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de Lourdes M, Pinto-Bastos A, Machado PP, Conceição E. Problematic eating behaviors in patients undergoing bariatric surgery: Studying their relationship with psychopathology. J Health Psychol 2021; 27:1535-1546. [PMID: 33406896 DOI: 10.1177/1359105320986889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study explored the associations between individuals presenting different problematic eating behaviors (Objective/Subjective binge-eating-OBE/SBE-and Compulsive/Non-compulsive grazing-C_Grazing/NC_Grazing) and eating disorder related symptoms. About 163 pre- and 131 post-bariatric patients were assessed. Assessment included: Face-to-face clinical interview to assess binge-eating and grazing episodes, and self-report measures to assess eating disorder symptomatology, psychological distress, and negative urgency. OBE and NC_Grazing were the problematic eating behaviors most and least associated with psychopathology, respectively. OBE and C_Grazing uniquely accounted for the significant variance in the most disordered eating variables. Our findings emphasize the need for the conceptualization of grazing behavior in the spectrum of disordered eating.
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Mason TB, Smith KE, Crosby RD, Engel SG, Wonderlich SA. Examination of momentary maintenance factors and eating disorder behaviors and cognitions using ecological momentary assessment. Eat Disord 2021; 29:42-55. [PMID: 31081472 PMCID: PMC6842669 DOI: 10.1080/10640266.2019.1613847] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The integrative cognitive-affective therapy (ICAT) momentary maintenance model proposes a number of situational factors that precipitate eating disorder (ED) behaviors and cognitions. The current study examines momentary situational triggers in relation to a broad range of ED symptoms in a diagnostically heterogeneous sample of individuals with ED psychopathology. In the current study, 30 women with binge eating pathology completed a 14-day ecological momentary assessment (EMA) protocol during which they responded to five random signals throughout the day. During signaled assessments, participants completed measures of self-criticism, interpersonal problems, self-regulation of binge eating, appearance concerns, and cognitive and behavioral ED symptoms. Multilevel models were used to examine prospective associations between hypothesized ICAT maintenance factors and ED symptoms. Within-subjects self-criticism prospectively predicted vomiting, restriction, preoccupation with thoughts of food, and urges to eat. Within-subjects interpersonal problems prospectively predicted vomiting, and within-subjects appearance concerns prospectively predicted preoccupation with thoughts of food. There were no significant predictors of binge eating. These results provide some support for hypothesized momentary situational triggers of ED symptoms in the momentary maintenance model of ICAT using naturalistic, momentary assessment. Specifically, it may be particularly useful for interventions such as ICAT to address momentary self-criticism when targeting a range of ED symptoms.
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Affiliation(s)
- Tyler B Mason
- Department of Preventive Medicine, University of Southern California , Los Angeles, CA, US
| | - Kathryn E Smith
- Department of Biobehavioral Research, Sanford Health , Fargo, North Dakota, US.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences , Fargo, North Dakota, US
| | - Ross D Crosby
- Department of Biobehavioral Research, Sanford Health , Fargo, North Dakota, US.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences , Fargo, North Dakota, US
| | - Scott G Engel
- Department of Biobehavioral Research, Sanford Health , Fargo, North Dakota, US.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences , Fargo, North Dakota, US
| | - Stephen A Wonderlich
- Department of Biobehavioral Research, Sanford Health , Fargo, North Dakota, US.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences , Fargo, North Dakota, US
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Mikhail ME. Affect Dysregulation in Context: Implications and Future Directions of Experience Sampling Research on Affect Regulation Models of Loss of Control Eating. Front Psychiatry 2021; 12:747854. [PMID: 34646178 PMCID: PMC8502879 DOI: 10.3389/fpsyt.2021.747854] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/01/2021] [Indexed: 01/04/2023] Open
Abstract
Loss of control eating is a core, transdiagnostic eating disorder symptom associated with psychological distress, functional impairment, and reduced quality of life. However, the factors that contribute to persistent loss of control eating despite negative consequences are not fully understood. Understanding the mechanisms that maintain loss of control eating is crucial to advance treatments that interrupt these processes. Affect regulation models of loss of control eating hypothesize that negative emotions trigger loss of control eating, and that loss of control eating is negatively reinforced because it temporarily decreases negative affect. Several variations on this basic affect regulation model have been proposed, including theories suggesting that negative affect decreases during loss of control eating rather than afterwards (escape theory), and that loss of control eating replaces one negative emotion with another that is less aversive (trade-off theory). Experience sampling designs that measure negative affect and eating behavior multiple times per day are optimally suited to examining the nuanced predictions of these affect regulation models in people's everyday lives. This paper critically reviews experience sampling studies examining associations between negative affect and loss of control eating, and discusses the implications for different affect regulation models of loss of control eating. The review concludes by proposing an expanded affect-focused model of loss of control eating that incorporates trait-level individual differences and momentary biological and environmental variables to guide future research. Clinical implications and recommendations are discussed.
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Affiliation(s)
- Megan E Mikhail
- Department of Psychology, Michigan State University, East Lansing, MI, United States
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54
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Tekkalaki B, Mohapatra S, Mohapatra M, Kar S. Perceived stress and emotional overeating during COVID-19 pandemic. ANNALS OF INDIAN PSYCHIATRY 2021. [DOI: 10.4103/aip.aip_18_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Pallanti S, Marras A, Makris N. A Research Domain Criteria Approach to Gambling Disorder and Behavioral Addictions: Decision-Making, Response Inhibition, and the Role of Cannabidiol. Front Psychiatry 2021; 12:634418. [PMID: 34603091 PMCID: PMC8484302 DOI: 10.3389/fpsyt.2021.634418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/30/2021] [Indexed: 12/14/2022] Open
Abstract
Gambling Disorder (GD) has been recently re-classified in the DSM-5 under the "substance-related and addictive disorders," in light of its genetic, endophenotypic, and phenotypic resemblances to substance dependence. Diminished control is a core defining concept of psychoactive substance dependence or addiction and has given rise to the concept of "behavioral" addictions, which are syndromes analogous to substance addiction, but with a behavioral focus other than ingestion of a psychoactive substance. The main symptom clusters are represented by loss of control, craving/withdrawal, and neglect of other areas of life, whereas in a Research Domain Criteria (RDoC) perspective, GD patients exhibit deficits in the domain of "Positive valence systems," particularly in the "Approach motivation" and "Reward learning" constructs, as well as in the "Cognitive systems," primarily in the "Cognitive control" construct. In the Addictions Neuroclinical Assessment (ANA), three relevant domains for addictions emerge: "Incentive salience," "Negative Emotionality," and "Executive Function." The endocannabinoid system (ECS) may largely modulate these circuits, presenting a promising pharmaceutical avenue for treating addictions. Up to now, research on cannabidiol has shown some efficacy in Attention Deficit/Hyperactivity Disorder (ADHD), whereas in behavioral addictions its role has not been fully elucidated, as well as its precise action on RDoC domains. Herein, we review available evidence on RDoC domains affected in GD and behavioral addictions and summarize insights on the use of cannabidiol in those disorders and its potential mechanisms of action on reward, decisional, and sensorimotor processes.
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Affiliation(s)
- Stefano Pallanti
- Institute of Neurosciences, Florence, Italy.,Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY, United States
| | - Anna Marras
- Institute of Neurosciences, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Nikolaos Makris
- Departments of Psychiatry and Neurology, Center for Morphometric Analysis, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
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56
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Limbers CA, Greenwood E, Horan MR. Convergent and discriminant validity of the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) Short-Form. Eat Behav 2020; 39:101442. [PMID: 33142126 DOI: 10.1016/j.eatbeh.2020.101442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Emotional eating is associated with a number of negative outcomes in children and adolescents, including higher levels of loss of control eating (i.e., the inability to control the amount of food consumed). There is a need for psychometrically sound and feasible measures that assess emotional eating in children and adolescents. The purpose of the current study was to evaluate the convergent and discriminant validity of the 10-item Emotional Eating Scale Adapted for Children and Adolescents (EES-C) Short-Form in a community sample of adolescents. We also sought to assess the reliability and structural validity of this measure. METHODS Participants were 128 adolescents ages 13 to 19 years (mean age = 15.10 years; SD = 2.09; 53.9% female). Most participants fell within the healthy BMI range (58.6%). Participants completed the EES-C Short-Form, the loss of control eating section of the Questionnaire on Eating and Weight Patterns-Adolescent Version 5, the Gratitude Questionnaire-Six-Item Form, and a demographic questionnaire. RESULTS Convergent validity of the EES-C Short-Form was supported in that adolescents who endorsed loss of control eating reported significantly greater levels of emotional eating (mean = 24.37; SD = 8.94) compared to adolescents who did not endorse loss of control eating (mean = 19.42; SD = 7.33; p ≤ .01; d = 0.61). The EES-C Short-Form was significantly correlated with a subjective measure of loss of control eating (rs = -0.255; p = .004), further demonstrating convergent validity. The EES-C Short-Form exhibited discriminant validity as demonstrated by a small, non-significant correlation with the Gratitude Questionnaire-Six-Item Form (rs = 0.086; p = .347). The EES-C Short-Form demonstrated acceptable reliability (Cronbach's alpha = 0.84; Ordinal alpha = 0.88; Coefficient omega = 0.85) and a unidimensional factor structure (CFI = 0.98; NNFI = 0.98; RMSEA = 0.08). CONCLUSIONS These data contribute to the existing research that support the EES-C Short-Form as a reliable and valid measure for assessing emotional eating in children and adolescents.
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Affiliation(s)
| | - Emma Greenwood
- Department of Psychology and Neuroscience, Baylor University, USA
| | - Madeline R Horan
- Department of Psychology and Neuroscience, Baylor University, USA
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57
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Berner LA, Sysko R, Rebello TJ, Roberto CA, Pike KM. Patient descriptions of loss of control and eating episode size interact to influence expert diagnosis of ICD-11 binge-eating disorder. J Eat Disord 2020; 8:71. [PMID: 33292557 PMCID: PMC7682053 DOI: 10.1186/s40337-020-00342-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/21/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Although data suggest that the sense of "loss of control" (LOC) is the most salient aspect of binge eating, the definition of LOC varies widely across eating disorder assessments. The WHO ICD-11 diagnostic guidelines for binge eating do not require an objectively large amount of food, which makes accurate LOC diagnosis even more critical. However, it can be especially challenging to assess LOC in the context of elevated weight status and in the absence of compensatory behaviors. This ICD-11 field sub-study examined how descriptions of subjective experience during distressing eating episodes, in combination with different eating episode sizes, influence diagnoses of binge-eating disorder (BED). METHOD Mental health professionals with eating disorder expertise from WHO's Global Clinical Practice Network (N = 192) participated in English, Japanese, and Spanish. Participants were asked to select the correct diagnosis for two randomly assigned case vignettes and to rate the clinical importance and ease of use of each BED diagnostic guideline. RESULTS The presence of LOC interacted with episode size to predict whether a correct diagnostic conclusion was reached. If the amount consumed during a typical distressing eating episode was only subjectively large compared to objectively large, clinicians were 23.1 times more likely to miss BED than to correctly diagnose it, and they were 9.7 times more likely to incorrectly diagnose something else than to correctly diagnose BED. In addition, clinicians were 10.8 times more likely to make a false positive diagnosis of BED when no LOC was described if the episode was objectively large. Descriptions of LOC that were reliably associated with correct diagnoses across episodes sizes included two that are similar to those already included in proposed ICD-11 guidelines and a third that is not. This third description of LOC focuses on giving up attempts to control eating because perceived overeating feels inevitable. CONCLUSIONS Results highlight the importance of detailed clarification of the LOC construct in future guidelines. Explicitly distinguishing LOC from distressing and mindless overeating could help promote consistent and accurate diagnosis of BED versus another or no eating disorder.
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Affiliation(s)
- Laura A Berner
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Robyn Sysko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tahilia J Rebello
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kathleen M Pike
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
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58
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Sepúlveda AR, Lacruz T, Solano S, Blanco M, Moreno A, Rojo M, Beltrán L, Graell M. Identifying Loss of Control Eating within Childhood Obesity: The Importance of Family Environment and Child Psychological Distress. CHILDREN-BASEL 2020; 7:children7110225. [PMID: 33187289 PMCID: PMC7696176 DOI: 10.3390/children7110225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/03/2020] [Accepted: 11/08/2020] [Indexed: 01/18/2023]
Abstract
This study aims to examine the differences in family environment, psychological distress, and disordered eating symptomatology between children classified by weight status with or without loss of control (LOC) eating and to test a model of the role of emotional regulation of LOC eating based on a dysfunctional family environment. A cross-sectional study was conducted among 239 families. The assessment measured family expressed emotion, family adaptability and cohesion, child levels of depression and anxiety, body esteem, and disordered eating attitudes. The assessment was carried out in primary care centers and primary schools. Child body mass index (BMI) was associated with higher expressed emotion, psychological distress, and disordered eating symptomatology. Children with obesity and LOC presented higher BMI, poorer body esteem, and more disordered eating attitudes than children without LOC. Children with overweight/obesity, both with or without LOC, exhibited higher psychological distress and emotional overinvolvement than normal-weight children. A partial mediation of depression or anxiety and disordered eating attitudes between expressed emotion and LOC was found. Findings support that children with overweight/obesity show more family and psychological distress. Body esteem issues and disordered eating attitudes could alert the presence of LOC in children with obesity. The function of LOC might be to cope with psychological distress that may appear in a dysfunctional family environment.
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Affiliation(s)
- Ana Rosa Sepúlveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
- Correspondence: ; Tel.: +34-914-975-214
| | - Tatiana Lacruz
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Santos Solano
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Miriam Blanco
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Alba Moreno
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Marta Rojo
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Lucía Beltrán
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, 28009 Madrid, Spain;
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Conceição E. Comment on: Interrater reliability of the eating disorder examination among postbariatric patients. Surg Obes Relat Dis 2020; 17:e5-e6. [PMID: 33153964 DOI: 10.1016/j.soard.2020.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/06/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Eva Conceição
- School of Psychology, University of Minho, Braga, Portugal
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60
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Silvani J, Schmidt MI, Zajdenverg L, Galliano LM, Antunes Nunes MA. Impact of binge eating during pregnancy on gestational weight gain and postpartum weight retention among women with gestational diabetes mellitus: LINDA-Brasil. Int J Eat Disord 2020; 53:1818-1825. [PMID: 32812662 DOI: 10.1002/eat.23361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/18/2020] [Accepted: 07/19/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Binge eating (BE) is associated with gestational weight gain, which is a risk factor for gestational diabetes (GDM). Little is known about this association in women with GDM. To evaluate the relationship of BE in pregnancy with gestational weight gain, BE at postpartum and postpartum weight retention in women with GDM. METHOD Lifestyle INtervention for Diabetes prevention After pregnancy (LINDA-Brasil) is a multicenter cohort study with 1,958 women with GDM. BE was assessed by interview during recruitment in pregnancy and at a phone interview at ~4 months postpartum. Gestational weight gain was classified according to the 2009 Institute of Medicine (IOM) recommendations. Poisson regression with robust variance was used to estimate adjusted relative risks (RR). RESULTS Prevalence of BE was 31.6% (95% confidence interval [CI] 29.5-33.6%) during pregnancy and 30.0% (95% CI 28.0-32.1%) at postpartum. The risk of exceeding the IOM's recommendation for gestational weight gain was 45% higher (RR 1.45, 95% CI 1.29-1.63) in women who had BE during pregnancy compared to those who did not. The risk of having postpartum weight retention above the 75th percentile was 33% higher (RR 1.33, 95% CI 1.10-1.59) among those with BE compared to those without. DISCUSSION Among these women with GDM, BE was frequent and was associated with excessive gestational weight gain and weight retention at postpartum. Thus, given the vulnerability of these periods of the life cycle, tracking this eating behavior is important for the management of gestational weight gain and for the prevention of excessive postpartum retention.
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Affiliation(s)
- Juliana Silvani
- Postgraduate Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Lenita Zajdenverg
- Diabetes and Nutrology Section, Internal Medicine Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leony Morgana Galliano
- Postgraduate Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Angélica Antunes Nunes
- Postgraduate Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Mason TB, Smith KE, Belcher BR, Dunton GF, Luo S. New Insights Into Causal Pathways Between the Pediatric Age-Related Physical Activity Decline and Loss of Control Eating: A Narrative Review and Proposed Conceptual Model. Front Psychol 2020; 11:578690. [PMID: 33154731 PMCID: PMC7591585 DOI: 10.3389/fpsyg.2020.578690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/14/2020] [Indexed: 01/01/2023] Open
Abstract
Research consistently suggests that loss of control (LOC) eating in children and adolescents is a key factor contributing to pediatric obesity and eating disorders. However, causes of pediatric LOC eating are yet unclear, and there is a lack of longitudinal research investigating the developmental processes contributing to LOC eating and related outcomes in youth. Physical activity is an understudied behavior that declines during middle childhood to adolescence and may exert an influence in the development of LOC eating via its impact on executive functioning. While physical activity levels and executive functioning have been linked to regulation of eating, no research has examined the mechanistic processes by which these domains may together impact LOC eating during childhood and adolescence. In the current narrative review, a model is proposed that suggests how physical activity and executive functioning influence LOC eating and related outcomes during childhood and adolescence. This model has the potential to influence future theoretical models of pediatric LOC eating and guide future prevention and intervention efforts.
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Affiliation(s)
- Tyler B. Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Kathryn E. Smith
- Department of Psychiatry and Behavioral Science, University of Southern California, Los Angeles, CA, United States
| | - Britni R. Belcher
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Genevieve F. Dunton
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Shan Luo
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
- Department of Medicine, University of Southern California, Los Angeles, CA, United States
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Egbert AH, Haedt-Matt A, Smith KE, Culbert K, Engel S, Goldschmidt AB. Momentary associations between positive affect dimensions and dysregulated eating during puberty in a diverse sample of youth with overweight/obesity. Int J Eat Disord 2020; 53:1667-1677. [PMID: 32706499 PMCID: PMC7878851 DOI: 10.1002/eat.23342] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/19/2020] [Accepted: 06/19/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The link between dysregulated positive affect and binge-eating behavior in youth with obesity is poorly understood. In addition, it is unclear how putative associations differ across developmental periods of rapid biological and emotional change, such as puberty, and in racial and ethnic minority youth, who are more likely to be overweight but are underrepresented in the literature. METHOD This study used a 2-week ecological momentary assessment protocol to examine independent and interactive effects of positive affect intensity/instability, and pubertal stage on two components of binge-eating behavior, loss of control eating (LOCE), and overeating. RESULTS Participants were 38 youth with overweight/obesity (ages 8-14 years; 78% African American/Hispanic). Positive affect instability was calculated using probability of acute change (PAC), representing the likelihood of extreme affective changes, and mean squared successive difference (MSSD), representing the average change in affect over successive recordings. There were no main effects of positive affect intensity on LOCE or overeating, but positive affect instability was negatively associated with overeating severity using both MSSD (p = .005) and PAC metrics (p = .001). However, moderation analyses including interactions with pubertal status revealed more extreme changes in positive affect (i.e., higher PAC) were related to greater overeating (p = .001) and LOCE severity (p = .043) in mid-late pubertal youth but not in pre-early pubertal youth. DISCUSSION Pubertal status may influence the association between disruptions in positive affect and dysregulated eating in youth, and positive affect instability may be important to consider in order to understand the emotional correlates of binge eating in youth with overweight/obesity.
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Affiliation(s)
- Amy H. Egbert
- Loyola University of Chicago,The Miriam Hospital/Alpert Medical School of Brown University
| | | | - Kathryn E. Smith
- Department of Psychiatry and Behavioral Science, University of Southern California
| | - Kristen Culbert
- Department of Family Medicine & Public Health Sciences, Wayne State University School of Medicine
| | - Scott Engel
- Center for Bio-behavioral Research, Sanford Research; Department of Psychiatry and Behavioral Science
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Ivezaj V, Lydecker JA, Wiedemann AA, Duffy AJ, Grilo CM. Does Bariatric Binge-Eating Size Matter? Conceptual Model and Empirical Support. Obesity (Silver Spring) 2020; 28:1645-1651. [PMID: 32729221 PMCID: PMC7484317 DOI: 10.1002/oby.22876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/09/2020] [Accepted: 05/01/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Bariatric surgery affects the quantity of food individuals can eat, yet some individuals still experience loss of control (LOC) while eating. This cross-sectional study examined a new classification system for binge/LOC eating following bariatric surgery. METHODS A total of 168 individuals who underwent bariatric surgery 6 months earlier and reported LOC eating were administered the Eating Disorder Examination-Bariatric Surgery Version interview and self-report measures of depressive symptoms, functional impairment, and physical and mental health-related quality of life. Three groups were created based on the largest LOC-eating episode determined by the Eating Disorder Examination-Bariatric Surgery Version interview as follows: (1) "traditional" objective binge-eating episodes, defined as eating unusually large quantities of food while having LOC; (2) "bariatric-objective binge eating," meaning unusually large quantities for postsurgical bariatric patients with LOC; and (3) "bariatric-subjective binge eating," meaning small quantities of food with LOC after surgery. RESULTS In total, 75% (n = 126) met criteria for the bariatric-objective binge episodes group, 10% (n = 17) met criteria for the traditional objective binge-eating group, and 15% (n = 25) met criteria for the bariatric-subjective binge episodes group. The three groups differed significantly, with a graded pattern by binge size, in global eating-disorder psychopathology, depressive symptoms, and functional impairment but not quality of life. CONCLUSIONS These findings provide empirical support for a new classification system for bariatric binge/LOC eating. Binge size was associated with distinct psychopathology. Longitudinal follow-up is needed to ascertain effects on clinical outcomes.
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Affiliation(s)
- Valentina Ivezaj
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Janet A. Lydecker
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | | | - Andrew J Duffy
- Yale School of Medicine, Department of Surgery, New Haven, CT, USA
| | - Carlos M. Grilo
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
- Yale University, Department of Psychology, New Haven, CT, USA
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Wiedemann AA, Ivezaj V, Lawson JL, Lydecker JA, Cooper Z, Grilo CM. Interrater reliability of the Eating Disorder Examination among postbariatric patients. Surg Obes Relat Dis 2020; 16:1988-1993. [PMID: 32933867 DOI: 10.1016/j.soard.2020.07.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/15/2020] [Accepted: 07/31/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Clinical assessment of eating behaviors with patients who undergo bariatric surgery is challenging because of the complexity of symptom presentation postoperatively. The Eating Disorder Examination (EDE) is a widely-used semistructured clinical interview of eating-disorder psychopathology, yet no studies have examined the interrater reliability among postoperative bariatric surgery patients. OBJECTIVES The present study aimed to examine the interrater reliability of the EDE, and an alternative classification of size-specific thresholds of binge-eating episodes in a postoperative bariatric surgery sample. SETTING University School of Medicine, United States. METHODS Participants interviewed were a randomly selected subset (n = 20) from a consecutive series of adults seeking treatment for eating concerns after bariatric surgery. Audio-taped interviews were rated independently by 1 of 4 expert raters. Interrater reliability was assessed using intraclass correlation coefficients (ICC) and kappa statistic. RESULTS ICCs for the original 4 EDE subscales were excellent, ranging from .88 to .98. ICCs for the alternative brief 3 subscales were also excellent, with a range of .78 to .97. ICCs for bariatric loss-of-control eating episodes were in the good to excellent range, with a range of .66 to .99. Kappa agreement for bariatric overeating episodes was moderate (.60). CONCLUSIONS These findings, based on 4 expert raters, suggest that complex eating-disorder psychopathology, as well as the newly proposed eating behavior with size thresholds relevant to bariatric patients, can be reliably assessed. To our knowledge, this is the first study to provide initial evaluation and support for the interrater reliability of the original EDE with additional modified eating categories developed for postbariatric surgery patients.
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Affiliation(s)
- Ashley A Wiedemann
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
| | - Valentina Ivezaj
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Jessica L Lawson
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; VA Connecticut Healthcare System, Orange, New Haven, Connecticut
| | - Janet A Lydecker
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Zafra Cooper
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Department of Psychology, Yale University, New Haven, Connecticut
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Romano KA, Heron KE, Amerson R, Howard LM, MacIntyre RI, Mason TB. Changes in disordered eating behaviors over 10 or more years: A meta-analysis. Int J Eat Disord 2020; 53:1034-1055. [PMID: 32415907 DOI: 10.1002/eat.23288] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The present meta-analysis evaluated changes in individuals' risk of engaging in distinct disordered eating behaviors (DEBs) in the long-term. METHOD Longitudinal studies assessing changes in DEBs via ≥2 assessments with a time lag of ≥10 years were included. Risk ratios were calculated for baseline to 10-14.9-year (M = 11.04) follow-up and baseline to ≥15-year (M = 18.62) follow-up changes in the use of binge eating, multiple purging, self-induced vomiting, laxatives, diuretics, diet pills, compensatory exercising, fasting/dieting, and multiple DEBs; Cohen's d was used for continuous binge-eating plus purging variable changes. Subgroup and meta-regression analyses tested whether eating disorder (ED) clinical sample versus nonclinical sample status, female versus male sex/gender, higher versus lower study bias, and baseline mean age and body mass index influenced overall effect magnitude for analyses with sufficient data. RESULTS Seventeen studies (26 [sub]samples) were included. Overall, individuals' risk of engaging in various restrictive eating and other compensatory behaviors decreased over time and the magnitudes of risk reductions for the use of certain compensatory DEBs were larger over longer follow-up durations. Specifically, for significant DEB change models, risk reductions spanned from 20.0-39.8% for 10-year follow-up and 24.7-74.8% for ≥15-year follow-up. However, nuances were found in the nature of these DEB changes as a function of DEB type, follow-up length, ED versus nonclinical sample composition, and baseline mean age. CONCLUSIONS These findings provide important information that can help identify treatment priorities and suggest that targeted and tailored preventative ED treatments warrant consistent implementation at the community-level, particularly for youth.
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Affiliation(s)
- Kelly A Romano
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA.,Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Kristin E Heron
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA.,Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Rachel Amerson
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Lindsay M Howard
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Rachel I MacIntyre
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
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Romano KA, Heron KE. Racial differences in overeating, loss of control eating, and binge eating: Extending core tenets of the Cognitive Behavioral Theory of Eating Disorders. Appetite 2020; 153:104747. [PMID: 32454077 DOI: 10.1016/j.appet.2020.104747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 05/15/2020] [Accepted: 05/17/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The present study examined racial differences in associations among body dissatisfaction, body checking, and dietary restraint relative to overeating, loss of control eating, and binge eating outcomes among college women. METHOD Young adult women (N = 903) at three Mid-Atlantic US institutions completed measures assessing negative body image and eating pathology via an online survey. Structural equation modeling was used to test a model examining associations among body dissatisfaction, body checking, dietary restraint, and disinhibited eating behaviors. Multigroup analyses examined whether these associations differed for women who identified as White (n = 432) versus Black (n = 359). RESULTS More frequent body checking explained associations between elevated body dissatisfaction and more frequent use of all three disinhibited eating outcomes for White and Black women, whereas restraint solely mediated an association between body dissatisfaction and overeating. The assessed constructs generally operated in a similar manner across racial groups. However, stronger associations among body dissatisfaction, restraint, and overeating, and between body checking and loss of control eating were identified for women who identified as White versus Black. CONCLUSIONS Eating disorder programming efforts targeting body checking behavior may prove useful in decreasing White and Black women's disinhibited eating.
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Affiliation(s)
- Kelly A Romano
- The Virginia Consortium Program in Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA.
| | - Kristin E Heron
- The Virginia Consortium Program in Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA; Old Dominion University, 250 Mills Godwin Building, Norfolk, VA, 23529, USA
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Altman DR, Tanofsky-Kraff M, Shank LM, Swanson TN, Ramirez E, Moore NA, Rubin SG, Byrne ME, LeMay-Russell S, Schvey NA, Kelly NR, Parker MN, Gubbi S, Brady SM, Yanovski SZ, Yanovski JA. Assessment of loss-of-control eating in healthy youth by interview and questionnaire. Int J Eat Disord 2020; 53:510-519. [PMID: 32202658 PMCID: PMC7217739 DOI: 10.1002/eat.23262] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate two questionnaires, an updated youth version of the questionnaire on eating and weight patterns (Questionnaire on Eating and Weight Patterns-5 Children/Adolescent [QEWP-C-5]) and the Loss-of-Control (LOC) Eating Disorder Questionnaire (LOC-ED-Q), against the Eating Disorder Examination (EDE) interview to assess the presence of LOC-eating among youth. METHOD Two-hundred and eighteen youths (12.8 ± 2.7 years) completed the QEWP-C-5, LOC-ED-Q, and EDE, depressive and anxiety questionnaires, and adiposity assessment. Sensitivity, specificity, positive-predictive value, negative-predictive value, and diagnostic accuracy were calculated; Cochran's Q and McNemar's tests were used to compare measures. Receiver operating characteristic area under the curve (AUC) analyses were performed. Mood and adiposity based on LOC-eating presence and absence based on each measure were examined. RESULTS The QEWP-C-5 and LOC-ED-Q demonstrated poor sensitivity (33%; 30%) and high specificity (95%; 96%) compared with the EDE. The AUCs suggested neither the QEWP-C-5 (0.64) nor the LOC-ED-Q (0.62) demonstrated acceptable diagnostic accuracy. Comparing distributions of LOC-eating presence between assessments, the QEWP-C-5 and EDE did not differ significantly (p = .10), while the LOC-ED-Q and EDE had significantly different distributions (p = .03). LOC-eating presence was associated with higher depressive and anxiety symptoms across all measures (ps < .02). Greater adiposity (ps < .02) was associated with LOC-eating presence on the EDE and LOC-ED-Q, and higher BMI z-score (p = .02) on the LOC-ED-Q. DISCUSSION Neither the QEWP-C-5 nor the LOC-ED-Q was sensitive for identifying LOC-eating presence as determined by the EDE, although both were associated with greater mood symptoms. Research is needed to improve self-report questionnaires to better screen for LOC-eating presence among pediatric populations.
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Affiliation(s)
- Deborah R. Altman
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD, 20814, USA
| | - Lisa M. Shank
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205,Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD, 20814, USA
| | - Taylor N. Swanson
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205,Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD, 20814, USA
| | - Eliana Ramirez
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Nia A. Moore
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sarah G. Rubin
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Meghan E. Byrne
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Sarah LeMay-Russell
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Natasha A. Schvey
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, and Prevention Science, College of Education, 5207 University of Oregon, Eugene, OR 97403-5207, USA
| | - Megan N. Parker
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Sriram Gubbi
- Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, MD, 20892, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Office of Obesity Research, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), DHHS, Bethesda, MD, 20892, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Correspondence to: Marian Tanofsky-Kraff, Ph.D., Professor, Department of Medical and Clinical Psychology and Medicine, USU, 4301 Jones Bridge Road, Bethesda, MD, 20814; ; Phone: 301-295-1482; Fax: 301-400-4296
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Ivezaj V, Wiedemann AA, Lawson JL, Grilo CM. Food Addiction in Sleeve Gastrectomy Patients with Loss-of-Control Eating. Obes Surg 2020; 29:2071-2077. [PMID: 30847764 DOI: 10.1007/s11695-019-03805-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Food addiction and binge eating share overlapping and non-overlapping features; the presence of both may represent a more severe obesity subgroup among treatment-seeking samples. Loss-of-control (LOC) eating, a key marker of binge eating, is one of the few consistent predictors of suboptimal weight outcomes post-bariatric surgery. This study examined whether co-occurring LOC eating and food addiction represent a more severe variant post-bariatric surgery. METHODS One hundred thirty-one adults sought treatment for weight/eating concerns approximately 6 months post-sleeve gastrectomy surgery. The Eating Disorder Examination-Bariatric Surgery Version assessed LOC eating, picking/nibbling, and eating disorder psychopathology. Participants completed the Yale Food Addiction Scale (YFAS), the Beck Depression Inventory-Second Edition (BDI-II), and the Short-Form Health Survey-36 (SF-36). RESULTS 17.6% met food addiction criteria on the YFAS. Compared to those without food addiction, the LOC group with food addiction reported significantly greater eating disorder and depression scores, more frequent nibbling/picking and LOC eating, and lower SF-36 functioning. CONCLUSION Nearly 18% of post-operative patients with LOC eating met food addiction criteria on the YFAS. Co-occurrence of LOC and food addiction following sleeve gastrectomy signals a more severe subgroup with elevated eating disorder psychopathology, problematic eating behaviors, greater depressive symptoms, and diminished functioning. Future research should examine whether this combination impacts long-term bariatric surgery outcomes.
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Affiliation(s)
- Valentina Ivezaj
- Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA.
| | | | - Jessica L Lawson
- Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA
| | - Carlos M Grilo
- Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA.,Yale University, New Haven, CT, 06511, USA
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Conceição EM, de Lourdes M, Peixoto AP, Pinto-Bastos A, Goldschmidt AB, Vaz AR. The utility of DSM-5 indicators of loss of control eating for the bariatric surgery population. EUROPEAN EATING DISORDERS REVIEW 2020; 28:423-432. [PMID: 32246543 DOI: 10.1002/erv.2737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/27/2020] [Accepted: 03/16/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVES This study investigated the utility of DSM-5 indicators of loss of control (LOC) eating in adult bariatric surgery patients who presented with binge-eating episodes. METHODS Participants (all women) were 40 preoperative and 28 postoperative bariatric surgery patients reporting objective binge eating (OBE), 46 preoperative and 52 postoperative with subjective binge-eating (SBE), 53 bulimia nervosa (BN) controls, and 34 binge-eating disorder (BED) controls. Face-to-face Eating Disorder Examination interviews and questionnaires were administered. ANOVA, T-test, χ 2 , and regressions compared the groups in terms of LOC indicators endorsed and to explain disordered eating psychopathology. RESULTS The indicator most commonly reported by bariatric patients with OBE was "feeling disgusted" (90% and 75% of pre- and postoperative groups), and the least endorsed was "eating alone" (40 and 28.6%). These indicators were reported by >84.9% of the BN and BED. Bariatric patients (pre- or post-surgery) with OBE only reported a higher number of indicators than patients with SBE only (t(150) = 2.34, p = .021). A higher number of indicators reported were associated with increased eating-related psychopathology (F(1,134) = 31.06, p < .001), but only for the post-surgery patients. CONCLUSIONS The LOC indicators proposed by DSM-5 need to be refined or revised for the bariatric population. Highlights Bariatric patients endorse fewer LOC indicators than BN or BED during a binge-eating episode. Some of the DSM-5 LOC indicators may not be suited to assess episodes of loss of control eating among bariatric patients. The Higher the number of LOC indicators reported, the higher the eating-related psychopathology.
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Affiliation(s)
| | | | - Ana P Peixoto
- School of Psychology, University of Minho, Braga, Portugal
| | | | - Andrea B Goldschmidt
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Ana R Vaz
- School of Psychology, University of Minho, Braga, Portugal
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Weinheimer EA, Chang A, Neubert SW, Wildes JE, Graham AK. Past, current, and future willingness to engage with treatment targets: Applying user-centered design to inform the design of a mobile behavioral intervention. Int J Eat Disord 2020; 53:611-617. [PMID: 32112592 PMCID: PMC7271441 DOI: 10.1002/eat.23252] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE User-centered design can improve engagement with and the potential efficacy of behavioral interventions, but is underutilized in health care. This work demonstrates how design methodologies can inform the design of a mobile behavioral intervention for binge eating and obesity. METHOD A needs assessment was conducted with end-users (N = 22 adults with obesity and recurrent binge eating [≥12 episodes in 3 months] who were interested in losing weight and addressing binge eating), which included assessing participants' past/current and future willingness to engage with 20 treatment targets for managing binge eating and weight. Targets focused on improving dietary intake, increasing physical activity, and reducing overvaluation of weight and/or shape, unhealthy weight control practices, and negative affect. RESULTS Participants' past and current use of targets varied. For all targets except those addressing unhealthy weight control practices, on average, participants had increasing levels of willingness to try targets. Among participants not currently using a target, at least some were willing to use every target again. DISCUSSION Findings inform ways to personalize how users begin treatment. Furthermore, this study exemplifies how user-centered design can inform ways to ensure that digital interventions are designed to meet end-users' needs to improve engagement and clinical impact.
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Affiliation(s)
| | - Angela Chang
- Center for Behavioral Intervention Technologies, Northwestern University,Department of Medical Social Sciences, Northwestern University
| | | | - Jennifer E. Wildes
- Department of Psychiatry & Behavioral Neuroscience, The University of Chicago
| | - Andrea K. Graham
- Center for Behavioral Intervention Technologies, Northwestern University,Department of Medical Social Sciences, Northwestern University,Address correspondence to Andrea K. Graham, PhD, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL 60611; Phone: 312-503-5266;
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Veronda AC, Allison KC, Crosby RD, Irish LA. Development, validation and reliability of the Chrononutrition Profile - Questionnaire. Chronobiol Int 2020; 37:375-394. [PMID: 31760843 PMCID: PMC7332160 DOI: 10.1080/07420528.2019.1692349] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/10/2019] [Indexed: 12/11/2022]
Abstract
Chrononutrition, or the circadian timing of food intake, has garnered attention as a topic of study due to its associations with health (e.g. weight gain); however, a valid and reliable assessment of chrononutrition in daily life has not yet been developed. This paper details the development and initial reliability and validity testing of the Chrononutrition Profile - Questionnaire (CP-Q). The CP-Q assesses six components of chrononutrition that are likely to influence health (breakfast skipping, largest meal, evening eating, evening latency, night eating, and eating window). This questionnaire is designed to assess general chrononutrition behaviors and preferred timing of food intake. The CP-Q can be used as a sole evaluation of chrononutrition, and can also be utilized in conjunction with existing dietary measures to provide a comprehensive assessment of one's eating behaviors. This measure offers health-care professionals, researchers, and stakeholders a cost-effective and comprehensive method of evaluating chrononutrition and identifying targets for health improvement.
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Affiliation(s)
- Allison C. Veronda
- Department of Psychology, North Dakota State University, Fargo, ND, United States
| | - Kelly C. Allison
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Ross D. Crosby
- Sanford Center for Biobehavioral Research, Sanford Research, Fargo, ND, United States
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, United States
| | - Leah A. Irish
- Department of Psychology, North Dakota State University, Fargo, ND, United States
- Sanford Center for Biobehavioral Research, Sanford Research, Fargo, ND, United States
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Naturalistic, multimethod exploratory study of sleep duration and quality as predictors of dysregulated eating in youth with overweight and obesity. Appetite 2019; 146:104521. [PMID: 31751632 DOI: 10.1016/j.appet.2019.104521] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 11/07/2019] [Accepted: 11/17/2019] [Indexed: 12/14/2022]
Abstract
Although poor sleep has been found to adversely impact eating and weight regulation in youth, past research is limited by retrospective reporting and/or non-naturalistic designs. We investigated the feasibility of combining three momentary, ecologically valid approaches to assessing sleep and eating behavior, and associations between these constructs, among youth (aged 8-14y) with overweight/obesity (n = 40). Participants completed 14 overlapping days of actigraphy assessment and smartphone-based ecological momentary assessment (EMA) of eating behavior, of which 3 days also included computerized, self-guided 24-h dietary recall. Feasibility of completing measures concurrently was evaluated by generating frequencies of compliance. Associations between sleep indices and next-day eating behavior were examined via generalized estimating equations. Of 29 participants who provided EMA and 24-h recall data that aligned with previous night actigraphy data, both EMA and sleep data were available on an average of 8.6 out of 14 possible days, and both 24-h recall and sleep data on an average of 2.7 out of 3 possible days. Each additional hour of sleep was associated with consuming fewer calories from solid fats, alcohol, and added sugars (b = 0.70; p = .04). Combining naturalistic, momentary assessments of sleep and eating behavior appears to be acceptable in youth. Larger experimental studies are needed to further understand associations between sleep parameters and eating behavior.
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Goldschmidt AB, Dickstein DP, MacNamara AE, Phan KL, O'Brien S, Le Grange D, Fisher JO, Keedy S. A Pilot Study of Neural Correlates of Loss of Control Eating in Children With Overweight/Obesity: Probing Intermittent Access to Food as a Means of Eliciting Disinhibited Eating. J Pediatr Psychol 2019; 43:846-855. [PMID: 29462339 DOI: 10.1093/jpepsy/jsy009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 02/01/2018] [Indexed: 11/12/2022] Open
Abstract
Objective Neural substrates of loss of control (LOC) eating are undercharacterized. We aimed to model intermittent access to food to elicit disinhibited eating in youth undergoing neuroimaging, given evidence that restricted food access may increase subsequent food intake via enhancing reward value of food and diminishing eating-related self-control. Methods Participants were 18 preadolescents (aged 9-12 years) who were overweight/obese with recent LOC eating (OW-LOC; n = 6); overweight/obese with no history of LOC eating (OW-CON; n = 5); or non-overweight with no history of LOC eating (NW-CON; n = 7). Participants underwent functional magnetic resonance imaging during a simulated food restriction paradigm in which they were alternately given restricted or unrestricted access to milkshake solutions. Results There were no significant main effects of restricted versus unrestricted access to milkshake flavors. Group main effects revealed increased activation for OW-LOC relative to OW-CON in areas related to attentional processes (right middle frontal gyrus), inhibitory control/attentional shifts (right and left cuneus), and emotion regulation (left cingulate gyrus); and for OW-LOC relative to NW-CON in areas related to response inhibition (right inferior frontal gyrus). Significant block type × group interaction effects were found for the right middle frontal gyrus, left cingulate gyrus, and left cuneus, but these appeared to be accounted for primarily by group. Discussion There were clear group differences in neural activity in brain regions related to self-regulation during a food restriction paradigm. Elevations in these regions among OW-LOC relative to OW-CON and NW-CON, respectively, may suggest that youth with LOC eating expended more cognitive effort to regulate ingestive behavior.
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Affiliation(s)
| | | | | | - K Luan Phan
- Departments of Psychiatry, Psychology, Anatomy, & Cell Biology, and Graduate Program in Neuroscience, University of Illinois at Chicago
| | | | | | | | - Sarah Keedy
- Psychiatry & Behavioral Neuroscience, University of Chicago
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Disordered eating after bariatric surgery: clinical aspects, impact on outcomes, and intervention strategies. Curr Opin Psychiatry 2019; 32:504-509. [PMID: 31343419 PMCID: PMC6768715 DOI: 10.1097/yco.0000000000000549] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Disordered eating behaviors (DEBs) are associated with poor weight outcomes following bariatric surgery. We describe DEBs most relevant to this population, their associations with weight outcomes, and emerging data on interventions for DEBs. RECENT FINDINGS Loss of control eating episodes and grazing have been the most well studied DEBs in bariatric samples. Although DEBs often remit after surgery even without targeted intervention, a subgroup of patients have persistent or newly developed DEBs postoperatively. Preoperative DEBs have little effect on weight outcomes, whereas preoperative impulse control-related features commonly associated with DEBs (e.g., inhibitory control) may have stronger predictive value. Postoperatively, DEBs appear to exert robust effects on concurrently measured weight. Postoperative interventions hold promise for optimizing treatment outcomes. SUMMARY We recommend the following to improve clinical care and move research forward: a common language for DEB constructs is needed to improve cross-talk among researchers and care providers; diagnostic schemes and assessment tools may require tailoring for the bariatric population; mechanisms underlying improvements in DEBs following surgery should be clarified; ongoing monitoring of DEBs in the postoperative period is warranted; and a stepped-care approach may improve weight outcomes in a cost-effective manner.
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Chao AM, Wadden TA, Walsh OA, Gruber KA, Alamuddin N, Berkowitz RI, Shaw Tronieri J. Perceptions of a large amount of food based on binge-eating disorder diagnosis. Int J Eat Disord 2019; 52:801-808. [PMID: 30927476 PMCID: PMC6609473 DOI: 10.1002/eat.23076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined what adults with binge-eating disorder (BED) and obesity perceived as the threshold for a large amount of food and how their evaluations compared to ratings by participants with obesity but without BED. METHOD This was a cross-sectional study of 150 participants with obesity. BED was assessed using the Questionnaire on Eating and Weight Patterns and confirmed via interview. Participants completed the Eating Patterns Questionnaire and Eating Inventory. RESULTS Participants with BED had significantly higher thresholds for a large amount of food relative to those without BED. Compared to participants without BED, those with BED had significantly higher thresholds on 13 of the 22 food items. In the overall sample, being male and having higher hunger scores were associated with greater thresholds. DISCUSSION Individuals with obesity and BED had larger portion standards than participants without BED. Individuals with BED may benefit from interventions targeted toward decreasing perceptions of portion sizes.
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Affiliation(s)
- Ariana M. Chao
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA;,Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Thomas A. Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Olivia A. Walsh
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Kathryn A. Gruber
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Naji Alamuddin
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Robert I. Berkowitz
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA;,Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Science, Philadelphia, PA, USA
| | - Jena Shaw Tronieri
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
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76
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Goldschmidt AB, Smith KE, Lavender JM, Engel SG, Haedt-Matt A. Trait-level facets of impulsivity and momentary, naturalistic eating behavior in children and adolescents with overweight/obesity. J Psychiatr Res 2019; 110:24-30. [PMID: 30580080 PMCID: PMC6360116 DOI: 10.1016/j.jpsychires.2018.12.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 01/08/2023]
Abstract
Impulsivity, and specific subdomains of inhibitory control and reward sensitivity, are trait-level factors that have been implicated in the onset and maintenance of pediatric obesity and disordered eating, but their associations with real-world eating behavior are unknown. We investigated associations of these trait-level constructs with naturalistic, momentary measures of loss of control (LOC) eating and overeating severity in a heterogeneous sample of youth (n = 40), aged 8-14y, with overweight/obesity. Self-report, parent-report, and behavioral data on trait-level impulsivity, reward sensitivity, and inhibitory control, respectively, were collected in the context of a 14-day ecological momentary assessment (EMA) protocol in which participants reported on their eating behavior, mood, hunger, and palatability of foods consumed in real-time. Generalized estimating equations revealed that more perseverative errors on a behavioral measure of visuomotor processing speed and a lower self-reported tendency to act without thinking (at a trend level) were related to greater overall LOC severity. Momentary associations between negative affect and LOC severity were stronger among individuals with greater perseverative errors. Results suggest that trait-level facets of impulsivity may directly influence an individual's tendency to engage in dysregulated eating behaviors, and may also impact susceptibility to state-level factors associated with occurrence of these behaviors. Momentary interventions for LOC eating may require tailoring to address temperamental factors related to impulsivity and inhibitory control.
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Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Weight Control and Diabetes Research Center, 196 Richmond St., Providence, RI, 02903, USA.
| | - Kathryn E Smith
- Sanford Research, 120 8th St. South, Fargo, ND, 58103, USA; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, 1919 Elm St. North, Fargo, ND, 58102, USA
| | - Jason M Lavender
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA; Department of Psychology, Illinois Institute of Technology, 3424 South State St., Chicago, IL, 60616, USA
| | - Scott G Engel
- Sanford Research, 120 8th St. South, Fargo, ND, 58103, USA; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, 1919 Elm St. North, Fargo, ND, 58102, USA
| | - Alissa Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, 3424 South State St., Chicago, IL, 60616, USA
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77
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Vainik U, García-García I, Dagher A. Uncontrolled eating: a unifying heritable trait linked with obesity, overeating, personality and the brain. Eur J Neurosci 2019; 50:2430-2445. [PMID: 30667547 DOI: 10.1111/ejn.14352] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 12/21/2018] [Accepted: 01/08/2019] [Indexed: 12/21/2022]
Abstract
Many eating-related psychological constructs have been proposed to explain obesity and overeating. However, these constructs, including food addiction, disinhibition, hedonic hunger, emotional eating, binge eating and the like all have similar definitions, emphasizing loss of control over intake. As questionnaires measuring the constructs correlate strongly (r > 0.5) with each other, we propose that these constructs should be reconsidered to be part of a single broad phenotype: uncontrolled eating. Such an approach enables reviewing and meta-analysing evidence obtained with each individual questionnaire. Here, we describe robust associations between uncontrolled eating, body mass index (BMI), food intake, personality traits and brain systems. Reviewing cross-sectional and longitudinal data, we show that uncontrolled eating is phenotypically and genetically intertwined with BMI and food intake. We also review evidence on how three psychological constructs are linked with uncontrolled eating: lower cognitive control, higher negative affect and a curvilinear association with reward sensitivity. Uncontrolled eating mediates all three constructs' associations with BMI and food intake. Finally, we review and meta-analyse brain systems possibly subserving uncontrolled eating: namely, (i) the dopamine mesolimbic circuit associated with reward sensitivity, (ii) frontal cognitive networks sustaining dietary self-control and (iii) the hypothalamus-pituitary-adrenal axis, amygdala and hippocampus supporting stress reactivity. While there are limits to the explanatory and predictive power of the uncontrolled eating phenotype, we conclude that treating different eating-related constructs as a single concept, uncontrolled eating, enables drawing robust conclusions on the relationship between food intake and BMI, psychological variables and brain structure and function.
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Affiliation(s)
- Uku Vainik
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.,Institute of Psychology, University of Tartu, Tartu, Estonia
| | | | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
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78
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Vainik U, Eun Han J, Epel ES, Janet Tomiyama A, Dagher A, Mason AE. Rapid Assessment of Reward-Related Eating: The RED-X5. Obesity (Silver Spring) 2019; 27:325-331. [PMID: 30677261 PMCID: PMC6352904 DOI: 10.1002/oby.22374] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/30/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The prevalence of obesity has created a plethora of questionnaires characterizing psychological aspects of eating behavior, such as reward-related eating (RRE). The Reward-based Eating Drive questionnaires (RED-9, RED-13) broadly and deeply assess the RRE construct. However, large-sample research designs require shorter questionnaires that capture RRE quickly and precisely. This study sought to develop a brief, reliable, and valid version of the RED questionnaire. METHODS All-subset correlation was used to find a subset that maximally associated with the full RED-13 in two separate samples. Results were validated in a third independent sample. Internal consistency, test-retest reliability, and ability to explain variance in external outcomes were also assessed. RESULTS A five-item questionnaire (RED-X5) correlated strongly with RED-13 in the independent sample (r = 0.95). RED-X5 demonstrated high internal consistency (omega total ≥ 0.80) and 6-month test-retest reliability (r = 0.72). RED-X5 accurately reproduced known associations between RED-13 and BMI, diabetes status, and craving for sweet and savory foods. As a novel finding, RED questionnaires predicted laboratory intake of chips. CONCLUSIONS RED-X5 is a short, reliable, and valid measure of the RRE construct and can be readily implemented in large-sample research designs in which questionnaire space is limited.
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Affiliation(s)
- Uku Vainik
- Montreal Neurological Institute, McGill University, Montreal, Canada
- Institute of Psychology, University of Tartu, Tartu, Estonia
| | - Jung Eun Han
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Elissa S. Epel
- UCSF Department of Psychiatry, Center for Health and Community, San Francisco, USA
- UCSF Osher Center for Integrative Medicine, San Francisco, USA
| | - A. Janet Tomiyama
- Department of Psychology, University of California Los Angeles, Los Angeles, USA
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Ashley E. Mason
- UCSF Department of Psychiatry, Center for Health and Community, San Francisco, USA
- UCSF Osher Center for Integrative Medicine, San Francisco, USA
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79
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Goldschmidt AB, Cotton BP, Mackey S, Laurent J, Bryson WC, Bond DS. Prevalence and Correlates of Loss of Control Eating among Adults Presenting for Methadone Maintenance Treatment. Int J Behav Med 2019; 25:693-697. [PMID: 30259293 DOI: 10.1007/s12529-018-9750-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Research suggests that substance use disorders and disordered eating are often comorbid. In light of the ongoing opioid epidemic, the purpose of the current study was to understand the prevalence and health-related correlates of loss of control (LOC) eating in adults seeking methadone maintenance treatment primarily for addiction to heroin and/or painkillers. METHODS Participants were 447 adults surveyed at presentation for methadone maintenance treatment who responded to survey items on LOC eating. Descriptive statistics were used to investigate the prevalence of engaging in LOC eating in the past 2 weeks. Chi-square tests, t tests, and analyses of covariance were used to compare individuals with (LOC+; n = 164) and without (LOC-; n = 283) recent LOC eating on psychosocial, pain-related, and weight-related characteristics. RESULTS Approximately one third of respondents endorsed LOC eating in the past 2 weeks. These participants reported greater affective symptoms, interpersonal dysfunction, pain intensity, and pain interference than the LOC- group (Cohen's d effect size range = .24-.94). LOC+ was also more likely to have engaged in recent illicit drug use and to report having concurrent overweight/obesity (φ effect size range = .09-.10). CONCLUSION The prevalence of LOC eating in adults seeking methadone maintenance treatment was more than triple what has been reported in previous studies using community samples. Given its associations with other health-related variables, the presence of LOC eating may be a marker for more severe psychopathology in individuals seeking methadone maintenance treatment. Future research is needed to understand mechanisms explaining this comorbidity and to develop novel ways to prevent and treat their co-occurrence.
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Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital, Weight Control and Diabetes Research Center, 196 Richmond Street, Providence, RI, 02903, USA.
| | - Brandi P Cotton
- College of Nursing, The University of Rhode Island, White Hall, 39 Butterfield Road, Kingston, RI, 02881, USA
| | - Scott Mackey
- Department of Psychiatry, The University of Vermont Larner College of Medicine, 1 South Prospect Street, Burlington, VT, 05401, USA
| | - Jennifer Laurent
- Department of Nursing, The University of Vermont College of Nursing and Health Sciences, 204 Rowell Hall, Burlington, VT, 05405, USA
| | - William C Bryson
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| | - Dale S Bond
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital, Weight Control and Diabetes Research Center, 196 Richmond Street, Providence, RI, 02903, USA
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80
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Hazzard VM, Hahn SL, Bauer KW, Sonneville KR. Binge eating-related concerns and depressive symptoms in young adulthood: Seven-year longitudinal associations and differences by race/ethnicity. Eat Behav 2019; 32:90-94. [PMID: 30665179 PMCID: PMC8253512 DOI: 10.1016/j.eatbeh.2019.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 01/10/2019] [Accepted: 01/13/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To examine longitudinal associations between binge eating-related concerns (i.e., cognitions associated with binge eating, such as embarrassment over amount eaten and fear of losing control over eating) and depressive symptoms among U.S. young adults and assess whether associations differ by race/ethnicity. METHODS This study used longitudinal data from Waves III (baseline; mean age = 21.77 years) and IV (follow-up; mean age = 28.76 years) of the National Longitudinal Study of Adolescent to Adult Health (N = 12,040). Linear regression models were run to examine associations between binge eating-related concerns at baseline and depressive symptoms at follow-up, adjusting for demographic covariates, baseline body mass index, and baseline depressive symptoms. RESULTS At baseline, 5.9% of participants reported embarrassment over amount eaten, 2.1% reported fear of losing control over eating, and 0.9% reported both binge eating-related concerns. In adjusted models, embarrassment over amount eaten (B = 0.81, p < .001), fear of losing control over eating (B = 1.57, p < .001), and endorsement of both binge eating-related concerns (B = 1.75, p < .001) at baseline were associated with higher depressive symptoms seven years later. The association between fear of losing control over eating and depressive symptoms differed by race/ethnicity (p = .001). Fear of losing control over eating was associated with higher depressive symptoms among non-Hispanic whites (B = 2.51, p < .001) and Asians/Pacific Islanders (B = 2.54, p = .009) but not among non-Hispanic blacks (B = -0.55, p = .48) or Hispanics/Latinos (B = -0.11, p = .92). DISCUSSION Binge eating-related concerns may contribute to depression risk among young adults, particularly among non-Hispanic whites and Asians/Pacific Islanders. Early identification of these cognitions and early intervention may help reduce depression risk in young adulthood.
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81
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Plateau CR, Bone S, Lanning E, Meyer C. Monitoring eating and activity: Links with disordered eating, compulsive exercise, and general wellbeing among young adults. Int J Eat Disord 2018; 51:1270-1276. [PMID: 30508261 DOI: 10.1002/eat.22966] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/29/2018] [Accepted: 09/19/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To explore the relationships between the use of food intake and activity monitoring tools with compulsive exercise, eating psychopathology, and psychological wellbeing. METHOD Participants (N = 352; mean age 21.90 years) indicated their use of activity and food intake monitoring tools, and completed the Compulsive Exercise Test (CET), Eating Disorders Examination Questionnaire (EDE-Q), and the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS). RESULTS Users of monitoring tools reported significantly higher CET and EDE-Q scores than nonusers. Positive associations were detected between the frequency of activity monitoring tool use with CET and EDE-Q scores. Participants who reported using monitoring tools primarily to manage weight and shape reported higher levels of eating and compulsive exercise psychopathology than those who reported using tools to improve health and fitness. DISCUSSION Features of compulsive exercise and eating psychopathology are elevated among users of food intake and activity monitoring tools; and particularly among those who report using the tools for weight and shape purposes. Longitudinal and experimental research is needed to further our understanding of these observed associations, and specifically to explore the prospective relationships between monitoring tool use, eating psychopathology, and compulsive exercise.
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Affiliation(s)
- Carolyn R Plateau
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Sarah Bone
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Emily Lanning
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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82
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Bodell LP, Forney KJ, Chavarria J, Keel PK, Wildes JE. Self-report measures of loss of control over eating: Psychometric properties in clinical and non-clinical samples. Int J Eat Disord 2018; 51:1252-1260. [PMID: 30265751 PMCID: PMC11037076 DOI: 10.1002/eat.22957] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/17/2018] [Accepted: 08/25/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Research evidence supports the clinical significance of subjective feelings of loss of control over eating; however, limited attention has been given to how this construct is assessed. Two measures have been developed in recent years (i.e., Eating Loss of Control Scale [ELOC] and Loss of Control over Eating Scale [LOCES]), but further validation in clinical and non-clinical samples is needed. METHOD The current study evaluated the psychometric properties, including factor structure, criterion validity, and measurement invariance of the ELOC and LOCES across two groups: (a) a clinical sample of individuals with eating disorders (n = 106) and (b) a non-clinical sample of college students (n = 321). RESULTS Confirmatory factor analyses indicated that the 16-item version of the ELOC and 7-item brief version of the LOCES provided good fit to the data in both samples. These measures were highly correlated (r = .83-.87) and associated with binge-eating and related psychopathology. The ELOC demonstrated partial invariance between men and women and between the clinical and non-clinical samples. The LOCES-brief demonstrated full invariance between men and women and partial invariance between the clinical and non-clinical samples. DISCUSSION Findings suggest that the 16-item ELOC and 7-item LOCES are reliable measures of severity of loss of control eating in clinical and non-clinical samples. Given the brevity of the LOCES-brief and evidence for measurement invariance across sex, it is recommended over the ELOC in heterogeneous samples. Future research is needed to confirm the validity of these measures across individuals with and without eating disorders.
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Affiliation(s)
- Lindsay P. Bodell
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - Katherine Jean Forney
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Jesus Chavarria
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Jennifer E. Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
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83
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Goldschmidt AB, Smith KE, Crosby RD, Boyd HK, Dougherty E, Engel SG, Haedt-Matt A. Ecological momentary assessment of maladaptive eating in children and adolescents with overweight or obesity. Int J Eat Disord 2018; 51:549-557. [PMID: 29626353 PMCID: PMC6002915 DOI: 10.1002/eat.22864] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/15/2018] [Accepted: 03/15/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Contextual factors related to maladaptive eating behavior in youth with overweight/obesity are poorly understood. This pilot study sought to elucidate immediate internal and external cues related to perceptions of overeating and loss of control (LOC) over eating in a heterogeneous sample of children and adolescents with overweight/obesity assessed in their natural environments. METHOD Community-based youth [N = 40; 55% female (n = 22)], aged 8-14 y (M age = 11.2 ± 1.9 y), with overweight/obesity (M z-BMI = 2.07 ± 0.49) reported on all eating episodes and their physiological, environmental, affective, and interpersonal antecedents and correlates via ecological momentary assessment over a 2-week period. Generalized estimating equations were used to assess the relationship between contextual variables and degree of overeating and LOC. RESULTS Eating occasions involving greater food hedonics (i.e., perceived palatability of food being consumed) were associated with greater LOC severity (within-subjects effect: B = 0.01, p = .015), although youth with lower overall levels of food hedonics reported higher LOC severity ratings on average (between-subjects effect: B = -0.04, p = .005). Youth reporting higher overall cravings reported higher average ratings of LOC severity (between-subjects effect: B = 0.20, p = .001). Finally, youth reporting greater overall influence of others on eating behavior evidenced greater average levels of overeating severity (between-subjects effect: B = 0.17, p < .001). DISCUSSION Eating-related factors appear to be most strongly associated with LOC severity, while environmental factors were most associated with overeating severity. Interventions targeting maladaptive eating in youth with overweight/obesity may benefit from helping youth incorporate palatable foods and satisfy cravings in a planned and controlled manner, and enhancing awareness of social-contextual effects on eating.
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Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Weight Control and Diabetes Research Center/The Miriam Hospital, Providence, RI
| | - Kathryn E. Smith
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Ross D. Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Hope K. Boyd
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medicine, Chicago, IL
| | | | - Scott G. Engel
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Alissa Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, Chicago, IL
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84
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Conceição EM, de Lourdes M, Pinto-Bastos A, Vaz AR, Brandão I, Ramalho S. Problematic eating behaviors and psychopathology in patients undergoing bariatric surgery: The mediating role of loss of control eating. Int J Eat Disord 2018; 51:507-517. [PMID: 29663468 DOI: 10.1002/eat.22862] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/10/2018] [Accepted: 03/11/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study compares different problematic eating behaviors (PEBs; objective [OBE]/subjective [SBE] binge-eating and compulsive [CG]/noncompulsive [NCG] grazing) in relation to the severity of loss of control (LOC) and psychopathology. We also investigate LOC as a mediator between PEBs and psychopathology. METHOD This cross-sectional study assessed a group of patients before bariatric surgery (n = 163), and a group of bariatric patients 12 months or more after surgery (n = 131). Face-to-face assessment: Eating Disorders Examination for binge-eating episodes; Rep(eat) for grazing. LOC was measured by five questions answered in a 5-point Likert scale. Self-report measures: disordered eating, grazing, negative urgency, depression, anxiety, and stress. RESULTS OBEs were reported by 26(8.8%), SBE by 29(9.8%), CG by 35(11.9%), and NCG by 36(12.2%) of patients. The different PEBs differed significantly in the severity of LOC (F(3,120)= 25.81, p < .001). Patients reporting OBEs scored higher and patients with NCG scored lower in most measures than patients with other PEBs. Patients with any PEBs scored higher in all self-report measures than those not reporting any PEBs, with statistical significance reached for uncontrolled eating (F(4,288)= 20.21, p < .001), emotional eating (F(4,288)= 23.10, p < .001), repetitive eating F(4,288)= 18.34, p < .001), and compulsive grazing (F(4,288)= 27.14, p < .001). LOC was found to be a full mediator between PEBs and psychopathology. DISCUSSION There is no evidence that the different PEBs differ in the psychopathology severity, independently of the experience of LOC eating during the eating episodes. We show evidence for the conceptualization of different PEB, including grazing, on a continuous scale of LOC and psychopathology.
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Affiliation(s)
- Eva M Conceição
- School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Ana Pinto-Bastos
- School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Ana Rita Vaz
- School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Isabel Brandão
- Faculty of Medicine, University of Porto, Centro Hospitalar de São João, Porto, Portugal
| | - Sofia Ramalho
- School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
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85
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Vannucci A, Ohannessian CM. Psychometric properties of the brief loss of control over eating scale (LOCES-B) in early adolescents. Int J Eat Disord 2018; 51:459-464. [PMID: 29469930 DOI: 10.1002/eat.22845] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 02/05/2018] [Accepted: 02/06/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the psychometric properties of the brief loss of control over eating scale (LOCES-B) in a community sample of adolescents. METHOD Participants were 1,116 adolescents (11-15 years; 53% girls; 53% non-Hispanic White) recruited from middle schools in the Northeast United States. Participants were administered self-report surveys during school in the fall of 2016. RESULTS Confirmatory factor analyses indicated that the LOCES-B total score was unidimensional, which was invariant across gender and weight status. The LOCES-B had excellent internal consistency (α = .92). The LOCES-B total score had large, positive relationships with the frequency of LOC eating episodes, objective bulimic episodes, and subjective bulimic episodes, and a small, positive relationship with objective overeating episode frequency. After adjusting for demographics, anthropometrics, and LOC eating frequency, adolescents reporting higher scores on the LOCES-B total score had greater body image dissatisfaction, more internalizing symptoms, and lower trait effortful control. DISCUSSION Findings suggested that the LOCES-B is a reliable and valid measure of LOC eating in early adolescents. The availability of the LOCES-B has the potential to elucidate the developmental trajectories, predictors, and outcomes of LOC eating across the full severity spectrum in large cohort studies of youth.
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Affiliation(s)
- Anna Vannucci
- Center for Behavioral Health, Connecticut Children's Medical Center, Hartford, Connecticut, 06106
| | - Christine McCauley Ohannessian
- Center for Behavioral Health, Connecticut Children's Medical Center, Hartford, Connecticut, 06106.,Department of Pediatrics and Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, 06030
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86
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Goode RW, Kalarchian MA, Craighead L, Conroy MB, Wallace J, Eack SM, Burke LE. The feasibility of a binge eating intervention in Black women with obesity. Eat Behav 2018; 29:83-90. [PMID: 29549863 PMCID: PMC5935580 DOI: 10.1016/j.eatbeh.2018.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 02/20/2018] [Accepted: 03/08/2018] [Indexed: 12/21/2022]
Abstract
INTRODUCTION U.S. Black women have the highest rates of obesity and report frequent binge eating behaviors. To our knowledge, no intervention research has aimed to treat binge eating specifically among Black women. The purpose of this study was to investigate the feasibility and preliminary effect of Appetite Awareness Treatment (AAT), an 8-week cognitive-behavioral binge eating intervention, among Black women with obesity, and who report binge eating. METHODS Participants (N = 31), had a mean (±SD) age of 48.8 ± 12.8 years, a body mass index of 33.7 ± 3.9 kg/m2, and reported at least one binge eating episode monthly over the last three months. Using a randomized controlled trial design, Black women were randomized to AAT or a wait-list control group (WAIT) group. We examined recruitment, attendance, retention, and adherence. Linear mixed models explored preliminary differences between the AAT and WAIT on the primary outcome variables of binge eating and eating self-efficacy measured at baseline and 8-weeks. RESULTS Approximately one-third of screened participants were eligible and did enroll. Participants completed 55% of homework assignments, and attended 59% of intervention sessions. Retention to AAT was 87.5%. Compared to participants in the WAIT group, AAT participants had greater decreases in binge eating scores and greater improvements in eating self-efficacy scores at the end of Week 8. CONCLUSION Results suggest that AAT is feasible among Black women with binge eating behaviors, with evidence of preliminary efficacy, providing a rationale for a trial of AAT in a larger sample of Black women.
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Affiliation(s)
- Rachel W. Goode
- Schools of Social Work and Nursing, 2117 Cathedral of Learning, Pittsburgh, PA 15260 University of Pittsburgh,School of Social Work, University of North Carolina at Chapel Hill; 325 Pittsboro Street; CB #3550; Chapel Hill, NC 27599-3550
| | - Melissa A. Kalarchian
- School of Nursing, Duquesne University; Fisher Hall, 600 Forbes Avenue, Pittsburgh, PA 15282
| | - Linda Craighead
- Department of Psychology, Emory University; 201 Dowman Drive; Atlanta, GA 30322
| | - Molly B. Conroy
- Division of General Internal Medicine, University of Utah, 30 N 1900E.; Room 9R218; Salt Lake City, Utah 84132
| | - John Wallace
- Schools of Social Work and Nursing, 2117 Cathedral of Learning, Pittsburgh, PA 15260 University of Pittsburgh
| | - Shaun M. Eack
- Schools of Social Work and Nursing, 2117 Cathedral of Learning, Pittsburgh, PA 15260 University of Pittsburgh
| | - Lora E. Burke
- Schools of Social Work and Nursing, 2117 Cathedral of Learning, Pittsburgh, PA 15260 University of Pittsburgh
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87
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Christoph MJ, Loth KA, Eisenberg ME, Haynos AF, Larson N, Neumark-Sztainer D. Nutrition Facts Use in Relation to Eating Behaviors and Healthy and Unhealthy Weight Control Behaviors. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:267-274.e1. [PMID: 29276019 PMCID: PMC5845784 DOI: 10.1016/j.jneb.2017.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 11/06/2017] [Accepted: 11/09/2017] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Investigate the relationship between use of Nutrition Facts labels on packaged foods and weight-related behaviors. DESIGN Cross-sectional survey in 2015-2016. PARTICIPANTS Young adult respondents (n = 1,817; 57% women; average age 31.0 ± 1.6 years) to the Project Eating and Activity in Teens and Young Adults-IV survey, the fourth wave of a longitudinal cohort study. VARIABLES MEASURED Use of Nutrition Facts labels on packaged foods; healthy, unhealthy, and extreme weight control behaviors; intuitive eating; binge eating. ANALYSIS Linear and logistic regression models were adjusted for age, ethnicity/race, education, income, and weight status. RESULTS In women, greater Nutrition Facts use was associated with a 23% and 10% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a 17% greater chance of engaging in binge eating. In men, greater label use was associated with a 27% and 17% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a lower level of intuitive eating. CONCLUSIONS AND IMPLICATIONS Professionals advising patients and clients on weight management may consider possible gender differences in response to weight loss and management guidance. Since label use was related to engagement in some unhealthy behaviors in addition to healthy behaviors, it is important to consider how individuals may use labels, particularly those at risk for, or engaging in, disordered eating behaviors. Future research investigating potential relationships between Nutrition Facts use, intuitive eating, and binge eating is needed.
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Affiliation(s)
- Mary J Christoph
- Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, MN.
| | - Katie A Loth
- Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Marla E Eisenberg
- Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Ann F Haynos
- Department of Psychiatry, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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88
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Hilbert A, Kurz S, Dremmel D, Weihrauch Blüher S, Munsch S, Schmidt R. Cue reactivity, habituation, and eating in the absence of hunger in children with loss of control eating and attention-deficit/hyperactivity disorder. Int J Eat Disord 2018; 51:223-232. [PMID: 29341214 DOI: 10.1002/eat.22821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Childhood loss of control (LOC) eating and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid conditions and present with disordered eating behaviors, such as overeating. This study sought to delineate shared and specific abnormalities in physiological, cognitive-motivational, and behavioral components of food-specific impulsivity in children with LOC eating and ADHD. Specifically, children's reactivity and habituation to food and eating in the absence of hunger were examined. METHODS Within this community-based study, four groups of 8-13-year-old children with LOC eating (n = 24), ADHD (n = 32), comorbid LOC eating/ADHD (n = 9), and matched controls (n = 34) received a standard laboratory test meal to establish satiety and were then exposed to their favorite snack food in a cue exposure/reactivity trial, while salivation and desire to eat were repeatedly assessed. Subsequently, they were offered a variety of snack foods ad libitum. RESULTS Children with LOC eating, ADHD, and LOC/ADHD did not differ from controls in salivary reactivity and habituation to food cues. Children with LOC eating and ADHD showed greater cue reactivity of the desire to eat than controls, but groups did not differ in its longer-term increments. At free access, only children with LOC/ADHD consumed significantly more energy than controls. Longer-term increments of desire to eat predicted greater energy intake beyond LOC/ADHD group status. DISCUSSION Desire to eat among children with comorbid LOC eating and ADHD was associated with overeating in the absence of hunger, which may contribute to excess weight gain. Delineation of the specific features of childhood LOC eating versus ADHD warrants further study.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Susanne Kurz
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.,Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Daniela Dremmel
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Susann Weihrauch Blüher
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.,Pediatric Endocrinology, Department of Pediatrics I, Martin Luther University of Halle, Halle, Germany
| | - Simone Munsch
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Ricarda Schmidt
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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89
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Manasse SM, Schumacher LM, Goldstein SP, Martin GJ, Crosby RD, Juarascio AS, Butryn ML, Forman EM. Are individuals with loss-of-control eating more prone to dietary lapse in behavioural weight loss treatment? An ecological momentary assessment study. EUROPEAN EATING DISORDERS REVIEW 2018; 26:259-264. [PMID: 29484774 DOI: 10.1002/erv.2583] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 01/05/2018] [Accepted: 02/04/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Individuals with overweight/obesity and loss-of-control eating (LOC) may experience poorer outcomes from behavioural weight loss due to reactivity to internal (e.g., affective and physical) states that impact treatment adherence (e.g., dietary lapses). This study examined (a) whether the presence of LOC increased risk for dietary lapses and (b) the moderating role of LOC on the relation between internal states and dietary lapses. METHOD Individuals (n = 189) with overweight and obesity completed ecological momentary assessment early in behavioural weight loss. RESULTS LOC was positively associated with dietary lapse. LOC did not moderate the relation between momentary changes in internal states and dietary lapses. However, the effect of average levels of internal states on lapses was attenuated for those with LOC. DISCUSSION Results suggest that those with LOC are at higher risk of dietary lapse, whereas elevated average levels of internal states may contribute to early inadherence for those without LOC.
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Affiliation(s)
- Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA, USA
| | - Leah M Schumacher
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA, USA
| | - Stephanie P Goldstein
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA, USA
| | - Gerald J Martin
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA, USA
| | - Ross D Crosby
- Department of Psychiatry and Behavioral Science, Neuropsychiatric Research Institute and the University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Adrienne S Juarascio
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA, USA
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA, USA
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA, USA
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90
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Goldschmidt AB, Lavender JM, Hipwell AE, Stepp SD, Keenan K. Examining Two Prevailing Models of Loss of Control Eating Among Community-Based Girls. Obesity (Silver Spring) 2018; 26:420-425. [PMID: 29280308 PMCID: PMC5783779 DOI: 10.1002/oby.22101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/28/2017] [Accepted: 11/28/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Cognitive-behavioral and interpersonal models of loss of control (LOC) eating have been underexplored in adolescents. METHODS By using data from community-based adolescent girls assessed annually over 4 years, the cognitive-behavioral (n = 416) and interpersonal (n = 418) models were examined by using a regression-based bootstrapping approach. RESULTS Body dissatisfaction at 14 years prospectively predicted LOC eating at 18 years, both directly (direct effect = -0.039; SE = 0.017; P = 0.02) and indirectly via dieting (indirect effect = -0.010; 95% CI: -0.022 to -0.003). Interpersonal functioning at 14 years was negatively associated with negative emotionality at 17 years, which, in turn, was prospectively associated with LOC eating at 18 years (indirect effect = 0.001; 95% CI: -0.001 to -0.0003); however, the direct association between age 14 interpersonal functioning and age 18 LOC eating was not significant (direct effect = -0.001; SE = 0.001; P = 0.47). CONCLUSIONS These findings support the cognitive-behavioral model, and partially support the interpersonal model, with the latter findings implying that over time, negative emotionality may promote LOC eating independent of the effects of prior social functioning. Prevention and early intervention efforts for LOC eating may benefit from integrating these theoretical frameworks.
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Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Jason M. Lavender
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephanie D. Stepp
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kate Keenan
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
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91
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Ivezaj V, Barnes RD, Cooper Z, Grilo CM. Loss-of-control eating after bariatric/sleeve gastrectomy surgery: Similar to binge-eating disorder despite differences in quantities. Gen Hosp Psychiatry 2018; 54:25-30. [PMID: 30056316 PMCID: PMC6245943 DOI: 10.1016/j.genhosppsych.2018.07.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/29/2018] [Accepted: 07/16/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To characterize loss-of-control eating following sleeve gastrectomy surgery by comparing relevant patient groups. METHOD Participants were 431 adults seeking treatment for eating/weight concerns categorized into one of four groups: 1) overweight/obesity (OW/OB), 2) binge-eating disorder (BED), 3) "Bariatric Binge-Eating Disorder" (Bar-BED) defined as meeting all criteria for DSM-5 binge-eating disorder, except for the requirement of an unusually large amount of food, following sleeve gastrectomy surgery, and 4) "Bariatric Loss-of-Control Eating" (Bar-LOC Only), defined as experiencing at least once weekly loss-of-control eating episodes during the past month without the other associated clinical features and distress that characterize Bar-BED, following sleeve gastrectomy surgery. RESULTS The Bar-BED and BED groups reported comparable levels of overall eating-disorder and depressive symptoms, and these levels were significantly higher than those levels reported by the OW/OB and Bar-LOC Only groups. Adjusting for age, body mass index, and race did not change the overall pattern of findings. CONCLUSION "Bariatric Binge-Eating Disorder" shares clinical features of DSM-5 binge-eating disorder, regardless of the quantity of food consumed. Careful assessment of loss-of-control eating, associated behavioral features, and distress is warranted following surgery. More broadly, our findings highlight the importance of assessing loss-of-control eating across patient groups with obesity.
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Affiliation(s)
- Valentina Ivezaj
- Yale School of Medicine, Psychiatry Department, New Haven, CT, United States of America.
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92
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Goldschmidt AB, Khoury J, Jenkins TM, Bond DS, Thomas JG, Utzinger LM, Zeller MH, Inge TH, Mitchell JE. Adolescent Loss-of-Control Eating and Weight Loss Maintenance After Bariatric Surgery. Pediatrics 2018; 141:peds.2017-1659. [PMID: 29237801 PMCID: PMC5744387 DOI: 10.1542/peds.2017-1659] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Loss-of-control (LOC) eating is common in adults undergoing bariatric surgery and is associated with poorer weight outcomes. Its long-term course in adolescent bariatric surgery patients and associations with weight outcomes are unclear. METHODS Adolescents (n = 234; age range = 13-19 years) undergoing bariatric surgery across 5 US sites were assessed for postsurgery follow-up at 6 months and 1, 2, 3, and 4 years. Descriptive statistics and generalized linear mixed models were used to describe the prevalence of LOC eating episodes involving objectively large amounts of food and continuous eating, respectively. Generalized linear mixed models investigated the association of any LOC eating with short- and long-term BMI changes. RESULTS At baseline, objectively large LOC eating was reported by 15.4% of adolescents, and continuous LOC eating by 27.8% of adolescents. Both forms of LOC eating were significantly lower at all postsurgical time points relative to presurgery (range = 0.5%-14.5%; Ps < .05). However, both behaviors gradually increased from 6-month to 4-year follow-up (Ps < .05). Presurgical LOC eating was not related to percent BMI change over follow-up (P = .79). However, LOC eating at 1-, 2-, and 3-year follow-up was associated with lower percent BMI change from baseline at the next consecutive assessment (Ps < .05). CONCLUSIONS Although presurgical LOC eating was not related to relative weight loss after surgery, postoperative LOC eating may adversely affect long-term weight outcomes. Rates of LOC eating decreased from presurgery to 6-months postsurgery but increased thereafter. Therefore, this behavior may warrant additional empirical and clinical attention.
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Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University and Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island
| | | | - Todd M. Jenkins
- Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Dale S. Bond
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University and Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island
| | - J. Graham Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University and Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island
| | - Linsey M. Utzinger
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Meg H. Zeller
- Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Thomas H. Inge
- Department of Surgery, University of Colorado, Denver and Children’s Hospital Colorado, Aurora, Colorado; and
| | - James E. Mitchell
- Department of Clinical Neuroscience, School of Medicine and Health Sciences, University of North Dakota, Fargo, North Dakota
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93
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Egbert AH, Wilfley DE, Eddy KT, Boutelle KN, Zucker N, Peterson CB, Celio Doyle A, Le Grange D, Goldschmidt AB. Attention-Deficit/Hyperactivity Disorder Symptoms Are Associated with Overeating with and without Loss of Control in Youth with Overweight/Obesity. Child Obes 2018; 14:50-57. [PMID: 28945463 PMCID: PMC5743031 DOI: 10.1089/chi.2017.0114] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND There is growing evidence that attention-deficit/hyperactivity disorder (ADHD) and loss of control (LOC) eating, both prevalent in children and adolescents, may be related to one another. However, the relationship between ADHD and overeating without LOC has been largely unexamined, thus precluding an understanding of the independent contributions of LOC and episode size in these associations. The current study sought to examine associations between ADHD symptoms and maladaptive eating by evaluating three different types of eating episodes characterized by the presence/absence of LOC and the amount of food consumed: objectively large LOC episodes [objective binge eating (OBE)], subjectively large binge episodes [subjective binge eating (SBE)], and objectively large overeating episodes without LOC [objective overeating (OO)]. METHODS Participants were 385 youth (M age = 10.89, SD = 2.25) drawn from five different research protocols at institutions across the United States. Participants and their parents completed questionnaires and semistructured interviews to assess ADHD symptoms, OBE, SBE, and OO. RESULTS As hypothesized, negative binomial regressions revealed that ADHD symptoms were significantly associated with OBE, χ2(1) = 16.61, p < 0.001, and with OO, χ2(1) = 10.64, p < 0.01. Contrary to expectations, they were not associated with SBE. CONCLUSIONS These results indicate the need for future studies to explore possible shared mechanisms (e.g., impulsivity) underlying associations between ADHD symptoms, OBE, and OO. Clinical implications include support for considering ADHD symptoms in programs that target both prevention of LOC eating and obesity more generally.
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Affiliation(s)
- Amy Heard Egbert
- Department of Psychology, Loyola University Chicago, Chicago, IL
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Kamryn T. Eddy
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Kerri N. Boutelle
- Department of Pediatrics and Psychiatry, University of California San Diego, La Jolla, CA
| | - Nancy Zucker
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Carol B. Peterson
- Department of Psychiatry, University of Minnesota Medical Center, Minneapolis, MN
| | - Angela Celio Doyle
- Eating Disorders Center, Evidence Based Treatment Centers of Seattle, Seattle, WA
| | - Daniel Le Grange
- Department of Psychiatry, University of California San Francisco, San Francisco, CA.,Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL
| | - Andrea B. Goldschmidt
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Weight Control and Diabetes Research Center/The Miriam Hospital, Providence, RI
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94
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Wiedemann AA, Ivezaj V, Barnes RD. Characterizing emotional overeating among patients with and without binge-eating disorder in primary care. Gen Hosp Psychiatry 2018; 55:38-43. [PMID: 30321775 PMCID: PMC6268114 DOI: 10.1016/j.genhosppsych.2018.09.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 09/07/2018] [Accepted: 09/10/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Emotional overeating and loss-of-control eating are associated with poorer weight-related and psychiatric outcomes, yet our understanding of the relationship between these variables is limited, particularly among individuals in primary care. This study examined the frequency of emotional overeating and relationship with loss-of-control eating among patients with and without binge-eating disorder (BED) seeking weight loss treatment in primary care. METHOD Participants were 131 adults (n = 105 female) with overweight/obesity seeking weight loss treatment in primary care. Participants completed the Eating Disorder Examination (semi-structured interview) and Yale Emotional Overeating Scale, which measures emotional overeating episodes. Height and weight were measured. Mean age and BMI were 47.60 years and 35.31 kg/m2, respectively. BED criteria were met by n = 35 (26.7%) participants. RESULTS Participants with BED endorsed more frequent emotional overeating episodes compared to those without BED. While total emotional overeating scores were not associated with loss-of-control eating, discrete types of emotional overeating episodes (e.g., loneliness) were associated with loss-of-control eating. Emotional overeating was most often reported in response to loneliness, boredom, or anxiety, which varied by BED status. CONCLUSIONS Most participants endorsed recent episodes of emotional overeating; those with BED endorsed more frequent episodes. Future research examining the impact of emotional overeating on weight loss treatment outcomes is warranted.
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Affiliation(s)
- Ashley A Wiedemann
- Yale School of Medicine, Psychiatry Department, New Haven, CT, United States of America.
| | - Valentina Ivezaj
- Yale School of Medicine, Psychiatry Department, New Haven, CT, United States of America
| | - Rachel D Barnes
- Yale School of Medicine, Psychiatry Department, New Haven, CT, United States of America
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95
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Goldschmidt AB, Crosby RD, Cao L, Wonderlich SA, Mitchell JE, Engel SG, Peterson CB. A preliminary study of momentary, naturalistic indicators of binge-eating episodes in adults with obesity. Int J Eat Disord 2018; 51:87-91. [PMID: 29112288 PMCID: PMC5745052 DOI: 10.1002/eat.22795] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/17/2017] [Accepted: 10/19/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Binge eating is common in adults with obesity. The Diagnostic and Statistical Manual for Psychiatric Disorders describes five indicators of binge eating (eating more rapidly than usual; eating until uncomfortably full; eating large amounts of food when not physically hungry; eating alone because of embarrassment over how much one is eating; and feeling disgusted with oneself, depressed, or very guilty after overeating), but their validity is unclear. METHOD We examined preliminary associations between the five indicators and binge versus nonbinge episodes among 50 adults with obesity via ecological momentary assessment. RESULTS Generalized linear models revealed that, relative to nonbinge episodes, self-reported binge episodes were associated with lower pre-episode hunger (p = .004), higher postepisode fullness (p < .001), a greater likelihood of reporting moderate to extreme shame prior to eating in conjunction with eating alone (p < .001), and a greater likelihood of reporting moderate to extreme disgust, depression, and/or guilt after eating (p < .001), but not with eating more rapidly than usual (p = .85). DISCUSSION Results support the validity of most binge-eating indicators, although the utility of the rapid eating criterion is questionable. Future research should examine whether modifying these indicators in binge-eating interventions would reduce the occurrence of loss of control and/or overeating.
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Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Ross D. Crosby
- Department of Biostatistics, Neuropsychiatric Research Institute, Fargo, ND, USA,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Li Cao
- Department of Biostatistics, Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Stephen A. Wonderlich
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA,Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, USA
| | - James E. Mitchell
- Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Scott G. Engel
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA,Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Carol B. Peterson
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
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