1
|
Bottera AR, Dougherty EN, Forester G, Peterson CB, Crosby RD, Engel SG, Crow SJ, Wildes JE, Wonderlich SA. Changes in evening-shifted loss of control eating severity following treatment for binge-eating disorder. Psychol Med 2024:1-8. [PMID: 38414359 DOI: 10.1017/s003329172400028x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND Loss of control eating is more likely to occur in the evening and is uniquely associated with distress. No studies have examined the effect of treatment on within-day timing of loss of control eating severity. We examined whether time of day differentially predicted loss of control eating severity at baseline (i.e. pretreatment), end-of-treatment, and 6-month follow-up for individuals with binge-eating disorder (BED), hypothesizing that loss of control eating severity would increase throughout the day pretreatment and that this pattern would be less pronounced following treatment. We explored differential treatment effects of cognitive-behavioral guided self-help (CBTgsh) and Integrative Cognitive-Affective Therapy (ICAT). METHODS Individuals with BED (N = 112) were randomized to receive CBTgsh or ICAT and completed a 1-week ecological momentary assessment protocol at baseline, end-of-treatment, and 6-month follow-up to assess loss of control eating severity. We used multilevel models to assess within-day slope trajectories of loss of control eating severity across assessment periods and treatment type. RESULTS Within-day increases in loss of control eating severity were reduced at end-of-treatment and 6-month follow-up relative to baseline. Evening acceleration of loss of control eating severity was greater at 6-month follow-up relative to end-of-treatment. Within-day increases in loss of control severity did not differ between treatments at end-of-treatment; however, evening loss of control severity intensified for individuals who received CBTgsh relative to those who received ICAT at 6-month follow-up. CONCLUSIONS Findings suggest that treatment reduces evening-shifted loss of control eating severity, and that this effect may be more durable following ICAT relative to CBTgsh.
Collapse
Affiliation(s)
| | - Elizabeth N Dougherty
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | - Glen Forester
- Center for Biobehavioral Research, Sanford Research, Fargo, ND, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Ross D Crosby
- Center for Biobehavioral Research, Sanford Research, Fargo, ND, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Scott G Engel
- Center for Biobehavioral Research, Sanford Research, Fargo, ND, USA
| | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
- Department of Psychiatry, Accanto Health, St. Paul, MN, USA
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | - Stephen A Wonderlich
- Center for Biobehavioral Research, Sanford Research, Fargo, ND, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| |
Collapse
|
2
|
Bottera AR, De Young KP. Loss of control eating exhibits an evening diurnal shift among females with bulimia nervosa and binge-eating disorder. EUROPEAN EATING DISORDERS REVIEW 2024; 32:56-65. [PMID: 37561640 DOI: 10.1002/erv.3021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/20/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
Loss of control (LOC) is a hallmark feature of binge eating that is associated with significant distress and impairment. Despite the central role diurnal rhythms may play in the development and maintenance of LOC eating, diurnal patterns of LOC remain understudied and poorly characterised. We assessed the diurnal timing of LOC in a sample of females with bulimia nervosa and binge-eating disorder who participated in a study assessing the impact of bright light exposure on binge eating, hypothesising that higher ratings of LOC would be more likely to occur later in the day. Participants (N = 34) completed a 22-day protocol during which they provided LOC ratings six times daily. Kernel density estimates describing LOC ratings across times of day were compared using permutation tests of equality. Results demonstrated an evening shift in LOC, wherein higher LOC was more likely to occur later in the day and lower LOC was more likely to occur earlier in the day. This study is the first to clearly depict the phenomenon that the likelihood of experiencing higher LOC increases throughout the day, pointing to the potential role diurnal rhythms, such as disrupted appetitive rhythms or mood variations, may play in maintaining binge eating.
Collapse
Affiliation(s)
- Angeline R Bottera
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois, USA
| | - Kyle P De Young
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| |
Collapse
|
3
|
Presseller EK, Karbassi N, Gian C, Juarascio AS. Unequivocally large, but not enormous: An examination of the nutritional content of objective and subjective binge-eating episodes using ecological momentary assessment data. Int J Eat Disord 2023; 56:1991-1997. [PMID: 37345531 PMCID: PMC10592441 DOI: 10.1002/eat.24016] [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] [Received: 09/29/2022] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE This study compared the macronutrient profiles of subjective binge-eating episodes (SBEs), objective binge-eating episodes (OBEs), and typical eating episodes. METHOD Twenty-one adults with binge eating completed ecological momentary assessment of all eating episodes for 2 weeks, including detailed monitoring of food types and portions. Binge-eating episodes (N = 237) were coded as OBEs (n = 76) or SBEs (n = 161). Calories and macronutrients were computed using manufacturer information and USDA Food and Nutrient Database for Dietary Studies. Multilevel regression models compared the eating episode types on caloric and macronutrient content. RESULTS OBEs contained an average of 121.5 (95.1) g fat, 363.7 (289.1) g carbohydrates, 65.2 (38.2) g protein, 20.9 (16.4) g fiber, and 2856.2 (1869.2) calories. SBEs contained 31.6 (30.5) g fat, 76.5 (54.0) g carbohydrates, 20.5 (21.6) g protein, 5.3 (5.9) g fiber, and 695.1 (505.9) calories. Although OBEs contained significantly more calories and grams of all macronutrients than SBEs (p < .001), the macronutrient proportions of OBEs and SBEs did not differ. The proportions of carbohydrates (p = .005) and protein (p < .001) in SBEs significantly differed from typical eating episodes. DISCUSSION Our findings offer preliminary evidence that OBEs and SBEs are more comparable in macronutrient profile than typical eating episodes. PUBLIC SIGNIFICANCE STATEMENT The present study compared the calories and grams of macronutrients in objectively large binge-eating episodes, subjectively large binge-eating episodes, and typical meals and snacks. Results suggest that objectively and subjectively large binge-eating episodes demonstrate similar profiles of macronutrients, which are different from the macronutrient profile of meals and snacks. These results may help the eating disorder field better study the impact of subjectively large binge-eating episodes.
Collapse
Affiliation(s)
- Emily K Presseller
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Nikoo Karbassi
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Christina Gian
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Nutrition Sciences Department, Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne S Juarascio
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
4
|
Thompson KA, DeVinney AA, Goy CN, Kuang J, Bardone-Cone AM. Subjective and objective binge episodes in relation to eating disorder and depressive symptoms among middle-aged women. Eat Weight Disord 2022; 27:1687-1694. [PMID: 34558018 DOI: 10.1007/s40519-021-01305-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/14/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Evidence suggests loss of control over eating may be the driving component of binge eating, a transdiagnostic symptom of eating disorders and highly comorbid with depressive symptoms. Prior studies have evaluated eating disorder and depressive symptoms across types of binge episodes among adolescent and young adult samples, yet no studies have focused on middle-aged women who may be particularly vulnerable to both binge eating and depressive symptoms. The goal of this study was to compare eating disorder symptoms and depressive symptoms across different types of binge eating episodes among middle-aged women. METHODS Women (N = 347), ages 40-63, completed an online survey about both objective (OBE) and subjective binge episodes (SBE), eating disorder symptoms, and depressive symptoms. Participants were categorized as OBEs only, SBEs only, both OBEs and SBEs, and no binge eating. RESULTS Controlling for group differences, results showed middle-aged women who experienced SBEs only reported greater levels of anorexia nervosa attitudes and behaviors compared to all other groups, and greater dietary restraint compared to those who experienced only OBEs and those with no binge eating. Middle-aged women who experienced any type of binge eating reported greater levels of body image concerns and depressive symptoms compared to those who reported no binge eating. CONCLUSIONS Findings suggest that loss of control is more clinically relevant in terms of associations with eating disorder and depressive symptoms in middle-aged women. LEVEL OF EVIDENCE Level V based on descriptive studies.
Collapse
Affiliation(s)
- Katherine A Thompson
- Department of Psychology and Neuroscience, University of North Carolina, CB #3270 Davie Hall, Chapel Hill, NC, 27599, USA
| | - Aubrey A DeVinney
- Department of Psychology and Neuroscience, University of North Carolina, CB #3270 Davie Hall, Chapel Hill, NC, 27599, USA
| | - Casey N Goy
- Department of Psychology and Neuroscience, University of North Carolina, CB #3270 Davie Hall, Chapel Hill, NC, 27599, USA
| | - Joanna Kuang
- Department of Psychology and Neuroscience, University of North Carolina, CB #3270 Davie Hall, Chapel Hill, NC, 27599, USA
| | - Anna M Bardone-Cone
- Department of Psychology and Neuroscience, University of North Carolina, CB #3270 Davie Hall, Chapel Hill, NC, 27599, USA.
| |
Collapse
|
5
|
Brownstone LM, Mihas P, M Butler R, Maman S, Peterson CB, Bulik CM, Bardone-Cone AM. Lived experiences of subjective binge eating: An inductive thematic analysis. Int J Eat Disord 2021; 54:2192-2205. [PMID: 34761418 DOI: 10.1002/eat.23636] [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: 07/31/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Growing evidence suggests that subjective binge eating (SBE; loss of control eating involving subjectively, but not objectively, large quantities of food) is clinically concerning even though it is not currently considered a diagnostic criterion for eating disorders. However, the lived experience of SBEs has not been examined in a systematic, and data-driven way. METHOD The current study used a qualitative, inductive interview approach to further define SBEs as described by individuals who experience them. Participants (N = 14; 11 cisgender women, Mage = 35.29, 12 White/non-Latinx) reported SBEs that occurred at least twice per week over the prior 3 months. We completed semi-structured qualitative phone interviews with participants regarding their most recent SBE and objective binge-eating episode (OBE) if applicable, as well as broader experiences and attitudes regarding non-binge eating. RESULTS Inductive, reflexive, thematic coding yielded descriptive and interpretive codes regarding SBEs. Main themes regarding SBE experience included: (a) SBEs Occur Across Contexts and Food Types, (b) SBEs Are Contrasts to General Over-Control, (c) SBEs Are Distress- and Disconnection-Inducing, Not Relieving, (d) SBEs Are Responses to Hunger and Restriction, and (e) SBEs Can Be "Echoes" of OBEs. DISCUSSION The current study explored the lived experiences of those who report SBEs and provides an important foundation for hypothesis generation for future research on and clinical interventions for SBEs.
Collapse
Affiliation(s)
- Lisa M Brownstone
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, Denver, Colorado, USA.,Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul Mihas
- The Odum Institute for Research in Social Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rachel M Butler
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Suzanne Maman
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Cynthia M Bulik
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.,Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anna M Bardone-Cone
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
6
|
Subjective binge eating: a marker of disordered eating and broader psychological distress. Eat Weight Disord 2021; 26:2201-2209. [PMID: 33200355 DOI: 10.1007/s40519-020-01053-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/13/2020] [Indexed: 01/20/2023] Open
Abstract
PURPOSE There is building, but limited evidence to suggest that subjective binge eating (SBE) is clinically concerning. The current study examined associated features of SBEs including disordered eating, body shame, negative affect, and interpersonal problems, as well as how SBE occurrence relates to other daily eating experiences. METHODS Participants were 400 individuals recruited via internet snowball or Amazon Mechanical Turk, including 132 with at least one SBE [with or without objective binge eating episodes (OBEs)] in the prior 3 months, 135 with at least one OBE (and no SBEs) in the prior 3 months, and 133 with no loss of control eating in the prior 3 months nor a likely lifetime history of anorexia nervosa. Participants responded to questionnaires assessing eating disorder behaviors (i.e., frequency of compensatory behaviors, dietary restriction), body shame, negative affect (depressive/anxiety symptoms), interpersonal difficulties, and perception of daily eating experiences. RESULTS Individuals with SBEs had higher numbers of vomiting, laxative misuse and hard exercise episodes, dietary restriction, body shame, depressive and anxiety symptoms, and negative perceptions of daily eating experiences as compared to those with only OBEs and no loss of control eating. CONCLUSION These results suggest that SBEs (whether on their own or combined with OBEs) are more related to disordered eating symptoms, body image concerns, depressive/anxiety symptoms, and general eating distress than OBEs on their own, suggesting that clinicians may view SBEs as markers of concern across domains. LEVEL OF EVIDENCE III, well-designed group-comparison regression analysis.
Collapse
|
7
|
Verzijl CL, Ahlich E, Schlauch RC, Rancourt D. The role of craving in emotional and uncontrolled eating. Appetite 2017; 123:146-151. [PMID: 29253669 DOI: 10.1016/j.appet.2017.12.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 11/10/2017] [Accepted: 12/11/2017] [Indexed: 10/18/2022]
Abstract
This study presents a novel application of the cognitive processing model of alcohol craving (CPMA) from the addictions field to the role of food craving in the well-established restrained eating-overeating relationship associated with binge eating disorder (BED). A community sample (N = 1058, ages 18-66) completed an online survey assessing four core domains: restrained eating, trait food craving, uncontrolled eating, and emotional eating. In accordance with the CPMA, food craving emerged as a significant indirect effect of the association between restrained eating and both uncontrolled and emotional eating. Gender did not significantly moderate any direct or indirect associations, suggesting that gender may not change the pattern of association between restrained eating and different facets of overeating. Results suggest that treatments targeting binge eating behaviors may benefit from 1) explicitly addressing the activation of food craving rather than concentrating on reducing restrained eating and 2) recognizing that food craving may be an important gender-neutral target with the potential to reduce binge and overeating behaviors. Future research should extend these preliminary findings by examining the application of the CPMA to eating behaviors while jointly investigating antecedents and contextual factors.
Collapse
Affiliation(s)
- Christina L Verzijl
- Department of Psychology, University of South Florida, 4202 East Fowler Ave, Tampa, FL 33620, United States
| | - Erica Ahlich
- Department of Psychology, University of South Florida, 4202 East Fowler Ave, Tampa, FL 33620, United States
| | - Robert C Schlauch
- Department of Psychology, University of South Florida, 4202 East Fowler Ave, Tampa, FL 33620, United States
| | - Diana Rancourt
- Department of Psychology, University of South Florida, 4202 East Fowler Ave, Tampa, FL 33620, United States.
| |
Collapse
|
8
|
Goldschmidt AB. Are loss of control while eating and overeating valid constructs? A critical review of the literature. Obes Rev 2017; 18:412-449. [PMID: 28165655 PMCID: PMC5502406 DOI: 10.1111/obr.12491] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/22/2016] [Accepted: 11/22/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND Binge eating is a marker of weight gain and obesity, and a hallmark feature of eating disorders. Yet its component constructs - overeating and loss of control (LOC) while eating - are poorly understood and difficult to measure. OBJECTIVE The objective of this study is to critically review the human literature concerning the validity of LOC and overeating across the age and weight spectrum. DATA SOURCES English-language articles addressing the face, convergent, discriminant and predictive validity of LOC and overeating were included. RESULTS Loss of control and overeating appear to have adequate face validity. Emerging evidence supports the convergent and predictive validity of the LOC construct, given its unique cross-sectional and prospective associations with numerous anthropometric, psychosocial and eating behaviour-related factors. Overeating may be best conceptualized as a marker of excess weight status. LIMITATIONS Binge eating constructs, particularly in the context of subjectively large episodes, are challenging to measure reliably. Few studies addressed overeating in the absence of LOC, thereby limiting conclusions about the validity of the overeating construct independent of LOC. Additional studies addressing the discriminant validity of both constructs are warranted. DISCUSSION Suggestions for future weight-related research and for appropriately defining binge eating in the eating disorders diagnostic scheme are presented.
Collapse
Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
| |
Collapse
|
9
|
Watson HJ, Fursland A, Bulik CM, Nathan P. Subjective binge eating with compensatory behaviors: a variant presentation of bulimia nervosa. Int J Eat Disord 2013; 46:119-26. [PMID: 22911884 DOI: 10.1002/eat.22052] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To determine whether a variant bulimic-type presentation, whereby one meets criteria for bulimia nervosa (BN) except that binge eating episodes are not objectively large (i.e., "subjective bulimia nervosa," SBN), has comparable clinical severity to established eating disorders, particularly BN. METHOD Treatment-seeking adults with BN (N = 112), SBN (N = 28), anorexia nervosa restricting type (AN-R) (N = 45), and AN-binge/purge type (AN-B/P) (N = 24) were compared. RESULTS Overall, SBN could not be meaningfully distinguished from BN. SBN and BN had equivalent eating pathology, depression and anxiety symptoms, low quality of life, impulsivity, Axis I comorbidity, and lifetime psychiatric history, and comparable clinical severity to AN-R and AN-B/P. DISCUSSION Individuals with SBN, differing from BN only by the smaller size of their binge eating episodes, had a form of eating disorder comparable in clinical severity to threshold AN and BN and warranting clinical attention. Health professionals and the community require greater awareness of this variant to optimize detection, treatment-seeking, and outcomes.
Collapse
Affiliation(s)
- Hunna J Watson
- Center for Clinical Interventions, Department of Health in Western Australia, Perth, Australia.
| | | | | | | |
Collapse
|
10
|
Palavras MA, Morgan CM, Borges FMB, Claudino AM, Hay PJ. An investigation of objective and subjective types of binge eating episodes in a clinical sample of people with co-morbid obesity. J Eat Disord 2013; 1:26. [PMID: 24999405 PMCID: PMC4081732 DOI: 10.1186/2050-2974-1-26] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 05/31/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Objective binge eating episodes (OBEs) refer to binge eating on an unusually large amount of food and are the core symptom in current definitions of bulimia nervosa (BN) and binge eating disorder (BED). Subjective binge eating episodes (SBEs) refer to eating on a small or moderate amount of food (that is perceived as large) and like OBEs are associated with loss of control (LOC). Reaching consensus on what is considered a large amount of food can however be problematic and it remains unclear if the size of a binge is an essential component for defining a binge eating episode. The aim of this study was to compare the eating disorder features and general psychopathology of subjects reporting OBEs with those reporting only SBEs. METHODS This is a retrospective secondary analysis of data from 70 obese participants at the recruitment phase of a multicentre trial for BED. Individuals who answered positively to the presence of binge eating and LOC over eating had their binge eating episodes further explored by interview and self-report. Two groups, those who reported current OBEs (with or without SBEs) and those who reported current SBEs only were compared for age, gender, marital status, body mass index (BMI), indicators of LOC over eating, severity of binge-eating and associated psychopathology. RESULTS The majority of participants in both the OBE and SBE groups endorsed the experience of at least four indicators of LOC. There were no significant differences between the groups. Both groups had high levels of binge-eating severity, moderate severity of associated depressive symptoms and frequent psychiatric co-morbidity. CONCLUSION Treatment seeking participants with obesity who reported SBEs alone were similar to those who reported OBEs in terms of eating disorder features and general psychopathology. These findings suggest that classificatory systems of mental illnesses should consider introducing SBEs as a feature of the diagnostic criteria for binge eating and, thus, facilitate the inclusion of participants with SBEs in treatment trials.
Collapse
Affiliation(s)
- Marly Amorim Palavras
- Programa de Atenção aos Transtornos Alimentares (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Christina Marcondes Morgan
- Programa de Atenção aos Transtornos Alimentares (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | | - Angélica Medeiros Claudino
- Programa de Atenção aos Transtornos Alimentares (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Phillipa J Hay
- Centre for Health Research School of Medicine University of Western Sydney, Psychiatry James Cook University, Sydney, Australia ; University of Western Sydney, Locked Bag 1797, Penrith NSW 2751, Australia
| |
Collapse
|
11
|
Smith KE, Crowther JH. An exploratory investigation of purging disorder. Eat Behav 2013; 14:26-34. [PMID: 23265398 DOI: 10.1016/j.eatbeh.2012.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 07/23/2012] [Accepted: 10/03/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Purging Disorder (PD) is an understudied pattern of behaviors within the Eating Disorder Not Otherwise Specified (EDNOS) category. Such categorization may suggest that PD is not clinically significant as other eating disorders. However, evidence has suggested that PD is associated with significant impairments in psychosocial functioning and well-being. Despite the apparent clinical significance of PD, it remains to be determined if PD is distinct from other clinically significant eating disorders. The present study sought to assess the phenomenology, clinical significance, and distinctiveness of PD. METHOD Group scores on measures of eating pathology, body image disturbance, and psychological correlates were compared using MANOVA among a female undergraduate sample (N=94) meeting diagnostic criteria for PD (n=20), Bulimia Nervosa (BN; n=35), restrained eating (n=18), and healthy controls (n=21). RESULTS Overall, results indicated the PD group reported less severe symptoms than BN but more severe symptoms than controls. The PD and restraint groups were similar on most variables (including subjective binge behavior), with the exception of perfectionism and hunger. DISCUSSION Findings support the conceptualization of PD as existing along a spectrum of bulimic spectrum disorders rather than as a distinct diagnostic category.
Collapse
|
12
|
Brownstone LM, Bardone-Cone AM, Fitzsimmons-Craft EE, Printz KS, Le Grange D, Mitchell JE, Crow SJ, Peterson CB, Crosby RD, Klein MH, Wonderlich SA, Joiner TE. Subjective and objective binge eating in relation to eating disorder symptomatology, negative affect, and personality dimensions. Int J Eat Disord 2013; 46:66-76. [PMID: 23109272 PMCID: PMC3832259 DOI: 10.1002/eat.22066] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The current study explored the clinical meaningfulness of distinguishing subjective (SBE) from objective binge eating (OBE) among individuals with threshold/subthreshold bulimia nervosa (BN). We examined relations between OBEs and SBEs and eating disorder symptoms, negative affect, and personality dimensions using both a group comparison and a continuous approach. METHOD Participants were 204 adult females meeting criteria for threshold/subthreshold BN who completed questionnaires related to disordered eating, affect, and personality. RESULTS Group comparisons indicated that SBE and OBE groups did not significantly differ on eating disorder pathology or negative affect, but did differ on two personality dimensions (cognitive distortion and attentional impulsivity). Using the continuous approach, we found that frequencies of SBEs (not OBEs) accounted for unique variance in weight/shape concern, diuretic use frequency, depressive symptoms, anxiety, social avoidance, insecure attachment, and cognitive distortion. DISCUSSION SBEs in the context of BN may indicate broader areas of psychopathology.
Collapse
Affiliation(s)
| | | | | | | | - Daniel Le Grange
- Department of Psychiatry & Behavioral Neuroscience, The University of Chicago
| | | | | | | | - Ross D. Crosby
- Department of Clinical Neuroscience, University of North Dakota
| | | | | | | |
Collapse
|
13
|
Peterson CB, Swanson SA, Crow SJ, Mitchell JE, Agras WS, Halmi KA, Crosby RD, Wonderlich SA, Berg KC. Longitudinal stability of binge-eating type in eating disorders. Int J Eat Disord 2012; 45:664-9. [PMID: 22407944 PMCID: PMC3645844 DOI: 10.1002/eat.22008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 11/23/2011] [Accepted: 12/31/2011] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the 2-year longitudinal stability of objective bulimic (binge eating) episodes (OBEs) and subjective bulimic (binge eating) episodes (SBEs) in a multisite eating disorders sample. METHOD Participants included 288 females with eating disorder symptoms who were assessed every 6 months using the Eating Disorder Examination. RESULTS Markov modeling revealed considerable longitudinal variability between types of binge eating over 6-month time intervals with relatively higher probability estimates for consistency between OBEs and SBEs than specific transitions between types for the overall sample as well as for eating disorder diagnostic groups. Transition patterns examining all five time points indicated notable variability in binge-eating patterns among participants. DISCUSSION These findings suggest that although longitudinal patterns of binge types are variable among individuals with eating disorders, consistency in OBEs and SBEs was the most common pattern observed.
Collapse
Affiliation(s)
- Carol B. Peterson
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota,Correspondence to: Carol B. Peterson, PhD, Department of Psychiatry, University of Minnesota Medical School, F282/2A West, 2450 Riverside Avenue South, Minneapolis, MN 55454.
| | - Sonja A. Swanson
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Scott J. Crow
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota
| | - James E. Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute and Department of Clinical Neuroscience, University of North Dakota School of Medicine Fargo, North Dakota
| | - W. Stewart Agras
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Katherine A. Halmi
- Department of Psychiatry, Weill Medical College, Cornell University, White Plains, New York
| | - Ross D. Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute and Department of Clinical Neuroscience, University of North Dakota School of Medicine Fargo, North Dakota
| | - Stephen A. Wonderlich
- Department of Clinical Research, Neuropsychiatric Research Institute and Department of Clinical Neuroscience, University of North Dakota School of Medicine Fargo, North Dakota
| | - Kelly C. Berg
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota
| |
Collapse
|
14
|
Dalle Grave R, Calugi S, Marchesini G. Objective and subjective binge eating in underweight eating disorders: associated features and treatment outcome. Int J Eat Disord 2012; 45:370-6. [PMID: 21656542 DOI: 10.1002/eat.20943] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2011] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To define the utility of the DSM-IV-TR definition of binge eating, as it applies to anorexia nervosa (AN) and underweight eating disorder not otherwise specified (ED-NOS). METHOD We investigated the psychopathological features associated with bulimic episodes in 105 underweight individuals with eating disorders who reported regular objective bulimic episodes with or without subjective bulimic episodes (OBE group, n = 33), regular subjective bulimic episodes only (SBE group, n = 36) and neither objective nor subjective bulimic episodes (n = 36, no-RBE group). The Eating Disorder Examination (EDE), anxiety, depression, and personality tests were administered before and upon completion of inpatient cognitive behavior therapy (CBT) treatment 6 months later. RESULTS Compared with the SBE group, OBE subjects had higher body mass index, and more frequent self-induced vomiting, while both OBE and SBE groups had more severe eating disorder psychopathology and lower self-directness than the no-RBE group. Dropout rates and outcomes in response to inpatient CBT were similar in the three groups. DISCUSSION Despite a few significant differences at baseline, the similar outcome in response to CBT indicates that categorizing patients with underweight eating disorder on the basis of the type or frequency of bulimic episodes is of limited clinical utility.
Collapse
Affiliation(s)
- Riccardo Dalle Grave
- Department of Eating Disorder and Obesity, Villa Garda Hospital, Garda (Vr), Italy
| | | | | |
Collapse
|
15
|
Mitchell JE, Karr TM, Peat C, Wonderlich S, Crosby RD, Engel S, Simonich H. A fine-grained analysis of eating behavior in women with bulimia nervosa. Int J Eat Disord 2012; 45:400-6. [PMID: 21956763 PMCID: PMC4201497 DOI: 10.1002/eat.20961] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/21/2011] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In the current study, we were interested in developing a typology of eating in patients with bulimia nervosa (BN) based on the size of the eating episode, whether the episode was followed by self-induced vomiting, and the degree of loss of control (LOC) self-reported by participants. METHOD Twenty-one women with BN, purging type, were evaluated using the Nutritional Data System for Research, the Eating Disorders Examination, and the Matrix. RESULTS The most common type of episode resembled what might be termed "normal" eating, which involved the consumption of <1,000 kcal with no sense of LOC and no vomiting. There was an increase in severity of self-assessed LOC in objectively large eating episodes with vomiting. Self-reported hunger prior to eating episodes did not seem to be predictive of subsequent behavior. Most people were engaged in other behaviors while eating. DISCUSSION The results of this study suggest a typology that included primarily four types of eating episodes. The results also suggest that when LOC is assessed on a Likert-scale rather than as a dichotomous variable, there is considerable variability in self-assessed degree of LOC.
Collapse
Affiliation(s)
- James E. Mitchell
- Neuropsychiatric Research Institute, Fargo, ND, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND
| | - Trisha M. Karr
- Neuropsychiatric Research Institute, Fargo, ND, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND
| | - Christina Peat
- Neuropsychiatric Research Institute, Fargo, ND, Department of Psychology, University of North Dakota, Grand Forks, ND
| | - Stephen Wonderlich
- Neuropsychiatric Research Institute, Fargo, ND, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND
| | - Ross D. Crosby
- Neuropsychiatric Research Institute, Fargo, ND, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND
| | - Scott Engel
- Neuropsychiatric Research Institute, Fargo, ND, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND
| | | |
Collapse
|
16
|
Clyne C, Blampied NM. Training in Emotion Regulation as a Treatment for Binge Eating: A Preliminary Study. BEHAVIOUR CHANGE 2012. [DOI: 10.1375/bech.21.4.269.66105] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractBinge eating within Binge Eating Disorder (BED) may represent ineffective management of, and inappropriate escape from, strong, dysphoric emotions, but treatments have been slow to incorporate an emotion regulation focus. Eleven women meeting criteria for BED participated in 11 sessions (2 hours per week) of a psychoeducational group program providing training in emotion recognition and management, problem-solving, assertion training, relaxation and stress management. Outcome was evaluated using a multiple-baseline design replicated across groups. Binges were self-monitored daily, and self-report questionnaires assessed wellbeing and emotion regulation at pretreatment, posttreatment and follow-up. Cognitive changes from pre to posttreatment were evaluated by Articulated Thoughts in Simulated Situations. The program was effective in reducing binge eating, alexithymia, stress and depression, and it improved coping and positive cognitions. No participant met criteria for BED at follow-up. The findings provide support for the inclusion of training in emotion recognition and regulation in treatments for BED and for affect regulation models of binge eating.
Collapse
|
17
|
Assessment methods for eating disorders and body image disorders. J Psychosom Res 2010; 69:601-11. [PMID: 21109049 DOI: 10.1016/j.jpsychores.2009.05.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2009] [Revised: 04/30/2009] [Accepted: 05/22/2009] [Indexed: 11/22/2022]
Abstract
The growing interest in the treatment and research of eating disorders has stimulated the development of assessment methods, and there are now many questionnaires for evaluating behavioral and attitudinal characteristics of eating pathology. The present article sets out to review the assessment tools that are widely used in clinical practice and research. In particular, it covers self-report measures with summaries of their psychometric properties. It also presents diagnostic questionnaires based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria. The instruments described include screening questionnaires, measurement tools for specific eating disorder symptoms, measurement of quality of life in eating disorders, and some tools for the measurement of body image disorder, a common feature of eating disorders. There is also a discussion of distorting factors that decrease the authenticity of assessment tools. These problems arise from the definition of some constructs and from the phenomena of denial and concealment, which are frequent among eating-disordered individuals. The frequent co-occurrence of other psychopathological features (e.g., multiimpulsive symptoms) shows that other psychological phenomena should also be evaluated in line with the assessment of eating disorders.
Collapse
|
18
|
Shomaker LB, Tanofsky-Kraff M, Elliott C, Wolkoff LE, Columbo KM, Ranzenhofer LM, Roza CA, Yanovski SZ, Yanovski JA. Salience of loss of control for pediatric binge episodes: does size really matter? Int J Eat Disord 2010; 43:707-16. [PMID: 19827022 PMCID: PMC2891915 DOI: 10.1002/eat.20767] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The subjective experience of loss of control (LOC) during eating, independent of overeating, may be a salient marker of disordered eating and risk for overweight in youth. However, few studies have directly tested this notion in an adequately powered sample. METHOD Three-hundred-sixty-seven youth (M ± SD age = 12.7 ± 2.8 y) were categorized as reporting objective binge eating (OBE; 12.5%), subjective binge eating (SBE; 11.4%), objective overeating without LOC (OO; 18.5%), or no episodes (NE; 57.5%). Disordered eating attitudes, general psychopathology, and adiposity were assessed. RESULTS Children with OBE and SBE generally did not differ in their disordered eating attitudes, emotional eating, eating in the absence of hunger, depressive and anxiety symptoms, or adiposity. However, both OBE and SBE youth had significantly greater disordered eating attitudes, emotional eating, eating in the absence of hunger, depressive and anxiety symptoms, and adiposity compared to those with OO or NE (ps < .05). DISCUSSION For non-treatment-seeking youth, LOC during eating episodes, rather than episode size, appears to be the most salient marker of eating and weight problems.
Collapse
Affiliation(s)
- Lauren B. Shomaker
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Marian Tanofsky-Kraff
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Camden Elliott
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Laura E. Wolkoff
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Kelli M. Columbo
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Lisa M. Ranzenhofer
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Caroline A. Roza
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Susan Z. Yanovski
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Division of Digestive Diseases and Nutrition, NIDDK, NIH, DHHS, Bethesda, MD
| | - Jack A. Yanovski
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| |
Collapse
|
19
|
Mond JM, Latner JD, Hay PH, Owen C, Rodgers B. Objective and subjective bulimic episodes in the classification of bulimic-type eating disorders: another nail in the coffin of a problematic distinction. Behav Res Ther 2010; 48:661-9. [PMID: 20434132 DOI: 10.1016/j.brat.2010.03.020] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 03/25/2010] [Accepted: 03/25/2010] [Indexed: 10/19/2022]
Abstract
We sought to further explore the validity of the distinction between objective bulimic episodes (OBEs) and subjective bulimic episodes (SBEs) in the study of bulimic-type eating disorders. Drawing on data obtained at the second, interview phase of a large-scale epidemiological study, we identified mutually exclusive subgroups of women with bulimic-type eating disorders who engaged in regular OBEs but not SBEs (n = 37) or regular SBEs but not OBEs (n = 52). These subgroups were compared on a wide range of outcomes, including socio-demographic characteristics, current levels of eating disorder psychopathology, general psychological distress and impairment in role functioning, current and lifetime impairment in quality of life specifically associated with an eating problem, (self)-recognition of an eating problem, health service utilization and use of psychotropic medication. The only difference between groups was that participants who reported regular OBEs were heavier than those who reported regular SBEs. The findings converge with those of previous research in suggesting that bulimic-type eating disorders characterized by regular SBEs, but not OBEs, do not differ in any clinically meaningful way from those characterized by regular OBEs, but not SBEs. Inclusion of bulimic-type eating disorders characterized by regular SBEs as a provisional category requiring further research in DSM-V appears warranted.
Collapse
Affiliation(s)
- J M Mond
- School of Biomedical and Health Sciences, University of Western Sydney, Campbelltown, Australia.
| | | | | | | | | |
Collapse
|
20
|
Wolfe BE, Baker CW, Smith AT, Kelly-Weeder S. Validity and utility of the current definition of binge eating. Int J Eat Disord 2009; 42:674-86. [PMID: 19610126 DOI: 10.1002/eat.20728] [Citation(s) in RCA: 153] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Binge eating, a cardinal symptom of bulimia nervosa (BN) and binge eating disorder (BED), continues to pose challenges in terms of its definition and thus construct validity and clinical utility. This article reviews the available empirical data that support or refute the current DSM-IV-TR defined characteristics of a binge episode. METHOD A systematic literature review was conducted using Medline/PubMed electronic database on DSM-IV-TR defined binge characteristics and associated attributes. RESULTS Data support the current DSM guidelines indicating that binge episodes typically occur in less than 2 h. Size of binge episodes has variability across BN and BED diagnostic groups. Loss of control (LOC) continues to be a core feature of binge eating. Negative affect is the most widely reported antecedent. Strikingly, little is known about binge episodes among individuals with anorexia nervosa-binge/purge subtype. DISCUSSION Available empirical evidence supports the current DSM duration and LOC attributes of a binge episode in BN and BED. However, a more controversial issues is the extent to which size is important in the definition of a binge episode (e.g., subjective vs. objective episodes) across diagnostic categories and the extent to which binge size informs prognosis, treatment, and clinical outcomes. Further study of binge eating attributes in AN is needed.
Collapse
Affiliation(s)
- Barbara E Wolfe
- Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, Massachusetts 02467, USA.
| | | | | | | |
Collapse
|
21
|
Abstract
OBJECTIVE This paper considers whether the criteria currently used to classify the diagnosis of binge eating disorder (BED) are valid and appropriate. METHOD We review evidence that reflects on the validity of the current criteria for binge eating episodes and BED, using literature retrieved through major psychology and psychiatry search engines (e.g., PsycInfo, PubMed). RESULTS Evidence from experimental research points to the relative importance of episode frequency, the amount of food consumed at episodes, the subjective sense of loss of control over eating, and several additional criteria associated with binge episodes in BED. Evidence on the differences in psychopathology between BED and bulimia nervosa and between BED and obesity without binge eating, as related to diagnostic criteria, is reviewed. CONCLUSION Although evidence concerning the diagnostic criteria of BED is mixed, broadening certain diagnostic criteria for binge eating episodes and BED might more accurately reflect the research literature and increase the number of individuals eligible for inclusion in treatment programs.
Collapse
Affiliation(s)
- Janet D Latner
- Department of Psychology, University of Hawaii, Honolulu, Hawaii 96822, USA.
| | | |
Collapse
|
22
|
Latner JD, Hildebrandt T, Rosewall JK, Chisholm AM, Hayashi K. Loss of control over eating reflects eating disturbances and general psychopathology. Behav Res Ther 2007; 45:2203-11. [PMID: 17229399 DOI: 10.1016/j.brat.2006.12.002] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2006] [Revised: 12/02/2006] [Accepted: 12/06/2006] [Indexed: 11/28/2022]
Abstract
This study examined the clinical significance of the loss of control over eating as a key component of eating disorders. It investigated the association of eating-related psychopathology and general psychopathology with objective bulimic episodes (OBEs; experiencing a loss of control while consuming large amounts of food) and subjective bulimic episodes (SBEs; experiencing a loss of control while consuming small/moderate amounts). A community sample of 81 women with a range of disordered eating was recruited: binge-eating disorder, bulimia nervosa, subclinical eating disturbances, or no eating disorders. They were interviewed using the Eating Disorder Examination and completed measures of eating-related and general psychopathology. Both OBE and SBE frequencies correlated significantly with measures of eating-related and general psychopathology, and no significant differences were found between the magnitudes of the correlations with either binge episode type. SBE frequency significantly and independently predicted global eating disorder psychopathology. The loss of control over eating, without consuming large amounts of food, was as closely associated with specific eating disorder psychopathology and general mental health as were traditionally defined OBEs. SBEs may be an important target of treatment and should be considered for future diagnostic classifications of eating disorders.
Collapse
Affiliation(s)
- Janet D Latner
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI 96822, USA.
| | | | | | | | | |
Collapse
|
23
|
Hildebrandt T, Latner J. Effect of self-monitoring on binge eating: treatment response or ‘binge drift’? EUROPEAN EATING DISORDERS REVIEW 2006. [DOI: 10.1002/erv.667] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
24
|
Abstract
OBJECTIVE The current study evaluates the clinical significance and distinctiveness of purging disorder (PD), an eating disorder characterized by recurrent purging in the absence of objective binge episodes (OBE) among normal-weight individuals. METHOD Women with PD (n = 37), bulimia nervosa (BN; n = 39), or no eating disorder (n = 35) completed clinical assessments. Women with PD (n = 23) and BN (n = 25) completed 6-month follow-up assessments. RESULTS Compared with controls, both eating-disordered groups reported significantly higher eating, Axis I, and Axis II pathology. Compared with BN, PD was associated with significantly lower eating concerns, disinhibition, and hunger. At 6-month follow-up, rates of remission did not differ significantly between PD and BN, and crossover between disorders was rare. CONCLUSION PD appears to be a clinically significant and potentially distinctive eating disorder.
Collapse
Affiliation(s)
- Pamela K Keel
- Department of Psychology, University of Iowa, Iowa City, Iowa 52242, USA.
| | | | | |
Collapse
|
25
|
Rushing JM, Jones LE, Carney CP. Bulimia Nervosa: A Primary Care Review. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2003; 5:217-224. [PMID: 15213788 PMCID: PMC419300 DOI: 10.4088/pcc.v05n0505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2003] [Accepted: 10/28/2003] [Indexed: 10/20/2022]
Abstract
Bulimia nervosa is a psychiatric condition that affects many adolescent and young adult women. The disorder is characterized by bingeing and purging behavior and can lead to medical complications. Thus, patients with bulimia nervosa commonly present in the primary care setting. Physical and laboratory examinations reveal markers of bulimia nervosa that are useful in making the diagnosis. Treatment is beneficial, and outcomes of early intervention are good. This article discusses the history, presentation, and tools needed for recognizing and treating bulimia nervosa in primary care.
Collapse
Affiliation(s)
- Jona M. Rushing
- Department of Psychiatry, and the Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City; and the Department of Epidemiology, University of Iowa College of Public Health, Iowa City
| | | | | |
Collapse
|