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Hamilton A, Smith SR, Lydecker JA. The Relationship of Self-identified Weight Status With Perceived Mental and Physical Health. J Psychiatr Pract 2023; 29:430-438. [PMID: 37948168 PMCID: PMC10653675 DOI: 10.1097/pra.0000000000000744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
OBJECTIVE This study examined whether individuals with higher weight (body mass index in the overweight or obesity range) self-identified as having overweight or obesity (Ow/Ob). The study also examined whether self-identifying as having Ow/Ob was associated with perceived mental health, perceived physical health, depression, and eating disorder psychopathology. METHODS Four study groups were created: those with Ow/Ob who self-identified as having Ow/Ob (Ow/Ob+), those with Ow/Ob who did not self-identify as having Ow/Ob (Ow/Ob-), those with core features of binge-eating disorder (BED) and Ow/Ob, and those with bulimia nervosa (BN) and Ow/Ob. Analyses of variance compared study groups on perceived health, depression, and eating disorder psychopathology. RESULTS The BED and BN groups were more likely to self-identify as having overweight/obesity compared with Ow/Ob groups without eating disorders. The Ow/Ob- group had the best-perceived health and the lowest levels of eating disorder psychopathology and depression compared with the other groups. The Ow/Ob+ group had better perceived mental health than the BED and BN groups but did not differ significantly from the Ow/Ob- group in perceived mental health. Perceived physical health in the Ow/Ob+ group was better than in the BED group and worse than in the Ow/Ob- group. The Ow/Ob+ group had higher levels of eating disorder psychopathology than the Ow/Ob- group. CONCLUSIONS Self-identifying as having obesity is associated with eating disorder psychopathology as well as poorer perceived mental and physical health. Providers should engage patients in discussions about their weight with the understanding that self-identifying as having overweight or obesity might indicate the presence of eating disorder psychopathology. Future clinical research should investigate the directionality or possible bidirectionality of this relationship.
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Decker KM, Reiter‐Purtill J, Bejarano CM, Goldschmidt AB, Mitchell JE, Jenkins TM, Helmrath M, Inge TH, Michalsky MP, Zeller MH. Psychosocial predictors of problematic eating in young adults who underwent adolescent bariatric surgery. Obes Sci Pract 2022; 8:545-555. [PMID: 36238228 PMCID: PMC9535670 DOI: 10.1002/osp4.590] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/18/2021] [Accepted: 12/23/2021] [Indexed: 11/08/2022] Open
Abstract
Introduction This study examined problematic eating and eating-related psychopathology among young adults who underwent adolescent bariatric surgery including concurrent and prospective associations with psychosocial factors and weight change. Methods VIEW point is a 6-year follow-up study within a prospective observational study series observing adolescents with severe obesity who had bariatric surgery (n = 139) or who presented to nonsurgical lifestyle modification programs (n = 83). Participants completed height/weight measurements, questionnaires, and diagnostic interviews. Regression analyses compared problematic eating across groups and examined Year 6 correlates (i.e., psychosocial factors and weight change) and baseline predictors (i.e., psychosocial factors) of eating-related psychopathology. Results Compared to the nonsurgical group, the surgical group reported lower eating-related psychopathology, objective binge eating, and grazing at Year 6. While chewing/spitting out and vomiting for weight/shape-related reasons were very infrequent for the surgical group, self-induced vomiting for other reasons (e.g., avoid plugging) was more common. For the surgical group, lower self-worth, greater internalizing symptoms, and higher weight-related teasing in adolescence predicted increased eating-related psychopathology in young adulthood. Year 6 eating-related psychopathology was concurrently associated with lower percent weight loss for the surgical group and greater percent weight gain for the nonsurgical group. Conclusion Undergoing adolescent bariatric surgery appears to afford benefit for problematic eating and eating-related psychopathology. Current findings suggest that the clinical intervention related to problematic eating and associated psychosocial concerns may be needed for young adults with obesity, regardless of surgical status.
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Affiliation(s)
- Kristina M. Decker
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Jennifer Reiter‐Purtill
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Carolina M. Bejarano
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Andrea B. Goldschmidt
- Department of Psychiatry and Human BehaviorWarren Alpert Medical SchoolBrown University and Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - James E. Mitchell
- Department of Clinical NeuroscienceSchool of Medicine and Health SciencesUniversity of North DakotaGrand ForksNorth DakotaUSA
| | - Todd M. Jenkins
- Division of Pediatric General and Thoracic SurgeryCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Michael Helmrath
- Division of Pediatric General and Thoracic SurgeryCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Thomas H. Inge
- Department of SurgeryUniversity of ColoradoAnschutz Medical Campusand Children's Hospital ColoradoAuroraColoradoUSA
| | | | - Meg H. Zeller
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
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3
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Hopp K, Catenacci VA, Dwivedi N, Kline TL, Wang W, You Z, Nguyen DT, Bing K, Poudyal B, Johnson GC, Jackman MR, Miller M, Steele CN, Serkova NJ, MacLean PS, Nemenoff RA, Gitomer B, Chonchol M, Nowak KL. Weight loss and cystic disease progression in autosomal dominant polycystic kidney disease. iScience 2022; 25:103697. [PMID: 35059607 PMCID: PMC8760407 DOI: 10.1016/j.isci.2021.103697] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/19/2021] [Accepted: 12/21/2021] [Indexed: 01/03/2023] Open
Abstract
Progression of autosomal dominant polycystic kidney disease (ADPKD) is modified by metabolic defects and obesity. Indeed, reduced food intake slows cyst growth in preclinical rodent studies. Here, we demonstrate the feasibility of daily caloric restriction (DCR) and intermittent fasting (IMF) in a cohort of overweight or obese patients with ADPKD. Clinically significant weight loss occurred with both DCR and IMF; however, weight loss was greater and adherence and tolerability were better with DCR. Further, slowed kidney growth correlated with body weight and visceral adiposity loss independent of dietary regimen. Similarly, we compared the therapeutic efficacy of DCR, IMF, and time restricted feeding (TRF) using an orthologous ADPKD mouse model. Only ADPKD animals on DCR lost significant weight and showed slowed cyst growth compared to ad libitum, IMF, or TRF feeding. Collectively, this supports therapeutic feasibility of caloric restriction in ADPKD, with potential efficacy benefits driven by weight loss.
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Affiliation(s)
- Katharina Hopp
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Consortium for Fibrosis Research and Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Corresponding author
| | - Victoria A. Catenacci
- Department of Medicine, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Nidhi Dwivedi
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Timothy L. Kline
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN 55901, USA
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN 55901, USA
| | - Wei Wang
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Zhiying You
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Dustin T. Nguyen
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Kristen Bing
- Department of Medicine, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Bhavya Poudyal
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN 55901, USA
| | - Ginger C. Johnson
- Department of Medicine, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Matthew R. Jackman
- Department of Medicine, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Marsha Miller
- Department of Medicine, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Cortney N. Steele
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Natalie J. Serkova
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Paul S. MacLean
- Department of Medicine, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Raphael A. Nemenoff
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Consortium for Fibrosis Research and Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Berenice Gitomer
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Michel Chonchol
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Consortium for Fibrosis Research and Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Kristen L. Nowak
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Corresponding author
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Ley SL, Zeller MH, Reiter-Purtill J, Kleiner DE, Dixon J, Xanthakos S. Unhealthy Eating, Psychopathology, and Nonalcoholic Fatty Liver Disease in Youth Presenting for Bariatric Surgery. J Pediatr Gastroenterol Nutr 2021; 73:670-676. [PMID: 34321421 PMCID: PMC8604750 DOI: 10.1097/mpg.0000000000003253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Little is known about the behavioral and psychosocial correlates of pediatric nonalcoholic fatty liver disease (NAFLD). Given diet contributes to the development and persistence of NAFLD, we examined (1) the prevalence of unhealthy eating behaviors (UEB), (2) whether these varied by NAFLD or nonalcoholic steatohepatitis (NASH) presence, and explored (3) the association of psychopathology with NAFLD. METHODS Before metabolic and bariatric surgery (MBS), adolescents (N = 159; Mage = 16.4; MBMI = 53.7 kg/m2, 73% girls, 62.3% white) self-reported presence/absence of 10 UEB (Questionnaire on Eating and Weight Patterns-Revised, Night Eating Questionnaire, Look AHEAD). NAFLD and NASH presence was assessed by intraoperative liver biopsy. Height/weight, blood pressure, and blood specimens were obtained. A medical comorbidity index was created (prediabetes/diabetes, dyslipidemia, elevated blood pressure). Psychopathology was assessed in a subgroup completing the Youth Self-Report (N = 98). RESULTS Binge eating disorder symptomatology was associated with higher odds of NAFLD whereas frequent eating out was associated with lower odds of NAFLD. Among those with NAFLD frequent eating out was associated with higher odds of NASH while nocturnal eating was associated with lower odds of NASH. Separate models identified internalizing psychopathology as associated with higher odds of NAFLD after controlling for demographics, number of UEB, and medical comorbidities. CONCLUSIONS Results suggest potential phenotypical differences between adolescents presenting for MBS with/without NAFLD, with implications for behavioral/psychosocial targets for screening and intervention. Replication should occur in a sample with greater gender and ethnic diversity to improve generalizability. Understanding differences in the context of surgical weight loss and comorbidity resolution is indicated.
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Affiliation(s)
- Sanita L Ley
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Meg H Zeller
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - David E Kleiner
- Laboratory of Pathology, National Cancer Institute, Bethesda, MD
| | - John Dixon
- Iverson Health Innovation Research Institute, Swinburne University, Melbourne, Australia
| | - Stavra Xanthakos
- Department of Pediatrics, University of Cincinnati College of Medicine
- Division of Gastroenterology, Hepatology & Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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de Moraes CEF, Appolinário JC, Mourilhe C, de Freitas SR, da Veiga GV. Reliability of the Brazilian version of the questionnaire on eating and weight patterns-5 (QEWP-5). Eat Weight Disord 2021; 26:2463-2470. [PMID: 33479922 DOI: 10.1007/s40519-020-01072-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 11/12/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE The Questionnaire on Eating and Weight Patterns-5 (QEWP-5) is a self-report instrument developed to screen individuals for binge eating disorder (BED) and bulimia nervosa (BN) as diagnosed by the DSM-5. This instrument was cross-culturally adapted for the Brazilian Portuguese and well understood by the target sample. The present study aimed to assess the test-retest reliability of the Brazilian version of QEWP-5 in a sample of undergraduate students from Dietitian and Psychology courses. METHODS The Brazilian version of QEWP-5 was administered to a sample of 345 male and female undergraduate students, from dietitian (n = 179) and psychology (n = 166) courses. The instrument was applied twice with a time interval of 2 weeks between the applications. The kappa coefficient was used to assess the temporal stability of the questionnaire in the screening of BED and BN. RESULTS Overall, the kappa coefficient for the screening of BED was .48, and for the screening of BN was .71. In the dietitian course, the temporal stability was .60 (for the assessment of BED) and .80 (for BN). In the psychology course, the kappa values for the assessment of BED and BN were .27 and .60, respectively. All values were statistically significant (p < .001). CONCLUSION In general, the stability of the Brazilian version of QEWP-5 was considered moderate to assess BED and substantial for the screening of BN in undergraduate students. Stratifying by course, the questionnaire had higher stability for the assessment of BED and BN in dietitian students. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- Carlos Eduardo Ferreira de Moraes
- Josué de Castro Nutrition Institute (INJC), Department of Social and Applied Nutrition (DNSA), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. .,Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil.
| | - José Carlos Appolinário
- Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil
| | - Carla Mourilhe
- Josué de Castro Nutrition Institute (INJC), Department of Social and Applied Nutrition (DNSA), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil
| | - Sílvia Regina de Freitas
- Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil.,State Institute of Diabetes e Endocrinology (IEDE), Rio de Janeiro, RJ, Brazil
| | - Glória Valéria da Veiga
- Josué de Castro Nutrition Institute (INJC), Department of Social and Applied Nutrition (DNSA), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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6
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Teodoro MC, Conceição EM, de Lourdes M, Alves JR, Neufeld CB. Grazing's frequency and associations with obesity, psychopathology, and loss of control eating in clinical and community contexts: A systematic review. Appetite 2021; 167:105620. [PMID: 34352352 DOI: 10.1016/j.appet.2021.105620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 12/01/2022]
Abstract
The term grazing is generally described as the repetitive and nonplanned consumption of small amounts of food, not in response to hunger/satiety sensations. The present study aims to identify and critically review studies examining the frequency of grazing in both clinical and community samples, as well as, to investigate its relationship with eating disorder psychopathology, Loss of Control eating (LOC), psychological impairment, and weight-related variables. This systematic review followed the PRISMA recommendations for reporting systematic reviews and meta-analysis. A total of 138 articles were initially retrieved from the database search. In the end, 18 articles were considered for this systematic review. The results were separated in Grazing and Grazing-like behavior (picking and nibbling). Results of studies of grazing-like behaviors displays that, in these studies, the results are sometimes inconsistent and controversial. On the other hand, studies of Grazing behavior showed more consistent results. These results show that the use of different definitions across the literature makes it difficult to establish comparisons across studies. In this literature review, the studies selected used five different definitions of grazing and five different instruments to assess this eating behavior which reinforces the requirement for standardized definition and evaluation. More, the studies hereby revised suggested that LOC eating was considered in association with grazing, being significantly associated with higher levels of psychopathology and psychological impairment. In accordance, a growing body of research argues that LOC eating was a stronger predictor of eating disorder psychopathology than the amounts of food consumed. Furthermore, the results found by studies show an advance to literature with an accordance about LOC, supported by evidences in studies of this review.
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Affiliation(s)
- Marília Consolini Teodoro
- Cognitive-Behavioral Intervention and Research Laboratory - LaPICC-USP, Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil.
| | - Eva M Conceição
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Jéssika Rodrigues Alves
- Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Carmem Beatriz Neufeld
- Cognitive-Behavioral Intervention and Research Laboratory - LaPICC-USP, Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil
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7
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Larson N, Loth KA, Eisenberg ME, Hazzard VM, Neumark-Sztainer D. Body dissatisfaction and disordered eating are prevalent problems among U.S. young people from diverse socioeconomic backgrounds: Findings from the EAT 2010-2018 study. Eat Behav 2021; 42:101535. [PMID: 34214761 PMCID: PMC8380709 DOI: 10.1016/j.eatbeh.2021.101535] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Body dissatisfaction and disordered eating are linked to adverse health consequences. Research describing socioeconomic patterns in the prevalence of these problems is important for informing the design of health services and efforts to improve health equity. METHODS Population-based cohort study (EAT 2010-2018: Eating and Activity over Time) of socioeconomically and ethnically/racially diverse U.S. young people who completed surveys as adolescents in 2009-2010 (mean age = 14.5 years) and as emerging adults in 2018 (mean age = 22.0 years). Participants were recruited from 20 schools in Minneapolis-St. Paul, Minnesota. Household socioeconomic status was determined using adolescent report of parental education, employment, and public assistance benefits. Analyses were conducted using data from 1531 participants and regression models that accounted for repeated measures within individuals. RESULTS Among females, high body dissatisfaction and unhealthy weight control behaviors (e.g., skipping meals) were more prevalent and regular use of lifestyle weight management behaviors (e.g., exercise) was less prevalent in the low SES group as compared to the middle and/or upper SES groups (p ≤ .010). Among males, thinness-oriented dieting, unhealthy weight control behaviors, and extreme weight control behaviors (e.g., taking diet pills) were all more prevalent in the low SES group as compared to the middle and/or upper SES groups (p ≤ .010). Few differences were observed across SES groups in models that adjusted for ethnic/racial identity and body mass index. CONCLUSIONS There is a need for greater attention to the reach and relevance of efforts to prevent disordered eating and improve body satisfaction to ensure efforts benefit young people across SES groups.
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Affiliation(s)
- Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN 55454, United States of America.
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota, Room 420, 717 Delaware Street SE, Minneapolis, MN 55414, United States of America.
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, University of Minnesota, Room 385, 717 Delaware St SE, Minneapolis, MN 55455, United States of America.
| | - Vivienne M Hazzard
- Sanford Center for Biobehavioral Research, 120 Eighth St S, Fargo, ND 58103, United States of America.
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN 55454, United States of America.
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Simone M, Emery RL, Hazzard VM, Eisenberg ME, Larson N, Neumark‐Sztainer D. Disordered eating in a population-based sample of young adults during the COVID-19 outbreak. Int J Eat Disord 2021; 54:1189-1201. [PMID: 33720460 PMCID: PMC8250323 DOI: 10.1002/eat.23505] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The present study aimed to describe the experience of, and factors associated with, disordered eating in a population-based sample of emerging adults during the COVID-19 outbreak. METHOD Participants in the EAT 2010-2018 (Eating and Activity over Time) study were invited to complete the C-EAT (COVID-19 EAT) survey in April-May 2020. There were 720 respondents to the survey (age: 24.7 ± 2.0 years). Psychological distress, stress, stress management, financial difficulties, and food insecurity during the COVID-19 pandemic were examined as cross-sectional correlates of disordered eating in 2020. Open-ended questions assessed the perceived impact of the pandemic on eating behaviors. RESULTS Low stress management was significantly associated with a higher count of extreme unhealthy weight control behaviors (UWCBs). Food insecurity, higher depressive symptoms, and financial difficulties were significantly associated with a higher count of less extreme UWCBs. Higher stress and depressive symptoms were significantly associated with greater odds of binge eating. Six themes pertaining to disordered eating during the pandemic emerged: (a) mindless eating and snacking; (b) increased food consumption; (c) generalized decrease in appetite or dietary intake; (d) eating to cope; (e) pandemic-related reductions in dietary intake; and (f) re-emergence or marked increase in eating disorder symptoms. DISCUSSION Psychological distress, stress management, financial difficulties, and abrupt schedule changes may have contributed to disordered eating during the COVID-19 pandemic. Interventions that target stress management, depressive symptoms, and financial strain and provide tools to develop a routine may be particularly effective for emerging adults at risk of developing disordered eating during public health crises.
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Affiliation(s)
- Melissa Simone
- Department of Psychiatry & Behavioral SciencesUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA,Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Rebecca L. Emery
- Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | | | - Marla E. Eisenberg
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Dianne Neumark‐Sztainer
- Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
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9
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Goldschmidt AB, Khoury JC, Mitchell JE, Jenkins TM, Bond DS, Zeller MH, Michalsky MP, Inge TH. Loss of Control Eating and Health Indicators Over 6 Years in Adolescents Undergoing Metabolic and Bariatric Surgery. Obesity (Silver Spring) 2021; 29:740-747. [PMID: 33759383 PMCID: PMC8474017 DOI: 10.1002/oby.23126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/22/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of this study was to assess associations between loss of control (LOC) eating and health outcomes among adolescents undergoing metabolic and bariatric surgery. METHODS A total of 234 adolescents were studied before and up to 6 years after surgery in a prospective, observational cohort design. Adolescents provided self-reports of LOC eating, pain severity, sleep quality, polycystic ovary syndrome, gastroesophageal reflux disease, and medication usage and objective measures of fasting glucose, serum insulin, glycohemoglobin A1c , cholesterol, triglycerides, and blood pressure. χ2 tests, Wilcoxon rank sums, and generalized linear mixed models were used to assess concurrent and prospective associations between LOC eating and health indicators. RESULTS LOC eating presented in 32.5% of adolescents before surgery and was positively associated with sleep disturbances and psychiatric medication usage. After surgery, LOC eating presented in 7.9% to 14.6% of participants and was correlated with improved low- and high-density lipoprotein cholesterol levels and greater back pain. LOC eating was inversely associated with low-density lipoprotein cholesterol at the next consecutive time point. CONCLUSIONS LOC eating was unexpectedly associated with improved low- and high-density lipoprotein cholesterol in adolescents undergoing metabolic and bariatric surgery. Deleterious effects of LOC eating on obesity-related health conditions, aside from back pain, were not detected. Metabolic and other weight-independent health benefits of surgery may persist postoperatively despite LOC eating and associated weight regain.
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Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Jane C. Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - James E. Mitchell
- Department of Psychiatry and Behavioral Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Todd M. Jenkins
- Department of Surgery, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Dale S. Bond
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Meg H. Zeller
- Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Marc P. Michalsky
- Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA
| | - Thomas H. Inge
- Department of Surgery, University of Colorado, Denver and Children’s Hospital Colorado, Aurora, CO, USA
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10
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Puhl RM, Lessard LM, Larson N, Eisenberg ME, Neumark-Stzainer D. Weight Stigma as a Predictor of Distress and Maladaptive Eating Behaviors During COVID-19: Longitudinal Findings From the EAT Study. Ann Behav Med 2020; 54:738-746. [PMID: 32909031 PMCID: PMC7499477 DOI: 10.1093/abm/kaaa077] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Weight stigma is common for people with obesity and harmful to health. Links between obesity and complications from COVID−19 have been identified, but it is unknown whether weight stigma poses adverse health implications during this pandemic. Purpose We examined longitudinal associations between prepandemic experiences of weight stigma and eating behaviors, psychological distress, and physical activity during the COVID-19 pandemic in a diverse sample of emerging adults. Methods Participants (N = 584, 64% female, mean age = 24.6 ± 2.0 years, mean body mass index [BMI] = 28.2) in the COVID-19 Eating and Activity over Time (C-EAT) study were cohort members of the population-based longitudinal study EAT 2010–2018. Weight stigma reported by participants in 2018 was examined as a predictor of binge eating, eating to cope, physical activity, depressive symptoms, and stress during COVID-19. Data were collected via online surveys during the U.S. outbreak of COVID-19 in 2020. Results Prepandemic experiences of weight stigma predicted higher levels of depressive symptoms (β = 0.15, p < .001), stress (β = 0.15, p = .001), eating as a coping strategy (β = 0.16, p < .001), and an increased likelihood of binge eating (odds ratio = 2.88, p < .001) among young adults during the COVID-19 pandemic but were unrelated to physical activity. Although associations remained after accounting for demographic characteristics and BMI, the magnitude of longitudinal associations was attenuated after adjusting for prior levels of the outcome variables. Conclusions Young adults who have experienced weight stigma may have increased vulnerability to distress and maladaptive eating during this pandemic. Public health messaging could be improved to support people of diverse body sizes and reduce the harmful consequences of weight stigma.
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Affiliation(s)
- Rebecca M Puhl
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.,Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | - Leah M Lessard
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Marla E Eisenberg
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Dianne Neumark-Stzainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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11
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Gowey M, Redden D, Lim C, Janicke D, Dutton G. Executive function phenotypes in pediatric obesity. Pediatr Obes 2020; 15:e12655. [PMID: 32506773 PMCID: PMC8496128 DOI: 10.1111/ijpo.12655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To comprehensively examine the behavioral phenotypes of children with and without executive function (EF) impairments in a clinical sample of youth with obesity. METHODS Youth aged 8 to 17 years (Mean age = 12.97) attending a medical clinic for obesity and their caregivers (N = 195 dyads) completed a battery of behavioral questionnaires. Caregiver-proxy report of EF was assessed using the Behavior Rating Inventory of Executive Function. Latent Class Analysis was conducted to identify EF groupings. Analysis of variance and chi-square tests were conducted to examine associations between EF groups and behavioral phenotypes. RESULTS Four latent classes of EF impairment were identified (No/Low Impairment; Behavioral Regulation Impairment; Metacognition Impairment; Global Impairment). There was an overall positive pattern of associations between these EF groups and behavioral/emotional symptoms, such that behavioral/emotional symptoms tended to increase with EF impairment. CONCLUSIONS Children with obesity and EF impairment demonstrate a dysregulated behavioral phenotype ranging from internalizing to externalizing behavioral and weight-related symptoms. This phenotype framework may be clinically beneficial for utilizing screening/assessment results to develop, tailor, and/or match treatment approaches in pediatric obesity.
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Affiliation(s)
- Marissa Gowey
- University of Alabama at Birmingham, Birmingham, Alabama
| | - David Redden
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Crystal Lim
- University of Mississippi Medical Center, Jackson, Mississippi
| | | | - Gareth Dutton
- University of Alabama at Birmingham, Birmingham, Alabama
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12
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Chevinsky JD, Wadden TA, Chao AM. Binge Eating Disorder in Patients with Type 2 Diabetes: Diagnostic and Management Challenges. Diabetes Metab Syndr Obes 2020; 13:1117-1131. [PMID: 32341661 PMCID: PMC7166070 DOI: 10.2147/dmso.s213379] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/26/2020] [Indexed: 12/21/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with an increased risk of disordered eating behaviors including binge eating disorder (BED). Comorbid BED in patients with T2DM has been associated with adverse clinical outcomes such as higher body mass index (BMI) and depressive symptoms. Identifying and addressing this disorder in patients with T2DM is a significant challenge for health-care providers. The purpose of this narrative review is to discuss current perspectives on BED in the context of T2DM with implications for screening and management of these highly comorbid conditions. BED continues to be underrecognized and underdiagnosed. However, there are established tools that providers can use to screen for BED such as the SCOFF Questionnaire and Questionnaire on Eating and Weight Patterns-5. There are several effective treatments for BED including cognitive behavioral therapy, interpersonal therapy, and lisdexamfetamine dimesylate. However, few studies have examined the effects of these treatments in patients with co-morbid T2DM and BED.
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Affiliation(s)
| | - Thomas A Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Ariana M Chao
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
- Correspondence: Ariana M Chao University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA19104, USATel +1215-746-7183Fax +1215-898-2878 Email
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13
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Gowey MA, Lim CS, Dutton GR, Silverstein JH, Dumont-Driscoll MC, Janicke DM. Executive Function and Dysregulated Eating Behaviors in Pediatric Obesity. J Pediatr Psychol 2019; 43:834-845. [PMID: 28595362 PMCID: PMC6093324 DOI: 10.1093/jpepsy/jsx091] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 05/23/2017] [Indexed: 01/12/2023] Open
Abstract
Objective To examine the association between caregiver proxy report of executive function (EF) and dysregulated eating behavior in children with obesity. Methods Participants were 195 youth with obesity aged 8-17 years, and their legal guardians. Youth height, weight, demographics, depressive symptoms, eating behaviors, and EF were assessed cross-sectionally during a medical visit. Analyses of covariance, adjusted for child age, gender, race/ethnicity, standardized BMI, depressive symptoms, and family income were used to examine differences in youth EF across caregiver and youth self-report of eating behaviors. Results Youth EF differed significantly by caregiver report of eating behavior but not youth self-report. Post hoc analyses showed that youth with overeating or binge eating had poorer EF than youth without these eating behaviors. Conclusions Executive dysfunction, as reported by caregivers, in youth with obesity may be associated with dysregulated eating behaviors predictive of poor long-term psychosocial and weight outcomes. Further consideration of EF-specific targets for assessment and intervention in youth with obesity may be warranted.
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Affiliation(s)
- Marissa A Gowey
- Division of Preventive Medicine, University of Alabama at Birmingham
| | - Crystal S Lim
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center
| | - Gareth R Dutton
- Division of Preventive Medicine, University of Alabama at Birmingham
| | | | | | - David M Janicke
- Department of Clinical and Health Psychology, University of Florida
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14
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Lydecker JA, Grilo CM. Food insecurity and bulimia nervosa in the United States. Int J Eat Disord 2019; 52:735-739. [PMID: 30920683 PMCID: PMC6555671 DOI: 10.1002/eat.23074] [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] [Received: 01/03/2019] [Revised: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Food insecurity occurs when access to food is limited by financial hardship. Yet, paradoxically, food insecurity is associated with overeating, with emerging evidence that it may be related to disordered eating. A recent report found that food insecurity was associated with binge-eating disorder (BED), but it is not yet known whether food insecurity is also associated with bulimia nervosa (BN). METHODS Participants were 873 respondents recruited online who completed a battery of established measures and were categorized into three study groups: healthy-weight (HW), BED, and BN. Hierarchical logistic regressions evaluated the extent to which low and very low food security were associated with BN compared with HW and BED study groups. RESULTS Low and very low food security were both associated with increased likelihood of BN group membership compared with HW but not BED. CONCLUSIONS Our findings suggest that food insecurity is associated with BN and also suggest that food insecurity's association with BN is similar to that for BED. These findings highlight the need for greater clinical and research attention to associations between food insecurity and eating disorders that include binge eating to inform eating-disorder prevention and treatment.
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Affiliation(s)
| | - Carlos M. Grilo
- Department of Psychiatry, Yale School of Medicine,Department of Psychology, Yale University
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15
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"There is no way to avoid the first bite": A qualitative investigation of addictive-like eating in treatment-seeking Brazilian women and men. Appetite 2019; 137:35-46. [PMID: 30794818 DOI: 10.1016/j.appet.2019.02.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/15/2018] [Accepted: 02/14/2019] [Indexed: 11/24/2022]
Abstract
There has been polarizing debate on addictive-like eating in recent years. To move toward valid definition and measurement of this construct, qualitative research describing individuals' experiences is needed. The present study explored how Brazilian men and women define and experience addictive-like eating. Interviews were conducted with 7 men and 8 women (Mage = 46.6 years, MBMI = 35.43 kg/m2) seeking treatment for addictive-like eating. Thematic analysis of interviews identified three saturated, overarching themes describing participants' conceptualizations of the (1) characteristics, (2) causal factors, and (3) consequences of addictive-like eating. Lack of control was a key characteristic of addictive-like eating described by all participants. A causal factor which most participants described was emotional eating. Consequences included emotional, interpersonal, occupational, and health-related impairments which appeared primarily related to weight gain, rather than to the pattern of addictive-like eating itself. These results are largely consistent with those of previous qualitative studies. Importantly, the symptoms described by our participants and in previous qualitative studies may be inadequately captured by existing self-report questionnaires designed to assess addictive-like eating. To address this potential limitation, we provide recommendations for assessing the full range of possible addictive-like eating symptoms.
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16
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Stener-Victorin E, Zhang H, Li R, Friden C, Li D, Wang W, Wang H, Chang C, Li S, Huo Z, Zhang H, Ji X, Linden-Hirschberg A, Qiao J. Acupuncture or metformin to improve insulin resistance in women with polycystic ovary syndrome: study protocol of a combined multinational cross sectional case-control study and a randomised controlled trial. BMJ Open 2019; 9:e024733. [PMID: 30612112 PMCID: PMC6326273 DOI: 10.1136/bmjopen-2018-024733] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is linked to hyperinsulinemia and insulin resistance with dysfunctional glucose metabolism. Pilot studies suggests that acupuncture treatment with combined manual and low-frequency electrical stimulation (electroacupuncture (EA)) of the needles decrease circulating glycated haemoglobulin (HbA1c) and homeostatic model assessment-insulin resistance. Therefore, we here aim to investigate if acupuncture treatment or metformin together with lifestyle or lifestyle management alone improves insulin sensitivity and related symptoms in overweight/obese women with PCOS. METHODS AND ANALYSIS This is a two-centre multinational (Sweden and China), cross-sectional case-control study combined with an open-labelled randomised controlled trial (RCT). Participants are randomised to one of three groups: (1) EA 2-3 times/week during 4 months+lifestyle management; (2) metformin, 500 mg, three/day during 4 months+lifestyle management; or (3) lifestyle management alone. The primary outcome measure in the RCT is changes in HbA1C. A total of 123 obese overweight women with PCOS will be enrolled and randomised into one of the three groups with a target power of at least 80% and 5% significance level based on two-sided tests. ETHICS AND DISSEMINATION The study has been approved by the Regional Ethical Review Board of Stockholm and of Peking University Third Hospital, China. Primary outcome data of the RCT will be published in a relevant journal together with supporting secondary outcome measurements. Further, outcome measurements will be published in separate papers as well as case-control data. EXPECTED RESULTS We anticipate that EA and metformin, both with lifestyle management, are equally effective and superior to lifestyle management alone for improvement of glycaemic control. TRIAL REGISTRATION NUMBERS NCT02647827 and EudraCT2015-004250-18.
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Affiliation(s)
| | - Haolin Zhang
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
| | - Rong Li
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Cecilia Friden
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
| | - Dong Li
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
| | - Wei Wang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Haining Wang
- Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, China
| | - Cuiqing Chang
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Shi Li
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
| | - ZeJun Huo
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
| | - Hua Zhang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, Beijing, China
| | - Xiaolan Ji
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
| | | | - Jie Qiao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
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17
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Rasmusson G, Lydecker JA, Coffino JA, White MA, Grilo CM. Household food insecurity is associated with binge-eating disorder and obesity. Int J Eat Disord 2018; 52:10.1002/eat.22990. [PMID: 30565270 PMCID: PMC6584603 DOI: 10.1002/eat.22990] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/09/2018] [Accepted: 11/13/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Food insecurity stems from limited financial resources. Yet, paradoxically, food insecurity is associated with overeating and excess weight. One subcategory of overeating is binge eating, which includes eating an unusually large amount of food while feeling a concurrent sense of loss of control. Associations between binge-eating disorder and food insecurity are not known, yet this is important to examine because binge eating is associated with more severe mental and physical health problems than overeating or obesity alone. METHOD Survey respondents (N = 1,250) were recruited online. Participants were categorized into study groups: healthy weight (HW), binge-eating disorder (BED), and obesity (OB). Using HW as a reference group, hierarchical logistic regressions evaluated the extent to which low and very low food security were associated with BED and OB. RESULTS Low food security and very low food security were both associated with increased likelihood of BED and OB group membership. CONCLUSIONS Results highlight the need to devote resources towards policy revisions, preventative interventions, and psychiatric treatments aimed at decreasing the overall association of food insecurity with BED and obesity among low-income Americans.
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Affiliation(s)
| | | | | | - Marney A. White
- Yale School of Public Health
- Department of Psychiatry, Yale School of Medicine
| | - Carlos M. Grilo
- Department of Psychiatry, Yale School of Medicine
- Department of Psychology, Yale University
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18
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Borgès Da Silva V, Borgès Da Silva R, Prud'homme A, Campan P, Azorin JM, Belzeaux R. Association between binge eating disorder and psychiatric comorbidity profiles in patients with obesity seeking bariatric surgery. Compr Psychiatry 2018; 87:79-83. [PMID: 30253268 DOI: 10.1016/j.comppsych.2018.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 09/13/2018] [Accepted: 09/14/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Eating disorders could be an important factor in the development of obesity, but psychiatric comorbidities are very heterogeneous in patients with obesity. Moreover, relationship between binge eating disorder and other psychiatric comorbidities is not clear. Our objective was to identify psychiatric comorbidity profiles of bariatric surgery candidates and to analyze the association between these profiles and binge-eating disorder. METHODS Our sample consisted of bariatric surgery candidates (n = 92) with mean Body Mass Index at 41.3 ± 0.6 kg/m2. To construct profiles, we classified patients according to their psychiatric comorbidities using cluster analysis techniques. We used logistic regression modelling to analyze associations between the presence of binge-eating disorder and the psychiatric comorbidity profiles. RESULTS We identified four profiles of psychiatric phenotypes. One of these profiles was not associated with any psychiatric disorder. Binge eating disorder was significantly associated with two profiles (p < 0.05): a profile with bipolar and obsessive-compulsive disorder (OR = 7.7 [1.7; 35.1]), and a profile with bipolar and panic disorder (OR = 20.7 [3.1; 137.5]). CONCLUSIONS Our multidimensional approach identified certain profiles specifically associated with binge-eating disorder in patients with obesity seeking bariatric surgery. These results may lead to a better understanding of the relationship between obesity and psychiatric disorders.
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Affiliation(s)
- Virginie Borgès Da Silva
- Centre Hospitalier Édouard Toulouse, Assistance publique des hôpitaux de Marseille, Marseille, France.
| | - Roxane Borgès Da Silva
- Department of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, P.O. Box 6128, Downtown Station Montréal, H3C3J7 Québec, Canada; University of Montreal Public Health Research Institute, C.P. 6128, Succ. Centre-ville, Montréal, Québec, H3C3J7, Canada; Center for Interuniversity Research and Analysis of Organizations, 1130 Rue Sherbrooke O #1400, Montréal, Québec H3A 2M8, Canada.
| | - Alexandre Prud'homme
- University of Montreal Public Health Research Institute, C.P. 6128, Succ. Centre-ville, Montréal, Québec, H3C3J7, Canada; Center for Interuniversity Research and Analysis of Organizations, 1130 Rue Sherbrooke O #1400, Montréal, Québec H3A 2M8, Canada.
| | - Pierre Campan
- Hôpital de La Conception, Assistance publique des hôpitaux de Marseille, Marseille, France.
| | - Jean Michel Azorin
- Pôle de psychiatrie, Hôpital Sainte Marguerite, Assistance Publique des hôpitaux de Marseille, 270 Boulevard de Sainte-Marguerite, 13009 Marseille, France.
| | - Raoul Belzeaux
- Pôle de psychiatrie, Hôpital Sainte Marguerite, Assistance Publique des hôpitaux de Marseille, 270 Boulevard de Sainte-Marguerite, 13009 Marseille, France; INT-UMR7289, CNRS Aix-Marseille Université; Fondation FondaMental, Créteil, France.
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Hunsaker SL, Garland BH, Rofey D, Reiter-Purtill J, Mitchell J, Courcoulas A, Jenkins TM, Zeller MH. A Multisite 2-Year Follow Up of Psychopathology Prevalence, Predictors, and Correlates Among Adolescents Who Did or Did Not Undergo Weight Loss Surgery. J Adolesc Health 2018; 63:142-150. [PMID: 29724670 PMCID: PMC6113090 DOI: 10.1016/j.jadohealth.2017.12.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 12/12/2017] [Accepted: 12/12/2017] [Indexed: 10/25/2022]
Abstract
PURPOSE We aimed to characterize prevalence, change, predictors, and correlates of psychopathology and associations with weight loss in adolescents with severe obesity 24 months after weight loss surgery (WLS) utilizing a controlled multisite sample design. METHODS Adolescents undergoing WLS (n = 139) and nonsurgical comparisons with severe obesity (NSComp; n = 83) completed validated questionnaires assessing psychopathology and potential predictors and correlates at presurgery/baseline and 24 months postoperatively/follow-up. RESULTS At 24 months, 34.7% of WLS and 37.7% of nonsurgical comparisons were categorized as "symptomatic" (Youth Self-Report ≥ borderline on at least one DSM scale). The majority maintained their symptomatic or nonsymptomatic status from baseline to 24 months postbaseline. Remission of symptoms was more common than the development of new symptomatology at 24 months. Beyond demographics, separate models of baseline predictors and concurrent correlates of 24-month psychopathology identified baseline psychopathology and loss of control (LOC) eating as significant. Alcohol use disorder (AUD) and LOC eating emerged as correlates in the concurrent model. For the WLS group, preoperative, postoperative, and change in symptomatology were not related to 24-month percent weight loss. CONCLUSIONS At 2 years, approximately one in three adolescents were symptomatic with psychopathology. Maintenance of symptomatic/nonsymptomatic status over time or remission was more common than new incidence. Although symptomatology was not predictive of surgical weight loss outcomes at 2 years, preoperative psychopathology and several other predictors (LOC eating) and correlates (LOC eating, AUD) emerged as signals for persistent mental health risks, underscoring the importance of pre- and postoperative psychosocial monitoring and the availability of adjunctive intervention resources.
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Affiliation(s)
- Sanita L. Hunsaker
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Beth H. Garland
- Department of Pediatrics, Texas Children’s Hospital, Houston, Texas
| | - Dana Rofey
- Department of Psychiatry, Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - James Mitchell
- Department of Neuroscience, Neuropsychiatric Research Institute, Fargo, North Dakota
| | - Anita Courcoulas
- Division of General Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Todd M. Jenkins
- Division of Bariatric Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Meg H. Zeller
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Address correspondence to: Meg H. Zeller, Ph.D., Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH 45229. (M.H. Zeller)
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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: 31] [Impact Index Per Article: 5.2] [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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Yoon C, Jacobs DR, Duprez DA, Dutton G, Lewis CE, Neumark-Sztainer D, Steffen LM, West DS, Mason SM. Questionnaire-based problematic relationship to eating and food is associated with 25 year body mass index trajectories during midlife: The Coronary Artery Risk Development In Young Adults (CARDIA) Study. Int J Eat Disord 2018; 51:10-17. [PMID: 29215750 DOI: 10.1002/eat.22813] [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: 08/10/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Problematic eating behaviors and attitudes are of public health concern. Questionnaire-based assessment of these behaviors is important for large-scale research on eating behaviors. The questionnaire on eating and weight patterns-revised (QEWP-R) measures potential problematic behaviors and attitudes toward food (including anxieties, compensatory actions, overeating and loss of control, dieting, and shape concerns) that in aggregate may indicate diagnosable eating disorders. An important question regards the prevalence of these issues and their longitudinal associations with body mass index (BMI) in generally healthy middle aged adults. METHOD Based on eight constructs measured on QEWP-R, we created a new problematic relationship to eating and food (PREF) scale by assigning a point for each construct endorsed. Analyses were conducted in 3,892 black and white men and women participating in the community-based Coronary Artery Risk Development in Young Adults (CARDIA) Study. The QEWP-R was administered in CARDIA year 10, when participants were aged 27-41 years. We used linear regression to model the relationship of individual constructs and the PREF scale to BMI over CARDIA follow-up. RESULTS Fifty-five percent of participants had 1-5 points and 4% had 6-8 points on the PREF scale. Each separate construct was positively associated with BMI, except concern about weight and shape. Adjusting for age, race, sex, education, and study center, mean BMI at CARDIA year 10, the time of PREF assessment, was approximately 1.0-2.5 kg/m2 higher per PREF category. CONCLUSION In middle age, problematic behaviors and attitudes toward food were common and associated with higher BMI.
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Affiliation(s)
| | | | | | | | | | | | | | - Delia S West
- University of South Carolina, Columbia, South Carolina
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22
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Goldschmidt AB, Wall MM, Choo THJ, Evans EW, Jelalian E, Larson N, Neumark-Sztainer D. Fifteen-year Weight and Disordered Eating Patterns Among Community-based Adolescents. Am J Prev Med 2018; 54:e21-e29. [PMID: 29132950 PMCID: PMC5736404 DOI: 10.1016/j.amepre.2017.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 08/24/2017] [Accepted: 09/07/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The current study aims to characterize weight-change trajectories and their concomitant associations with prospectively measured dieting and other disordered eating behaviors among initially nonoverweight adolescents during the transition to adulthood. METHODS A population-based sample (n=1,091) self-reported their height/weight, dieting, unhealthy weight-control behaviors, and binge eating at 5-year intervals between 1998/1999 and 2013/2014, spanning early/middle adolescence through middle/late young adulthood. Data were analyzed in 2016/2017. RESULTS Groups were categorized as those who were never overweight (n=562), were overweight during at least one measurement point and gained weight more rapidly (n=246) or gradually (n=238) than their peers, or were overweight during at least one measurement point but returned to nonoverweight status by middle/late young adulthood (n=45). Thus, nearly half of adolescents became overweight during the transition to adulthood. Those who were never overweight had the lowest rates of dieting (males: F[9, 1,314]=2.54, p=0.0069, females: F[9, 1,927]=3.02, p=0.0014) and unhealthy weight-control behaviors (males: F[9, 1,313]=3.30, p=0.0005, females: F[9, 1,927]=3.02, p=0.0014), whereas some of these behaviors tended to track with weight gain in rapid and gradual weight gainers. CONCLUSIONS Although adolescents who are already overweight are most frequently targeted for weight-gain prevention and early intervention programs, results suggest that healthy lifestyle interventions could also benefit individuals who may be perceived as low risk for overweight in adulthood by nature of being nonoverweight in adolescence. Dieting and unhealthy weight-control behaviors tended to be associated with weight gain, suggesting that they are ineffective in addition to being potentially harmful.
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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, Rhode Island.
| | - Melanie M Wall
- Department of Biostatistics, Columbia University, New York, New York
| | - Tse-Hwei J Choo
- Department of Biostatistics, Columbia University, New York, New York
| | - E Whitney Evans
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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23
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Hymowitz G, Salwen J, Salis KL. A mediational model of obesity related disordered eating: The roles of childhood emotional abuse and self-perception. Eat Behav 2017; 26:27-32. [PMID: 28131963 PMCID: PMC6075711 DOI: 10.1016/j.eatbeh.2016.12.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 12/23/2016] [Accepted: 12/30/2016] [Indexed: 10/20/2022]
Abstract
The extant literature indicates negative self-perceptions are a risk factor for disordered eating (DE) and DE is a risk factor for overweight and obesity. While childhood emotional abuse (EA) is often linked to DE and obesity, it is typically not included in comprehensive models of these health problems. Further investigation of interactions among EA, self-perception, and DE is needed to refine treatments for overweight, obesity, and DE. This study evaluated a model of DE and weight difficulties in which negative self-perception mediate the relationship between EA and DE, and DE predicts body mass index (BMI) in a population of emerging adults. Further, this study investigated the utility of history of EA for prediction of DE and classification of individuals with and without DE. Self-report questionnaires on childhood trauma, psychopathology, and eating behaviors were administered to 598 undergraduate students. Latent variable analysis confirmed the hypothesized model. Recursive partitioning determined that individuals reporting a high level of EA likely meet criteria for night eating syndrome (NES) or binge eating disorder (BED), and history of EA has a moderate to high level of specificity as a predictor of BED and NES. These findings confirm the necessity of evaluating EA and DE in emerging adults with weight difficulties, and the importance of assessing self-perception and DE in individuals with a history of EA. Future studies should investigate the utility of addressing EA and self-perception in interventions for DE and obesity and to determine whether these findings can be generalized to a clinical population.
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Affiliation(s)
- Genna Hymowitz
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2520, United States; Department of Surgery, Stony Brook Medicine, Stony Brook, NY 11794-8191, United States.
| | - Jessica Salwen
- Department of Psychology, Stony Brook University, Stony
Brook, NY 11794-2520, United States
| | - Katie Lee Salis
- Department of Psychology, Stony Brook University, Stony
Brook, NY 11794-2520, United States
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24
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Rodgers RF, Watts AW, Austin SB, Haines J, Neumark-Sztainer D. Disordered eating in ethnic minority adolescents with overweight. Int J Eat Disord 2017; 50:665-671. [PMID: 27987207 PMCID: PMC5459664 DOI: 10.1002/eat.22652] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 10/20/2016] [Accepted: 11/04/2016] [Indexed: 11/08/2022]
Abstract
High rates of disordered eating exist among adolescents with overweight and among ethnic/racial minority adolescents. Given the lack of research examining how eating disorder risk is moderated by both overweight and ethnicity/race, this study aimed to explore interactions between ethnicity/race and overweight status on disordered eating behaviors in a population-based adolescent sample. Cross-sectional data from adolescents (n = 2,271; 52% females) of White (23%), Black (34%), Hispanic (20%), and Asian (23%; 82% Hmong) ethnicity/race participating in the EAT 2010 study were used to examine associations between overweight status and disordered eating behaviors across ethnic/racial groups. Disordered eating behaviors occurred more frequently among adolescents with overweight compared with those without overweight across all ethnic/racial groups. Although some differences in the prevalence of disordered eating were found by ethnicity/race, particularly in girls, no consistent patterns of interaction emerged. Overweight White and Hispanic girls reported the highest risk for dieting, while the highest risk for unhealthy weight control behaviors was among overweight Black girls, and for overeating among overweight White and Asian girls. Within a society in which thinness is highly valued and being overweight is stigmatized, across diverse cultural groups, adolescents with overweight are at risk for disordered eating.
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Affiliation(s)
- Rachel F. Rodgers
- Department of Applied Psychology, Northeastern University, Boston, USA,Laboratoire de Stress Traumatique, Université Toulouse Paul Sabatier, Toulouse, France
| | - Allison W. Watts
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
| | - S. Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA,Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Canada
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
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25
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Utzinger LM, Gowey MA, Zeller M, Jenkins TM, Engel SG, Rofey DL, Inge TH, Mitchell JE. Loss of control eating and eating disorders in adolescents before bariatric surgery. Int J Eat Disord 2016; 49:947-952. [PMID: 27196378 PMCID: PMC5082705 DOI: 10.1002/eat.22546] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 03/04/2016] [Accepted: 03/08/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study assessed loss of control (LOC) eating and eating disorders (EDs) in adolescents undergoing bariatric surgery for severe obesity. METHOD Preoperative baseline data from the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) multisite observational study (n = 242; median BMI = 51 kg/m2 ; mean age= 17; 76% female adolescents; 72% Caucasian) included anthropometric and self-report questionnaires, including the Questionnaire of Eating and Weight Patterns-Revised (QEWP-R), the Night Eating Questionnaire (NEQ), the Beck Depression Inventory (BDI-II), and the Impact of Weight on Quality of Life-Kids (IWQOL-Kids) RESULTS: LOC eating (27%) was common and ED diagnoses included binge-eating disorder (7%), night eating syndrome (5%), and bulimia nervosa (1%). Compared to those without LOC eating, those with LOC eating reported greater depressive symptomatology and greater impairment in weight-related quality of life. DISCUSSION Before undergoing bariatric surgery, adolescents with severe obesity present with problematic disordered eating behaviors and meet diagnostic criteria for EDs. LOC eating, in particular, was associated with several negative psychosocial factors. Findings highlight targets for assessment and intervention in adolescents before bariatric surgery. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:947-952).
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Affiliation(s)
- Linsey M Utzinger
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota.
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine & Health Sciences, Fargo, North Dakota.
| | - Marissa A Gowey
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Meg Zeller
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Todd M Jenkins
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Scott G Engel
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine & Health Sciences, Fargo, North Dakota
| | - Dana L Rofey
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Thomas H Inge
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - James E Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine & Health Sciences, Fargo, North Dakota
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26
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Abstract
This article reviews current eating disorder self-report and interview measures and makes recommendations for choosing assessment devices for practice and research. The authors also incorporate overviews of related measures, such as body satisfaction and restrained eating. The presentation of women with eating disorders on measures of general psychological functioning (such as the Minnesota Multiphasic Personality Inventory) is also discussed. Implications and recommendations for practice are presented, as are recommendations for future research. The lack of validation of, and urgent need for, eating disorder assessment measures with ethnic minority women is discussed throughout.
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Bauer LO, Manning KJ. Challenges in the Detection of Working Memory and Attention Decrements among Overweight Adolescent Girls. Neuropsychobiology 2016; 73:43-51. [PMID: 26812684 PMCID: PMC5024346 DOI: 10.1159/000442670] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 11/18/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND The present study is unique in employing unusually difficult attention and working memory tasks to reveal subtle cognitive decrements among overweight/obese adolescents. It evaluated novel measures of background electroencephalographic (EEG) activity during one of the tasks and tested correlations of these and other measures with psychological and psychiatric predictors of obesity maintenance or progression. METHODS Working memory and sustained attention tasks were presented to 158 female adolescents who were rated on dichotomous (body mass index percentile <85 vs. ≥85) and continuous (triceps skinfold thickness) measures of adiposity. RESULTS The results revealed a significant association between excess adiposity and performance errors during the working memory task. During the sustained attention task, overweight/obese adolescents exhibited more EEG frontal beta power as well as greater intraindividual variability in reaction time and beta power across task periods than their normal-weight peers. Secondary analyses showed that frontal beta power during the sustained attention task was positively correlated with anxiety, panic, borderline personality features, drug abuse, and loss of control over food intake. CONCLUSIONS The findings suggest that working memory and sustained attention decrements do exist among overweight/obese adolescent girls. The reliable detection of the decrements may depend on the difficulty of the tasks as well as the manner in which performance and brain activity are measured. Future studies should examine the relevance of these decrements to dietary education efforts and treatment response.
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Affiliation(s)
- Lance O. Bauer
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT 06030-2103, USA
| | - Kevin J. Manning
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT 06030-2103, USA
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28
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Wilfley DE, Citrome L, Herman BK. Characteristics of binge eating disorder in relation to diagnostic criteria. Neuropsychiatr Dis Treat 2016; 12:2213-23. [PMID: 27621631 PMCID: PMC5010172 DOI: 10.2147/ndt.s107777] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included "binge eating disorder," DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and "shape and weight concerns." Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors' knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive-compulsive, and impulsive disorders) and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes) comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional eating). Future revisions of the BED diagnostic criteria should consider the inclusion of BED subtypes, perhaps based on the overvaluation of shape/weight, and an evidence-based reassessment of severity criteria.
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Affiliation(s)
- Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO
| | - Leslie Citrome
- Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla, NY
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29
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Goldschmidt AB, Wall MM, Zhang J, Loth KA, Neumark-Sztainer D. Overeating and binge eating in emerging adulthood: 10-year stability and risk factors. Dev Psychol 2015; 52:475-83. [PMID: 26689758 DOI: 10.1037/dev0000086] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Overeating (eating an unusually large amount of food) and binge eating (overeating with loss of control [LOC]) predict adverse health consequences in adolescence. We aimed to characterize the stability of and risk factors for these distinct but interrelated constructs during critical developmental transitions. We used a population-based sample (n = 1,902) that completed surveys at 5-year intervals spanning adolescence and young adulthood. The trajectories of no overeating, overeating, binge eating, and binge eating disorder (BED; recurrent binge eating with associated distress) were characterized using cross-tabulations. Body mass index, depressive symptoms, self-esteem, and body satisfaction were examined as risk factors for no overeating, overeating, and binge eating (including BED) 5-years later using multinomial logistic regression. We found that all overeating categories tended to remit to no overeating at 5-year follow-up. Although overeating had the lowest remittance rates at each time-point, binge eating and BED showed higher rates of persistence or worsening of symptoms during the transition from late adolescence/early young adulthood to early/middle young adulthood. Overeating and binge eating had similar risk factors, although for females, depressive symptoms, body satisfaction, and self-esteem in late adolescence/early young adulthood differentially predicted binge eating versus overeating in early/middle young adulthood (ps < .05). While overeating with or without LOC tends to remit over time, problematic eating persists for a subset of individuals. Greater psychosocial problems in late adolescence/early young adulthood predicted greater odds of binge eating relative to overeating in early/middle young adulthood among females, indicating that poorer psychosocial functioning in this developmental stage portends more severe eating-related psychopathology later in life.
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Affiliation(s)
| | | | - Jun Zhang
- Department of Biostatistics, Columbia University
| | - Katie A Loth
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
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30
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Goldschmidt AB, Wall M, Choo THJ, Becker C, Neumark-Sztainer D. Shared risk factors for mood-, eating-, and weight-related health outcomes. Health Psychol 2015; 35:245-52. [PMID: 26690639 DOI: 10.1037/hea0000283] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Given the overlap among depressive symptoms, disordered eating, and overweight, identifying shared risk factors for these conditions may inform public health interventions. This study aimed to examine cross-sectional and prospective relationships among these 3 conditions, and identify potential shared eating-related and psychosocial variable risk factors (i.e., body dissatisfaction, dieting, teasing experiences). METHOD A population-based sample (n = 1,902) self-reported depressive symptoms, disordered eating (binge eating, extreme weight control behaviors), weight status, and several putative risk factors (body satisfaction, dieting frequency, weight-related teasing) at 5-year intervals spanning early/middle adolescence, middle adolescence/early young adulthood, and early/middle young adulthood. RESULTS There was moderate overlap among depressive symptoms, disordered eating, and overweight at each time point, and moderate stability in each condition over time. Body dissatisfaction and dieting were the most potent shared risk factors for later depressive symptoms, disordered eating, and overweight among males and females (ps < .05). CONCLUSIONS Depressive symptoms, disordered eating, and overweight share several risk factors, including dieting and body dissatisfaction, which may be effective targets for interventions aiming to simultaneously prevent these 3 conditions.
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Affiliation(s)
| | - Melanie Wall
- Department of Biostatistics, Columbia University
| | | | | | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
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31
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Goldschmidt AB, Wall MM, Loth KA, Neumark-Sztainer D. Risk Factors for Disordered Eating in Overweight Adolescents and Young Adults. J Pediatr Psychol 2015; 40:1048-55. [PMID: 26050243 PMCID: PMC4723677 DOI: 10.1093/jpepsy/jsv053] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/21/2015] [Accepted: 05/15/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate risk factors for disordered eating among overweight youth, a subset of the population particularly at risk for such behaviors. METHODS A population-based sample of overweight youth (n = 553) self-reported their disordered eating (binge eating, extreme weight control behaviors), depression-related symptoms, body dissatisfaction, and weight-related teasing at 5-year intervals spanning early/middle adolescence (Time 1; T1), middle adolescence/early young adulthood (Time 2; T2), and early/middle young adulthood (Time 3; T3). RESULTS Using logistic regression, we found that T2 depression-related symptoms (p = .02) and body dissatisfaction (p = .01), and increases in body dissatisfaction from T1 to T2 (p = .03), predicted disordered eating incidence at T3. CONCLUSIONS Depression-related symptoms and body dissatisfaction appear to be important risk factors for disordered eating among overweight youth. Eating disorder prevention programs should address these factors along with behaviors maintaining or exacerbating excess weight status.
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Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago,
| | | | - Katie A Loth
- Division of Epidemiology and Community Health, School of Public Health, Department of Psychiatry, Medical School, and
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, Division of Adolescent Health and Medicine, Department of Pediatrics, University of Minnesota
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32
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Eslick GD, Howell SC, Talley NJ. Dysmotility Symptoms Are Independently Associated With Weight Change: A Population-based Study of Australian Adults. J Neurogastroenterol Motil 2015; 21:603-11. [PMID: 26424045 PMCID: PMC4622143 DOI: 10.5056/jnm14124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 04/16/2015] [Accepted: 07/16/2015] [Indexed: 01/12/2023] Open
Abstract
Background/Aims Weight loss is a recognized alarm symptom for organic gastrointestinal (GI) disease, yet the association between weight change (loss or gain) and specific GI symptoms remains poorly described. We assess the associations between GI symptoms and weight change in a population-based sample of Australian adults. Methods The prevalence of 26 GI symptoms was determined by a postal survey to 5000 residents in western Sydney, Australia (60% response rate). These were classified a priori into 5 symptom groups–abdominal pain, esophageal symptoms, dysmotility symptoms, diarrhea and constipation. Weight change was measured by two items which assessed weight loss and weight gain. Clinically relevant weight change was defined as a loss or gain of 3 or more kilograms in the past 3 months. Results Prevalence estimates for clinically relevant weight loss and gain in the past 3 months were 10.3% and 8.1%, respectively. When the 5 symptom groups were evaluated simultaneously, the dysmotility symptoms of fullness after meals emerged as a predictor of both weight loss (OR, 1.57; 95% CI, 1.32–1.88; P < 0.001) and weight gain (OR, 0.85; 95% CI, 0.72–0.99; P = 0.040), which also included bloating (OR, 1.64; 95% CI 1.46–1.84; P < 0.001). The associations remained significant following adjustment for socio-economic status, body mass index, and eating behaviors. Conclusions Specific dysmotility symptoms are independently predictive of both weight loss and weight gain. Different pathogenic mechanisms may be involved.
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Affiliation(s)
- Guy D Eslick
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Medicine, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia
| | - Stuart C Howell
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Medicine, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia
| | - Nicholas J Talley
- Department of Medicine, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia.,Faculty of Health, The University of Newcastle, Callaghan, New South Wales, Australia
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Schvey NA, White MA. The internalization of weight bias is associated with severe eating pathology among lean individuals. Eat Behav 2015; 17:1-5. [PMID: 25514799 DOI: 10.1016/j.eatbeh.2014.11.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 10/10/2014] [Accepted: 11/18/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The internalization of weight bias is associated with clinically significant eating pathology among overweight adults. However, these relationships have not yet been assessed in lean individuals, who may perceive themselves to be overweight and subsequently internalize weight bias. The aim of the present study, therefore, was to determine whether lean individuals internalize weight bias and if the internalization of weight bias among lean respondents is associated with eating pathology. METHOD Participants were 197 lean (mean BMI: 22.28±1.89, range 15.80-24.98) adults who completed the Weight Bias Internalization Scale (WBIS) and measures of disordered eating behaviors and attitudes via an anonymous online survey. RESULTS Based on convergence of responses from the EDE-Q and QEWP-R, and using DSM-5 behavioral criteria, 10% and 15% of participants were classified into a binge eating and binge/purge group, respectively. WBIS scores were significantly higher among those with binge and/or purge behaviors compared to those without eating pathology. Bivariate correlations revealed positive associations between WBIS score and BMI, depression, and all EDE-Q subscales (restraint, eating concern, shape concern, weight concern). Logistic regressions indicated that internalized weight bias was significantly associated with binge/purge behaviors (OR=4.67, 95% CI: 2.38-9.17, p<.001) and binge eating (OR=2.29, 95% CI: 1.26-4.19, p<.01). DISCUSSION These novel findings suggest that lean individuals may internalize weight bias. Importantly, the internalization of weight bias among lean individuals is associated with clinically significant eating pathology.
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Affiliation(s)
- Natasha A Schvey
- Department of Psychology, Yale University, New Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
| | - Marney A White
- Department of Psychology, Yale University, New Haven, CT, United States; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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34
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Grilo CM, Ivezaj V, White MA. Evaluation of the DSM-5 severity indicator for binge eating disorder in a community sample. Behav Res Ther 2015; 66:72-6. [PMID: 25701802 DOI: 10.1016/j.brat.2015.01.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 01/21/2015] [Accepted: 01/22/2015] [Indexed: 11/29/2022]
Abstract
Research has examined various aspects of the diagnostic criteria for binge-eating disorder (BED) but has yet to evaluate the DSM-5 severity criterion. This study examined the DSM-5 severity criterion for BED based on binge-eating frequency and tested an alternative severity specifier based on overvaluation of shape/weight. 338 community volunteers categorized with DSM-5 BED completed a battery of self-report instruments. Participants were categorized first using DSM-5 severity levels and second by shape/weight overvaluation and were compared on clinical variables. 264 (78.1%) participants were categorized as mild, 67 (19.8%) as moderate, 6 (1.8%) as severe, and 1 (0.3%) as extreme. Analyses comparing mild and moderate severity groups revealed no significant differences in demographic variables or BMI; the moderate severity group had greater eating-disorder psychopathology (small effect-sizes) but not depression than the mild group. Participants with overvaluation (N = 196; 60.1%) versus without (N = 130; 39.9%) did not differ significantly in age, sex, BMI, or binge-eating frequency. The overvaluation group had significantly greater eating-disorder psychopathology and depression than the non-overvaluation group. The greater eating-disorder and depression levels (medium-to-large effect-sizes) persisted after adjusting for ethnicity/race and binge-eating severity/frequency, without attenuation of effect-sizes. Findings from this non-clinical community sample provide support for overvaluation of shape/weight as a specifier for BED as it provides stronger information about severity than the DSM-5 rating based on binge-eating. Future research should include treatment-seeking patients with BED to test the utility of DSM-5 severity specifiers and include broader clinical validators.
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Affiliation(s)
- Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, United States; Department of Psychology, Yale University, United States.
| | - Valentina Ivezaj
- Department of Psychiatry, Yale School of Medicine, United States
| | - Marney A White
- Department of Psychiatry, Yale School of Medicine, United States; Yale School of Public Health, United States
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Goldschmidt AB, Wall MM, Choo THJ, Larson NI, Neumark-Sztainer D. Mediators involved in the relation between depressive symptoms and weight status in female adolescents and young adults. Int J Obes (Lond) 2015; 39:1027-9. [PMID: 25640769 PMCID: PMC4464990 DOI: 10.1038/ijo.2015.6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 01/07/2015] [Accepted: 01/21/2015] [Indexed: 11/25/2022]
Abstract
Depression may be a risk factor for overweight status, but mechanisms involved in this relationship are unclear. This study explored behavioral factors involved in the relationship between adolescent depression symptoms and adult overweight status. A population-based cohort of female participants in Project EAT (n=1,035) was followed over 10 years and reported on psychological functioning, weight status, and eating and activity patterns in early/middle adolescence (1999=Time 1; T1), middle adolescence/early young adulthood (2004=Time 2; T2), and early/middle young adulthood (2009=Time 3; T3). Structural equation models were fit which included T1 depression scores predicting overweight status at T3, with T2 fruit and vegetable consumption, moderate-to-vigorous physical activity, and binge eating examined as mediators. There were small but significant effects of T1 depression scores predicting an increased likelihood of T3 overweight status (standardized estimate=0.038; p=.007), and of T2 binge eating mediating the relation between T1 depression and T3 overweight status (standardized indirect effect estimate=.036; p=.009). Binge eating may be one pathway to overweight among depressed females, suggesting that recognition and treatment of eating pathology in individuals with depression may help prevent overweight. Examination of other behavioral (and non-behavioral) factors explaining the relationship between depression and overweight is warranted.
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Affiliation(s)
- A B Goldschmidt
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | - M M Wall
- Department of Biostatistics, Columbia University, New York, NY, USA
| | - T-H J Choo
- Department of Biostatistics, Columbia University, New York, NY, USA
| | - N I Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - D Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Hartmann AS, Gorman MJ, Sogg S, Lamont EM, Eddy KT, Becker AE, Thomas JJ. Screening for DSM-5 Other Specified Feeding or Eating Disorder in a Weight-Loss Treatment-Seeking Obese Sample. Prim Care Companion CNS Disord 2014; 16:14m01665. [PMID: 25667810 DOI: 10.4088/pcc.14m01665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/22/2014] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of specific self-report questionnaires in detecting DSM-5 eating disorders identified via structured clinical interview in a weight-loss treatment-seeking obese sample, to improve eating disorder recognition in general clinical settings. METHOD Individuals were recruited over a 3-month period (November 2, 2011, to January 10, 2012) when initially presenting to a hospital-based weight-management center in the northeastern United States, which offers evaluation and treatment for outpatients who are overweight or obese. Participants (N = 100) completed the Structured Clinical Interview for DSM-IV eating disorder module, a DSM-5 feeding and eating disorders interview, and a battery of self-report questionnaires. RESULTS Self-reports and interviews agreed substantially in the identification of bulimia nervosa (DSM-IV and DSM-5: tau-b = 0.71, P < .001) and binge-eating disorder (DSM-IV and DSM-5: tau-b = 0.60, P < .001), modestly for subthreshold binge-eating disorder (tau-b = 0.44, P < .001), and poorly for other subthreshold conditions (night-eating syndrome: tau-b = -0.04, P = .72, r = 0.06 [DSM-5]). DISCUSSION Current self-report assessments are likely to identify full syndrome DSM-5 eating disorders in treatment-seeking obese samples, but unlikely to detect DSM-5 other specified feeding or eating disorders. We propose specific content changes that might enhance clinical utility as suggestions for future evaluation.
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Affiliation(s)
- Andrea S Hartmann
- Institute of Psychology, Universität Osnabrück, Osnabrück, Germany (Dr Hartmann); Massachusetts General Hospital, Boston (Drs Gorman, Sogg, Eddy, Becker, and Thomas and Mr Lamont); and Department of Psychiatry (Drs Gorman, Sogg, Eddy, and Thomas) and Department of Global Health and Social Medicine (Dr Becker), Harvard Medical School, Boston, Massachusetts
| | - Mark J Gorman
- Institute of Psychology, Universität Osnabrück, Osnabrück, Germany (Dr Hartmann); Massachusetts General Hospital, Boston (Drs Gorman, Sogg, Eddy, Becker, and Thomas and Mr Lamont); and Department of Psychiatry (Drs Gorman, Sogg, Eddy, and Thomas) and Department of Global Health and Social Medicine (Dr Becker), Harvard Medical School, Boston, Massachusetts
| | - Stephanie Sogg
- Institute of Psychology, Universität Osnabrück, Osnabrück, Germany (Dr Hartmann); Massachusetts General Hospital, Boston (Drs Gorman, Sogg, Eddy, Becker, and Thomas and Mr Lamont); and Department of Psychiatry (Drs Gorman, Sogg, Eddy, and Thomas) and Department of Global Health and Social Medicine (Dr Becker), Harvard Medical School, Boston, Massachusetts
| | - Evan M Lamont
- Institute of Psychology, Universität Osnabrück, Osnabrück, Germany (Dr Hartmann); Massachusetts General Hospital, Boston (Drs Gorman, Sogg, Eddy, Becker, and Thomas and Mr Lamont); and Department of Psychiatry (Drs Gorman, Sogg, Eddy, and Thomas) and Department of Global Health and Social Medicine (Dr Becker), Harvard Medical School, Boston, Massachusetts
| | - Kamryn T Eddy
- Institute of Psychology, Universität Osnabrück, Osnabrück, Germany (Dr Hartmann); Massachusetts General Hospital, Boston (Drs Gorman, Sogg, Eddy, Becker, and Thomas and Mr Lamont); and Department of Psychiatry (Drs Gorman, Sogg, Eddy, and Thomas) and Department of Global Health and Social Medicine (Dr Becker), Harvard Medical School, Boston, Massachusetts
| | - Anne E Becker
- Institute of Psychology, Universität Osnabrück, Osnabrück, Germany (Dr Hartmann); Massachusetts General Hospital, Boston (Drs Gorman, Sogg, Eddy, Becker, and Thomas and Mr Lamont); and Department of Psychiatry (Drs Gorman, Sogg, Eddy, and Thomas) and Department of Global Health and Social Medicine (Dr Becker), Harvard Medical School, Boston, Massachusetts
| | - Jennifer J Thomas
- Institute of Psychology, Universität Osnabrück, Osnabrück, Germany (Dr Hartmann); Massachusetts General Hospital, Boston (Drs Gorman, Sogg, Eddy, Becker, and Thomas and Mr Lamont); and Department of Psychiatry (Drs Gorman, Sogg, Eddy, and Thomas) and Department of Global Health and Social Medicine (Dr Becker), Harvard Medical School, Boston, Massachusetts
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Fuller-Tyszkiewicz M, Richardson B, Skouteris H, Austin D, Castle D, Busija L, Klein B, Holmes M, Broadbent J. Optimizing prediction of binge eating episodes: a comparison approach to test alternative conceptualizations of the affect regulation model. J Eat Disord 2014; 2:28. [PMID: 25254111 PMCID: PMC4172954 DOI: 10.1186/s40337-014-0028-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although a wealth of studies have tested the link between negative mood states and likelihood of a subsequent binge eating episode, the assumption that this relationship follows a typical linear dose-response pattern (i.e., that risk of a binge episode increases in proportion to level of negative mood) has not been challenged. The present study demonstrates the applicability of an alternative, non-linear conceptualization of this relationship, in which the strength of association between negative mood and probability of a binge episode increases above a threshold value for the mood variable relative to the slope below this threshold value (threshold dose response model). METHODS A sample of 93 women aged 18 to 40 completed an online survey at random intervals seven times per day for a period of one week. Participants self-reported their current mood state and whether they had recently engaged in an eating episode symptomatic of a binge. RESULTS As hypothesized, the threshold approach was a better predictor than the linear dose-response modeling of likelihood of a binge episode. The superiority of the threshold approach was found even at low levels of negative mood (3 out of 10, with higher scores reflecting more negative mood). Additionally, severity of negative mood beyond this threshold value appears to be useful for predicting time to onset of a binge episode. CONCLUSIONS Present findings suggest that simple dose-response formulations for the association between negative mood and onset of binge episodes miss vital aspects of this relationship. Most notably, the impact of mood on binge eating appears to depend on whether a threshold value of negative mood has been breached, and elevation in mood beyond this point may be useful for clinicians and researchers to identify time to onset.
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Affiliation(s)
| | - Ben Richardson
- />School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Helen Skouteris
- />School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - David Austin
- />School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - David Castle
- />Psychiatry Department, University of Melbourne, Melbourne, VIC Australia
- />St Vincent’s Hospital, Melbourne, VIC Australia
| | - Lucy Busija
- />Faculty of Health, Deakin University, Burwood, Australia
| | - Britt Klein
- />DVC-Research & Innovation Portfolio; the School of Health Sciences; and the Collaborative Research Network, Federation University, Ballarat, Australia
- />National Institute for Mental Health Research, The Australian National University, Canberra, Australia
| | - Millicent Holmes
- />School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Jaclyn Broadbent
- />School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
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Gearhardt AN, Boswell RG, White MA. The association of "food addiction" with disordered eating and body mass index. Eat Behav 2014; 15:427-33. [PMID: 25064294 PMCID: PMC4115253 DOI: 10.1016/j.eatbeh.2014.05.001] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 04/17/2014] [Accepted: 05/19/2014] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The contribution of an addictive process to elevated body mass index (BMI) and disordered eating is an area of growing interest. Yet, little is known about how "food addiction" may be related to disordered eating and obesity. The ability of addictive-like eating to account for eating pathology not captured by traditional eating disorders is unknown. No prior research has examined the association of "food addiction" with bulimia nervosa (BN). Finally, little is understood about the association of "food addiction" with patterns of dieting and weight gain. The current study was conducted to address these gaps in the literature. MATERIAL AND METHODS Participants (N=815) were recruited from online advertisements nationwide and completed measures related to "food addiction", BMI, weight history, and disordered eating. RESULTS Addictive-like eating was associated with elevated current and lifetime highest BMI, weight cycling, and eating pathology. The prevalence of "food addiction" was higher in participants with BN than in those with binge eating disorder (BED). "Food addiction" continued to be related to clinically relevant variables, especially elevated BMI, even when participants did not meet criteria for BED or BN. The co-occurrence of "food addiction" with eating disorders appears to be associated with a more severe variant of eating pathology. DISCUSSION An addictive-type response to highly palatable food may be contributing to eating-related problems, including obesity and eating disorders. BN relative to BED appears to be more strongly associated with "food addiction." Additionally, the concept of "food addiction" appears to capture clinically relevant information in participants who do not meet criteria for either BN or BED. Further examination of "food addiction" may be important in understanding the mechanisms underlying certain types of problematic eating behavior.
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Affiliation(s)
- Ashley N Gearhardt
- Department of Psychology, University of Michigan, 2268 East Hall, 530 Church St., Ann Arbor, MI, 48103.
| | - Rebecca G Boswell
- Department of Psychology, Yale University, 2 Hillhouse Ave., New Haven, CT, 06511
| | - Marney A White
- Department of Psychology, Yale University, 2 Hillhouse Ave., New Haven, CT, 06511; Department of Psychiatry, Yale University School of Medicine, 300 George St., New Haven, CT, 06511; Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College St., New Haven, CT, 06511
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Abstract
OBJECTIVE Ghrelin, a peptide hormone secreted mainly by the stomach, increases appetite and food intake. Surprisingly, ghrelin levels are lower in obese individuals with binge eating disorder (BED) than in obese non-BED individuals. Acute psychological stress has been shown to raise ghrelin levels in animals and humans. Our aim was to assess ghrelin levels after a cold pressor test (CPT) in women with BED. We also examined the relationship between the cortisol stress response and changes in ghrelin levels. METHODS Twenty-one obese (mean [standard deviation] body mass index = 34.9 [5.8] kg/m(2)) women (10 non-BED, 11 BED) underwent the CPT, hand submerged in ice water for 2 minutes. Blood samples were drawn for 70 minutes and assayed for ghrelin and cortisol. RESULTS There were no differences between the groups in ghrelin levels at baseline (-10 minutes). Ghrelin rose significantly after the CPT (F = 2.4, p = .024) peaking at 19 minutes before declining (F = 17.9, p < .001), but there were no differences between the BED and non-BED groups. Area under the curve for ghrelin was not related to ratings of pain, stress, hunger, or desire to eat after CPT. In addition, there were no observed relationships between the area under the curves for ghrelin or cortisol after stress. CONCLUSIONS Although there were no differences between BED groups, there was a significant rise in ghrelin in obese humans after a stressor, consistent with other recent reports suggesting a stress-related role for ghrelin.
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Daily self-weighing and adverse psychological outcomes: a randomized controlled trial. Am J Prev Med 2014; 46:24-9. [PMID: 24355668 PMCID: PMC4157390 DOI: 10.1016/j.amepre.2013.08.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 05/22/2013] [Accepted: 08/28/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Despite evidence that daily self-weighing is an effective strategy for weight control, concerns remain regarding the potential for negative psychological consequences. PURPOSE The goal of the study was to examine the impact of a daily self-weighing weight-loss intervention on relevant psychological constructs. DESIGN A 6-month RCT. SETTING/PARTICIPANTS The study sample (N=91) included overweight men and women in the Chapel Hill NC area. INTERVENTION Between February and August 2011, participants were randomly assigned to a daily self-weighing intervention or delayed-intervention control group. The 6-month intervention included daily self-weighing for self-regulation of diet and exercise behaviors using an e-scale that transmitted weights to a study website. Weekly e-mailed lessons and tailored feedback on daily self-weighing adherence and weight-loss progress were provided. MAIN OUTCOME MEASURES Self-weighing frequency was measured throughout the study using e-scales. Weight was measured in-clinic at baseline, 3 months, and 6 months. Psychological outcomes were assessed via self-report at the same time points. RESULTS In 2012, using linear mixed models and generalized estimating equation models, there were no significant differences between groups in depressive symptoms, anorectic cognitions, disinhibition, susceptibility to hunger, and binge eating. At 6 months, there was a significant group X time interaction for body dissatisfaction (p=0.007) and dietary restraint (p<0.001), with the intervention group reporting lower body dissatisfaction and greater dietary restraint compared to controls. CONCLUSIONS Results indicate that a weight-loss intervention that focuses on daily self-weighing does not cause adverse psychological outcomes. This suggests that daily self-weighing is an effective and safe weight-control strategy among overweight adults attempting to lose weight. TRIAL REGISTRATION This study is registered at clinicaltrials.gov NCT01369004.
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Wiedemann AA, Saules KK, Ivezaj V. Emergence of New Onset substance use disorders among post-weight loss surgery patients. Clin Obes 2013; 3:194-201. [PMID: 25586736 DOI: 10.1111/cob.12034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 08/21/2013] [Accepted: 08/27/2013] [Indexed: 12/21/2022]
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Elevated rates of substance use disorders (SUDs), particularly (but not only) alcohol use, are observed among post-weight loss surgery (WLS) patients. The development of SUDs among post-WLS patients typically occurs 1-2 years post-surgery. Post-WLS patients are developing SUD at a much later time of life than is typical of SUDs in the general population, suggesting they constitute a distinct SUD phenotype that is directly related to having undergone WLS. WHAT THIS STUDY ADDS Overall, findings suggest that post-WLS patients are overrepresented in substance abuse treatment programmes, and the majority of them report no history of SUD before WLS. Relative to non-WLS patients in SUD treatment, post-WLS patients in substance abuse treatment are disproportionally diagnosed with alcohol dependence, including alcohol withdrawal. Post-WLS patients may be at elevated risk for development of New Onset SUD in the absence of a prior SUD history; this group is phenotypically different from those with a history of substance abuse prior to surgery, and such patients may have unique treatment needs. A comprehensive substance abuse treatment facility began observing increased admissions who reported histories of weight loss surgery (WLS). Emerging evidence suggests that roughly half of post-WLS patients in substance abuse treatment developed their substance use disorder (SUD) after surgery. The present study examined differences between SUD patients who developed New Onset SUD after surgery and those with a reported SUD onset before WLS (SUD Hx+ group). Participants completed a questionnaire and participated in a semi-structured interview. Data were also obtained from participants' electronic medical records. Of the total treatment sample (n = 4658), 2.8% reported a history of WLS. Post-WLS patients were significantly more likely to be diagnosed with alcohol use disorders (AUDs). Among post-WLS patients who were interviewed (n = 56), 60% were classified as New Onset SUD, while only 40% were SUD Hx+. SUD Hx+ cases reported using significantly more types of substances than New Onset cases and were more likely to report pre-surgical binge eating disorder (BED). Post-WLS patients are overrepresented in substance abuse treatment and are disproportionally diagnosed AUDs. Post-WLS patients may be at elevated risk for development of New Onset SUD at a time in life (middle age) when SUD onset is relatively uncommon.
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Affiliation(s)
- A A Wiedemann
- Psychology Department, Eastern Michigan University, Ypsilanti, MI, USA
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Schvey NA, Roberto CA, White MA. Clinical correlates of the Weight Bias Internalization Scale in overweight adults with binge and purge behaviours. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/21662630.2013.794523] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rosenberger PH, Dorflinger L. Psychosocial factors associated with binge eating among overweight and obese male veterans. Eat Behav 2013; 14:401-4. [PMID: 23910790 DOI: 10.1016/j.eatbeh.2013.06.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 04/11/2013] [Accepted: 06/07/2013] [Indexed: 12/25/2022]
Abstract
The study's primary objective is to compare psychosocial characteristics of overweight/obese male Veterans who report binge eating with those who do not report binge eating. Participants include 111 overweight/obese male Veterans who completed questionnaires assessing binge eating, depression, stress, body image, self-efficacy for healthy eating and physical activity, and barriers to physical activity. Of the study sample, 25.2% are classified as binge eaters. Binge eating status is not significantly associated with age, race/ethnicity, weight, or BMI. Binge eating is associated with higher scores on measures of depression, barriers to exercise, self-classified weight, and lower self-efficacy for both healthy eating and exercise, but is not associated with body satisfaction or recent stress. Findings suggest that a sizable minority of overweight/obese male Veterans engage in binge eating. Depressive symptoms, self-efficacy, and perceived barriers all significantly predicted binge eating. These findings have implications both for identification of overweight/obese men at risk for binge eating disorder as well as for weight loss treatment in the Veteran population.
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Debar LL, Wilson GT, Yarborough BJ, Burns B, Oyler B, Hildebrandt T, Clarke GN, Dickerson J, Striegel RH. Cognitive Behavioral Treatment for Recurrent Binge Eating in Adolescent Girls: A Pilot Trial. COGNITIVE AND BEHAVIORAL PRACTICE 2013; 20:147-161. [PMID: 23645978 DOI: 10.1016/j.cbpra.2012.04.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
There is a need for treatment interventions to address the high prevalence of disordered eating throughout adolescence and early adulthood. We developed an adolescent-specific manualized CBT protocol to treat female adolescents with recurrent binge eating and tested its efficacy in a small, pilot randomized controlled trial. We present lessons learned in recruiting adolescents, a description of our treatment approach, acceptability of the treatment for teens and parents, as well as results from the pilot trial. Participants in the CBT group had significantly fewer posttreatment eating binges than those in a treatment as usual/delayed treatment (TAU-DT) control group; 100% of CBT participants were abstinent at follow-up. Our results provide preliminary support for the efficacy of this adolescent adaptation of evidence-based CBT for recurrent binge eating. The large, robust effect size estimate observed for the main outcome (NNT=2) places this among the larger effects observed for any mental health intervention.
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Affiliation(s)
- Lynn L Debar
- Kaiser Permanente Center for Health Research, Portland
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Grilo CM, Masheb RM, Brody M, Toth C, Burke-Martindale CH, Rothschild BS. Childhood Maltreatment in Extremely Obese Male and Female Bariatric Surgery Candidates**. ACTA ACUST UNITED AC 2012; 13:123-30. [PMID: 15761171 DOI: 10.1038/oby.2005.16] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine rates of self-reported childhood maltreatment in extremely obese bariatric surgery candidates and to explore associations with sex, eating disorder features, and psychological functioning. RESEARCH METHODS AND PROCEDURES Three hundred forty (58 men and 282 women) extremely obese consecutive candidates for gastric bypass surgery completed a questionnaire battery. The Childhood Trauma Questionnaire was given to assess childhood maltreatment. RESULTS Overall, 69% of patients self-reported childhood maltreatment: 46% reported emotional abuse, 29% reported physical abuse, 32% reported sexual abuse, 49% reported emotional neglect, and 32% reported physical neglect. Except for higher rates of emotional abuse reported by women, different forms of maltreatment did not differ significantly by sex. Different forms of maltreatment were generally not associated with binge eating, current BMI, or eating disorder features. At the Bonferonni-corrected significance level, emotional abuse was associated with higher eating concerns and body dissatisfaction, and emotional neglect was associated with higher eating concerns. In terms of psychological functioning, at the Bonferonni-corrected level, emotional abuse and emotional neglect were associated with higher depression and lower self-esteem, and physical abuse was associated with higher depression. DISCUSSION Extremely obese bariatric surgery candidates reported rates of maltreatment comparable with those reported by clinical groups and roughly two to three times higher than normative community samples. Reported experiences of maltreatment differed little by sex and were generally not significantly associated with current BMI, binge eating, or eating disorder features. In contrast, maltreatment-notably emotional abuse and neglect-were significantly associated with higher depression and lower self-esteem.
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Affiliation(s)
- Carlos M Grilo
- Department of Psychiatry, Yale Psychiatric Research, Yale University School of Medicine, P.O. Box 208098, 301 Cedar Street, New Haven, CT 06520, USA.
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Sioka E, Tzovaras G, Oikonomou K, Katsogridaki G, Zachari E, Papamargaritis D, Pinaka O, Zacharoulis D. Influence of Eating Profile on the Outcome of Laparoscopic Sleeve Gastrectomy. Obes Surg 2012. [DOI: 10.1007/s11695-012-0831-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Kolotkin RL, Westman EC, Østbye T, Crosby RD, Eisenson HJ, Binks M. Does Binge Eating Disorder Impact Weight-Related Quality of Life? ACTA ACUST UNITED AC 2012; 12:999-1005. [PMID: 15229340 DOI: 10.1038/oby.2004.122] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To determine whether binge eating disorder (BED) impacts weight-related quality of life in obese individuals seeking weight loss treatment and to investigate the role of psychological symptoms, BMI, and demographic variables in the relationship between BED and weight-related quality of life. RESEARCH METHODS AND PROCEDURES Three hundred seventeen women (BMI = 37.6) and 213 men (BMI = 41.3) completed questionnaires on admission into an intensive residential lifestyle modification program. Weight-related quality of life was assessed using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite). The presence of BED was determined using the Questionnaire on Eating and Weight Patterns-Revised. Psychological symptoms were assessed using the Beck Depression Inventory and the global severity index of the Symptom Checklist 90-R. RESULTS BED prevalence in this sample was 17.9%. Participants with BED, in comparison with those without BED, were more likely to be women (75.8% vs. 56.3%, p < 0.001), younger (45.0 vs. 49.7 years, p = 0.003), white (98.9% vs. 91.7%), heavier (BMI = 42.0 vs. 38.5, p = 0.002), psychologically distressed, and more impaired on total IWQOL-Lite (51.5 vs. 65.3, p < 0.001) and all IWQOL-Lite subscales. However, after controlling for demographic variables, BMI, and psychological symptoms, BED was not independently associated with weight-related quality of life. DISCUSSION The association between BED and impairment in quality of life that has been previously reported in the literature may largely be accounted for by differences between those with and without BED on demographic variables, BMI, and psychological symptoms. BED does not seem to independently impact weight-related quality of life.
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Affiliation(s)
- Ronette L Kolotkin
- Obesity and Quality of Life Consulting, 1004 Norwood Avenue, Durham, NC 27707, USA.
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Arikian A, Peterson CB, Swanson SA, Berg KC, Chartier L, Durkin N, Crow SJ. Establishing thresholds for unusually large binge eating episodes. Int J Eat Disord 2012; 45:222-6. [PMID: 21520216 PMCID: PMC3638727 DOI: 10.1002/eat.20930] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2011] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study examined group differences in ratings of amounts of food at the threshold of what is considered "unusually large" to develop empirically derived definitions of binge eating criteria for bulimia nervosa and binge eating disorder. METHOD Groups included undergraduate students, community members, and participants from an eating disorder (ED) longitudinal study. Data were collected via self-report questionnaires. RESULTS Ordinal logistic regression indicated that males reported a higher threshold for amounts of food compared to females. Overweight participants from the student and ED samples, but not from the community sample, reported higher thresholds. The presence of binge eating and fear of weight gain were also associated with higher thresholds. DISCUSSION These findings provide evidence that gender, social context, BMI, and eating disorder status are important considerations in determining what is an unusually large amount of food. Future diagnostic guidelines should consider the importance of these factors when defining binge eating.
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Affiliation(s)
- Aimee Arikian
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA.
| | - Carol B. Peterson
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Sonja A. Swanson
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Kelly C. Berg
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | | | - Nora Durkin
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Scott J. Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
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Grilo CM, White MA. A controlled evaluation of the distress criterion for binge eating disorder. J Consult Clin Psychol 2011; 79:509-14. [PMID: 21707133 DOI: 10.1037/a0024259] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Research has examined various aspects of the validity of the research criteria for binge eating disorder (BED) but has yet to evaluate the utility of Criterion C, "marked distress about binge eating." This study examined the significance of the marked distress criterion for BED using 2 complementary comparison groups. METHOD A total of 1,075 community volunteers completed a battery of self-report instruments as part of an Internet study. Analyses compared body mass index (BMI), eating-disorder psychopathology, and depressive levels in 4 groups: 97 participants with BED except for the distress criterion (BED-ND), 221 participants with BED including the distress criterion (BED), 79 participants with bulimia nervosa (BN), and 489 obese participants without binge eating or purging (NBPO). Parallel analyses compared these study groups using the broadened frequency criterion (i.e., once weekly for binge/purge behaviors) proposed for the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the 4th edition (DSM-IV) twice-weekly frequency criterion. RESULTS The BED group had significantly greater eating-disorder psychopathology and depressive levels than the BED-ND group. The BED group, but not the BED-ND group, had significantly greater eating-disorder psychopathology than the NBPO comparison group. The BN group had significantly greater eating-disorder psychopathology and depressive levels than all 3 other groups. The group differences in eating-disorder psychopathology existed even after controlling for depression levels, BMI, and demographic variables, although some differences between the BN and BED groups were attenuated when controlling for depression levels. CONCLUSIONS These findings provide support for the validity of the "marked distress" criterion for the diagnosis of BED.
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Affiliation(s)
- Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519, USA.
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Lier HØ, Biringer E, Stubhaug B, Eriksen HR, Tangen T. Psychiatric disorders and participation in pre- and postoperative counselling groups in bariatric surgery patients. Obes Surg 2011; 21:730-7. [PMID: 20396993 DOI: 10.1007/s11695-010-0146-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Psychological and behavioural factors seem to influence the results of bariatric surgery and the ability to achieve sustained weight loss and subjective wellbeing after the operation. Adequate pre- and postoperative psychological counselling are suggested to improve the results of surgery. However, some patients are reluctant to participate in pre- and postoperative counselling. The aim of the present study was to investigate the possible influence of psychiatric disorders on willingness to participate in group counselling in patients accepted for bariatric surgery. METHODS One hundred and forty-one patients referred to bariatric surgery (F/M: 103/38) with mean body mass index (BMI) of 45.2 kg/m2 (SD = 5.3) and mean age of 42.0 years (SD = 10.4) were interviewed with Mini International Neuropsychiatric Interview (M.I.N.I.) and Structured Clinical Interview (SCID-II) preoperatively. RESULTS The overall prevalence of current psychiatric disorders was 49%. Thirty-one percent did not want to participate in counselling groups. Patients who were unwilling to participate in counselling groups had significantly higher prevalence of social phobia (32%/ 12%, p = 0.006) and avoidant personality disorder (27%/ 12%, p = 0.029) than patients who agreed to participate. CONCLUSIONS Psychiatric disorders are prevalent among candidates for bariatric surgery. Social phobia and avoidant personality disorder seem to influence the willingness to participate in counselling groups. Individual counselling and/or web-based counselling might be recommended for bariatric surgery patients who are reluctant to participate in group counselling.
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Affiliation(s)
- Haldis Ø Lier
- Section of Mental Health Research, Haugesund Hospital, Helse Fonna HF, P.O. Box 2170, 5504, Haugesund, Norway.
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