoms. RESULTS The nonobese BED group was significantly younger and was less likely to receive treatment. The obese group had more concerns about weight and reported more objective binge eating episodes. No differences were found on any other subscales of the EDE or BDI. DISCUSSION Our main finding was that there are more similarities than differences between the nonobese and obese individuals with BED. The severity of the psychopathology does not seem to be related to BMI. More awareness of the existence of nonobese individuals with BED is needed. Early detection and treatment may prevent the development of overweight and it's consequences.
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Schulz S, Laessle R, Hellhammer D. No evidence of increased cortisol stress response in obese women with binge eating disorder. Eat Weight Disord 2011; 16:e209-11. [PMID: 22290038 DOI: 10.1007/bf03325134] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Increased cortisol levels after stress have been associated with excessive food intake during binges in obese women with binge eating disorder (BED). The present study tried to replicate these findings in a sample of obese women with BED compared to obese women without BED. Twenty women with a mean BMI of 37.75 kg/m² were studied. Salivary cortisol was sampled before and after a socially evaluated cold pressure test at 8 time points. Both comparison groups showed the expected cortisol increase after the stressor (p<0.03), but no significant differences between groups emerged (p=0.96). These results do not support an increased stress reactivity of HPA in BED. Instead they would favour psychological explanations of binges, focusing on diminished perception of satiety.
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Affiliation(s)
- S Schulz
- Department of Clinical and Physiological Psychology, University of Trier, Trier, Germany
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Krabbenborg MAM, Danner UN, Larsen JK, Veer N, Elburg AA, Ridder DTD, Evers C, Stice E, Engels RCME. The Eating Disorder Diagnostic Scale: Psychometric Features Within a Clinical Population and a Cut-off Point to Differentiate Clinical Patients from Healthy Controls. EUROPEAN EATING DISORDERS REVIEW 2011; 20:315-20. [DOI: 10.1002/erv.1144] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 04/07/2011] [Accepted: 06/10/2011] [Indexed: 10/17/2022]
Affiliation(s)
| | | | - Junilla K. Larsen
- Behavioural Science Institute; Radboud University Nijmegen; The Netherlands
| | - Nienke Veer
- Department of Psychiatry; Sint Antonius Hospital; The Netherlands
| | - Annemarie A. Elburg
- Altrecht Eating Disorders Rintveld; Altrecht Mental Health Institute; The Netherlands
| | - Denise T. D. Ridder
- Department of Clinical and Health Psychology; Utrecht University; The Netherlands
| | - Catharine Evers
- Department of Clinical and Health Psychology; Utrecht University; The Netherlands
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Legenbauer T, Petrak F, de Zwaan M, Herpertz S. Influence of depressive and eating disorders on short- and long-term course of weight after surgical and nonsurgical weight loss treatment. Compr Psychiatry 2011; 52:301-11. [PMID: 21497225 DOI: 10.1016/j.comppsych.2010.06.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 06/21/2010] [Accepted: 06/25/2010] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate the influence of depressive and eating disorders on short- and long-term weight loss after surgical and non-surgical weight-reduction treatment. Covariations between the disorders were considered. METHOD In a longitudinal naturalistic study, current diagnoses at baseline and lifetime diagnoses of depressive and eating disorders were assessed in participants who were undertaking a very-low-calorie diet (n = 250) and in bariatric surgery patients (n = 153). Lifetime diagnosis of a mental disorder was defined as presence of a mental disorder only in the past. Body weight was measured at baseline, 1 year after baseline, and 4 years after baseline. Mental comorbidity was assessed through use of standardized interviews at baseline. A structural equation modeling procedure was applied to test the associations between course of weight and mental disorders. Analyses were based on the intention to treat samples. Missing values were replaced by use of multiple imputation procedures. RESULTS Neither depression nor eating disorders were associated with weight changes at the 1-year follow-up, but a specific effect emerged for bariatric surgery patients after 4 years: depression (current and lifetime) predicted smaller body mass index loss, whereas lifetime diagnosis of eating disorder was associated with greater weight loss. CONCLUSIONS Individuals who report depressive disorders prior to bariatric surgery should be monitored more closely in order to identify patients who would benefit from additional therapy with the goal of improving weight-loss outcome.
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Affiliation(s)
- Tanja Legenbauer
- Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, University Hospital of the Ruhr University of Bochum, D-44791 Bochum, Germany.
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Brietzke E, Moreira CLR, Toniolo RA, Lafer B. Clinical correlates of eating disorder comorbidity in women with bipolar disorder type I. J Affect Disord 2011; 130:162-5. [PMID: 21071093 DOI: 10.1016/j.jad.2010.10.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2009] [Revised: 09/22/2010] [Accepted: 10/10/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To report on the presence of current and lifetime eating disorders (ED) in a well-defined sample of 137 female individuals with bipolar disorder type I. METHODS Trained psychiatrists interviewed the patients, and the diagnoses of BD and comorbidities were confirmed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Axis I Disorders. Clinical and demographic characteristics of both groups (group with ED vs. group without ED) were compared. RESULTS Female patients with ED had an earlier onset of BD and an increased number of mood episodes, predominantly depressive. Women in the ED group also had higher rates of comorbidity with substance use disorders and anxiety disorders and reported a history of suicide attempts more frequently than women without ED. CONCLUSION The presence of ED is a correlate of severity of BD type I, and interventions should be developed to minimize distress and suicide risk and to improve treatment outcome.
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Affiliation(s)
- Elisa Brietzke
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
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67
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Dalle Grave R. Eating disorders: progress and challenges. Eur J Intern Med 2011; 22:153-60. [PMID: 21402245 DOI: 10.1016/j.ejim.2010.12.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Revised: 12/11/2010] [Accepted: 12/17/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND Eating disorders are common health problems afflicting mainly female adolescents and young women. They are associated with important physical health and psychosocial morbidity, and carry increased risk of death. Their cause is not yet completely understood and their management is complex, with some patients resisting all available treatments. AIMS OF THIS REVIEW: To provide the readers with an update regarding our knowledge and understanding of eating disorders. METHODS Medline database has been used for searching articles on eating disorders published since 1980. The key words used were eating disorders, anorexia nervosa, bulimia nervosa, bulimia, and binge eating. Professional books published during this period has been also reviewed. CONCLUSIONS In the last 30 years a substantial improvement has been achieved both in the understanding and management of eating disorders, but many problems still need to be resolved. Three principal priorities should be addressed. First, the actual classification of eating disorders should be revised, since about half the cases seen in clinical practice receive a diagnosis of eating disorder not otherwise specified, and it is common to observe a migration between eating disorder diagnoses. Second, the research on pathogenesis should better clarify the exact role of genetic and environmental risk factors, and how they interact and vary across the development and maintenance of eating disorders. Third, there is an urgent need both to disseminate the few evidence-based treatments available, and to develop more potent treatments for all the eating disorder diagnostic categories.
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Affiliation(s)
- Riccardo Dalle Grave
- Department of Eating & Weight Disorder, Villa Garda Hospital, Garda (VR), Italy.
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68
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Danner UN, Ouwehand C, van Haastert NL, Hornsveld H, de Ridder DTD. Decision-making impairments in women with binge eating disorder in comparison with obese and normal weight women. EUROPEAN EATING DISORDERS REVIEW 2011; 20:e56-62. [PMID: 21308871 DOI: 10.1002/erv.1098] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The purpose of the current study was to examine decision making in female patients with binge eating disorder (BED) in comparison with obese and normal weight women. METHOD In the study, 20 patients with BED, 21 obese women without BED and 34 healthy women participated. Decision making was assessed using the Iowa Gambling Task (IGT). Several questionnaires were administered measuring binge eating severity, sensitivity for punishment and reward, and self-control. RESULTS The findings indicated that the BED and obese group performed poorly on the IGT. Participants who have BED and are obese did not improve their choice behaviour over time, whereas participants with normal weight showed a learning effect. An association between IGT performance and binge eating severity was found. CONCLUSION This study demonstrates that patients with BED display decision-making deficits on the IGT comparable with other forms of disordered eating. Future research should focus on unravelling the processes underlying the deficits.
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Affiliation(s)
- Unna N Danner
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands.
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69
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Geller J, Dunn EC. Integrating Motivational Interviewing and Cognitive Behavioral Therapy in the Treatment of Eating Disorders: Tailoring Interventions to Patient Readiness for Change. COGNITIVE AND BEHAVIORAL PRACTICE 2011. [DOI: 10.1016/j.cbpra.2009.05.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Legenbauer TM, de Zwaan M, Mühlhans B, Petrak F, Herpertz S. Do mental disorders and eating patterns affect long-term weight loss maintenance? Gen Hosp Psychiatry 2010; 32:132-40. [PMID: 20302986 DOI: 10.1016/j.genhosppsych.2009.09.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Revised: 09/04/2009] [Accepted: 09/09/2009] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study aimed to assess the impact of mental disorders on weight loss maintenance among initially successful weight losers who participated in a very-low-calorie diet program. METHOD A total of 251 obese individuals were assessed in a prospective longitudinal study over a period of 4 years. Mental disorders and eating patterns were assessed by structured interviews at baseline and by standardized questionnaires at baseline (T(1)), after 1 year (T(2)) and on 3-year follow-up (T(3)). Analyses were performed with an intention-to-treat method. RESULTS Based on the intention-to-treat sample, 166 successful weight losers at T(2) (weight loss > or = 10%) were identified. Of those, 47 (28.3%) maintained a weight loss of > or = 5% of their pretreatment weight, whereas 119 (71.7%) maintained a loss of less than 5% of their pretreatment weight at T(3). History of substance abuse/dependence disorder and grazing prior to treatment increased the likelihood of successful weight loss maintenance. High levels of cognitive control, low levels of disinhibition on 3-year follow-up and initial body mass index also were associated with successful weight loss maintenance. CONCLUSION Strategies that helped individuals overcome earlier mental disorders might help to establish better self-regulation and maintain high cognitive control of eating and subsequently increase the possibility of maintaining weight loss in the long run.
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Affiliation(s)
- Tanja Marina Legenbauer
- Department of Psychosomatic Medicine and Psychotherapy, LWL-Klinik Dortmund, Ruhr-University Bochum, 44287 Dortmund, Germany.
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71
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Referral to a dietitian uncovers why this woman cannot lose weight. JAAPA 2009; 22:36-8. [DOI: 10.1097/01720610-200910000-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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72
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Laessle RG, Schulz S. Stress-induced laboratory eating behavior in obese women with binge eating disorder. Int J Eat Disord 2009; 42:505-10. [PMID: 19172596 DOI: 10.1002/eat.20648] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To compare the microstructural eating behavior of obese patients with and without binge eating disorder (BED) after stress induction in laboratory. METHOD Forty-eight obese women were investigated. Seventeen were assigned to the group of BED. Group (BED vs. non-BED) by condition (stress vs. no stress) interaction effect on feeding variables, measured by a universal eating monitor, was tested. Stress was induced by the trier social stress test (TSST) and chocolate pudding served as laboratory food. RESULTS From the nonstress to the stress condition, patients with BED, when compared with non-BED had a greater increase in average eating rate (p < .01) and a corresponding greater increase in the frequency of spoonfuls (p < .02). The BED group also showed a different change in acceleration/deceleration from the nonstress to the stress condition compared to the non-BED group (p < .04). DISCUSSION Obese individuals with BED appear to exhibit a different response to stress than obese non-BED individuals and individuals with bulimia nervosa.
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Affiliation(s)
- Reinhold G Laessle
- Department of Clinical and Theoretical Psychobiology, University of Trier, Trier 54286, Germany.
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Castrogiovanni S, Soreca I, Troiani D, Mauri M. Binge eating, weight gain and psychosocial adjustment in patients with bipolar disorder. Psychiatry Res 2009; 169:88-90. [PMID: 19625088 DOI: 10.1016/j.psychres.2008.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Revised: 09/25/2007] [Accepted: 06/12/2008] [Indexed: 01/01/2023]
Abstract
Binge Eating (BE) is a common eating pattern in patients with Bipolar Disorder (BD). BE may confer an increased risk for obesity, morbidity, mortality and poorer quality of life. We assessed the presence of BE and its impact on body weight, body image and self-esteem in 50 patients with BD and 50 age- and gender-matched controls. The presence and severity of BE was assessed with the Binge Eating Scale (BES). The Body Image and Self-Esteem Evaluation Scale (B-WISE) was used to assess the psychosocial impact of weight gain. Body Mass Index (BMI) was calculated. Nine (18%) patients had a score >27, indicating a likely diagnosis of BE. None of the control subjects had a BES score >17. No association between BES score and the medications was found. Patients had a significantly higher BES score, significantly higher BMI, waist circumference and fasting blood glucose. Although the B-Wise score was higher in the controls, the difference was not statistically significant. This study suggests that BE is prevalent in patients with BD. The presence of BE eating is a predictor of higher BMI, indicating that the disruption of eating behavior may be a pathway to weight gain.
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Affiliation(s)
- Silvia Castrogiovanni
- Department of Psychiatry, Neurobiology, Pharmacology and Biotechnologies, School of Medicine, University of Pisa, Pisa, Italy
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74
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Effect of dichotomous thinking on the association of depression with BMI and weight change among obese females. Behav Res Ther 2009; 47:529-34. [DOI: 10.1016/j.brat.2009.02.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2008] [Revised: 02/19/2009] [Accepted: 02/20/2009] [Indexed: 11/24/2022]
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Abstract
A thorough understanding of weight related issues is required for the assessment of patients with obesity and eating disorders. Body weight adjusted for height is used for the diagnosis of both anorexia nervosa (AN) and obesity. For AN, the DSM IV A criterion refers to 85 % of expected weight as a guideline, for overweight and obesity BMI cut-offs are commonly used. Because the BMI distribution changes during childhood and adolescence, the 85(th) and 95(th) BMI centiles are used in the USA to classify children as at risk of overweight and obesity, respectively. 85 % of expected weight is approximately equivalent to the 10(th) BMI centile.
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Affiliation(s)
- Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, University of Duisburg-Essen, Virchowstrasse 174, 45147 Essen, Germany
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76
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Gorin AA, Niemeier HM, Hogan P, Coday M, Davis C, DiLillo VG, Gluck ME, Wadden TA, West DS, Williamson D, Yanovski SZ. Binge eating and weight loss outcomes in overweight and obese individuals with type 2 diabetes: results from the Look AHEAD trial. ACTA ACUST UNITED AC 2008; 65:1447-55. [PMID: 19047532 DOI: 10.1001/archpsyc.65.12.1447] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Binge eating (BE) is common in overweight and obese individuals with type 2 diabetes mellitus, but little is known about how BE affects weight loss in this population. OBJECTIVE To determine whether BE was related to 1-year weight losses in overweight and obese individuals with type 2 diabetes participating in an ongoing clinical trial. DESIGN, SETTING, AND PARTICIPANTS The Look AHEAD (Action for Health in Diabetes) trial is a randomized controlled trial examining the long-term effect of intentional weight loss on cardiovascular disease in overweight and obese adults with type 2 diabetes. A total of 5145 overweight and obese individuals aged 45 to 76 years with type 2 diabetes participated in this study. INTERVENTIONS Participants were randomly assigned to an intensive lifestyle intervention or to enhanced usual care (a diabetes support and education control condition). MAIN OUTCOME MEASURES At baseline and 1 year, participants had their weight measured and completed a fitness test and self-report measures of BE and dietary intake. Four groups were created based on BE status at baseline and 1 year (yes/yes, no/no, yes/no, and no/yes). Analyses controlled for baseline differences between binge eaters and non-binge eaters. RESULTS Most individuals (85.4%) did not report BE at baseline or 1 year (no/no), 7.5% reported BE only at baseline (yes/no), 3.7% reported BE at both times (yes/yes), and 3.4% reported BE only at 1 year (no/yes), with no differences between intensive lifestyle intervention and diabetes support and education conditions (P = .14). Across intensive lifestyle intervention and diabetes support and education, greater weight losses were observed in participants who stopped BE at 1 year (mean [SE] weight loss, 5.3 [0.4] kg) and those who reported no BE at either time (mean [SE] weight loss, 4.8 [0.1] kg) than in those who continued BE (mean [SE] weight loss, 3.1 [0.6] kg) and those who began BE at 1 year (mean [SE] weight loss, 3.0 [0.6] kg) (P < .001). Post hoc analyses suggested that these differences were due to changes in caloric intake. CONCLUSION Overweight and obese individuals with type 2 diabetes who stop BE appear to be just as successful at weight loss as non-binge eaters after 1 year of treatment. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00017953.
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Affiliation(s)
- Amy A Gorin
- Department of Psychology, Center for Health, Intervention, and Prevention, University of Connecticut, 2006 Hillside Rd, Unit 1248, Storrs, CT 06269-1248, USA.
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77
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Jolly fat or sad fat? Appetite 2008; 51:635-40. [DOI: 10.1016/j.appet.2008.05.055] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Revised: 05/19/2008] [Accepted: 05/19/2008] [Indexed: 11/22/2022]
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Ryan M, Gallanagh J, Livingstone MB, Gaillard C, Ritz P. The prevalence of abnormal eating behaviour in a representative sample of the French diabetic population. DIABETES & METABOLISM 2008; 34:581-6. [PMID: 18922726 DOI: 10.1016/j.diabet.2008.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Revised: 05/05/2008] [Accepted: 05/19/2008] [Indexed: 10/21/2022]
Abstract
AIM To assess the relationship between abnormal eating behaviour (AEB) and diabetes in a sample of French adult patients with type 1 (T1D) and type 2 (T2D) diabetes. METHODS Ninety-four consecutively recruited patients self-completed a series of validated questionnaires. RESULTS Over one-fourth of men with T1D (26%) or T2D (27%) and 11% of female T2D patients reported consistent and pathological overeating or binge-eating during the previous six months. Glycaemic control in these T1D patients was poorer than in T1D patients defined as normal eaters (NORM) (11.9% versus 9.6%), but did not reach statistical significance (P=0.08), and no significant difference was observed in the T2D group (P=0.61) either. T2D patients reported being markedly more restrained when eating than did the T1D patients (P=0.002), and their restraint increased along with their BMI (P<0.001). Patients who overate or binged also reported greater general hunger (P=0.02) and disinhibition (P=0.003) than did the NORM patients. CONCLUSION AEB is present in French diabetic patients at levels that are probably higher than among the general population. These results highlight the need for: (1) greater awareness among diabetes clinicians of the problem; (2) regular screening of diabetic patients for AEB; and (3) adaptation of therapeutic and dietary recommendations for this patient subgroup.
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Affiliation(s)
- M Ryan
- Pôle de maladies métaboliques et médecine interne, EDN-CHU d'Angers, 4, rue Larrey, 49033 Angers cedex, France
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Wölnerhanssen BK, Peters T, Kern B, Schötzau A, Ackermann C, von Flüe M, Peterli R. Predictors of outcome in treatment of morbid obesity by laparoscopic adjustable gastric banding: results of a prospective study of 380 patients. Surg Obes Relat Dis 2008; 4:500-6. [DOI: 10.1016/j.soard.2008.03.252] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Revised: 03/05/2008] [Accepted: 03/17/2008] [Indexed: 10/21/2022]
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Castellini G, Lapi F, Ravaldi C, Vannacci A, Rotella CM, Faravelli C, Ricca V. Eating disorder psychopathology does not predict the overweight severity in subjects seeking weight loss treatment. Compr Psychiatry 2008; 49:359-63. [PMID: 18555056 DOI: 10.1016/j.comppsych.2008.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Revised: 01/11/2008] [Accepted: 01/17/2008] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Many obese subjects show relevant psychological distress. The aims of this study were to assess the psychopathological and clinical features of a sample of overweight or obese subjects seeking weight loss treatment and to evaluate the possible, significant associations between the levels of overweight and the specific and general eating disorder psychopathology. METHODS A total of 397 consecutive overweight (body mass index > or =25 kg/m(2)) patients seeking treatment for weight loss at the Outpatient Clinic for Obesity of the University of Florence were studied. The prevalence of binge eating disorder was assessed using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. All subjects were assessed through the self-report version of the Eating Disorder Examination Questionnaire, the Beck Depression Inventory, and the State-Trait Anxiety Inventory. RESULTS The current prevalence of binge eating disorder was 24.2%; 35% of the subjects were overweight during childhood. High prevalence rates of clinical significant depressive (38%) and anxious (71.5%) symptoms were observed. Binge eating disorder, the severity of specific eating disorder psychopathology, and depressive and anxious symptoms were not associated with the severity of overweight. CONCLUSIONS The severity of the specific and general eating disorder psychopathology does not predict the levels of overweight. A positive association between severe eating disorder psychopathology and clinical depression was observed.
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Affiliation(s)
- Giovanni Castellini
- Psychiatric Unit, Department of Neuropsychiatric Sciences, Florence University School of Medicine, 50134 Firenze, Italy
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Fortuyn HAD, Swinkels S, Buitelaar J, Renier WO, Furer JW, Rijnders CA, Hodiamont PP, Overeem S. High prevalence of eating disorders in narcolepsy with cataplexy: a case-control study. Sleep 2008; 31:335-41. [PMID: 18363309 DOI: 10.1093/sleep/31.3.335] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES To study the prevalence of and symptoms of eating disorders in patients with narcolepsy. DESIGN We performed a case-control study comparing symptoms of eating disorders in patients with narcolepsy versus healthy population controls, using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN 2.1). To study whether an increased body mass index (BMI) could be responsible for symptoms of an eating disorder, we also compared patients with BMI-matched controls, using the SCAN as well as the Eating Disorder Examination-Questionnaire. SETTING University hospital. PATIENTS AND PARTICIPANTS Patients with narcolepsy/cataplexy (n = 60) were recruited from specialized sleep centers. Healthy controls (n = 120) were drawn from a population study previously performed in the Netherlands. Separately, 32 BMI-matched controls were recruited. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS In total, 23.3% of the patients fulfilled the criteria for a clinical eating disorder, as opposed to none of the control subjects. Most of these were classified as Eating Disorder-Not Otherwise Specified, with an incomplete form of binge eating disorder. On the symptom level, half of the patients reported a persistent craving for food, as well as binge eating. Twenty-five percent of patients even reported binging twice a week or more often. When compared with BMI-matched controls, the significant increases persisted in symptoms of eating disorders among patients with narcolepsy. Except for a higher level of interference in daily activities due to eating problems in patients using antidepressants, medication use did not influence our findings. CONCLUSIONS The majority of patients with narcolepsy experience a number of symptoms of eating disorders, with an irresistible craving for food and binge eating as the most prominent features. Eating disorder symptomatology interfered with daily activities. These findings justify more attention for eating disorders in the treatment of patients with narcolepsy.
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Mauro M, Taylor V, Wharton S, Sharma AM. Barriers to obesity treatment. Eur J Intern Med 2008; 19:173-80. [PMID: 18395160 DOI: 10.1016/j.ejim.2007.09.011] [Citation(s) in RCA: 142] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2007] [Revised: 08/30/2007] [Accepted: 09/26/2007] [Indexed: 11/17/2022]
Abstract
Obesity, one of the most prevalent health problems in the Western world, is a chronic and progressive condition. Therefore, as with other chronic diseases, patients with obesity require lifelong treatment. Long-term efficacy and effectiveness of obesity treatments is notoriously poor. This may in part be attributable to the substantial barriers that undermine long-term obesity management strategies. These can include lack of recognition of obesity as a chronic condition, low socioeconomic status, time constraints, intimate saboteurs, and a wide range of comorbidities including mental health, sleep, chronic pain, musculoskeletal, cardiovascular, respiratory, digestive and endocrine disorders. Furthermore, medications used to treat some of these disorders may further undermine weight-loss efforts. Lack of specific obesity training of health professionals, attitudes and beliefs as well as coverage and availability of obesity treatments can likewise pose important barriers. Health professionals need to take care to identify, acknowledge and address these barriers where possible to increase patient success as well as compliance and adherence with treatments. Failure to do so may further undermine the sense of failure, low self esteem and self efficacy already common among obese individuals. Addressing treatment barriers can save resources and increase the prospect of long-term success.
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Affiliation(s)
- Marina Mauro
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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Latzer Y, Vander S, Gilat I. Socio-demographic characteristics of eating disorder patients in an outpatient clinic: a descriptive epidemiological study. EUROPEAN EATING DISORDERS REVIEW 2008; 16:139-46. [PMID: 18000965 DOI: 10.1002/erv.841] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The present study focused on the differential help-seeking characteristics of eating disorder (ED) patients. METHOD Written reports of 698 ED-related patients who were referred to the largest outpatient ED clinic in Israel during the period 1991-2002 were retrieved from the patient files. RESULTS The typical profile was as follows: female, Israeli-born, secular, Jewish, urban, Ashkenazi (Western origin) ethnic background and high-level of parental education. Noteworthy, were the high percentage of kibbutz patients and the low percentages of patients from both the Arab and Jewish religious sectors. DISCUSSION The results are discussed in light of the socio-cultural impact on professional help-seeking among individuals suffering from ED.
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Affiliation(s)
- Yael Latzer
- Eating Disorders Clinic, Psychiatric Division, Rambam Medical Center, Haifa, Israel.
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84
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Lourenço BH, Arthur T, Rodrigues MDB, Guazzelli I, Frazzatto E, Deram S, Nicolau CY, Halpern A, Villares SMF. Binge eating symptoms, diet composition and metabolic characteristics of obese children and adolescents. Appetite 2008; 50:223-30. [PMID: 17804118 DOI: 10.1016/j.appet.2007.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2007] [Revised: 06/28/2007] [Accepted: 07/15/2007] [Indexed: 10/23/2022]
Abstract
This study aimed to determine the occurrence of symptoms of binge eating (BE) among children and adolescents seeking treatment for their obesity, as well as to evaluate their diet composition and metabolic characteristics. The Binge Eating Scale (BES) was answered by 128 children and adolescents (10.77+/-2.04 years, BMI 29.15+/-4.98 kg/m2, BMI Z score 2.28+/-0.46, 53.91% pubescent), who were classified into two subgroups--binge eaters (score greater than or equal to 18 points) and non-binge eaters (score lower than 18 points). Anthropometric data, body composition and Tanner stages were collected and dietary evaluation conducted. Blood pressure was determined, and glucose, lipid profile and insulin assays were performed. Insulin resistance was determined using HOMA-IR. BE symptoms were present in 39.06% of patients. Carbohydrate intake in diet composition was significantly higher among binge eaters. Children with BE did not demonstrate significant dissimilar metabolic characteristics when compared to their counterparts without BE. Therefore, BE seems to be a prevalent problem among children and adolescents seeking help for their obesity. When associated with obesity, this eating behaviour can influence macronutrient consumption through increased carbohydrate intake. Further research would be valuable to verify the reproducibility of these findings.
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Affiliation(s)
- Barbara H Lourenço
- Laboratory for Molecular Studies in Obesity-LIM-25, University of São Paulo Medical School, Avenida Doutor Arnaldo, 455-Sala 4305, São Paulo-SP CEP 01246-903, Brazil.
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Adipositas ist mehr als eine Essstörung - die multidimensionale Betrachtung einer Pandemie. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2008; 54:4-31. [DOI: 10.13109/zptm.2008.54.1.4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wolfe BE. Issues of body weight and eating behavior in psychiatric and mental health nursing practice. J Am Psychiatr Nurses Assoc 2008; 13:343-4. [PMID: 21672872 DOI: 10.1177/1078390307310144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Barbara E Wolfe
- Center for Nursing Research Wm. F. Connell School of Nursing Boston College Chestnut Hill, MA
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87
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Dingemans AE, Spinhoven P, van Furth EF. Predictors and mediators of treatment outcome in patients with binge eating disorder. Behav Res Ther 2007; 45:2551-62. [PMID: 17643390 DOI: 10.1016/j.brat.2007.06.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2006] [Revised: 06/07/2007] [Accepted: 06/12/2007] [Indexed: 11/23/2022]
Abstract
A randomized controlled trial (N=52) was conducted comparing cognitive-behavioral therapy with a waiting list control group to identify mediators and predictors of treatment outcome. Reduction of weight concerns mediated abstinence of binge eating at post-treatment. Abstinence was marginally mediated by changes in eating and shape concerns, depressive symptoms and global severity of general psychopathology. Neither treatment outcome nor status at 1-year follow-up could be predicted by severity of eating disorder, comorbid psychopathology or maladaptive core beliefs at baseline or at post-treatment. The only predictor for abstinence at both post-treatment and 1-year follow-up was the coping style palliative reacting: higher scores predicted less favorable outcomes. Lower expression of emotions at post-treatment predicted more reduction of eating disorder psychopathology at follow-up. No other patient characteristics allowing treatment-patient matching could be identified.
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Affiliation(s)
- Alexandra E Dingemans
- Center for Eating Disorders Ursula, PO Box 422, 2260 AK Leidschendam, The Netherlands.
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Marano G, Cuzzolaro M, Vetrone G, Garfinkel PE, Temperilli F, Spera G, Dalle Grave R, Calugi S, Marchesini G. Validating the Body Uneasiness Test (BUT) in obese patients. Eat Weight Disord 2007; 12:70-82. [PMID: 17615491 DOI: 10.1007/bf03327581] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To investigate the psychometric properties of the Body Uneasiness Test (BUT) in a large sample of subjects with obesity seeking treatment. BUT is a 71-item self-report questionnaire in two parts: BUT-A which measures weight phobia, body image concerns, avoidance, compulsive self-monitoring, detachment and estrangement feelings towards one's own body (depersonalization); and BUT-B, which looks at specific worries about particular body parts or functions. METHODS We recruited a clinical sample of 1,812 adult subjects (age range 18-65 years, females 1,411, males 401) with obesity (Body Mass Index, BMI > or = 30 kg/m2) and a normal weight (BMI value between 18.5 and 25 kg/m2) non-clinical sample of 457 adult subjects (females 248, males 209) with an Eating Attitudes Test-26 (EAT-26) score under the cut-off point 20 (scores > or = 20 indicate possible cases of eating disorders). RESULTS The exploratory and confirmatory analyses confirmed a structural five-factor model for BUT-A and an eight-factor model for BUT-B. Internal consistency was satisfactory. Concurrent validity with Binge Eating Scale (BES) and Three-Factor Eating Questionnaire (TFEQ) was evaluated. The authors calculated mean values for BUT scores in adult (18-65 years) patients with obesity, and evaluated the influence of gender, age and BMI. Females obtained statistically significant higher scores than males in all age groups and in all classes of obesity; patients with obesity, compared with normal weight subjects, generally obtained statistically significant higher scores, but few differences could be attributed to the influence of BMI. CONCLUSION The BUT can be a valuable multidimensional tool for the clinical assessment of body uneasiness in obesity; the scores of its sub-scales do not show a linear correlation with BMI values.
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Affiliation(s)
- G Marano
- Obesity and Eating Disorders Unit, ASL Rovigo
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89
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McElroy SL, Hudson JI, Capece JA, Beyers K, Fisher AC, Rosenthal NR. Topiramate for the treatment of binge eating disorder associated with obesity: a placebo-controlled study. Biol Psychiatry 2007; 61:1039-48. [PMID: 17258690 DOI: 10.1016/j.biopsych.2006.08.008] [Citation(s) in RCA: 197] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2006] [Revised: 08/10/2006] [Accepted: 08/11/2006] [Indexed: 11/21/2022]
Abstract
BACKGROUND In a single-center, placebo-controlled study, topiramate reduced binge eating and weight in patients with binge eating disorder (BED) and obesity. The current investigation evaluated the safety and efficacy of topiramate in a multicenter, placebo-controlled trial. METHODS Eligible patients between 18 and 65 years with >or= 3 binge eating days/week and a body mass index (BMI) between 30 and 50 kg/m2 were randomized. RESULTS A total of 407 patients enrolled; 13 failed to meet inclusion criteria, resulting in 195 topiramate and 199 placebo patients. Topiramate reduced binge eating days/week (-3.5 +/- 1.9 vs. -2.5 +/- 2.1), binge episodes/week (-5.0 +/- 4.3 vs. -3.4 +/- 3.8), weight (-4.5 +/- 5.1 kg vs. .2 +/- 3.2 kg), and BMI (-1.6 +/- 1.8 kg/m2 vs. .1 +/- 1.2 kg/m2) compared with placebo (p < .001). Topiramate induced binge eating remission in 58% of patients (placebo, 29%; p < .001). Discontinuation rates were 30% in each group; adverse events (AEs) were the most common reason for topiramate discontinuation (16%; placebo, 8%). Paresthesia, upper respiratory tract infection, somnolence, and nausea were the most common AEs with topiramate. CONCLUSIONS This multicenter study in patients with BED associated with obesity demonstrated that topiramate was well tolerated and efficacious in improving the features of BED and in reducing obesity.
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Affiliation(s)
- Susan L McElroy
- Psychopharmacology Research Program, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0559, USA.
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90
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Position of the American Dietetic Association: Nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa, and other eating disorders. ACTA ACUST UNITED AC 2007; 106:2073-82. [PMID: 17186637 DOI: 10.1016/j.jada.2006.09.007] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
It is the position of the American Dietetic Association that nutrition intervention, including nutritional counseling, by a registered dietitian (RD) is an essential component of the team treatment of patients with anorexia nervosa, bulimia nervosa, and other eating disorders during assessment and treatment across the continuum of care. Diagnostic criteria for eating disorders provide important guidelines for identification and treatment. However, it is thought that a continuum of disordered eating may exist that ranges from persistent dieting to subthreshold conditions and then to defined eating disorders, which include anorexia nervosa, bulimia nervosa, and binge eating disorder. Understanding the complexities of eating disorders, such as influencing factors, comorbid illness, medical and psychological complications, and boundary issues, is critical in the effective treatment of eating disorders. The nature of eating disorders requires a collaborative approach by an interdisciplinary team of psychological, nutritional, and medical specialists. The RD is an integral member of the treatment team and is uniquely qualified to provide medical nutrition therapy for the normalization of eating patterns and nutritional status. RDs provide nutritional counseling, recognize clinical signs related to eating disorders, and assist with medical monitoring while cognizant of psychotherapy and pharmacotherapy that are cornerstones of eating disorder treatment. Specialized resources are available for RDs to advance their level of expertise in the field of eating disorders. Further efforts with evidenced-based research must continue for improved treatment outcomes related to eating disorders along with identification of effective primary and secondary interventions.
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91
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Grucza RA, Przybeck TR, Cloninger CR. Prevalence and correlates of binge eating disorder in a community sample. Compr Psychiatry 2007; 48:124-31. [PMID: 17292702 PMCID: PMC1924970 DOI: 10.1016/j.comppsych.2006.08.002] [Citation(s) in RCA: 263] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Revised: 06/29/2006] [Accepted: 08/14/2006] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Diagnostic criteria for binge eating disorder (BED) appear in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition as "criteria for further study." Few epidemiological studies of BED have been conducted. Our aim was to describe the prevalence and correlates of BED, as assessed by the Patient Health Questionnaire (PHQ) in a community sample. METHOD Descriptive epidemiology from a survey of 910 randomly ascertained participants residing in the greater metropolitan area of St Louis, Mo. RESULTS Sixty individuals (6.6%) screened positive for current BED, as assessed by the PHQ (BED+). Men were as likely to screen positive as women. BED+ subjects were at substantially elevated odds for depression, generalized anxiety disorder, panic attacks, and past suicide attempts; individuals with obesity who screened negative for BED (BED-) were not at elevated odds for these syndromes. BED+ subjects, but not other obese individuals, exhibited substantially lower scores on measures of mental health-related quality of life. Personality traits associated with BED symptoms included high Novelty Seeking, high Harm Avoidance, and low Self-directedness. Personality and psychiatric profiles in obese, BED- individuals were closer to those for normal-weight, BED- individuals, suggesting that BED is distinct from typical obesity. BED+ subjects reported mean body mass index of 34.1, more than 6 units above BED- subjects. CONCLUSION PHQ-BED criteria are associated with substantial impairment, psychiatric comorbidity, and obesity and effectively discriminate obese individuals with psychological problems from obese subjects without similar problems. BED may be considerably more prevalent than other eating disorders and equally prevalent among men and women.
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Affiliation(s)
- Richard A Grucza
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA.
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92
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Abstract
OBJECTIVES To review the scientific evidence examining the comorbidity among eating disorders and bipolar disorder (BD). METHODS We reviewed all published English-language studies addressing the comorbidity of anorexia nervosa, bulimia, bulimia nervosa, and binge eating disorder in patients with BD and studies of comorbidity of BD in patients with eating disorders. In addition, we discuss the pharmacologic treatment implications from reviewed studies of agents used in BD and eating disorders. RESULTS Community and clinical population studies of the lifetime prevalence rates of eating disorders in patients with BD, and of BD in patients with eating disorders, particularly when subthreshold and spectrum manifestations of these disorders are included, indicate high rates of comorbidity among these illnesses. CONCLUSIONS Pharmacologic treatment approaches to patients with BD and a co-occurring eating disorder require examination of the possible adverse effects of the treatment of each syndrome on the other and attempts to manage both syndromes with agents that might be beneficial to both.
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Affiliation(s)
- Susan L McElroy
- Psychopharmacology Research Program, Department of Psychiatry, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, USA.
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93
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Riener R, Schindler K, Ludvik B. Psychosocial variables, eating behavior, depression, and binge eating in morbidly obese subjects. Eat Behav 2006; 7:309-14. [PMID: 17056406 DOI: 10.1016/j.eatbeh.2005.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2005] [Revised: 10/05/2005] [Accepted: 11/01/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Binge eating disorder (BED) is a frequent and significant psychiatric comorbidity among patients seeking treatment for obesity. The purpose of this study was to determine whether morbidly obese subjects with BED differ from those without BED (NBED) in terms of eating behavior, social/environmental variables, and depression. RESEARCH METHODS AND PROCEDURES Out of 110 morbidly obese (BMI > or = 40 kg/m2) subjects, 88 could be reliably classified as BED (19) or NBED (69). These subjects (age 42.0+/-13.4 years, BMI 47.0+/-5.7 kg/m2) were examined by a semi-structured interview and by validated questionnaires to assess depression and eating behavior. RESULTS Subjects with BED showed higher scores of disinhibited eating (12.3+/-2.7 vs. 9.1+/-3.6, p<0.05), were more likely to attribute obesity to their eating habits (chi2=8.4, p<0.05), and rated their social environment regarding relationships as less supportive and cohesive (chi2=10.6, p=0.001). In addition, patients with BED experienced an earlier onset of obesity (chi2=6.3, p<0.05). No relationship, however, was found between binge eating disorder and depression. DISCUSSION Morbidly obese patients with BED exhibit typical psychological features when compared to those without BED. Their recognition by a structured psychological evaluation in conjunction with questionnaires might be necessary to develop appropriate therapeutic strategies to facilitate weight loss.
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Affiliation(s)
- Raphaela Riener
- Division of Endocrinology and Metabolism, Department of Internal Medicine 3, Medical University Vienna, Waehringer Guertel 18-20, Vienna, Austria.
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94
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Foltin RW. "Tasting and wasting" behavior in non-human primates: aberrant behavior or normal behavior in "times of plenty". Physiol Behav 2006; 89:587-97. [PMID: 16942783 DOI: 10.1016/j.physbeh.2006.07.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2006] [Revised: 07/17/2006] [Accepted: 07/18/2006] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to develop a foraging model that engenders large meals. Eight free-feeding baboons were first given periodic access to a chocolate sugar-coated candy (M & Ms) and then a jelly sugar-coated candy (Skittles). Baboons had access to food 24 h each day, but they had to complete a two-phase operant procedure in order to eat. Responding on one lever during a 30-min appetitive phase was required before animals could start a consumption phase, where responding on another lever led to food delivery, i.e., a meal. 3 days a week for 8 or 9 weeks baboons received candy during the first meal and then food pellets were available: a 2 month interval when only pellets were available separated periods of candy access. All baboons ate as much candy in the single candy meal as they did pellets throughout the remainder of the day. Beginning week 5 of M & M access, five baboons began to waste a large number of M & Ms by spitting them out. Baboons wasted few Skittles or pellets. Pellet intake was less, but total caloric intake was greater on days that animals had access to either candy. Pellet, but not candy eating varied between males and females: males began eating pellets sooner in the day, ate more pellet meals and more pellets. Periodic access to a preferred candy food engendered large amounts of candy consumption in all baboons, and periodic access to M & Ms engendered food tasting and wasting behavior in 5 of 8 baboons.
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Affiliation(s)
- Richard W Foltin
- Division on Substance Abuse, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 120, New York, NY 10032, USA.
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Ghaderi A. Does individualization matter? A randomized trial of standardized (focused) versus individualized (broad) cognitive behavior therapy for bulimia nervosa. Behav Res Ther 2006; 44:273-88. [PMID: 16389065 DOI: 10.1016/j.brat.2005.02.004] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2004] [Revised: 01/19/2005] [Accepted: 02/03/2005] [Indexed: 11/19/2022]
Abstract
Does higher level of individualization increase treatment efficacy? Fifty patients with bulimia nervosa were randomized into either manual-based (focused) or more individualized (broader) cognitive behavioral therapy guided by logical functional analysis. Eating disorders Examination and a series of self-report questionnaires were used for assessment at pre-, and post-treatment as well as at follow-up. Both conditions improved significantly at post-treatment, and the results were maintained at the 6 months follow-up. There were no statistically and clinically significant differences between the two conditions at post-treatment with the exception of abstinence from objective bulimic episodes, eating concerns, and body shape dissatisfaction, all favoring the individualized, broader condition. Both groups improved concerning self-esteem, perceived social support from friends, and depression. The improvements were maintained at follow-up. Ten patients (20%) did not respond to the treatment. Notably, a majority of non-responders (80%) were in the manual-based condition. Non-responders showed extreme dominance of rule-governed behavior, and lack of contact with actual contingencies compared to responders. The study provided preliminary support for the superiority of higher level of individualization (i.e. broader CBT) in terms of the response to treatment, and relapses. However, the magnitude of effects was moderate, and independent replications, with blind assessment procedures, and a larger sample sized are needed before more clear cut conclusions can be drawn.
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Affiliation(s)
- Ata Ghaderi
- Department of Psychology, Uppsala University, Box 1225, SE-751 42 Uppsala, Sweden.
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96
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Dingemans AE, Spinhoven P, van Furth EF. Maladaptive core beliefs and eating disorder symptoms. Eat Behav 2006; 7:258-65. [PMID: 16843229 DOI: 10.1016/j.eatbeh.2005.09.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2005] [Revised: 09/26/2005] [Accepted: 09/29/2005] [Indexed: 11/25/2022]
Abstract
This study compared maladaptive core beliefs of eating-disordered groups (full and subthreshold syndrome) and healthy controls and investigated the association between eating disorder symptoms and core beliefs. Participants were compared on self-report measures of core beliefs (YSQ) and eating disorder psychopathology (BITE). Anorexia nervosa (AN; both subtypes) and bulimia nervosa (BN) patients had significantly more core beliefs than healthy controls. Binge eating disorder (BED) patients had intermediate scores between AN and BN on the one hand and healthy controls on the other hand. No correlation was found between core beliefs and frequency of binge eating. Frequency of vomiting, laxative misuse and fasting was positively associated with all domains of core beliefs. Patients with eating disorders have some core beliefs which are not directly related to eating, weight or shape. Frequency of purging and fasting behaviors is associated with more severe maladaptive core beliefs. Our data demonstrate the importance of identifying purging and fasting as significant clinical markers.
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Affiliation(s)
- A E Dingemans
- National Center for Eating Disorders, PO Box 422, 2260 AK Leidschendam, The Netherlands.
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97
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Herpertz S, Burgmer R, Stang A, de Zwaan M, Wolf AM, Chen-Stute A, Hulisz T, Jöckel KH, Senf W. Prevalence of mental disorders in normal-weight and obese individuals with and without weight loss treatment in a German urban population. J Psychosom Res 2006; 61:95-103. [PMID: 16813851 DOI: 10.1016/j.jpsychores.2005.10.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2005] [Revised: 09/12/2005] [Accepted: 10/03/2005] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate the prevalence rates of mental disorders in normal-weight individuals and obese individuals with and without weight loss treatment. METHODS A sample of 251 participants in a conventional weight loss treatment, 153 pre-bariatric surgery patients, 174 normal-weight control participants, and 128 obese control participants not actively losing weight at the time of the investigation were examined. RESULTS Lifetime prevalence rates of mental disorders in obese women ranged from 46.7% to 60.1% compared with 41.7% in normal-weight women and from 48.0% to 54.4% in obese men compared with 29.8% in normal-weight men. Prevalence rates of mental disorders did not differ significantly between normal-weight and obese women not currently in weight loss treatment; however, the rates were significantly lower compared with both obese treatment groups. Compared with normal-weight men, obese men not currently in weight loss treatment and obese men participating in conventional weight loss treatment showed significantly higher prevalence rates of mental disorders. CONCLUSION Unlike obese male individuals, obese female participants not currently in weight loss treatment did not differ from normal-weight participants with regard to comorbidity of mental disorders. However, obese female participants who were engaged in weight loss treatment exhibited significantly higher prevalence rates than normal-weight participants.
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Affiliation(s)
- Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, Westfälische Klinik Dortmund, Ruhr University Bochum, Dortmund, Germany.
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98
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de Man Lapidoth J, Ghaderi A, Norring C. Eating disorders and disordered eating among patients seeking non-surgical weight-loss treatment in Sweden. Eat Behav 2006; 7:15-26. [PMID: 16360619 DOI: 10.1016/j.eatbeh.2005.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2004] [Revised: 04/27/2005] [Accepted: 05/26/2005] [Indexed: 11/17/2022]
Abstract
The aim of this cross-sectional descriptive study of 194 Swedish men and women seeking non-surgical weight-loss treatment was to investigate the presence of eating disorders and binge eating symptoms and to compare these two groups of patients with a group without eating disorder- or binge eating symptoms. The groups were compared in regard to co-morbid psychopathology, Health Related Quality of Life (HRQL) and anthropometric data. Of the total sample, 9.8% fulfilled criteria for any eating disorder. An additional 7.2% indicated binge eating symptoms without having an eating disorder. The three groups were significantly different in regard to psychopathology scales and most HRQL items. Eating disorders and binge eating symptoms are common among patients seeking non-surgical weight-loss treatments in Sweden and both groups showed elevated levels of co-morbid psychopathology and lower HRQL compared to patients without disordered eating. These findings point to the importance of assessing the full range of eating disorder symptoms and disorders as well as HRQL and co-morbid psychopathology before weight-loss treatment, as these factors might affect treatment outcome.
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99
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Dunn EC, Neighbors C, Larimer ME. Motivational enhancement therapy and self-help treatment for binge eaters. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2006; 20:44-52. [PMID: 16536664 DOI: 10.1037/0893-164x.20.1.44] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aims of this study were to evaluate whether a single session of motivational enhancement therapy (MET) would increase participant readiness to change, improve the efficacy of self-help treatment for binge eaters, and improve participant compliance with the self-help manual. METHOD Participants with bulimia nervosa or binge eating disorder were randomly assigned either to attend a 1-hr MET session prior to receiving the self-help manual (n = 45) or to receive the self-help manual only (n = 45). Participants were followed for 4 months for assessment of self-reported eating disorder outcome and compliance. RESULTS The MET intervention resulted in increased readiness to change for binge eating compared with the self-help-only (SH) condition. Few differences were found between the MET condition and the SH condition for changes in eating attitudes and frequency of binge eating and compensatory behaviors. No significant effects were found for compliance. DISCUSSION This research adds to the literature regarding the use of brief motivational interventions to enhance readiness for change in populations with eating disorders.
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Affiliation(s)
- Eric C Dunn
- Department of Psychology, University of Washington, WA, USA.
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100
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Swaab DF. The human hypothalamus in metabolic and episodic disorders. PROGRESS IN BRAIN RESEARCH 2006; 153:3-45. [PMID: 16876566 DOI: 10.1016/s0079-6123(06)53001-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- D F Swaab
- Netherlands Institute for Neuroscience, Meibergdreef 47, 1105BA Amsterdam, The Netherlands.
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