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Serrano-Fuentes N, Rogers A, Portillo MC. Beyond individual responsibility: Exploring lay understandings of the contribution of environments on personal trajectories of obesity. PLoS One 2024; 19:e0302927. [PMID: 38718062 PMCID: PMC11078422 DOI: 10.1371/journal.pone.0302927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 04/13/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Reversing the upward trajectory of obesity requires responding by including the multiple influences on weight control. Research has focused on individual behaviours, overlooking the environments where individuals spend their lives and shape lifestyles. Thus, there is a need for lay understandings of the impact of environments as a cause and solution to obesity. This research aimed to understand the influence of environments on the adoption of health practices in adults with obesity and to identify lay strategies with which to address environmental barriers to behaviour change. METHODS Nineteen adults with a history of obesity living in the United Kingdom were interviewed through video conferencing between May 2020 and March 2021. Semi-structured interviews and socio-demographic questionnaires were used, and data analysed through hermeneutic phenomenology informed reflexive thematic analysis. RESULTS Three main themes were created: living with convenience and normalcy: the increased accessibility of unhealthy food, people interacting with digital media for positive practice change, and the need to prioritise prevention in schools, the National Health Service and the food industry. CONCLUSIONS The food environment was the major barrier, while interactions with social media was the most important opportunity to adopt healthy practices. The National Health Service was considered an obesogenic environment, something relevant since it has been traditionally recognised as an obesity management system. The perceptions from individuals with a history of obesity provide new suggestions on the influence of previously overlooked environments to design more adequate and effective interventions and policies that consider, more than in the past, the environments where people spend their lives.
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Affiliation(s)
- Nestor Serrano-Fuentes
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Anne Rogers
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Mari Carmen Portillo
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton, United Kingdom
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2
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Bennett BL, Latner JD. Mindful eating, intuitive eating, and the loss of control over eating. Eat Behav 2022; 47:101680. [PMID: 36334338 DOI: 10.1016/j.eatbeh.2022.101680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The loss of control over eating (LOCE) is frequently cited as a core process of eating disturbances. In contrast, mindful eating and intuitive eating have been identified as adaptive styles of eating and have been associated with positive psychological constructs. Therefore, the present study aimed to investigate whether mindful or intuitive eating are potential protective factors for the loss of control over eating. METHODS 1155 participants (64.2 % female) were recruited from a large university. Participants were administered select subscales of the Intuitive Eating Scale - 2nd edition (IES-2) and Mindful Eating Questionnaire (MEQ), and the brief Loss of Control over Eating Scale (LOCES-B). RESULTS Controlling for BMI and age, intuitive and mindful eating were significantly associated with LOCE, F (8,966) = 114.78, p < .001, R2 = 0.49. Both IES-2 subscales were negatively associated with LOCE: 1) eating for physical rather than emotional reasons and 2) reliance on hunger and satiety cues, p < .001. One MEQ subscale was negatively associated with LOCE: disinhibition, p < .001. The MEQ subscales assessing awareness and external cues were not significantly associated with LOCE. CONCLUSIONS Results suggest that while some forms of mindful eating and intuitive eating are potential protective factors, others may be less relevant to LOCE. These findings have implications for treatment, as they suggest intuitive eating may counteract the loss of control over eating. The findings also provide evidence for convergent validity of the LOCES by clarifying positive constructs that may protect against the development of this core eating pathology.
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Affiliation(s)
- Brooke L Bennett
- Rudd Center for Food Policy and Health, University of Connecticut, 1 Constitution Plaza, Suite 600, Hartford, CT 06103, USA; Department of Psychology, University of Hawai'i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI 96822-2294, USA.
| | - Janet D Latner
- Department of Psychology, University of Hawai'i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI 96822-2294, USA.
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3
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Felonis CR, Gillikin LM, Lin M, Manasse SM, Juarascio AS. Anhedonia in cognitive behavioral therapy for binge eating spectrum disorders. Eat Disord 2022; 31:362-374. [PMID: 36394391 DOI: 10.1080/10640266.2022.2141701] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Anhedonia is theorized as being relevant to binge eating spectrum disorders (BESDs) by palatable foods substituting the pleasure typically obtained from day-to-day activities. The current study examined whether anhedonia is associated with eating pathology at baseline and whether it predicts cognitive behavioral therapy (CBT) outcomes alone and when controlling for non-anhedonia depression symptoms. Ninety-three individuals from two randomized controlled trials completed the Eating Disorder Examination and Beck Depression Inventory-II at pre-, mid-, and post-treatment. Results showed that anhedonia was positively associated with global eating pathology at baseline, and larger pre- to mid-treatment anhedonia and non-anhedonia reductions predicted larger pre- to post-treatment global eating pathology reductions, though the anhedonia association was no longer significant when controlling for non-anhedonia depression. Anhedonia appears to be related to global eating pathology in CBT for BESDs, but not loss of control eating. Further research is needed to elucidate the relationship between anhedonia and BESDs.
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Affiliation(s)
- Christina R Felonis
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Lindsay M Gillikin
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Mandy Lin
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne S Juarascio
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
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4
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Burr EK, Dvorak RD, Stevenson BL, Schaefer LM, Wonderlich SA. Ability to tolerate distress moderates the indirect relationship between emotion regulation difficulties and loss-of-control over eating via affective lability. Eat Behav 2021; 43:101561. [PMID: 34517279 PMCID: PMC8629940 DOI: 10.1016/j.eatbeh.2021.101561] [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: 12/28/2020] [Revised: 07/27/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Loss-of-control eating (LOCE), inability to refrain from or cease eating, may contribute to significant distress and dysfunction, yet research is lacking specificity on vulnerabilities contributing to LOCE as an independent construct. Preliminary evidence indicates potential roles of distress tolerance, emotion regulation, and affective lability, but the relationship between these variables and LOCE has been under-assessed. MATERIAL AND METHODS A sample (N = 3968) consisting of university students completed an assessment of pathological eating and affiliated affective vulnerabilities. A latent variable structural equation model (SEM) was generated to predict LOCE by way of affective lability and indirectly, emotion regulation difficulties and low distress tolerance, controlling for general eating pathology. RESULTS Findings indicated a significant direct effect of affective lability on LOCE, as well as significant indirect effects of emotion regulation difficulties and distress tolerance on LOCE, via affect lability. Additionally, distress tolerance moderated the relationship between emotion regulation difficulties and affective lability, such that lower ability to tolerate distress strengthened the relationship and higher distress tolerance capability attenuated it. DISCUSSION Findings suggest an influence of distress tolerance on the relationship between poor emotion regulation and affective lability, which in turn may affect LOCE. Clinical implications and suggestions for future research are discussed.
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Affiliation(s)
- Emily K Burr
- Department of Psychology, University of Central Florida, United States of America.
| | - Robert D Dvorak
- Department of Psychology, University of Central Florida, United States of America.
| | | | - Lauren M Schaefer
- Sanford Center for Bio-behavioral Research, Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, United States of America
| | - Stephen A Wonderlich
- Sanford Center for Bio-behavioral Research, Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, United States of America.
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5
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Why people join pro-Ana online communities? A psychological textual analysis of eating disorder blog posts. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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6
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Mourilhe C, Moraes CED, Veiga GD, Q da Luz F, Pompeu A, Nazar BP, Coutinho ESF, Hay P, Appolinario JC. An evaluation of binge eating characteristics in individuals with eating disorders: A systematic review and meta-analysis. Appetite 2021; 162:105176. [PMID: 33639247 DOI: 10.1016/j.appet.2021.105176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 12/16/2020] [Accepted: 02/19/2021] [Indexed: 01/29/2023]
Abstract
The objective of this review is to provide an updated synthesis of studies in individuals with eating disorders that examined the following components of binge eating episodes (BEEs): caloric intake, episode duration, and also the association of BEE size with psychopathology. A systematic review and meta-analysis were performed following the PRISMA guidelines. Searches were conducted on PubMed, PsycINFO, Scopus, SciELO, ScienceDirect and ProQuest databases. Meta-analysis was performed using random effects models and meta-regression. Forty-three studies were included. There was a paucity of information regarding BEE in individuals with anorexia nervosa. The pooled caloric intake of participants with bulimia nervosa (BN) during BEE in laboratory studies was significantly greater in comparison to the caloric intake during BEE in clinical studies [(3070 (95%CI 2596, 3544) vs. 1789 (95%CI 1498, 2081)], respectively. In participants with binge eating disorder (BED), the pooled means were 2088 (95%CI 1819, 2358) kcal in laboratory studies and 1903 (95%CI 1622, 2184) kcal in clinical studies, with no statistically significant difference between groups. Overall, BEE had a mean duration of 37.3 min in participants with BN and 41.7 min in those with BED. We found a positive correlation between the average caloric intake and level of depression (β = 55.5; p = 0.019). BEE in individuals with BN or BED were characterized by the consumption of extremely large quantities of calories. This was mainly found in laboratory studies of individuals with BN. BEE had a mean duration of less than 1 h in individuals with BN or BED. BEE size was positively associated with depression severity. Future research should explore the relevance of binge size as a core component of binge eating in clinical samples, in males, and in pediatric populations.
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Affiliation(s)
- Carla Mourilhe
- Federal University of Rio de Janeiro, Institute of Psychiatry, Obesity and Eating Disorders Group - Av. Venceslau Brás, 71, Botafogo, CEP:22290-140, Rio de Janeiro, Brazil; Federal University of Rio de Janeiro, Institute of Nutrition Josue de Castro, Department of Social and Applied Nutrition - Av. Carlos Chagas Filho, 373 - bloco J, 2° andar - Cidade Universitária, CEP:21941-902, Rio de Janeiro, Brazil.
| | - Carlos EduardoFerreira de Moraes
- Federal University of Rio de Janeiro, Institute of Psychiatry, Obesity and Eating Disorders Group - Av. Venceslau Brás, 71, Botafogo, CEP:22290-140, Rio de Janeiro, Brazil.
| | - GloriaValeria da Veiga
- Federal University of Rio de Janeiro, Institute of Nutrition Josue de Castro, Department of Social and Applied Nutrition - Av. Carlos Chagas Filho, 373 - bloco J, 2° andar - Cidade Universitária, CEP:21941-902, Rio de Janeiro, Brazil.
| | - Felipe Q da Luz
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), São Paulo, SP 05403-010, Brazil.
| | - Amanda Pompeu
- Federal University of Rio de Janeiro, Institute of Psychiatry, Obesity and Eating Disorders Group - Av. Venceslau Brás, 71, Botafogo, CEP:22290-140, Rio de Janeiro, Brazil.
| | - Bruno Palazzo Nazar
- Federal University of Rio de Janeiro, Institute of Psychiatry, Obesity and Eating Disorders Group - Av. Venceslau Brás, 71, Botafogo, CEP:22290-140, Rio de Janeiro, Brazil.
| | - Evandro Silva Freire Coutinho
- The State University of Rio de Janeiro, Institute of Social Medicine - R. São Francisco Xavier, 524 - Maracanã, CEP:20550-900, Rio de Janeiro, Brazil.
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, School of Medicine - David Pilgrim Avenue, Campbelltown, NSW 2560, Australia.
| | - Jose Carlos Appolinario
- Federal University of Rio de Janeiro, Institute of Psychiatry, Obesity and Eating Disorders Group - Av. Venceslau Brás, 71, Botafogo, CEP:22290-140, Rio de Janeiro, Brazil.
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7
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Richson BN, Forbush KT, Schaumberg K, Crosby RD, Peterson CB, Crow SJ, Mitchell JE. Are the Criterion B binge-eating symptoms interchangeable in understanding binge-eating severity? An item response theory analysis. Int J Eat Disord 2020; 53:1983-1992. [PMID: 32945003 DOI: 10.1002/eat.23383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/29/2020] [Accepted: 08/30/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The Criterion B binge-eating symptoms represent five symptoms associated with binge eating. Any three out of five symptoms can be used to meet Criterion B. However, Criterion B symptoms may not be interchangeable in terms of how binge-eating severity is associated with each symptom. Item response theory (IRT) can test how endorsing each symptom relates to the overall level (i.e., severity) of binge-eating measured by Criterion B. We used IRT to identify (a) how each Criterion B symptom corresponded with binge-eating severity in a transdiagnostic binge-eating sample and (b) how well each symptom differentiated individuals with differing levels of severity. METHOD Participants (N = 219) were adults (80.8% female) with a current ED that included objective binge-eating episodes assessed via semi-structured interview. A two-parameter logistic IRT model evaluated how endorsement of each Criterion B symptom corresponded with the level of latent binge-eating severity. RESULTS "Eating large amounts when not hungry" and "eating alone" reflected the highest binge-eating severity. "Eating alone" was the best discriminator across different binge-eating severity levels, whereas "uncomfortably full" was the poorest discriminator across binge-eating severity levels. DISCUSSION Criterion B symptoms were not interchangeable in terms of what level of binge-eating severity corresponded with symptom endorsement. "Eating large amounts when not hungry" or "eating alone" may signify elevated binge-eating severity, whereas "uncomfortably full" and "feeling disgusted/depressed/guilty" were not necessarily indicative of elevated severity. Results suggested that Criterion B may need to be revised to eliminate symptoms that are redundant with other binge-eating diagnostic criteria.
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Affiliation(s)
- Brianne N Richson
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Katherine Schaumberg
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
| | - James E Mitchell
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA.,Department of Psychiatry and Behavioral Science, University of North Dakota, Fargo, North Dakota, USA
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8
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Abstract
"Overeating" is a significant public health concern, but little is known about how lay people conceptualize overeating. This study explored participants' conceptions of overeating. Participants were 175 university students and 296 community members (56% women) who were asked to rate the extent to which several statements reflected the concept of "overeating" (1 = Does not capture the meaning at all; 7 = Captures the meaning perfectly). Results showed that eating outside of hunger was viewed as being most strongly linked to the conceptualization of overeating; mindless eating, eating more than some normative amount, and a lack of restriction were all moderately linked to the conceptualization of overeating; and the quality of the food/eating style was rated as least relevant to the conceptualization of overeating. Participants with a higher BMI, participants who perceived themselves as fat, restrained eaters, and participants with an indication of eating pathology rated all of the constructs as more relevant to the concept of overeating than did their respective counterparts, but their overall pattern of responding was the same. The present research provides some initial insights into people's thoughts on what it means to "overeat," which is important given that simply believing that one has overeaten (regardless of the actual amount consumed) can have adverse psychological and behavioral consequences. These insights provide an avenue for future research to explore whether lay conceptions could be more adaptively reshaped to reduce the negative effects of perceived overeating.
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9
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Moraes CEFD, Mourilhe C, Freitas SRD, Veiga GVD, Marcus MD, Appolinário JC. Cross-cultural adaptation of the Brazilian version of the Questionnaire on Eating and Weight Patterns-5 (QEWP-5). TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 42:39-47. [PMID: 32130307 DOI: 10.1590/2237-6089-2019-0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 06/06/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The Questionnaire on Eating and Weight Patterns-5 (QEWP-5) is a self-report instrument developed to screen individuals for binge eating disorder (BED), as defined by the DSM-5. However, this version of the instrument had not been adapted for the Brazilian population. OBJECTIVE To describe translation and cross-cultural adaptation of the QEWP-5 into Brazilian Portuguese. METHODS Translation and cross-cultural adaptation of the QEWP-5 included the following steps: forward translation, comparison of translations and a synthesis version, blind back-translations, comparison of the back translations with the original version, and a comprehensibility test. The comprehensibility test was conducted with a sample of 10 participants with BED or bulimia nervosa and 10 eating disorders experts. Additionally, a Content Validity Index (CVI-I) was calculated for each item and then averaged to produce an index for the entire scale (CVI-Ave), to assess content equivalence. RESULTS Some inconsistencies emerged during the process of translation and adaptation. However, the expert committee solved them by consensus. The participants of the comprehensibility test understood the Brazilian version of QEWP-5 well. Only 2 patients (20%) had doubts about items related to subjective binge eating episodes. Content equivalence analysis rated all items relevant, with CVI-I ranging from 0.8 to 1.0 and an overall CVI-Ave of 0.94. In view of the good overall assessment of the pre-final version of the instrument, additional changes were not made to the final version. CONCLUSION The Brazilian version of the QEWP-5 was cross-culturally adapted and was well understood by the target population. Further studies are required to assess its psychometric properties.
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Affiliation(s)
- Carlos Eduardo Ferreira de Moraes
- Departamento de Nutrição Social e Aplicada (DNSA), Instituto de Nutrição Josué de Castro (INJC), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Grupo de Obesidade e Transtornos Alimentares (GOTA), Instituto de Psiquiatria, UFRJ, Rio de Janeiro, RJ, Brazil
| | - Carla Mourilhe
- Departamento de Nutrição Social e Aplicada (DNSA), Instituto de Nutrição Josué de Castro (INJC), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Grupo de Obesidade e Transtornos Alimentares (GOTA), Instituto de Psiquiatria, UFRJ, Rio de Janeiro, RJ, Brazil
| | - Sílvia Regina de Freitas
- Grupo de Obesidade e Transtornos Alimentares (GOTA), Instituto de Psiquiatria, UFRJ, Rio de Janeiro, RJ, Brazil.,Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, RJ, Brazil
| | - Glória Valéria da Veiga
- Departamento de Nutrição Social e Aplicada (DNSA), Instituto de Nutrição Josué de Castro (INJC), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Marsha D Marcus
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - José Carlos Appolinário
- Grupo de Obesidade e Transtornos Alimentares (GOTA), Instituto de Psiquiatria, UFRJ, Rio de Janeiro, RJ, Brazil
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10
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Goel NJ, Burnette CB, Mazzeo SE. Racial and ethnic differences in the association between parent-oriented perfectionism and disordered eating in college women. Int J Eat Disord 2020; 53:191-200. [PMID: 31593340 DOI: 10.1002/eat.23179] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 09/11/2019] [Accepted: 09/13/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVE This study examined the associations between parent-oriented dimensions of perfectionism (parental expectations [PE] and parental criticism [PC]) and eating disorder (ED) symptomatology across racial/ethnic groups. It was hypothesized that parent-oriented perfectionism would be positively associated with ED symptomatology for White and Asian American women. METHOD Undergraduate women (N = 1,173) completed questionnaires assessing perfectionism, EDs, and demographics. One-way analyses of variance tested differences in PE and PC across racial/ethnic groups; post-hoc Tukey tests probed significant differences. Multiple linear regressions assessed associations between parent-oriented perfectionism and ED symptomatology. Hurdle models tested the association between PE and PC and the frequency and odds of endorsing ED symptomatology. RESULTS There were significant group differences in PE and PC. PE was positively linked with various ED symptoms in Latina, Asian American, and multiracial women, and was negatively related to purging in multiracial women. PC was positively associated with body dissatisfaction in White, Black, and multiracial women, but displayed differential associations with ED symptomatology in all racial/ethnic groups. DISCUSSION Levels of parent-oriented dimensions of perfectionism, and their relations to ED symptomatology, might vary across racial/ethnic groups. PE, in particular, is both more elevated, and more strongly linked to eating pathology in Asian American women, whereas PC appears to be especially relevant to ED symptoms in Black women. Findings underscore the importance of considering the role of culture in ED symptomatology. Clinicians and researchers might consider incorporating assessments of parent-oriented perfectionism into their practice.
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Affiliation(s)
- Neha J Goel
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.,Institute for Inclusion, Inquiry and Innovation (iCubed), Virginia Commonwealth University, Richmond, Virginia
| | - C Blair Burnette
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.,Institute for Inclusion, Inquiry and Innovation (iCubed), Virginia Commonwealth University, Richmond, Virginia.,Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia
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11
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Tan W, Holt N, Krug I, Ling M, Klettke B, Linardon J, Baxter K, Hemmings S, Howard D, Hughes E, Rivelli-Rojas I, Fuller-Tyszkiewicz M. Trait body image flexibility as a predictor of body image states in everyday life of young Australian women. Body Image 2019; 30:212-220. [PMID: 31377478 DOI: 10.1016/j.bodyim.2019.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/17/2019] [Accepted: 07/17/2019] [Indexed: 10/26/2022]
Abstract
The present study evaluated whether individuals with varying levels of trait body image flexibility differ in the severity, variability, and correlates of state body dissatisfaction experienced in their daily lives. One hundred and forty-seven women completed a baseline measure of trait body image flexibility, followed by a 7-day ecological momentary assessment phase in which participants self-reported state body dissatisfaction, disordered eating behavior, drive for thinness, and appearance comparisons at 10 semi-random intervals daily. Higher trait body image flexibility predicted lower average scores, less frequent reporting of high state body dissatisfaction, and less variability in their state body dissatisfaction ratings. Individuals with higher trait body image flexibility were also less likely to engage in a range of behaviors and cognitions previously shown to produce body dissatisfaction, including upward appearance comparisons, drive for thinness, binge eating, and dieting. However, few of these state-based relationships involving body dissatisfaction and these related behaviors and cognitions were moderated by trait body image flexibility. Overall, this pattern of findings suggests that body image flexible individuals may have less negative body image because they are less inclined to engage in behaviors and cognitions in their daily lives that encourage negative body image.
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Affiliation(s)
- Weixi Tan
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Naomi Holt
- School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mathew Ling
- School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
| | - Bianca Klettke
- School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
| | - Jake Linardon
- School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
| | - Kimberley Baxter
- School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
| | - Shelley Hemmings
- School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
| | - Dominika Howard
- School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
| | - Erin Hughes
- School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
| | | | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia; Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria, 3125, Australia.
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12
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Smith VM, Seimon RV, Harris RA, Sainsbury A, da Luz FQ. Less Binge Eating and Loss of Control over Eating Are Associated with Greater Levels of Mindfulness: Identifying Patterns in Postmenopausal Women with Obesity. Behav Sci (Basel) 2019; 9:E36. [PMID: 30965602 PMCID: PMC6523377 DOI: 10.3390/bs9040036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 11/16/2022] Open
Abstract
Obesity is a public health concern resulting in widespread personal, social, and economic burden. Many individuals with obesity report feeling unable to stop eating or to control their food intake (i.e., a loss of control over eating) despite their best efforts. Experiencing loss of control over eating predicts further eating pathology and is a key feature of binge eating. Mindfulness (i.e., awareness and acceptance of current thoughts, feelings, sensations, and surrounding events) has emerged as a potential strategy to treat such eating disorder behaviors, but it is not known whether there is merit in investigating this strategy to address binge eating in postmenopausal women with obesity. Thus, this study aimed to examine the relationships between binge eating and mindfulness in postmenopausal women with obesity seeking weight loss treatment. Participants (n = 101) were assessed with the Eating Disorder Examination Questionnaire, the Loss of Control over Eating Scale, the Five-Facet Mindfulness Questionnaire, and the Langer Mindfulness Scale. Participants´ overall scores on both mindfulness scales were significantly and negatively correlated with binge eating frequency or the severity of loss of control over eating. Moreover, participants who reported fewer binge eating episodes were significantly more mindful than those who reported greater frequencies of binge eating episodes within the past 28 days. These findings suggest a merit in investigating the use of mindfulness-based therapies to treat binge eating in postmenopausal women with obesity.
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Affiliation(s)
- Veronica M Smith
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia.
| | - Radhika V Seimon
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia.
| | - Rebecca A Harris
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia.
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia.
| | - Felipe Q da Luz
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia.
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13
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Li N, Mitchison D, Touyz S, Hay P. Cross-sectional comparison of health-related quality of life and other features in people with and without objective and subjective binge eating using a general population sample. BMJ Open 2019; 9:e024227. [PMID: 30787086 PMCID: PMC6398903 DOI: 10.1136/bmjopen-2018-024227] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Evidence suggests that while objective binge eating (OBE) and subjective binge eating (SBE) differ in the amount of food consumed, both are associated with impairment in people with eating disorders. However, only OBE is accounted for in the diagnostic criteria of eating disorders. This study compared the sociodemographic profile and burden of OBE versus SBE at a population level. DESIGN Population-based survey. PARTICIPANTS A representative sample of 3028 men and women. Participants were categorised into four groups based on their reporting of binge eating in the past 3 months: non-binge eating group (no OBE or SBE), OBE group, SBE group and OSBE group (both OBE and SBE). OUTCOME MEASURES Demographics (age, genderand body mass index, BMI), binge eating, distress, weight/shape overvaluation and health-related quality of life. Groups were compared on sociodemographic information, overvaluation and health-related quality of life. The OBE and SBE groups were also compared on the distress related to binge eating. RESULTS No differences were found between the SBE group and OBE group in age, gender, BMI, mental health-related quality of life and overvaluation (all p>0.05). However, differences were found in the OSBE participants, namely that they were younger, had a higher mean BMI, lower mental health-related quality of life and higher overvaluation of weight/shape than the non-binge-eating participants (all p<0.001). Proportions of participants who reported distress related to binge eating in the OBE and SBE groups also did not differ (p=0.678). CONCLUSION There is little difference in the demographic profile or burden of people who engage in OBE versus SBE, supporting the proposed inclusion of SBE in the diagnostic criteria for eating disorders in International Classification of Diseases-11. People who experience both OBE and SBE may experience a relatively higher eating disorder severity and impairment.
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Affiliation(s)
- Natalie Li
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Deborah Mitchison
- Psychology Department, Macquarie University, Sydney, New South Wales, Australia
| | - Stephen Touyz
- Clinical Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Phillipa Hay
- Translational Health Research Institure, School of Medicine, Western Sydney, Penrith, New South Wales, Australia
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14
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Kelly NR, Cotter E, Guidinger C. Men who engage in both subjective and objective binge eating have the highest psychological and medical comorbidities. Eat Behav 2018; 30:115-119. [PMID: 29990652 DOI: 10.1016/j.eatbeh.2018.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 06/18/2018] [Accepted: 07/03/2018] [Indexed: 11/24/2022]
Abstract
Data suggest that assessing for the presence of loss of control (LOC) while eating is more useful in identifying risk for excess weight gain and psychosocial comorbidities than focusing on the amount of food consumed during episodes of perceived overeating. Yet, most of this research has included children and women. The current study examined whether perceived overeating patterns with and without LOC were uniquely associated with eating- and weight-related comorbidities in a community sample of young men. Participants (N = 1114; 18-30 y) completed a brief online survey assessing body mass index (BMI); perceived overeating habits, including overeating without LOC (OEs), and subjective (SBEs) and objective binge eating episodes (OBEs); weight-related medical comorbidities; and disordered eating pathology. After adjusting for BMI and race/ethnicity, men who reported engaging in both OBE(s) and SBE(s) were the most likely to have a weight-related medical comorbidity, and reported the highest levels of dietary restraint, concerns about body fat, and excessive exercise pathology. Group differences remained even after adjusting for frequency of disordered eating episodes, a common indicator of severity of comorbid pathology. The current study's findings suggest that young men who engage in both OBE(s) and SBE(s) may be at the highest risk for chronic disease and psychological concerns, although additional studies with prospective data are necessary to confirm this hypothesis.
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Affiliation(s)
- Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America.
| | - Elizabeth Cotter
- Department of Health Studies, American University, United States of America
| | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America
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15
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Micali N, Al Essimii H, Field AE, Treasure J. Pregnancy loss of control over eating: a longitudinal study of maternal and child outcomes. Am J Clin Nutr 2018; 108:101-107. [PMID: 29873682 DOI: 10.1093/ajcn/nqy040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background To our knowledge, no previous studies have investigated longitudinal outcomes of maternal loss of control over eating (LOC) in pregnancy in a general population sample. Objective We aimed to determine whether pregnancy LOC is associated with dietary, gestational weight gain, and offspring birth-weight outcomes in a large population-based prospective study of pregnant women and their children. We also explored the association with offspring weight at age 15.5 y. Design Women (n = 11,132) from the Avon Longitudinal Study of Parents and Children (ALSPAC) were included. Crude and adjusted logistic and multinomial regression models were used. LOC in pregnancy and diet at 32 wk of gestation were assessed by self-report. Pregnancy weight gain and birth weight were obtained from obstetric records. Child weight and height were objectively measured at age 15.5 y. Results LOC in pregnancy was common (36.3%). Women with pregnancy LOC reported higher total energy intake, consumed more snacks, and had lower vitamin B-6, A, and C intake compared with women without LOC. Women with frequent LOC had lower vitamin B-1 and folate intake [respectively: b = -0.05 (95% CI: -0.07, -0.02) and b = -7.1 (95% CI: -11.8, -2.3) in adjusted analyses], and gained on average 3.74 kg (95% CI: 3.33, 4.13 kg) more than women without LOC. Frequent and occasional LOC were associated with higher birth weight [respectively: b = 0.07 (95% CI: 0.03, 0.1), b = 0.04 (95% CI: 0.02, 0.06)]. Offspring of mothers with frequent pregnancy LOC had 2-fold increased odds of being overweight/obese at 15.5 y [OR = 2.02 (95% CI: 1.37, 3.01)]. Conclusions Pregnancy LOC eating is common and has an adverse short- and long-term impact on mother and offspring, but has received very limited attention. Our findings further the understanding of risk factors for obesity and highlight a need for improved identification of maternal pregnancy loss of control eating. This trial was registered at clinicaltrials.gov as NCT03269253.
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Affiliation(s)
- Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Great Ormond Street Institute of Child Health, Child and Adolescent Mental Health, Palliative Care and Pediatrics Section, University College London, London, United Kingdom.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.,Service de Psychiatrie de l'enfant et de l'adolescent, Department of Children and Adolescents (DEA), University Hospital of Geneva (HUG), Geneva, Switzerland
| | - Haya Al Essimii
- Department of Clinical Nutrition, College of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia.,Metabolic Medicine Research Unit, Division of Medicine, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Alison E Field
- Department of Epidemiology, Brown University School of Public Health, Providence, RI.,Department of Pediatrics, Warren Alpert School of Medicine of Brown University, Providence, RI
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
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16
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Potential psychological & neural mechanisms in binge eating disorder: Implications for treatment. Clin Psychol Rev 2018; 60:32-44. [DOI: 10.1016/j.cpr.2017.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 02/08/2023]
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17
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Lord VM, Reiboldt W, Gonitzke D, Parker E, Peterson C. Experiences of recovery in binge-eating disorder: a qualitative approach using online message boards. Eat Weight Disord 2018; 23:95-105. [PMID: 27796846 DOI: 10.1007/s40519-016-0335-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 10/07/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE In this study, qualitative methods were employed to analyze secondary data from the anonymous postings of a pro-recovery website in an effort to investigate the changes in thinking of binge-eating disorder (BED) sufferers who were able to recover from the disorder, understand more fully how guilt and self-blame affect recovery, and explore the perceived motivators and challenges to recovery. METHOD 681 messages from 65 participants pertaining to BED were analyzed from January 1, 2014-January 1, 2015 through thematic analysis. Coding strategies were employed to reveal patterns within the experiences of the participants. RESULTS The researchers identified three themes surrounding "changes in thinking" from analysis of the message board postings: admitting the disorder, recognizing unhealthy coping behaviors, and seeing recovery. Further analysis of postings suggested that guilt and self-blame hinder recovery by promoting a feedback cycle of binging, which leads to further guilt and self-blame. The data ultimately identified experiences that resulted in or hindered recovery. The experience of validation appeared to result in recovery; those who experienced validation were less inclined to engage in disordered eating behaviors. Conversely, weight loss or attempts at weight loss hindered recovery by ultimately promoting more disordered eating behaviors. CONCLUSION This qualitative analysis of message board postings offers authentic, credible data with a unique perspective. Practitioners working in the field of eating disorders such as registered dietitian nutritionists or therapists might use evidence from the data to guide their practice.
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Affiliation(s)
- Vanessa M Lord
- Department of Family and Consumer Sciences, California State University, Long Beach, Long Beach, CA, 90840, USA
| | - Wendy Reiboldt
- Department of Family and Consumer Sciences, California State University, Long Beach, Long Beach, CA, 90840, USA
| | - Dariella Gonitzke
- Department of Family and Consumer Sciences, California State University, Long Beach, Long Beach, CA, 90840, USA
| | - Emily Parker
- Department of Family and Consumer Sciences, California State University, Long Beach, Long Beach, CA, 90840, USA
| | - Caitlin Peterson
- Department of Family and Consumer Sciences, California State University, Long Beach, Long Beach, CA, 90840, USA.
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18
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Carey JB, Saules KK, Carr MM. A qualitative analysis of men's experiences of binge eating. Appetite 2017; 116:184-195. [DOI: 10.1016/j.appet.2017.04.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 11/24/2022]
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19
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Blostein F, Assari S, Caldwell CH. Gender and Ethnic Differences in the Association Between Body Image Dissatisfaction and Binge Eating Disorder among Blacks. J Racial Ethn Health Disparities 2017; 4:529-538. [PMID: 27352115 PMCID: PMC10867815 DOI: 10.1007/s40615-016-0255-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 06/03/2016] [Accepted: 06/07/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The research on binge eating has overwhelmingly focused on Whites. We aimed to study gender and ethnic differences in the association between body image dissatisfaction and binge eating in a nationally representative sample of Black adults in the USA. METHODS This cross-sectional study used data from the National Survey of American Life (NSAL), 2003-2004. Self-identified Caribbean Black (n = 1621) and African American (3570) adults aged 18 and older were enrolled. The independent variable was body dissatisfaction measured with two items. Using the World Health Organization Composite International Diagnostic Interview (WHO-CIDI), outcome was lifetime binge eating without hierarchy according to the DSM-IV criteria. Covariates included age, socioeconomic factors (i.e., education and marital status), and body mass index. Ethnicity and gender were focal moderators. Logistic regressions were used for data analysis. RESULTS Despite comparable prevalence of lifetime binge eating (5 vs 4 %, p > 0.05), African Americans reported higher body image dissatisfaction than Caribbean Blacks (36 vs 29 %, p > 0.05). In the pooled sample, body dissatisfaction was a strong predictor of lifetime binge eating disorders. There was a significant interaction (p = 0.039) between ethnicity and body image dissatisfaction on binge eating, suggesting a stronger association between body image dissatisfaction and lifetime binge eating for Caribbean Blacks (OR = 11.65, 95 % 6.89-19.72) than African Americans (OR = 6.72, 95 % CI 3.97-11.37). Gender did not interact with body image dissatisfaction on binge eating. CONCLUSION Ethnic variation in the link between body image dissatisfaction and binge eating may be due to within-race cultural differences in body image between African Americans and Caribbean Blacks. This may include different definitions, norms, and expectations regarding the body size. Findings suggest that ethnicity may bias relevance of body image dissatisfaction as a diagnostic criterion for binge eating disorders among diverse populations of Blacks.
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Affiliation(s)
- Freida Blostein
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, 1415 Washington Heights, 2858 SPH I, Ann Arbor, MI, 48109-2029, USA.
| | - Shervin Assari
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, 1415 Washington Heights, 2858 SPH I, Ann Arbor, MI, 48109-2029, USA
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Cleopatra Howard Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, 1415 Washington Heights, 2858 SPH I, Ann Arbor, MI, 48109-2029, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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20
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Pila E, Mond JM, Griffiths S, Mitchison D, Murray SB. A thematic content analysis of #cheatmeal images on social media: Characterizing an emerging dietary trend. Int J Eat Disord 2017; 50:698-706. [PMID: 28075492 DOI: 10.1002/eat.22671] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 11/08/2022]
Abstract
Despite the pervasive social endorsement of "cheat meals" within pro-muscularity online communities, there is an absence of empirical work examining this dietary phenomenon. The present study aimed to characterize cheat meals, and explore the meaning ascribed to engagement in this practice. Thematic content analysis was employed to code the photographic and textual elements of a sample (n = 600) that was extracted from over 1.6 million images marked with the #cheatmeal tag on the social networking site, Instagram. Analysis of the volume and type of food revealed the presence of very large quantities (54.5%) of calorie-dense foods (71.3%) that was rated to qualify as an objective binge episode. Photographic content of people commonly portrayed highly-muscular bodies (60.7%) in the act of intentional body exposure (40.0%). Meanwhile, textual content exemplified the idealization of overconsumption, a strict commitment to fitness, and a reward-based framework around diet and fitness. Collectively, these findings position cheat meals as goal-oriented dietary practices in the pursuit of physique-ideals, thus underscoring the potential clinical repercussions of this socially-endorsed dietary phenomenon.
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Affiliation(s)
- Eva Pila
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada.,Eating Disorders Program, Department of Psychiatry, University of California, San Francisco, California
| | - Jonathan M Mond
- School of Health Sciences, Faculty of Health, University of Tasmania, Tasmania, Australia
| | - Scott Griffiths
- School of Psychology, University of Sydney, Sydney, Australia
| | - Deborah Mitchison
- Department of Psychology, Macquarie University, Macquarie, Australia
| | - Stuart B Murray
- Eating Disorders Program, Department of Psychiatry, University of California, San Francisco, California
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21
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Eating disorders in the context of preconception care: fertility specialists’ knowledge, attitudes, and clinical practices. Fertil Steril 2017; 107:494-501. [DOI: 10.1016/j.fertnstert.2016.10.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/25/2016] [Accepted: 10/25/2016] [Indexed: 01/01/2023]
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22
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Stefano EC, Wagner AF, Mond JM, Cicero DC, Latner JD. Loss of Control Over Eating Scale (LOCES): Validation in undergraduate men and women with and without eating disorder symptoms. Eat Behav 2016; 23:137-140. [PMID: 27679970 DOI: 10.1016/j.eatbeh.2016.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 09/19/2016] [Indexed: 10/21/2022]
Abstract
The present study aimed to further validate the Loss of Control Over Eating Scale (LOCES) for use with undergraduate men and women with and without eating disorder (ED) symptoms. A total of 261 participants completed the LOCES and the Eating Disorder Examination - Questionnaire (EDE-Q) and were identified as non-clinical or having probable ED symptomatology based on previously used EDE-Q cutoff scores. Results indicated that the LOCES and its subscales were significantly associated with and a significant predictor of global ED pathology and binge episode frequency. The LOCES behavioral subscale appeared to be a stronger predictor of episode frequency compared to other subscales. The ED pathology groups reported significantly higher LOCES scores compared to the non-ED pathology groups. Binary logistic regression analyses revealed that the LOCES was able to accurately distinguish between those with ED pathology and those without ED pathology in the majority of cases. Findings from the present study suggest that the LOCES is highly predictive of ED pathology, strongly associated with ED cognitions and behaviors, and an accurate index for global eating disorder pathology. Future directions for research are discussed.
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Affiliation(s)
- Emily C Stefano
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States.
| | - Allison F Wagner
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Jonathan M Mond
- Department of Psychology, Macquarie University, Sydney, Australia
| | - David C Cicero
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Janet D Latner
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States
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23
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Goldschmidt AB, Accurso EC, Crosby RD, Cao L, Ellison J, Smith TL, Klein MH, Mitchell JE, Crow SJ, Wonderlich SA, Peterson CB. Association between objective and subjective binge eating and psychopathology during a psychological treatment trial for bulimic symptoms. Appetite 2016; 107:471-477. [PMID: 27554184 DOI: 10.1016/j.appet.2016.08.104] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/10/2016] [Accepted: 08/17/2016] [Indexed: 10/21/2022]
Abstract
Although loss of control (LOC) while eating is a core construct of bulimia nervosa (BN), questions remain regarding its validity and prognostic significance independent of overeating. We examined trajectories of objective and subjective binge eating (OBE and SBE, respectively; i.e., LOC eating episodes involving an objectively or subjectively large amount of food) among adults participating in psychological treatments for BN-spectrum disorders (n = 80). We also explored whether changes in the frequency of these eating episodes differentially predicted changes in eating-related and general psychopathology and, conversely, whether changes in eating-related and general psychopathology predicted differential changes in the frequency of these eating episodes. Linear mixed models with repeated measures revealed that OBE decreased twice as rapidly as SBE throughout treatment and 4-month follow-up. Generalized linear models revealed that baseline to end-of-treatment reductions in SBE frequency predicted baseline to 4-month follow-up changes in eating-related psychopathology, depression, and anxiety, while changes in OBE frequency were not predictive of psychopathology at 4-month follow-up. Zero-inflation models indicated that baseline to end-of-treatment changes in eating-related psychopathology and depression symptoms predicted baseline to 4-month follow-up changes in OBE frequency, while changes in anxiety and self-esteem did not. Baseline to end-of-treatment changes in eating-related psychopathology, self-esteem, and anxiety predicted baseline to 4-month follow-up changes in SBE frequency, while baseline to end-of-treatment changes in depression did not. Based on these findings, LOC accompanied by objective overeating may reflect distress at having consumed an objectively large amount of food, whereas LOC accompanied by subjective overeating may reflect more generalized distress related to one's eating- and mood-related psychopathology. BN treatments should comprehensively target LOC eating and related psychopathology, particularly in the context of subjectively large episodes, to improve global outcomes.
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Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA.
| | - Erin C Accurso
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Ross D Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, USA; Department of Clinical Neuroscience, The University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Li Cao
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Jo Ellison
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Tracey L Smith
- VA South Central Mental Illness Research, Education & Clinical Center, VA HSR&D Center for Innovations in Quality, Effectiveness & Safety (IQuEST), Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Marjorie H Klein
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - James E Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, USA; Department of Clinical Neuroscience, The University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA; The Emily Program, St. Paul, MN, USA
| | - Stephen A Wonderlich
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, USA; Department of Clinical Neuroscience, The University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
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24
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Gerlach G, Loeber S, Herpertz S. Personality disorders and obesity: a systematic review. Obes Rev 2016; 17:691-723. [PMID: 27230851 DOI: 10.1111/obr.12415] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/22/2016] [Accepted: 03/14/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Studies demonstrate an association between personality traits and obesity as well as their prognostic influence on weight course. In contrast, only few studies have investigated the association between personality disorders (PDs) and obesity. OBJECTIVE The present review summarizes through a comprehensive and critical evaluation the results of 68 studies identified by database research (PubMed and PsycINFO) covering the last 35 years that investigated the association between PDs, overweight and obesity as well as the predictive value of PDs for the development of obesity and the effectiveness of weight reduction treatments. RESULTS Adults with any PD have a higher risk of obesity. In the female general population, there is an association between avoidant or antisocial PD and severe obesity. Further, women with paranoid or schizotypal PD have a higher risk of obesity. Clinical studies including foremost female participants showed a higher comorbidity of PDs, especially borderline PD and avoidant PD, in binge-eating disorder. Regarding both genders, patients with PD show less treatment success in conservative weight-loss treatment programmes for obesity than patients without PD. CONCLUSIONS In prevention and conservative weight-loss treatment strategies, more care should be taken to address the special needs of patients with comorbid PDs.
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Affiliation(s)
- G Gerlach
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University, Bochum, Germany
| | - S Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - S Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University, Bochum, Germany
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25
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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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26
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Berner LA, Arigo D, Mayer LE, Sarwer DB, Lowe MR. Examination of central body fat deposition as a risk factor for loss-of-control eating. Am J Clin Nutr 2015; 102:736-44. [PMID: 26354534 PMCID: PMC4588740 DOI: 10.3945/ajcn.115.107128] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 07/31/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Elevated body mass index (BMI), higher waist-to-hip ratio, and body dissatisfaction have been investigated as risk factors for the development of bulimic symptoms. Central fat deposition may be particularly relevant to eating disorders. To our knowledge, the longitudinal relations between fat distribution, body dissatisfaction, and loss-of-control (LOC) eating development and maintenance have not been studied. OBJECTIVE We examined body fat distribution, independent of BMI and depressive symptoms, as a unique correlate and predictor of body dissatisfaction and LOC eating cross-sectionally and over a 2-y follow-up. DESIGN Body composition was measured by using dual-energy X-ray absorptiometry in 294 adult women at risk of weight gain at baseline, 6 mo, and 24 mo. We assessed LOC eating, body dissatisfaction, and depressive symptoms at baseline, 6 wk, 6 mo, 12 mo, and 24 mo by using the Eating Disorder Diagnostic Interview, the Multidimensional Body-Self Relations Questionnaire-Appearance Scales Body Areas Satisfaction subscale, and the Center for Epidemiologic Studies-Depression Scale, respectively. RESULTS Independent of BMI, baseline total percentage body fat, percentage trunk fat, and percentage abdominal fat were related to greater body dissatisfaction. Total percentage body fat and trunk fat tended to be associated with greater body dissatisfaction at all subsequent time points. Women with a greater percentage trunk fat, specifically abdominal fat, were at highest risk of developing LOC eating. In the full sample, women with higher baseline percentage trunk and abdominal fat showed increases in LOC eating episode frequency over time, whereas LOC eating frequency remained stable among women with smaller percentages of fat in trunk and abdominal regions. CONCLUSION These findings lend further support to the premise that increased central body fat deposition is associated with body image dissatisfaction and suggest that it may represent a risk and maintenance factor for LOC eating. This trial was registered at clinicaltrials.gov as NCT00456131.
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Affiliation(s)
- Laura A Berner
- Department of Psychology, Drexel University, Philadelphia, PA;
| | - Danielle Arigo
- Department of Psychology, Drexel University, Philadelphia, PA
| | - Laurel Es Mayer
- Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY; and
| | - David B Sarwer
- Departments of Psychiatry and Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Michael R Lowe
- Department of Psychology, Drexel University, Philadelphia, PA
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Coker EL, von Lojewski A, Luscombe GM, Abraham SF. The difficulty in defining binge eating in obese women: how it affects prevalence levels in presurgical bariatric patients. Eat Behav 2015; 17:130-5. [PMID: 25704360 DOI: 10.1016/j.eatbeh.2015.01.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 12/18/2014] [Accepted: 01/28/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We aim to determine how increasing the specificity of binge eating criteria affects the prevalence of self-reported binge eating among presurgical bariatric patients. METHOD 197 women ages 20 to 65 being assessed for bariatric surgery with a BMI greater than 30kg/m(2) were interviewed and completed the Eating and Exercise Examination. RESULTS The prevalence of self-reported binge eating was 55% (n=109). The addition of the criterion 'more than a little loss of control/distress' reduced the rate to 23% (n=45), a minimum of six servings of food reduced the rate to 34% (n=67). The addition of a minimum frequency of twice per week for six months (DSM-VI) reduced the rate to 22% (n=43), or once per week for three months (DSM-5) reduced the rate to 53% (n=104). DISCUSSION More precise definitions and diagnostic criteria for binge eating may result in more consistent reports of prevalence levels of BED.
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Affiliation(s)
- Elise L Coker
- Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
| | - Astrid von Lojewski
- Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; Life Weight Loss Centre, Suite 2, Level 4, 171 Bigge Street, Liverpool, NSW 2170, Australia
| | - Georgina M Luscombe
- The School of Rural Health, The University of Sydney, PO Box 1191, Orange, NSW 2800, Australia
| | - Suzanne F Abraham
- Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
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Macpherson-Sánchez AE. Integrating fundamental concepts of obesity and eating disorders: implications for the obesity epidemic. Am J Public Health 2015; 105:e71-85. [PMID: 25713933 PMCID: PMC4358173 DOI: 10.2105/ajph.2014.302507] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2014] [Indexed: 12/12/2022]
Abstract
Physiological mechanisms promote weight gain after famine. Because eating disorders, obesity, and dieting limit food intake, they are famine-like experiences. The development of the concept of meeting an ideal weight was the beginning of increasing obesity. Weight stigma, the perception of being fat, lack of understanding of normal growth and development, and increased concern about obesity on the part of health providers, parents, and caregivers have reinforced each other to promote dieting. Because weight suppression and disinhibition provoke long-term weight increase, dieting is a major factor producing the obesity epidemic. The integrated eating disorder-obesity theory included in this article emphasizes that, contrary to dieters, lifetime weight maintainers depend on physiological processes to control weight and experience minimal weight change.
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Affiliation(s)
- Ann E Macpherson-Sánchez
- Ann E. Macpherson-Sánchez is with the Department of Agricultural Education, University of Puerto Rico, Mayagüez
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29
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Calderone A, Mauri M, Calabrò PF, Piaggi P, Ceccarini G, Lippi C, Fierabracci P, Landi A, Vitti P, Santini F. Exploring the concept of eating dyscontrol in severely obese patients candidate to bariatric surgery. Clin Obes 2015; 5:22-30. [PMID: 25611584 DOI: 10.1111/cob.12080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/28/2014] [Accepted: 09/08/2014] [Indexed: 11/29/2022]
Abstract
Eating dyscontrol constitutes a potential negative predictor for the outcome of treatment strategies for obese patients. The aim of this study was to examine the qualitative characteristics of eating dyscontrol in obese patients who engage in binge eating (BE) compared with those who do not (NBE), and to analyse the relationship between eating dyscontrol and axis-I, axis-II, spectrum psychopathology using instruments that explore mood, panic-agoraphobic, social-phobic, obsessive-compulsive and eating disorders spectrum psychopathology (SCI-MOODS-SR, SCI-PAS-SR, SCI-SHY-SR, SCI-OBS-SR, SCI-ABS-SR). This was a cross-sectional study involving a clinical sample of adult obese patients with severe obesity (average body mass index = 45 ± 8 kg m(-2) ) and candidate to bariatric surgery who were recruited between November 2001 and November 2010 at the Obesity Center of the Endocrinology Unit, University Hospital of Pisa. All participants completed a face-to-face interview, including a diagnostic assessment of axes-I and II mental disorders (using the Structured Clinical Interview for Manual of Mental Disorders, fourth edition [SCID]-I and SCID-II) and filled out self-report spectrum instruments. Among obese patients not affected by BE, eating dyscontrol was highly represented. Indeed, 39.7% (N = 177) of subjects endorsed six or more items of the Anorexia-Bulimia Spectrum Self-Report, lifetime version domain exploring this behaviour. The cumulative probability of having axis-I, axis-II and a spectrum condition disorder increased significantly with the number of eating dyscontrol items endorsed. In both BE and NBE obese subjects, eating dyscontrol may represent an independent dimension strongly related to the spectrum psychopathology and axes I/II disorders. A systematic screening for eating dyscontrol symptoms by means of self-report spectrum instruments may be valuable to assign specific treatment strategies.
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Affiliation(s)
- A Calderone
- Obesity Center at the Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
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30
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Gerlach G, Herpertz S, Loeber S. Personality traits and obesity: a systematic review. Obes Rev 2015; 16:32-63. [PMID: 25470329 DOI: 10.1111/obr.12235] [Citation(s) in RCA: 165] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 09/22/2014] [Accepted: 10/01/2014] [Indexed: 12/19/2022]
Abstract
Based on a bio-social-ecological systems model of the development and maintenance of obesity, there has been in the last few years a growing research interest in the association of obesity and personality traits. The aim of the present review was a comprehensive and critical evaluation of the existing literature taking into account the methodological quality of studies to enhance our understanding of personality traits associated with body weight, the development of overweight and obesity as well as the effectiveness of weight loss interventions including bariatric surgery. Personality traits play an important role both as risk as well as protective factors in the development of overweight and obesity. While thus in particular 'neuroticism', 'impulsivity' and 'sensitivity to reward' appear as risk factors, 'conscientiousness' and 'self-control' have been shown to have a protective function in relation to weight gain. Conscientiousness is a measure of regulation of internal urges and self-discipline, and may thus provide a potential source of control over impulsive reward-oriented behaviour. The results of the present review suggest that, within the context of therapeutic weight reduction measures, it is meaningful to identify subgroups of patients for whom specific treatment options need to be developed, such as measures for strengthening self-control skills.
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Affiliation(s)
- G Gerlach
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University, Bochum, Germany
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31
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Lavender JM, Alosco ML, Spitznagel MB, Strain G, Devlin M, Cohen R, Paul R, Crosby RD, Mitchell JE, Wonderlich SA, Gunstad J. Association between binge eating disorder and changes in cognitive functioning following bariatric surgery. J Psychiatr Res 2014; 59:148-54. [PMID: 25201638 PMCID: PMC4457311 DOI: 10.1016/j.jpsychires.2014.08.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 07/25/2014] [Accepted: 08/07/2014] [Indexed: 01/13/2023]
Abstract
Evidence suggests that both obesity and binge eating disorder (BED) may be associated with deficits in cognitive functioning. The purpose of this study was to examine whether a lifetime history of BED would be associated with changes in several domains of cognitive functioning (attention, executive function, language, and memory) following bariatric surgery. Participants were 68 bariatric surgery patients who completed a computerized battery of cognitive tests within 30 days prior to undergoing surgery and again at a 12-Month postoperative follow-up. Results revealed that on the whole, participants displayed improvements from baseline to follow-up in attention, executive function, and memory, even after controlling for diagnostic history of depression; no changes were observed for language. However, individuals with and without a history of BED did not differ in changes in body mass index or in the degree of improvement in cognitive functioning from baseline to follow-up. Such results suggest that a history of BED does not influence changes in cognitive functioning following bariatric surgery. Future research will be needed to further clarify the role of BED in predicting cognitive function over time.
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Affiliation(s)
- Jason M. Lavender
- Neuropsychiatric Research Institute, Fargo, ND, USA,Corresponding author. Jason Lavender, Ph.D., Neuropsychiatric Research Institute, 120 8th Street South, Fargo, ND, 58103.
| | | | | | | | | | | | - Robert Paul
- University of Missouri-St. Louis, St. Louis, MO, USA
| | - Ross D. Crosby
- Neuropsychiatric Research Institute, Fargo, ND, USA,University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - James E. Mitchell
- Neuropsychiatric Research Institute, Fargo, ND, USA,University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Stephen A. Wonderlich
- Neuropsychiatric Research Institute, Fargo, ND, USA,University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
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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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33
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Latner JD, Mond JM, Kelly MC, Haynes SN, Hay PJ. The Loss of Control Over Eating Scale: development and psychometric evaluation. Int J Eat Disord 2014; 47:647-59. [PMID: 24862351 DOI: 10.1002/eat.22296] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 04/21/2014] [Accepted: 04/27/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study describes the development, content validity, and convergent validity of the Loss of Control over Eating Scale (LOCES). METHOD An initial pool of 56 items covering 13 facets of loss-of-control eating was assembled by reviewing qualitative literature, clinical descriptions, and research on binge eating. Eating disorder experts (n = 34) and eating disorder clients (n = 22) rated each proposed item's clarity and relevance to the construct of loss-of-control eating, rated 13 facets for their relevance to the construct, and provided open-ended feedback about the items and facets. Based on the experts' and clients' quantitative and qualitative feedback, scale items were clarified, 28 items were added, and 10 were deleted. University students (n = 476; 70% female, mean age = 20.4 years) completed the resulting 74-item questionnaire, rating how often they had the experience identified in the item while eating in the last 4 weeks. They also completed the measures of eating disturbance, general distress, functional impairment, and general self-control. RESULTS The resulting 24-item LOCES (Cronbach's α = .96) retained items with highest item-total correlations and coverage of the 12 construct facets that experts rated as important. The LOCES was significantly correlated with eating disturbances, general distress, functional impairment, and general self-control. Three subfactors were identified: behavioral, cognitive/dissociative, and positive/euphoric aspects of loss-of-control eating. A brief, seven-item version of the LOCES was developed and validated. DISCUSSION A thorough process of development, content validation, and psychometric evaluation in multiple samples yielded the multifaceted LOCES and its brief form. These instruments may be useful in assessing loss-of-control eating in both clinical and nonclinical settings.
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Affiliation(s)
- Janet D Latner
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, Hawai'i
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34
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Holmes M, Fuller-Tyszkiewicz M, Skouteris H, Broadbent J. Improving Prediction of Binge Episodes by Modelling Chronicity of Dietary Restriction. EUROPEAN EATING DISORDERS REVIEW 2014; 22:405-11. [DOI: 10.1002/erv.2315] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 07/15/2014] [Accepted: 07/20/2014] [Indexed: 01/23/2023]
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Fitzsimmons-Craft EE, Ciao AC, Accurso EC, Pisetsky EM, Peterson CB, Byrne CE, Le Grange D. Subjective and objective binge eating in relation to eating disorder symptomatology, depressive symptoms, and self-esteem among treatment-seeking adolescents with bulimia nervosa. EUROPEAN EATING DISORDERS REVIEW 2014; 22:230-6. [PMID: 24852114 DOI: 10.1002/erv.2297] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 04/13/2014] [Accepted: 05/01/2014] [Indexed: 11/10/2022]
Abstract
This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment-seeking adolescents with bulimia nervosa. We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self-esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self-esteem; however, the SBE group had significantly greater depression. Examining continuous variables, OBEs (not SBEs) accounted for significant unique variance in global ED pathology, vomiting, and self-esteem. SBEs (not OBEs) accounted for significant unique variance in restraint and depression. Both OBEs and SBEs accounted for significant unique variance in eating concern; neither accounted for unique variance in weight/shape concern, laxative use, diuretic use, or driven exercise. Loss of control, rather than amount of food, may be most important in defining binge eating. Additionally, OBEs may indicate broader ED pathology, while SBEs may indicate restrictive/depressive symptomatology.
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Affiliation(s)
- Ellen E Fitzsimmons-Craft
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA; Department of Psychology, University of North Carolina, Chapel Hill, NC, USA
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36
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Holmes M, Fuller-Tyszkiewicz M, Skouteris H, Broadbent J. Tests of an extension of the dual pathway model of bulimic symptoms to the state-based level. Eat Behav 2014; 15:280-5. [PMID: 24854819 DOI: 10.1016/j.eatbeh.2014.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 01/16/2014] [Accepted: 03/11/2014] [Indexed: 11/16/2022]
Abstract
The dual pathway model proposes that trait body dissatisfaction leads to bulimic symptoms via two distinct pathways: dieting and trait negative affect. As many of these modelled variables have state-based equivalents, the present study evaluated the generalisability of this model to predict associations between state body dissatisfaction and instances of disordered eating. 124 women aged 18 to 40 years completed an online survey (accessed via a mobile phone device with web access) over a 7-day period. The mobile phone device prompted participants at random intervals seven times daily to self-report their state body dissatisfaction, current mood experiences, dieting attempts, and disordered eating practices. Multi-level mediation modelling revealed that both negative mood states and dieting significantly mediated the state body dissatisfaction-disordered eating relationships, although the strength of these associations depended on the aspect of disordered eating measured and individual differences in trait body dissatisfaction, internalization of appearance standards, tendency towards dieting, and BMI. Collectively, these results not only support adapting the dual pathway model to the state-level, but also suggest that several of the model implied pathways may be more relevant for individuals with more pathological eating- and body-related concerns and behaviours.
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Affiliation(s)
| | | | - Helen Skouteris
- School of Psychology, Deakin University, Victoria, Australia
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37
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Brockmeyer T, Skunde M, Wu M, Bresslein E, Rudofsky G, Herzog W, Friederich HC. Difficulties in emotion regulation across the spectrum of eating disorders. Compr Psychiatry 2014; 55:565-71. [PMID: 24411653 DOI: 10.1016/j.comppsych.2013.12.001] [Citation(s) in RCA: 171] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 11/14/2013] [Accepted: 12/01/2013] [Indexed: 10/25/2022] Open
Abstract
Theoretical models consider difficulties in emotion regulation (ER) as central trans-diagnostic phenomena across the spectrum of eating disorders (ED). However, there is a lack of studies directly comparing ED subtypes regarding ER problems. Furthermore, patients with anorexia nervosa-restricting type (AN-R) and patients with AN-binge/purge type (AN-BP) have usually been merged into one overall AN group in previous research on ER. In order to overcome these limitations of previous studies, the present study investigated specific ER difficulties in 120 patients with different ED subtypes, including AN-R, AN-BP, bulimia nervosa (BN), and binge-eating disorder (BED). As compared to 60 healthy normal-weight controls (NWC) and 29 healthy over-weight controls (OWC), all ED subtypes reported greater difficulties in ER. ED subtypes did not differ regarding most domains of ER except BED showing less severe ER difficulties in some domains. In addition, AN-BP but not BN reported greater impulse control difficulties than AN-R and BED. The findings underscore the relevance of ER difficulties in ED and support the trans-diagnostic view of ER difficulties being present across the whole spectrum of ED. In addition, the present results suggest that certain domains of ER may be linked more closely to certain ED subtypes than to others.
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Affiliation(s)
- Timo Brockmeyer
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Mandy Skunde
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Mudan Wu
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Esther Bresslein
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Gottfried Rudofsky
- Division of Endocrinology and Metabolism, Department of Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
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38
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Blomquist KK, Roberto CA, Barnes RD, White MA, Masheb RM, Grilo CM. Development and validation of the eating loss of control scale. Psychol Assess 2014; 26:77-89. [PMID: 24219700 PMCID: PMC4021596 DOI: 10.1037/a0034729] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recurrent objective bulimic episodes (OBE) are a defining diagnostic characteristic of binge eating disorder (BED) and bulimia nervosa (BN). OBEs are characterized by experiencing loss of control (LOC) while eating an unusually large quantity of food. Despite nosological importance and complex heterogeneity across patients, measurement of LOC has been assessed dichotomously (present/absent). This study describes the development and initial validation of the Eating Loss of Control Scale (ELOCS), a self-report questionnaire that examines the complexity of the LOC construct. Participants were 168 obese treatment-seeking individuals with BED who completed the Eating Disorder Examination interview and self-report measures. Participants rated their LOC-related feelings or behaviors on continuous Likert-type scales and reported the number of LOC episodes in the past 28 days. Principal component analysis identified a single-factor, 18-item scale, which demonstrated good internal reliability (α = .90). Frequency of LOC episodes was significantly correlated with frequency of OBEs and subjective bulimic episodes. The ELOCS demonstrated good convergent validity and was significantly correlated with greater eating pathology, greater emotion dysregulation, greater depression, and lower self-control but not with body mass index. The findings suggest that the ELOCS is a valid self-report questionnaire that may provide important clinical information regarding experiences of LOC in obese persons with BED. Future research should examine the ELOCS in other eating disorders and nonclinical samples.
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Affiliation(s)
| | | | - Rachel D Barnes
- Department of Psychiatry, School of Medicine, Yale University
| | - Marney A White
- Department of Psychiatry, School of Medicine, Yale University
| | - Robin M Masheb
- Department of Psychiatry, School of Medicine, Yale University
| | - Carlos M Grilo
- Department of Psychiatry, School of Medicine, Yale University
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Rohrer JE, Vickers-Douglas KS, Stroebel RJ. Uncontrolled eating and obesity in adult primary care patients. Obes Res Clin Pract 2013; 3:I-II. [PMID: 24345565 DOI: 10.1016/j.orcp.2009.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Accepted: 01/23/2009] [Indexed: 11/24/2022]
Abstract
SUMMARY OBJECTIVE The purpose of this study was to assess the independent effects of health confidence and uncontrolled eating on obesity risk in primary care patients. METHODS A random sample of primary care patients served by a large medical clinic in the mid-western United States was surveyed January-March of 2008; and 944 cases met criteria for the study. The odds of being obese (BMI ≥ 30) were modeled using multiple logistic regression. Uncontrolled eating was measured with a single question addressing problems with food control. Weight control motivation, health confidence, demographic variables, and health behaviors were used as covariates. RESULTS Nearly 47 percent of our respondents reported uncontrolled eating; 42.2 percent of uncontrolled eaters were obese, compared with only 9.4 percent of persons who never had problems with food control. About 27 percent of non-obese persons reported no trouble with food control, compared to 9.4 percent of obese patients having no trouble. Over 70 percent of obese respondents reported at least some trouble with food control, compared to only 37 percent of non-obese patients. Not being able to control food or having some trouble controlling food exhibited the strongest independent association with obesity (OR 6.67, CI 3.91-11.4). CONCLUSIONS Adult primary care patients who reported inability to control their eating behavior were more likely to be obese. These effects persisted after adjusting for demographic and behavioral variables. The results of this study suggest that obesity is partly the result of uncontrolled eating. Health promotion programs may have to be patterned after those designed for substance abuse and dependency.
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Affiliation(s)
- James E Rohrer
- Employee and Community Health, Mayo Clinic-Rochester, 200 First Street SW, Rochester, MN 55905, United States.
| | - Kristin S Vickers-Douglas
- Employee and Community Health, Mayo Clinic-Rochester, 200 First Street SW, Rochester, MN 55905, United States
| | - Robert J Stroebel
- Employee and Community Health, Mayo Clinic-Rochester, 200 First Street SW, Rochester, MN 55905, United States
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Abstract
We examined the relative contribution of different forms of eating disorder (ED) pathology to impairment in mental and physical health-related quality of life (QOL) in women with a wide range of ED symptoms. Female participants from an outpatient ED clinic (n = 53) and the local community (n = 214) completed measures of ED features and mental and physical health-related QOL. Across the sample, ED features were significantly associated with most mental and physical domains of QOL. In multiple regression analyses controlling for age and body mass index, ED features significantly predicted impairment in mental and physical QOL. Extreme shape and weight concern significantly and independently predicted most QOL subscales (β range = 0.19-0.44). The prominent contribution of shape and weight concern to both mental and physical QOL impairment underlines the importance of addressing body dissatisfaction in the treatment and prevention of EDs.
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Koch S, Quadflieg N, Fichter M. Purging disorder: a comparison to established eating disorders with purging behaviour. EUROPEAN EATING DISORDERS REVIEW 2013; 21:265-75. [PMID: 23629831 DOI: 10.1002/erv.2231] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study is part of the larger Christina Barz Study, and it compared consecutively admitted patients with purging disorder (PurD; N = 225) with consecutively admitted patients with anorexia nervosa binge eating/purging subtype (AN-bp; N = 503) and bulimia nervosa purging subtype (BN-p; N = 756). Participants answered self-rating questionnaires on admission, at the end of inpatient treatment, and in a 5-year follow-up. Patients with PurD reported lower severity of general psychopathology than patients with AN-bp and lower severity of eating disorder symptoms than patients with AN-bp and BN-p on admission. Eating disorder symptoms of patients with PurD improved less during the course than of the comparison groups. Diagnostic perseverance was stronger in the PurD group than for patients with AN-bp; mortality was higher than for patients with BN-p. Predictors for better outcome differed for the groups. Our results provide new data about the long-term course of patients with PurD and indicate clinical relevance of the disorder.
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Affiliation(s)
- Sonja Koch
- Department of Psychiatry, University of Munich, Germany
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Stigmatizing attitudes differ across mental health disorders: a comparison of stigma across eating disorders, obesity, and major depressive disorder. J Nerv Ment Dis 2013; 201:281-5. [PMID: 23538972 DOI: 10.1097/nmd.0b013e318288e23f] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The aim of the current article was to compare stigmatizing attitudes toward eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), with stigma toward another weight-related condition (obesity) and a non-weight-related mental disorder (major depressive disorder [MDD]). Participants (N = 447) read five vignettes describing a woman with AN, BN, BED, obesity, or MDD and responded to questionnaires examining stigmatizing attitudes. The targets with EDs were blamed more for their condition than the targets with MDD, whereas persons with obesity were held more responsible for their condition than any other target. On the other hand, the target with MDD was perceived as more impaired than any other target. Lack of self-discipline was attributed more to the development of BED and obesity than to any other condition. Stigmatizing attitudes vary across mental health disorders, and future research should aim to specifically target stigmatizing beliefs to reduce and prevent discrimination toward mental health disorders and obesity.
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43
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Diagnostic Issues of Binge Eating in Eating Disorders. EUROPEAN EATING DISORDERS REVIEW 2013; 21:175-83. [DOI: 10.1002/erv.2227] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 12/13/2012] [Accepted: 01/27/2013] [Indexed: 11/07/2022]
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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.
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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
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Mond JM. Classification of bulimic-type eating disorders: from DSM-IV to DSM-5. J Eat Disord 2013; 1:33. [PMID: 24999412 PMCID: PMC4081768 DOI: 10.1186/2050-2974-1-33] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 06/28/2013] [Indexed: 12/12/2022] Open
Abstract
Proposed changes to the classification of bulimic-type eating disorders in the lead up to the publication of DSM-5 are reviewed. Several of the proposed changes, including according formal diagnostic status to binge eating disorder (BED), removing the separation of bulimia nervosa (BN) into purging and non-purging subtypes, and reducing the binge frequency threshold from twice per week to once per week for both BN and (BED), have considerable empirical evidence to support them and will likely have the effect of facilitating clinical practice, improving access to care, improving public and professional awareness and understanding of these disorders and stimulating the additional research needed to address at least some problematic issues. However, the omission of any reference to variants of BN characterized by subjective, but not objective, binge eating episodes, and to the undue influence of weight or shape on self-evaluation or similar cognitive criterion in relation to the diagnosis of BED, is regrettable, given their potential to inform clinical and research practice and given that there is considerable evidence to support specific reference to these distinctions. Other aspects of the proposed criteria, such as retention of behavioral indicators of impaired control associated with binge eating and the presence of marked distress regarding binge eating among the diagnostic for BED, appear anomalous in that there is little or no evidence to support their validity or clinical utility. It is hoped that these issues will be addressed in final phase of the DSM-5 development process.
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Affiliation(s)
- Jonathan M Mond
- Research School of Psychology, Australian National University, Canberra ACT 0200, Australia
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46
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Fischer S, Meyer AH, Hermann E, Tuch A, Munsch S. Night eating syndrome in young adults: delineation from other eating disorders and clinical significance. Psychiatry Res 2012; 200:494-501. [PMID: 22883837 DOI: 10.1016/j.psychres.2012.07.028] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Revised: 07/10/2012] [Accepted: 07/20/2012] [Indexed: 11/26/2022]
Abstract
The Night Eating Syndrome (NES) is a recently described disordered eating style whose status in current diagnostic systems needs to be further clarified. The aim of this study was to increase knowledge about the clinical features of NES in a sample of 1514 young adults aged 18-26 years from the general population who participated in an anonymous Internet survey. We first examined characteristics of NES and tried to delineate it from healthy controls as well as from other eating disorders in terms of socio-demography, eating disorder pathology and general psychopathology. Second, we attempted to further clarify the clinical utility of the NES by assessing the degree of distress as well as impairment. Twenty (1.3%) participants with NES were identified and there was only modest overlap between NES and both Binge Eating Disorder (BED) and Bulimia nervosa (BN) according to questionnaire-based DSM-IV criteria. Compared to healthy controls, NES individuals reported more pronounced eating disorder pathology as well as general psychopathology (depressive symptoms, chronic social stress). NES seems to be associated with considerable distress and impairment. Implications for the validity and classification of NES are discussed.
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Affiliation(s)
- Sophia Fischer
- Department of Child and Adolescent Psychiatry of the University of Basel (UPK Basel), Switzerland
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47
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Ulman TF, Von Holle A, Torgersen L, Stoltenberg C, Reichborn-Kjennerud T, Bulik CM. Sleep disturbances and binge eating disorder symptoms during and after pregnancy. Sleep 2012; 35:1403-11. [PMID: 23024439 DOI: 10.5665/sleep.2124] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
STUDY OBJECTIVE We compared sleep problems during pregnancy and sleep dissatisfaction 18 months after pregnancy in pregnant women with binge eating disorder (BED) symptoms and pregnant women without an eating disorder. DESIGN Norwegian Mother and Child Cohort Study (MoBa). PATIENTS OR PARTICIPANTS Data were gathered from 72,435 women. A total of 1,495 (2.1%) women reported having BED symptoms both before and during pregnancy; 921 (1.3%) reported pre-pregnancy BED symptoms that remitted during pregnancy; 1,235 (1.7%) reported incident BED symptoms during pregnancy; and 68,784 (95.0%) reported no eating disorder symptoms before or during pregnancy (referent). MEASUREMENTS AND RESULTS Questionnaires were collected at 3 time points, with a median completion time of 17.1 weeks gestation, 30.1 weeks gestation, and 18.7 months after childbirth. We collected information on demographics, eating disorder status before and during pregnancy, sleep problems during the first 18 weeks of pregnancy, hours of sleep during the third trimester, and sleep satisfaction 18 months after childbirth. All BED symptom groups were significantly more likely to report sleep problems during the first 18 weeks of pregnancy than the referent (adjusted odds ratio [OR] = 1.26-1.42, false discovery rate [FDR] P < 0.05). In the third trimester, women with incident BED symptoms during pregnancy were more likely to report more hours of sleep than the referent (adjusted OR = 1.49, FDR P < 0.01). All BED symptom groups had higher odds of reporting more dissatisfaction with sleep 18 months after childbirth (adjusted ORs = 1.28-1.47, FDR P < 0.01). CONCLUSIONS BED before or during pregnancy is associated with sleeping problems during pregnancy and dissatisfaction with sleep 18 months after childbirth. Health care professionals should inquire about BED during pregnancy as it may be associated with sleep disturbances, in addition to the hallmark eating concerns.
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Affiliation(s)
- T Frances Ulman
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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48
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Kelly NR, Lydecker JA, Mazzeo SE. Positive cognitive coping strategies and binge eating in college women. Eat Behav 2012; 13:289-92. [PMID: 22664415 DOI: 10.1016/j.eatbeh.2012.03.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 03/21/2012] [Accepted: 03/23/2012] [Indexed: 01/24/2023]
Abstract
The current study explored whether specific cognitive coping strategies moderated the relation between global eating disorder symptomatology and binge eating frequency. Global eating disorder symptomatology and cognitive coping strategies (i.e., self-blame, acceptance, rumination, positive refocusing, refocus on planning, positive reappraisal, putting into perspective, catastrophizing, and other-blame) were evaluated in a sample of women who reported engaging in binge eating in the absence of compensatory behaviors (N=419). Moderation analyses indicated that most positive cognitive coping strategies were associated with reduced binge eating frequency; however, there was no such buffering effect among individuals who reported engaging in acceptance, or in negative coping strategies. These results suggest that focusing on specific positive cognitive coping skills might be an effective approach to decreasing binge eating frequency, although additional experimental research is needed.
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Affiliation(s)
- Nichole R Kelly
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA, USA.
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49
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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.
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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
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50
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McElroy SL, Guerdjikova AI, Mori N, O’Melia AM. Pharmacological management of binge eating disorder: current and emerging treatment options. Ther Clin Risk Manag 2012; 8:219-41. [PMID: 22654518 PMCID: PMC3363296 DOI: 10.2147/tcrm.s25574] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Growing evidence suggests that pharmacotherapy may be beneficial for some patients with binge eating disorder (BED), an eating disorder characterized by repetitive episodes of uncontrollable consumption of abnormally large amounts of food without inappropriate weight loss behaviors. In this paper, we provide a brief overview of BED and review the rationales and data supporting the effectiveness of specific medications or medication classes in treating patients with BED. We conclude by summarizing these data, discussing the role of pharmacotherapy in the BED treatment armamentarium, and suggesting future areas for research.
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Affiliation(s)
- Susan L McElroy
- Lindner Center of HOPE, Mason, and Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Anna I Guerdjikova
- Lindner Center of HOPE, Mason, and Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Nicole Mori
- Lindner Center of HOPE, Mason, and Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Anne M O’Melia
- Lindner Center of HOPE, Mason, and Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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