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Carbone EA, Aloi M, Rania M, de Filippis R, Quirino D, Fiorentino TV, Segura-Garcia C. The relationship of food addiction with binge eating disorder and obesity: A network analysis study. Appetite 2023; 190:107037. [PMID: 37714336 DOI: 10.1016/j.appet.2023.107037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/17/2023]
Abstract
Food addiction (FA) has been associated with binge eating disorder (BED) and obesity at varying levels of severity and treatment outcomes. Despite much debate and scientific interest in FA, the mechanisms that underlie its co-occurrence with both conditions are not yet well understood. In order to understand this relationship, this study explores FA in a clinical sample of individuals with BED and obesity using network analysis (NA). A total of 303 patients (151 with BED and 152 with obesity) completed a battery of tests that investigated eating psychopathology, eating behaviours, emotional dysregulation, depression and FA. Two different NAs were conducted to investigate the interaction between these variables and FA. The BED and obesity groups were comparable in age (38 ± 14 vs. 42 ± 13 years), body mass index (38.8 ± 8.5 vs 42.4 ± 7.8), sex and demographics. According to the expected influence values, binge eating severity and depression were identified as the central nodes in both networks. In the BED group, binge eating severity was the central node and showed strong connections to both FA and grazing. In contrast, in the obesity group, depression was the central node, but its connections were weak, with only marginal associations to FA. These results suggest that FA represents an important and distinct construct of the two populations. In patients with BED, FA is intimately connected to other loss-of-control-related eating behaviours, such as binge eating and grazing. Conversely, in those with obesity, depression explains the relationship of FA with pathological eating behaviours. The presence of FA seems to be a distinguishing characteristic in the psychopathology of patients suffering from obesity with and without BED, and this could have implications for the prevention, treatment and management of these disorders.
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Affiliation(s)
- Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Matteo Aloi
- Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy; Department of Health Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Marianna Rania
- Center for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, 88100, Catanzaro, Italy
| | - Renato de Filippis
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Daria Quirino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy; Center for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, 88100, Catanzaro, Italy.
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2
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Mavragani A, Srivastava P, Presseller EK, Lin M, Patarinski AGG, Manasse SM, Forman EM. Using Continuous Glucose Monitoring to Detect and Intervene on Dietary Restriction in Individuals With Binge Eating: The SenseSupport Withdrawal Design Study. JMIR Form Res 2022; 6:e38479. [PMID: 36515992 PMCID: PMC9798259 DOI: 10.2196/38479] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Dietary restraint is a key factor for maintaining engagement in binge eating among individuals with binge eating disorder (BED) and bulimia nervosa (BN). Reducing dietary restraint is a mechanism of change in cognitive behavioral therapy (CBT) for individuals with BN and BED. However, many individuals who undergo CBT fail to adequately reduce dietary restraint during treatment, perhaps owing to difficulty in using treatment skills (eg, regular eating) to reduce dietary restraint during their daily lives. The SenseSupport system, a novel just-in-time, adaptive intervention (JITAI) system that uses continuous glucose monitoring to detect periods of dietary restraint, may improve CBT to reduce dietary restraint during treatment by providing real-time interventions. OBJECTIVE This study aimed to describe the feasibility, acceptability, and initial evaluation of SenseSupport. We presented feasibility, acceptability, target engagement, and initial treatment outcome data from a small trial using an ABAB (A=continuous glucose monitoring data sharing and JITAIs-Off, B=continuous glucose monitoring data sharing and JITAIs-On) design (in which JITAIs were turned on for 2 weeks and then turned off for 2 weeks throughout the treatment). METHODS Participants (N=30) were individuals with BED or BN engaging in ≥3 episodes of ≥5 hours without eating per week at baseline. Participants received 12 sessions of CBT and wore continuous glucose monitors to detect eating behaviors and inform the delivery of JITAIs. Participants completed 4 assessments and reported eating disorder behaviors, dietary restraint, and barriers to app use weekly throughout treatment. RESULTS Retention was high (25/30, 83% after treatment). However, the rates of continuous glucose monitoring data collection were low (67.4% of expected glucose data were collected), and therapists and participants reported frequent app-related issues. Participants reported that the SenseSupport system was comfortable, minimally disruptive, and easy to use. The only form of dietary restraint that decreased significantly more rapidly during JITAIs-On periods relative to JITAIs-Off periods was the desire for an empty stomach (t43=1.69; P=.049; Cohen d=0.25). There was also a trend toward greater decrease in overall restraint during JITAs-On periods compared with JITAIs-Off periods, but these results were not statistically significant (t43=1.60; P=.06; Cohen d=0.24). There was no significant difference in change in the frequency of binge eating during JITAIs-On periods compared with JITAIs-Off periods (P=.23). Participants demonstrated clinically significant, large decreases in binge eating (t24=10.36; P<.001; Cohen d=2.07), compensatory behaviors (t24=3.40; P=.001; Cohen d=0.68), and global eating pathology (t24=6.25; P<.001; Cohen d=1.25) from pre- to posttreatment. CONCLUSIONS This study describes the successful development and implementation of the first intervention system combining passive continuous glucose monitors and JITAIs to augment CBT for binge-spectrum eating disorders. Despite the lower-than-anticipated collection of glucose data, the high acceptability and promising treatment outcomes suggest that the SenseSupport system warrants additional investigation via future, fully powered clinical trials. TRIAL REGISTRATION ClinicalTrials.gov NCT04126694; https://clinicaltrials.gov/ct2/show/NCT04126694.
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Affiliation(s)
| | - Paakhi Srivastava
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, United States
| | - Emily K Presseller
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, United States.,Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Mandy Lin
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, United States
| | - Anna G G Patarinski
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, United States
| | - Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, United States
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, United States.,Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
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3
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De Young KP, Bottera AR. A biobehavioral circadian model of restrictive eating and binge eating. Int J Eat Disord 2022; 55:1291-1295. [PMID: 35704385 DOI: 10.1002/eat.23758] [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: 03/31/2022] [Revised: 05/17/2022] [Accepted: 05/27/2022] [Indexed: 11/11/2022]
Abstract
Caloric consumption occurs in rhythms, typically during daytime, waking hours, marked by peaks at mealtimes. These rhythms are disrupted in individuals with eating disorders; mealtime peaks are blunted and delayed relative to sleep/waketimes. Individuals with eating disorders also tend to experience an overall phase delay in appetite; they lack hunger earlier in the day and experience atypically high hunger later in the day, the latter of which may culminate in binge-eating episodes. This disruptive appetitive behavior-early in the day restrictive eating and later in the day binge eating-may be partially accounted for by circadian disruptions, which play a role in coordinating appetitive rhythms. Moreover, restrictive eating and binge eating themselves may further disrupt circadian synchronization, as meal timing serves as one of many external signals to the central circadian pacemaker. Here, we introduce the biobehavioral circadian model of restrictive eating and binge eating, which posits a central role for circadian disruption in the development and maintenance of restrictive eating and binge eating, highlighting modifiable pathways unacknowledged in existing explanatory models. Evidence supporting this model would implicate the need for biobehavioral circadian regulation interventions to augment existing eating disorder treatments for individuals experiencing circadian rhythm disruption. PUBLIC SIGNIFICANCE: Existing treatments for eating disorders that involve binge eating and restrictive eating mandate a regular pattern of eating; this is largely responsible for early behavioral change. This intervention may work partly by regulating circadian rhythm and diurnal appetitive disruptions. Supplementing existing treatments with additional elements specifically designed to regulate circadian rhythm and diurnal appetitive rhythms may increase the effectiveness of treatments, which presently do not benefit all who receive them.
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Affiliation(s)
- Kyle P De Young
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
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Romo-Nava F, Guerdjikova AI, Mori NN, Scheer FAJL, Burgess HJ, McNamara RK, Welge JA, Grilo CM, McElroy SL. A matter of time: A systematic scoping review on a potential role of the circadian system in binge eating behavior. Front Nutr 2022; 9:978412. [PMID: 36159463 PMCID: PMC9493346 DOI: 10.3389/fnut.2022.978412] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/16/2022] [Indexed: 01/26/2023] Open
Abstract
Background Emerging research suggests that food intake timing, eating behavior and food preference are associated with aspects of the circadian system function but the role that the circadian system may play in binge eating (BE) behavior in humans remains unclear. Objective To systematically evaluate the evidence for circadian system involvement in BE behavior. Methods Systematic searches of PubMed, EMBASE, and Scopus were performed for reports published from inception until May 2020 (PROSPERO Registration CRD42020186325). Searches were conducted by combining Medical Subject Headings related to the circadian system, BE behavior, and/or interventions. Observational and interventional studies in humans with BE behavior published in peer-review journals in the English language were included. Studies were assessed using quality and risk of bias tools (AXIS, ROB 2.0, or ROBINS). Results The search produced 660 articles, 51 of which were included in this review. Of these articles, 46 were observational studies and 5 were interventional trials. Evidence from these studies suggests that individuals with BE behavior tend to have more food intake, more binge cravings, and more BE episodes later in the day. Hormonal and day/night locomotor activity rhythm disturbances may be associated with BE behavior. Furthermore, late diurnal preference ("eveningness") was associated with BE behavior and chronobiological interventions that shift the circadian clock earlier (e.g., morning bright light therapy) were found to possibly decrease BE behavior. Substantive clinical overlap exists between BE and night eating behavior. However, there is a significant knowledge gap regarding their potential relationship with the circadian system. Limitations include the lack of studies that use best-established techniques to assess the chronobiology of BE behavior, heterogeneity of participants, diagnostic criteria, and study design, which preclude a meta-analytic approach. Conclusion Current evidence, although limited, suggests that the circadian system may play a role in the etiology of BE behavior. Further mechanistic studies are needed to fully characterize a potential role of the circadian system in BE behavior. A chronobiological approach to studying BE behavior may lead to identification of its neurobiological components and development of novel therapeutic interventions. Systematic review registration [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020186325], identifier [CRD42020186325].
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Affiliation(s)
- Francisco Romo-Nava
- Lindner Center of HOPE, Mason, OH, United States,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, United States,*Correspondence: Francisco Romo-Nava,
| | - Anna I. Guerdjikova
- Lindner Center of HOPE, Mason, OH, United States,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Nicole N. Mori
- Lindner Center of HOPE, Mason, OH, United States,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Frank A. J. L. Scheer
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Department of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, United States,Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Helen J. Burgess
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Robert K. McNamara
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Jeffrey A. Welge
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, United States,Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Carlos M. Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Susan L. McElroy
- Lindner Center of HOPE, Mason, OH, United States,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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do Rosário Caldas N, Braulio VB, Brasil MAA, Furtado VCS, de Carvalho DP, Cotrik EM, Dantas JR, Zajdenverg L. Binge eating disorder, frequency of depression, and systemic inflammatory state in individuals with obesity - A cross sectional study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:489-497. [PMID: 35758834 PMCID: PMC10697643 DOI: 10.20945/2359-3997000000489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 03/07/2022] [Indexed: 06/15/2023]
Abstract
Introduction Binge eating disorder (BED) is the most prevalent eating disorder in individuals with obesity. Its association with factors that control hunger and satiety has not yet been elucidated. We evaluated whether levels of inflammatory markers, frequency of psychiatric comorbidities, and appetite-related hormones levels differ between individuals with obesity with and without BED. Subjects and methods The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-5 - Clinician Version (SCID-5-CV), Binge Eating Scale, and Hospital Anxiety and Depression Scale were evaluated in 39 individuals with obesity. Plasma levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), leptin, ghrelin, and glucagon-like peptide-1 (GLP-1) were measured. Results Individuals of the BED group exhibited significantly higher percentages of altered eating patterns (hyperphagia, bingeing, post-dinner eating, feeling "stuffed", and emotional eating), higher depressive symptom scores and levels of leptin, CRP, and TNF-α, compared to those from the non-BED group. Logistic regression showed that BED was independently associated with depressive symptoms and CRP levels. Conclusion Individuals with obesity and BED showed greater psychiatric comorbidity, worse eating patterns and worse inflammatory profile than those without BED. BED should be assessed as an indicator of clinical severity in patients with obesity.
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Affiliation(s)
- Nelson do Rosário Caldas
- Universidade Federal do Rio de Janeiro, Serviço de Psiquiatria e Psicologia Médica, Rio de Janeiro, RJ, Brasil,
| | - Valeria Bender Braulio
- Universidade Federal do Rio de Janeiro, Serviço de Nutrologia, Rio de Janeiro, RJ, Brasil
| | - Marco Antônio Alves Brasil
- Universidade Federal do Rio de Janeiro, Serviço de Psiquiatria e Psicologia Médica, Rio de Janeiro, RJ, Brasil
| | | | - Denise Pires de Carvalho
- Universidade Federal do Rio de Janeiro, Instituto de Biofísica Carlos Chagas Filho, Rio de Janeiro, RJ, Brasil
| | - Ervin Michelstaedter Cotrik
- Universidade Federal do Rio de Janeiro, Serviço de Psiquiatria e Psicologia Médica, Rio de Janeiro, RJ, Brasil
| | - Joana Rodrigues Dantas
- Universidade Federal do Rio de Janeiro, Serviço de Nutrologia, Rio de Janeiro, RJ, Brasil
| | - Lenita Zajdenverg
- Universidade Federal do Rio de Janeiro, Serviço de Nutrologia, Rio de Janeiro, RJ, Brasil
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Spirou D, Raman J, Leith M, Collison J, Bishay RH, Ahlenstiel G, Hay P, Smith E. The psychometric properties of the grazing questionnaire in an obesity sample with and without binge eating disorder. J Eat Disord 2022; 10:82. [PMID: 35710487 PMCID: PMC9202494 DOI: 10.1186/s40337-022-00604-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite being the first validated measure of grazing, the Grazing Questionnaire (GQ) has not been investigated among individuals with obesity. Therefore, the current study aimed to examine the psychometric properties of the GQ in an obesity sample. METHODS Participants (N = 259) were recruited from community and clinical settings in Australia. The sample comprised adults with normal weight (n = 77) and obesity (n = 182). A portion of individuals with obesity (n = 102) had binge eating disorder (BED). Data from the obesity group was examined to establish the factor structure, validity, and reliability of the GQ. A one-way ANOVA with planned contrasts was conducted to compare scores on the GQ across groups. RESULTS Confirmatory factor analysis revealed that the 2-factor model of the GQ was the best model fit for individuals with obesity. The GQ demonstrated high internal consistency, test-retest reliability over 3 months, and convergent and divergent validity. As hypothesised, the obesity group had significantly higher scores on the GQ than the normal weight group, while the obesity with BED group had significantly higher scores than the obesity without BED group. CONCLUSION This was the first study to investigate the psychometric properties of the GQ in an obesity sample. Overall, findings indicated that the GQ is a psychometrically sound measure of grazing among individuals with obesity. These findings provide further support for two distinct subtypes of grazing and highlight the importance of increased assessment and management of grazing behaviours for individuals with obesity and eating disorders. Maintaining a healthy weight is one of the greatest challenges for individuals with obesity. Certain eating patterns such as grazing may contribute to difficulties in weight management. Grazing is the repetitive and unplanned eating of small amounts of food that is not related to feeling hungry. Researchers and clinicians often use self-report questionnaires to measure grazing. However, the first validated questionnaire of grazing has not been investigated among individuals with obesity. Therefore, the goal of this study was to examine and validate the Grazing Questionnaire in individuals with obesity. Overall, our results showed that the Grazing Questionnaire is a valid and reliable self-report measure of grazing in individuals with obesity. Similar to previous research, we found that there are two subtypes of grazing. The first subtype involves continuous, unplanned eating. The second subtype is associated with a sense of loss of control over eating. We also found that people with obesity and binge eating disorder graze more than people with obesity that do not have binge eating disorder, while both groups graze more than individuals with normal weight. We recommend that clinicians routinely assess and treat unhelpful grazing patterns when working with individuals with obesity and eating disorders.
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Affiliation(s)
- Dean Spirou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia. .,Blacktown Metabolic and Weight Loss Program, Department of Endocrinology and Diabetes, Blacktown Hospital, Blacktown, Sydney, NSW, Australia. .,School of Medicine, Western Sydney University, Sydney, NSW, Australia.
| | - Jayanthi Raman
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Mimi Leith
- School of Psychology, Western Sydney University, Sydney, NSW, Australia
| | - James Collison
- Australian College of Applied Professions, Sydney, NSW, Australia
| | - Ramy H Bishay
- Blacktown Metabolic and Weight Loss Program, Department of Endocrinology and Diabetes, Blacktown Hospital, Blacktown, Sydney, NSW, Australia.,School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Golo Ahlenstiel
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Storr Liver Centre, Westmead Millennium Institute, Westmead Hospital, University of Sydney, Sydney, NSW, Australia.,Department of Gastroenterology and Hepatology, Blacktown and Mount Druitt Hospitals, WSLHD, Sydney, NSW, Australia
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Evelyn Smith
- School of Psychology, Western Sydney University, Sydney, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
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Forlano R, Harlow C, Mullish BH, Thursz MR, Manousou P, Yee M. Binge-eating disorder is associated with an unfavorable body mass composition in patients with non-alcoholic fatty liver disease. Int J Eat Disord 2021; 54:2025-2030. [PMID: 34272900 DOI: 10.1002/eat.23584] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/14/2022]
Abstract
The interaction between eating disorders and non-alcoholic fatty liver disease (NAFLD) remains unexplored, especially with regards to binge-eating disorder (BED). Our team conducted a service evaluation project in order to assess risk factors for the presence of BED among patients with NAFLD and the impact of BED on body mass composition. The overall prevalence of patients screening positive to BED Screener-7 (BEDS-7) was 28.4%, while a previous diagnosis of depression and marital status (as single or separated) were independently associated with positive BED. Furthermore, patients with positive BEDS-7 had higher BMI, with greater visceral component and overall lower muscle mass. There was no difference in terms of liver disease severity as assessed by noninvasive markers of fibrosis. However, as body mass composition and sarcopenia have been shown to be associated to disease progression in patients with NAFLD, further studies are required to ascertain the long-term impact of BED in these patients. Moreover, further work is warranted to identify to implement multidisciplinary approach within clinical psychology for the management of patients with BED, who may be particularly challenging in terms of achieving lifestyle modifications. As a hepatology community, we should address NAFLD with a more holistic approach.
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Affiliation(s)
- Roberta Forlano
- Liver Unit/Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Christopher Harlow
- Liver Unit/Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Benjamin H Mullish
- Liver Unit/Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Mark R Thursz
- Liver Unit/Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Pinelopi Manousou
- Liver Unit/Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Michael Yee
- Section of Endocrinology and Metabolic Medicine, St Mary's Hospital, Imperial College NHS Trust, London, UK
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Teodoro MC, Conceição EM, de Lourdes M, Alves JR, Neufeld CB. Grazing's frequency and associations with obesity, psychopathology, and loss of control eating in clinical and community contexts: A systematic review. Appetite 2021; 167:105620. [PMID: 34352352 DOI: 10.1016/j.appet.2021.105620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 12/01/2022]
Abstract
The term grazing is generally described as the repetitive and nonplanned consumption of small amounts of food, not in response to hunger/satiety sensations. The present study aims to identify and critically review studies examining the frequency of grazing in both clinical and community samples, as well as, to investigate its relationship with eating disorder psychopathology, Loss of Control eating (LOC), psychological impairment, and weight-related variables. This systematic review followed the PRISMA recommendations for reporting systematic reviews and meta-analysis. A total of 138 articles were initially retrieved from the database search. In the end, 18 articles were considered for this systematic review. The results were separated in Grazing and Grazing-like behavior (picking and nibbling). Results of studies of grazing-like behaviors displays that, in these studies, the results are sometimes inconsistent and controversial. On the other hand, studies of Grazing behavior showed more consistent results. These results show that the use of different definitions across the literature makes it difficult to establish comparisons across studies. In this literature review, the studies selected used five different definitions of grazing and five different instruments to assess this eating behavior which reinforces the requirement for standardized definition and evaluation. More, the studies hereby revised suggested that LOC eating was considered in association with grazing, being significantly associated with higher levels of psychopathology and psychological impairment. In accordance, a growing body of research argues that LOC eating was a stronger predictor of eating disorder psychopathology than the amounts of food consumed. Furthermore, the results found by studies show an advance to literature with an accordance about LOC, supported by evidences in studies of this review.
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Affiliation(s)
- Marília Consolini Teodoro
- Cognitive-Behavioral Intervention and Research Laboratory - LaPICC-USP, Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil.
| | - Eva M Conceição
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Jéssika Rodrigues Alves
- Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Carmem Beatriz Neufeld
- Cognitive-Behavioral Intervention and Research Laboratory - LaPICC-USP, Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil
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9
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Katan A, Kelly AC. A two-week daily diary study examining the association between daily self-compassion and symptoms of bulimia nervosa. Int J Eat Disord 2021; 54:1438-1448. [PMID: 33998025 DOI: 10.1002/eat.23533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Individuals with symptoms of bulimia nervosa (BN) are more likely to binge and purge on days of greater negative affect. Given that self-compassion helps individuals cope more adaptively with distress, the present study examined the contribution of daily fluctuations in self-compassion to eating disorder symptoms in women who endorse symptoms of BN. The directionality of these associations was also examined. METHOD For 2 weeks, 124 women who met the DSM-5 criteria for BN completed nightly measures of their daily eating pathology and self-compassion. RESULTS Self-compassion levels varied almost as much within a person from day-to-day as between-persons (i.e., from one person to the next). Multilevel modeling revealed that within persons, higher daily levels of self-compassion were associated with a reduced probability of both binge eating and inappropriate compensation, and lower levels of dietary restraint and clinical impairment. Secondary analyses revealed that these variables mutually influenced one another within but not across days. Between persons, higher mean levels of self-compassion over the 2 weeks were associated with less dietary restraint and clinical impairment but were unrelated to binge eating and compensatory behaviors. DISCUSSION For women who report symptoms consistent with BN, responding to daily distress with greater self-compassion than usual may attenuate the psychosocial and behavioral symptoms of their eating disorder. Similarly, days of reduced eating pathology may facilitate self-compassion. Future research using experimental paradigms and ecological momentary assessments may shed further light on the ways in which self-compassion and eating pathology relate to one another in this population.
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Affiliation(s)
- Aleece Katan
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Allison C Kelly
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
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Linnaranta O, Bourguignon C, Crescenzi O, Sibthorpe D, Buyukkurt A, Steiger H, Storch KF. Late and Instable Sleep Phasing is Associated With Irregular Eating Patterns in Eating Disorders. Ann Behav Med 2020; 54:680-690. [PMID: 32211873 PMCID: PMC7459186 DOI: 10.1093/abm/kaaa012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Sleep problems are common in eating disorders (EDs). PURPOSE We evaluated whether sleep-phasing regularity associates with the regularity of daily eating events. METHODS ED patients (n = 29) completed hourly charts of mood and eating occasions for 2 weeks. Locomotor activity was recorded continuously by wrist actigraphy for a minimum of 10 days, and sleep was calculated based on periods of inactivity. We computed the center of daily inactivity (CenDI) as a measure of sleep phasing and consolidation of the daily inactivity (ConDI) as a measure of daily sleep rhythm strength. We assessed interday irregularities in the temporal structure of food intake using the standard deviation (SD) of frequency (IFRQ), timing (ITIM), and interval (IINT) of food intake. A self-evaluation of other characteristics included mood, anxiety, and early trauma. RESULTS A later phasing of sleep associated with a lower frequency of eating (eating frequency with the CenDI rho = -0.49, p = .007). The phasing and rhythmic strength of sleep correlated with the degree of eating irregularity (CenDI with ITIM rho = 0.48, p = .008 and with IINT rho = 0.56, p = .002; SD of CenDI with ITIM rho = 0.47, p = .010, and SD of ConDI with IINT rho = 0.37, p = .048). Childhood Trauma Questionnaire showed associations with variation of sleep onset (rho = -0.51, p = .005) and with IFRQ (rho = 0.43, p = .023). CONCLUSIONS Late and variable phasing of sleep associated robustly with irregular pattern of eating. Larger data sets are warranted to enable the analysis of diagnostic subgroups, current medication, and current symptomatology and to confirm the likely bidirectional association between eating pattern stability and the timing of sleep.
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Affiliation(s)
- Outi Linnaranta
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Clément Bourguignon
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Olivia Crescenzi
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | | | - Asli Buyukkurt
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Howard Steiger
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Eating Disorders Continuum, Douglas University Institute, Montreal, QC, Canada
| | - Kai-Florian Storch
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
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Abstract
The popularity of physique sports is increasing, yet there are currently few comprehensive nutritional guidelines for these athletes. Physique sport now encompasses more than just a short phase before competition and offseason guidelines have recently been published. Therefore, the goal of this review is to provide an extensive guide for male and female physique athletes in the contest preparation and recovery period. As optimal protein intake is largely related to one’s skeletal muscle mass, current evidence supports a range of 1.8-2.7 g/kg. Furthermore, as a benefit from having adequate carbohydrate to fuel performance and activity, low-end fat intake during contest preparation of 10-25% of calories allows for what calories remain in the “energy budget” to come from carbohydrate to mitigate the negative impact of energy restriction and weight loss on training performance. For nutrient timing, we recommend consuming four or five protein boluses per day with one consumed near training and one prior to sleep. During competition periods, slower rates of weight loss (≤0.5% of body mass per week) are preferable for attenuating the loss of fat-free mass with the use of intermittent energy restriction strategies, such as diet breaks and refeeds, being possibly beneficial. Additionally, physiological and psychological factors are covered, and potential best-practice guidelines are provided for disordered eating and body image concerns since physique athletes present with higher incidences of these issues, which may be potentially exacerbated by certain traditional physique practices. We also review common peaking practices, and the critical transition to the post-competition period.
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12
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Johansson AK, Norring C, Unell L, Johansson A. Diet and behavioral habits related to oral health in eating disorder patients: a matched case-control study. J Eat Disord 2020; 8:7. [PMID: 32128206 PMCID: PMC7045484 DOI: 10.1186/s40337-020-0281-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 01/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients suffering from eating disorders (ED) have a substantially increased risk for developing poor oral health. In this regard, dietary habits in combination with obsessive behavior as well as the expression and intensity of the disease are of utmost importance. This study aimed to investigate diet and behavioral habits in patients with ED compared to healthy controls. METHODS All patients who initiated treatment in an ED clinic during 1 year were invited to participate in the study. Sixty-five patients were admitted out of which 54 agreed to participate: 50 women and 4 men, mean age 21.5 years, range 10-50 years. From a public dental health clinic, 54 sex-and age-matched controls where selected. In all participants a comprehensive questionnaire was completed. ED patients were analyzed with respect to their self-perceived disease state: when they felt "relatively good" (ED-good) and "bad" (ED-bad) as well as if they reported vomiting or not. RESULTS The ED-good patients reported significantly higher intake of caffeine-containing and cola light soft drinks and both study groups reported a lower intake of regularly sweetened carbonated drinks compared to controls. ED-bad reported significantly lower intake of number of meal and sweet intake while both study groups brushed their teeth more frequently than controls. As regards awareness of detrimental dietary intake and the possible risk for oral health complications did not differ between patients and controls except that the ED groups were more aware that vomiting and brushing thereafter could damage their teeth. ED patients went less often to the dentist for regular checkups than controls. Vomiting ED patients differed in several of the parameters related to dietary and other behaviors compared to no vomiting subjects. According to regression analyses and compared to healthy controls, predictive variables for ED-good were: higher intake of caffeine containing drinks (OR 1.34, CI 1.10-1.64) and lower intake of regular soft drinks (OR 0.57, CI 0.35-0.94). For ED-bad, lower frequency intake of lunch meals (OR 0.59, CI 0.39-0.88) and sweet biscuits were predictive (OR 0.15, CI 0.05-0.48). CONCLUSIONS ED patients present a number of dietary and other types of behavior that are potentially harmful for oral health. It is important to retrieve reports on the ED behaviors in both relatively good and bad disease state in order for the medical team to prescribe adequate advice and treatment.
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Affiliation(s)
- Ann-Katrin Johansson
- 1Department of Clinical Dentistry-Cariology, Faculty of Medicine, University of Bergen, Årstadveien 19, 5009 Bergen, Norway
| | - Claes Norring
- 2Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lennart Unell
- 3School of Health and Medical Sciences, Örebro University and Region Örebro County Council, Örebro, Sweden
| | - Anders Johansson
- 4Department of Clinical Dentistry-Prosthodontics, Faculty of Medicine, University of Bergen, Bergen, Norway
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13
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Rantala MJ, Luoto S, Krama T, Krams I. Eating Disorders: An Evolutionary Psychoneuroimmunological Approach. Front Psychol 2019; 10:2200. [PMID: 31749720 PMCID: PMC6842941 DOI: 10.3389/fpsyg.2019.02200] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 09/12/2019] [Indexed: 12/18/2022] Open
Abstract
Eating disorders are evolutionarily novel conditions. They lead to some of the highest mortality rates of all psychiatric disorders. Several evolutionary hypotheses have been proposed for eating disorders, but only the intrasexual competition hypothesis is extensively supported by evidence. We present the mismatch hypothesis as a necessary extension to the current theoretical framework of eating disorders. This hypothesis explains the evolutionarily novel adaptive metaproblem that has arisen when mating motives conflict with the large-scale and easy availability of hyper-rewarding but obesogenic foods. This situation is exacerbated particularly in those contemporary environments that are characterized by sedentary lifestyles, ever-present junk foods, caloric surplus and the ubiquity of social comparisons that take place via social media. Our psychoneuroimmunological model connects ultimate-level causation with proximate mechanisms by showing how the adaptive metaproblem between mating motives and food rewards leads to chronic stress and, further, to disordered eating. Chronic stress causes neuroinflammation, which increases susceptibility to OCD-like behaviors that typically co-occur with eating disorders. Chronic stress upregulates the serotonergic system and causes dysphoric mood in anorexia nervosa patients. Dieting, however, reduces serotonin levels and dysphoric mood, leading to a vicious serotonergic-homeostatic stress/starvation cycle whereby cortisol and neuroinflammation increase through stringent dieting. Our psychoneuroimmunological model indicates that between-individual and within-individual variation in eating disorders partially arises from (co)variation in gut microbiota and stress responsivity, which influence neuroinflammation and the serotonergic system. We review the advances that have been made in recent years in understanding how to best treat eating disorders, outlining directions for future clinical research. Current evidence indicates that eating disorder treatments should aim to reduce the chronic stress, neuroinflammation, stress responsivity and gut dysbiosis that fuel the disorders. Connecting ultimate causes with proximate mechanisms and treating biopsychosocial causes rather than manifest symptoms is expected to bring more effective and sophisticated long-term interventions for the millions of people who suffer from eating disorders.
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Affiliation(s)
| | - Severi Luoto
- English, Drama and Writing Studies, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Tatjana Krama
- Department of Biotechnology, Daugavpils University, Daugavpils, Latvia
| | - Indrikis Krams
- Department of Biotechnology, Daugavpils University, Daugavpils, Latvia
- Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
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14
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Helms ER, Prnjak K, Linardon J. Towards a Sustainable Nutrition Paradigm in Physique Sport: A Narrative Review. Sports (Basel) 2019; 7:sports7070172. [PMID: 31315180 PMCID: PMC6681103 DOI: 10.3390/sports7070172] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/02/2019] [Accepted: 07/11/2019] [Indexed: 12/13/2022] Open
Abstract
Physique athletes strive for low body fat with high lean mass and have higher body image and eating disorder rates than the general population, and even other weightlifting populations. Whether athletes with a background or tendency to develop these issues are drawn to the sport, or whether it drives these higher incidences, is unknown. However, the biological drive of cyclical energy restriction may contribute to binge-eating behavior. Additionally, requisite monitoring, manipulation, comparison, and judgement of one's physique may contribute to body image concerns. Contest preparation necessitates manipulating body composition through energy restriction and increased expenditure, requiring dietary restraint and nutrition, exercise, and physique assessment. Thus, competitors are at mental health risk due to (1) pre-existing or predispositions to develop body image or eating disorders; (2) biological effects of energy restriction on eating psychology; and (3) dietary restraint attitudes and resultant physique, exercise, and nutrition monitoring behavior. In our narrative review we cover each factor, concluding with tentative best-practice recommendations, including dietary flexibility, slower weight loss, structured monitoring, gradual returns to offseason energy intakes, internal eating cues, appropriate offseason body compositions, and support from nutrition and mental health professionals. A mental health focus is a needed paradigm shift in bodybuilding nutrition practice and research.
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Affiliation(s)
- Eric R Helms
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand.
| | - Katarina Prnjak
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
| | - Jake Linardon
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
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15
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Abstract
Binge-eating disorder (BED), first included as a diagnostic entity in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, is characterized by recurrent episodes of binge eating without regular compensatory behaviors to prevent weight gain. With a complex multifactorial etiology, BED is the most frequent eating disorder co-occuring with significant psychopathology, mental and physical comorbidity, obesity, and life impairment. Despite its significance, BED is not sufficiently diagnosed or treated. Evidence-based treatments for BED include psychotherapy and structured self-help treatment, with cognitive-behavioral therapy as most well-established approach, and pharmacotherapy with lisdexamfetamine as FDA approved medication with a limitation of use.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Philipp-Rosenthal-Strasse 27, Leipzig 04103, Germany.
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16
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Roustaee R, Houshiarrad A, Tajik E, Hajifaraji M. Assessment of Dietary Intakes and Food habits in Female Adolescents with Eating Disorders. NUTRITION AND FOOD SCIENCES RESEARCH 2018. [DOI: 10.29252/nfsr.5.4.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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17
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Annameier SK, Kelly NR, Courville AB, Tanofsky-Kraff M, Yanovski JA, Shomaker LB. Mindfulness and laboratory eating behavior in adolescent girls at risk for type 2 diabetes. Appetite 2018; 125:48-56. [PMID: 29407527 PMCID: PMC5878719 DOI: 10.1016/j.appet.2018.01.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/29/2017] [Accepted: 01/26/2018] [Indexed: 11/23/2022]
Abstract
Mindfulness-based intervention has become increasingly popular to address disinhibited eating in obesity and type 2 diabetes (T2D). Theoretically, present-moment attention promotes the ability to recognize and respond to internal hunger cues and to differentiate physiological hunger from other stimuli. Yet, there is limited research describing the relationship of mindfulness with disinhibited eating patterns in adolescents. In this study, we evaluated the relationship of dispositional mindfulness to laboratory eating in 107 adolescent (12-17 years) girls at risk for T2D. Adolescents reported dispositional mindfulness, were evaluated for recent loss-of-control-eating (LOC-eating) by interview, and participated in two successive, standardized laboratory test meals to assess eating when hungry as well as eating in the absence of hunger (EAH). Adolescents rated state appetite throughout the test meal paradigms. In analyses adjusting for body composition and other possible confounds, mindfulness was inversely related to caloric intake during the EAH paradigm. Mindfulness did not relate to energy intake when hungry. Instead, there was a significant interaction of reported LOC-eating by state hunger, such that girls with recent, reported LOC-eating and high state hunger consumed more calories when hungry, regardless of mindfulness. Findings suggest that in girls at risk for T2D, mindfulness may play a role in disinhibited eating. A propensity for LOC-eating may be most salient for overeating in a high hunger state.
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Affiliation(s)
- Shelly K Annameier
- Human Development and Family Studies, College of Health and Human Sciences, Colorado State University, United States
| | - Nichole R Kelly
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States; Counseling Psychology and Human Services and the Prevention Science Institute, College of Education, University of Oregon, United States
| | - Amber B Courville
- Nutrition Department, National Institutes of Health Clinical Center, United States
| | - Marian Tanofsky-Kraff
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States; Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, United States
| | - Jack A Yanovski
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States
| | - Lauren B Shomaker
- Human Development and Family Studies, College of Health and Human Sciences, Colorado State University, United States; Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States; Community and Behavioral Health, Colorado School of Public Health, United States.
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18
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Linardon J, Phillipou A, Newton R, Fuller-Tyszkiewicz M, Jenkins Z, Cistullo LL, Castle D. Testing the relative associations of different components of dietary restraint on psychological functioning in anorexia nervosa and bulimia nervosa. Appetite 2018; 128:1-6. [PMID: 29807122 DOI: 10.1016/j.appet.2018.05.138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/11/2018] [Accepted: 05/24/2018] [Indexed: 10/16/2022]
Abstract
Although empirical evidence identifies dietary restraint as a transdiagnostic eating disorder maintaining mechanism, the distinctiveness and significance of the different behavioural and cognitive components of dietary restraint are poorly understood. The present study examined the relative associations of the purportedly distinct dietary restraint components (intention to restrict, delayed eating, food avoidance, and diet rules) with measures of psychological distress (depression, anxiety, and stress), disability, and core eating disorder symptoms (overvaluation and binge eating) in patients with anorexia nervosa (AN) and bulimia nervosa (BN). Data were analysed from a treatment-seeking sample of individuals with AN (n = 124) and BN (n = 54). Intention to restrict, food avoidance, and diet rules were strongly related to each other (all r's > 0.78), but only weakly-moderately related to delayed eating behaviours (all r's < 0.47). In subsequent moderated ridge regression analyses, delayed eating was the only restraint component to independently predict variance in measures of psychological distress. Patient diagnosis did not moderate these associations. Overall, findings indicate that delayed eating behaviours may be a distinct component from other indices of dietary restraint (e.g., intention to restrict, food avoidance, diet rules). This study highlights the potential importance of ensuring that delayed eating behaviours are screened, assessed, and targeted early in treatment for patients with AN and BN.
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Affiliation(s)
- Jake Linardon
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia.
| | - Andrea Phillipou
- Centre for Mental Health, Swinburne University of Technology, John St, Hawthorn, VIC 3122, Australia; Department of Mental Health, St Vincent's Hospital, Level 2, 46 Nicholson St, Fitzroy, VIC 3065, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC 3010, Australia; Department of Mental Health, Austin Hospital, 145 Studley Rd, Heidelberg, VIC 3084, Australia
| | - Richard Newton
- Department of Mental Health, Austin Hospital, 145 Studley Rd, Heidelberg, VIC 3084, Australia
| | | | - Zoe Jenkins
- Department of Mental Health, St Vincent's Hospital, Level 2, 46 Nicholson St, Fitzroy, VIC 3065, Australia
| | | | - David Castle
- Department of Psychiatry, The University of Melbourne, Parkville, VIC 3010, Australia; Department of Psychiatry, St Vincent's Hospital, Australia
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19
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Heriseanu AI, Hay P, Corbit L, Touyz S. Grazing in adults with obesity and eating disorders: A systematic review of associated clinical features and meta-analysis of prevalence. Clin Psychol Rev 2017; 58:16-32. [DOI: 10.1016/j.cpr.2017.09.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/18/2017] [Accepted: 09/12/2017] [Indexed: 02/06/2023]
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20
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León-Vázquez CDD, Rivera-Márquez JA, Bojorquez-Chapela I, Unikel-Santoncini C. Variables associated with disordered eating behaviors among freshman students from Mexico City. SALUD PUBLICA DE MEXICO 2017; 59:258-265. [PMID: 28902313 DOI: 10.21149/8000] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 03/14/2017] [Indexed: 11/06/2022] Open
Abstract
Objective: To estimate the prevalence of disordered eating behaviors (DEB) and identify their associations with demographic and psychological variables among freshman students at a public university in Mexico City. Materials and methods: A sample of 892 subjects participated in the study. Bivariate and multinomial models were performed to determine associations between DEB and covariates. Results: Of those surveyed, 6.8% of the women and 4.1% of the men exhibited DEB (p<0.05). The variables increasing the risk of eating disorders (ED) for women were internalization of the aesthetic thin ideal (IATI), body mass index (BMI), self-esteem and physical activity, while for men they were IATI, drive for muscularity, and self-esteem. Conclusions: The frequency of DEB among women and men and the internalization of the thin ideal in both sexes suggest the possibility of a change in the precursor conditions for eating disorders, particularly for men, who exhibit increased risk of such behaviors.
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Affiliation(s)
| | - José Alberto Rivera-Márquez
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana, campus Xochimilco. Ciudad de México, México
| | - Ietza Bojorquez-Chapela
- Departamento de Estudios de Población, El Colegio de la Frontera Norte. Tijuana, Baja California, México
| | - Claudia Unikel-Santoncini
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. Ciudad de México, México
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21
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Elran-Barak R, Goldschmidt AB, Crow SJ, Peterson CB, Hill L, Crosby RD, Mitchell JE, Le Grange D. Is laxative misuse associated with binge eating? Examination of laxative misuse among individuals seeking treatment for eating disorders. Int J Eat Disord 2017; 50:1114-1118. [PMID: 28766762 PMCID: PMC5861734 DOI: 10.1002/eat.22745] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/13/2017] [Accepted: 07/13/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Our research focuses on laxative misuse, which has been understudied in previous eating disorders (ED) research, to understand its prevalence and correlates among individuals seeking ED treatment. We also test the association between laxative misuse and binge eating to examine the assumption that laxative misuse is intended to compensate for binge eating. METHOD Participants were 2,295 ED treatment-seeking adults (29.5 ± 10.5) who self-reported their disordered eating behaviors on the Eating Disorder Questionnaire. Participants met DSM-5 diagnostic criteria for anorexia nervosa (AN: 11.5%, n = 264), bulimia nervosa (BN: 39.0%, n = 896), binge-eating disorder (14.9%, n = 343), or other specified feeding or eating disorder (34.5%, n = 792). RESULTS Nearly 25% of participants (n = 571) reported misusing laxatives during the last month. Laxative misusers with AN reported significantly higher frequency of laxative misuse relative to misusers with BN (F(1,440) = 5.226, p = .023, ηp2= .012). Among laxative misusers, there was no association between frequency of binge eating and frequency of laxative misuse. DISCUSSION Laxative misusers with AN tend to misuse laxatives more frequently than those with BN. Binge eating was not related to laxative misuse in our sample. Future research may use real-time data collection to understand the function of laxative misuse and to validate our cross-sectional findings.
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Affiliation(s)
| | - Andrea B. Goldschmidt
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI
| | - Scott J. Crow
- Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN,The Emily Program, St Paul., MN
| | - Carol B. Peterson
- Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN
| | - Laura Hill
- The Center for Balanced Living, Worthington, OH
| | - Ross D. Crosby
- Department of Clinical Neuroscience, Neuropsychiatric Research Institute, Fargo, ND
| | - James E. Mitchell
- Department of Clinical Neuroscience, Neuropsychiatric Research Institute, Fargo, ND
| | - Daniel Le Grange
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
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22
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Eating patterns in adolescents with type 1 diabetes: Associations with metabolic control, insulin omission, and eating disorder pathology. Appetite 2017; 114:226-231. [DOI: 10.1016/j.appet.2017.03.035] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 03/23/2017] [Accepted: 03/23/2017] [Indexed: 12/15/2022]
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23
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Cachelin FM, Thomas C, Vela A, Gil-Rivas V. Associations between meal patterns, binge eating, and weight for Latinas. Int J Eat Disord 2017; 50:32-39. [PMID: 27436488 PMCID: PMC5191965 DOI: 10.1002/eat.22580] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 05/26/2016] [Accepted: 06/06/2016] [Indexed: 11/10/2022]
Abstract
Establishing a regular pattern of eating is a core element of treatment for binge eating, yet no research to date has examined meal patterns of Latina women. OBJECTIVE Compare eating patterns of Latinas who binge eat and those who do not, and examine associations between meal patterns and binge episodes, associated distress and concerns, and body mass index (BMI). METHOD One-hundred fifty-five Latinas [65 Binge Eating Disorder (BED), 22 Bulimia Nervosa (BN), 68 with no eating disorder] were assessed with the Eating Disorder Examination. RESULTS There were no significant differences in eating patterns between groups. Breakfast was the least and dinner the most consumed meal. For the BED group: greater frequency of lunch consumption was associated with higher BMI while more frequent evening snacking was associated with lower BMI and with less weight importance; more frequent breakfast consumption, mid-morning snack consumption and total meals were associated with greater distress regarding binge eating. For the BN group, evening snack frequency was associated with less dietary restriction and more weight and shape concern; total snack frequency was associated with more weight concern. Regular meal eaters reported more episodes of binge eating than those who did not eat meals regularly. DISCUSSION Associations with meal patterns differed by eating disorder diagnosis. Study findings mostly are not consistent with results from prior research on primarily White women. CBT treatments may need to be tailored to address the association between binge eating and regular meal consumption for Latinas. Culturally, appropriate modifications that address traditional eating patterns should be considered. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:32-39).
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Affiliation(s)
- Fary M Cachelin
- Health Psychology Program and Department of Psychology, University of North Carolina at Charlotte
| | - Colleen Thomas
- Health Psychology Program and Department of Psychology, University of North Carolina at Charlotte
| | - Alyssa Vela
- Health Psychology Program and Department of Psychology, University of North Carolina at Charlotte
| | - Virginia Gil-Rivas
- Health Psychology Program and Department of Psychology, University of North Carolina at Charlotte
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24
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Stress-induced eating in women with binge-eating disorder and obesity. Biol Psychol 2016; 131:96-106. [PMID: 27836626 DOI: 10.1016/j.biopsycho.2016.11.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/27/2016] [Accepted: 11/03/2016] [Indexed: 12/20/2022]
Abstract
The purpose of the current study was to investigate stress-induced eating in women with binge-eating disorder (BED) and obesity. Three groups of women [obese with BED (n=9); obese non-BED (n=11); and normal weight (NW) non-BED (n=12)], rated their levels of hunger and psychological distress before and after completing the Trier Social Stress Test, followed by food anticipation and then consumption of their preferred snack food. We differentiated between the motivational and hedonic components of eating by measuring the amount of food participants poured into a serving bowl compared to the amount consumed. Stress did not affect poured and consumed calories differently between groups. Across all subjects, calories poured and consumed were positively correlated with post-stress hunger, but calories poured was positively correlated with post-stress anxiety and negative affect. These results indicate that stress-related psychological factors may be more strongly associated with the motivational drive to eat (i.e. amount poured) rather than the hedonic aspects of eating (i.e. amount consumed) for women in general. Exploratory correlation analyses per subgroup suggest that post-stress hunger was positively associated with calories poured and consumed in both non-BED groups. In the obese BED group, calories consumed was negatively associated with dietary restraint and, although not significantly, positively associated with stress-induced changes in anxiety.These findings suggest that stress-induced snacking in obese BED women may be influenced by psychological factors more so than homeostatic hunger mechanisms. After controlling for dietary restraint and negative affect, the NW non-BED women ate a greater percentage of the food they poured than both obese groups, suggesting that obesity may be associated with a heightened motivational drive to eat coupled with a reduction in hedonic pleasure from eating post-stress. Further studies that incorporate novel approaches to measuring the motivational versus hedonic aspects of stress-induced eating may expose nuanced eating behaviors that differentiate BED and obesity. If confirmed, our findings would support prevention and treatment strategies that target subsets of women based on obesity and BED status.
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Tack J, Deloose E, Ang D, Scarpellini E, Vanuytsel T, Van Oudenhove L, Depoortere I. Motilin-induced gastric contractions signal hunger in man. Gut 2016; 65:214-24. [PMID: 25539673 DOI: 10.1136/gutjnl-2014-308472] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 11/24/2014] [Indexed: 12/12/2022]
Abstract
RATIONALE Hunger is controlled by the brain, which receives input from signals of the GI tract (GIT). During fasting, GIT displays a cyclical motor pattern, the migrating motor complex (MMC), regulated by motilin. OBJECTIVES To study the relationship between hunger and MMC phases (I-III), focusing on spontaneous and pharmacologically induced phase III and the correlation with plasma motilin and ghrelin levels. The role of phase III was also studied in the return of hunger after a meal in healthy individuals and in patients with loss of appetite. FINDINGS In fasting healthy volunteers, mean hunger ratings during a gastric (62.5±7.5) but not a duodenal (40.4±5.4) phase III were higher (p<0.0005) than during phase I (27.4±4.7) and phase II (37±4.5). The motilin agonist erythromycin, but not the cholinesterase inhibitor neostigmine, induced a premature gastric phase III, which coincided with an increase in hunger scores from 29.2±7 to 61.7±8. The somatostatin analogue octreotide induced a premature intestinal phase III without a rise in hunger scores. Hunger ratings significantly correlated (β=0.05; p=0.01) with motilin plasma levels, and this relationship was lost after erythromycin administration. Motilin, but not ghrelin administration, induced a premature gastric phase III and a rise in hunger scores. In contrast to octreotide, postprandial administration of erythromycin induced a premature gastric phase III accompanied by an early rise in hunger ratings. In patients with unexplained loss of appetite, gastric phase III was absent and hunger ratings were lower. CONCLUSIONS Motilin-induced gastric phase III is a hunger signal from GIT in man.
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Affiliation(s)
- J Tack
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - E Deloose
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - D Ang
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - E Scarpellini
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - T Vanuytsel
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - L Van Oudenhove
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - I Depoortere
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
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Ellison JM, Simonich HK, Wonderlich SA, Crosby RD, Cao L, Mitchell JE, Smith TL, Klein MH, Crow SJ, Peterson CB. Meal patterning in the treatment of bulimia nervosa. Eat Behav 2016; 20:39-42. [PMID: 26630618 PMCID: PMC4701380 DOI: 10.1016/j.eatbeh.2015.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 09/28/2015] [Accepted: 11/11/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study examined the relationship between changes in meal and snack consumption and eating disorder behaviors in a treatment sample of bulimic adults. METHOD Eighty adults with bulimia nervosa (BN) were randomized to one of two treatments. Meal and snack consumption, binge eating frequency, and purging behavior frequency were assessed at baseline, end-of-treatment, and at four month follow-up using the Eating Disorder Examination (EDE). RESULTS Generalized linear models indicated that increased consumption of evening meals over the course of treatment was related to a significant decrease in the rate of binge eating and purging at four month follow-up; these results remained significant when controlling for changes in depression over the course of treatment. CONCLUSIONS The findings support the importance of focusing efforts on developing a pattern of regular evening meal consumption among individuals in the treatment of BN.
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Affiliation(s)
- Jo M Ellison
- Neuropsychiatric Research Institute, 120 8th St. S., Fargo, ND 58103, United States.
| | - Heather K Simonich
- Neuropsychiatric Research Institute, 120 8th St. S., Fargo, ND 58103, United States
| | - Stephen A Wonderlich
- Neuropsychiatric Research Institute, 120 8th St. S., Fargo, ND 58103, United States; School of Medicine and Health Sciences, University of North Dakota, 1919 Elm St. N., Fargo, ND 58102, United States
| | - Ross D Crosby
- Neuropsychiatric Research Institute, 120 8th St. S., Fargo, ND 58103, United States
| | - Li Cao
- Neuropsychiatric Research Institute, 120 8th St. S., Fargo, ND 58103, United States
| | - James E Mitchell
- Neuropsychiatric Research Institute, 120 8th St. S., Fargo, ND 58103, United States
| | - Tracey L Smith
- Psychiatry and Behavioral Sciences, Baylor College of Medicine, 2002 Holcombe Blvd., Houston, TX 77030, United States
| | - Marjorie H Klein
- Department of Psychiatry, University of Wisconsin, 6001 Research Park Blvd., Madison, WI 53719, United States
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota, 2450 Riverside Avenue South, Minneapolis, MN 55454, United States
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota, 2450 Riverside Avenue South, Minneapolis, MN 55454, United States
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Kass AE, Accurso EC, Goldschmidt AB, Anam S, Byrne CE, Kinasz K, Goodyear A, O'Brien S, Le Grange D. Picking and nibbling in children and adolescents with eating disorders. Int J Eat Disord 2015; 48:1102-5. [PMID: 26282064 PMCID: PMC4754954 DOI: 10.1002/eat.22444] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 07/15/2015] [Accepted: 07/20/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Picking and nibbling (P&N), defined as eating in an unplanned and repetitious way between meals and snacks, is prevalent among adults with eating disorders (EDs), but unexamined among youth with EDs. This study sought to assess the prevalence of P&N in youth with EDs and its association with ED and comorbid pathology. METHOD Youth (N = 515; ages 7-18) who presented to one outpatient ED research-clinical program were assessed for ED and comorbid pathology. RESULTS Two-fifths (n = 214, 41.6%) of youth endorsed P&N. These individuals were older (p < .001) and had a higher percent expected body weight (p = .006) than those who denied P&N. Controlling for age and percent expected body weight, P&N was only associated with global ED pathology in youth with anorexia nervosa (AN) or atypical AN (p = .007). P&N was not associated with ED diagnosis, ED pathology in youth with bulimia nervosa or subclinical bulimia nervosa, binge eating, compensatory behaviors, secret eating, or the presence of a mood or anxiety disorder (p's > .05). DISCUSSION Consistent with research in adults, P&N is prevalent but not significantly associated with ED pathology, except for global ED pathology in youth with AN/atypical AN, or comorbid disorders.
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Affiliation(s)
- Andrea E. Kass
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois,Correspondence to: Andrea Kass, Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 South Maryland Avenue, MC 3077, Chicago, IL 60637.
| | - Erin C. Accurso
- Department of Psychiatry, University of California, San Francisco, California
| | - Andrea B. Goldschmidt
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois
| | - Seeba Anam
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois
| | - Catherine E. Byrne
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois
| | - Kate Kinasz
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois
| | - Alexandria Goodyear
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois
| | - Setareh O'Brien
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois
| | - Daniel Le Grange
- Department of Psychiatry, University of California, San Francisco, California
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Abstract
Binge eating disorder (BED), now recognized as a distinct eating disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is the most prevalent eating disorder. Although nearly half of individuals with BED are obese, BED also occurs in nonobese individuals. Despite the relatively high percentage of weight loss treatment-seeking individuals meeting BED criteria, primary care physicians may not be familiar with or have ever diagnosed BED. Many providers may also have difficulty distinguishing BED as a contributory factor in obesity. This review differentiates BED from other causes of obesity by describing how obese individuals with BED differ from obese individuals without BED and from nonobese individuals with BED in areas including psychopathology, behavior, genetics, physiology, quality of life and productivity. The ways in which health-care providers can identify individuals who may have BED are also highlighted so the proper course of treatment is pursued. Overall, obese individuals with BED demonstrate a number of key characteristics that differentiate them from obese individuals without eating disorders, including increased impulsivity in response to food stimuli with loss of control over eating, resulting in the consumption of more calories. They also experience significant guilt and other negative emotions following a meal. In addition, individuals with BED patients have more psychiatric comorbidity, display more psychopathology, exhibit longer binge durations, consume more meals as snacks during the day and have less dietary restraint compared with individuals with BED who are not obese. However, the differences between individuals with BED who are obese versus not obese are not as prominent. Taken together, the evidence appears to support the conclusion that BED is a unique and treatable neurobehavioral disorder associated with distinct behavioral and psychological profiles and distinct medical and functional outcomes, and that it is not merely a subtype of obesity.
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Affiliation(s)
- C Brendan Montano
- a Connecticut Clinical Research Center, Private Practice, Internal Medicine , Cromwell , CT , USA
| | - Natalie L Rasgon
- b Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , CA , USA
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Elran-Barak R, Sztainer M, Goldschmidt AB, Crow SJ, Peterson CB, Hill LL, Crosby RD, Powers P, Mitchell JE, Le Grange D. Dietary Restriction Behaviors and Binge Eating in Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder: Trans-diagnostic Examination of the Restraint Model. Eat Behav 2015; 18:192-6. [PMID: 26122390 PMCID: PMC8686697 DOI: 10.1016/j.eatbeh.2015.05.012] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 03/16/2015] [Accepted: 05/13/2015] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To compare dietary restriction behaviors among adults with eating disorders involving binge eating, including anorexia nervosa-binge/purge subtype (AN-BE/P), bulimia nervosa (BN), and binge eating disorder (BED), and to examine whether dietary restriction behaviors impact binge eating frequency across diagnoses. METHOD Participants included 845 treatment seeking adults (M=30.42+10.76years) who met criteria for DSM-5 AN-BE/P (7.3%;n=62), BN (59.7%;n=504), and BED (33.0%;n=279). All participants self-reported their past and current eating disorder symptoms on the Eating Disorder Questionnaire. RESULTS Adults with AN-BE/P and BN reported significantly more dietary restriction behaviors (e.g. eating fewer meals per day, higher frequency of fasting, consuming small and low calorie meals) in comparison to adults with BED. Adults with AN-BE/P and BN who reported restricting food intake via eating fewer meals per day had more frequent binge eating episodes. However, adults with BN who reported restricting food intake via eating small meals and low calorie meals had less frequent binge eating episodes. DISCUSSION This study provides mixed support for the restraint model by suggesting that not all dietary restriction behaviors are associated with higher levels of binge eating. It may be that adults with BN who report a higher frequency of eating small and low calorie meals display more control over their eating in general, and therefore also have lower frequency of binge eating. Clinicians should assess for dietary restriction behaviors at the start of treatment prior to assuming that all forms of strict dieting and weight control behaviors similarly impact binge eating.
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Affiliation(s)
- Roni Elran-Barak
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.
| | - Maya Sztainer
- Department of Psychiatry, University of Chicago, Chicago,
IL, USA
| | | | - Scott J. Crow
- Department of Psychiatry, University of Minnesota School of
Medicine, Minneapolis, MN, USA
| | - Carol B. Peterson
- Department of Psychiatry, University of Minnesota School of
Medicine, Minneapolis, MN, USA
| | - Laura L. Hill
- The Center for Balanced Living, Worthington, OH, USA
| | - Ross D. Crosby
- Department of Clinical Neuroscience, University of North
Dakota School of Medicine and Health Sciences, and the Neuropsychiatric Research
Institute, Fargo, ND, USA
| | - Pauline Powers
- Clinical and Translational Science Institute, Health
Sciences Center University of South Florida, Tampa, FL, USA
| | - James E. Mitchell
- Department of Clinical Neuroscience, University of North
Dakota School of Medicine and Health Sciences, and the Neuropsychiatric Research
Institute, Fargo, ND, USA
| | - Daniel Le Grange
- Department of Psychiatry and Department of Pediatrics,
University of California, San Francisco, CA, USA
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Amianto F, Ottone L, Abbate Daga G, Fassino S. Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5. BMC Psychiatry 2015; 15:70. [PMID: 25885566 PMCID: PMC4397811 DOI: 10.1186/s12888-015-0445-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 03/18/2015] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Binge Eating Disorders is a clinical syndrome recently coded as an autonomous diagnosis in DSM-5. Individuals affected by Binge Eating Disorder (BED) show significantly lower quality of life and perceived health and higher psychological distress compared to the non-BED obese population. BED treatment is complex due to clinical and psychological reasons but also to high drop-out and poor stability of achieved goals. The purpose of this review is to explore the available data on this topic, outlining the state-of-the-art on both diagnostic issues and most effective treatment strategies. METHODS We identified studies published in the last 6 years searching the MeSH Term "binge eating disorder", with specific regard to classification, diagnosis and treatment, in major computerized literature databases including: Medline, PubMed, PsychINFO and Science Direct. RESULTS A total of 233 studies were found and, among them, 71 were selected and included in the review. REVIEW Although Binge Eating Disorder diagnostic criteria showed empirical consistency, core psychopathology traits should be taken into account to address treatment strategies. The available body of evidence shows psychological treatments as first line interventions, even if their efficacy on weight loss needs further exploration. Behavioral and self-help interventions evidenced some efficacy in patients with lower psychopathological features. Pharmacological treatment plays an important role, but data are still limited by small samples and short follow-up times. The role of bariatric surgery, a recommended treatment for obesity that is often required also by patients with Binge Eating Disorder, deserves more specific studies. Combining different interventions at the same time does not add significant advantages, planning sequential treatments, with more specific interventions for non-responders, seems to be a more promising strategy. CONCLUSIONS Despite its recent inclusion in DSM-5 as an autonomous disease, BED diagnosis and treatment strategies deserve further deepening. A multidisciplinary and stepped-care treatment appears as a promising management strategy. Longer and more structured follow-up studies are required, in order to enlighten long term outcomes and to overcome the high dropout rates affecting current studies.
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Affiliation(s)
- Federico Amianto
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
| | - Luisa Ottone
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
| | - Giovanni Abbate Daga
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
| | - Secondo Fassino
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
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A comparison of eating disorder psychopathology, appearance satisfaction, and self-esteem in overweight and obese women with and without binge eating. Eat Behav 2015; 17:86-9. [PMID: 25668799 DOI: 10.1016/j.eatbeh.2015.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 12/15/2014] [Accepted: 01/28/2015] [Indexed: 01/02/2023]
Abstract
This study investigated the differences in eating disorder psychopathology, appearance satisfaction, and self-esteem between 194 overweight/obese college women with and without binge eating. Participants were categorized as binge eating (BE; n=56) or non-binge eating (NBE; n=138) based on reports of binge eating at least once per week on average for the past 28days and no episodes of vomiting or laxative use in the past 28days. The BE group had significantly greater levels of eating, weight, and shape concerns and lower levels of appearance satisfaction and self-esteem than the NBE group. For the BE group, binge eating frequency was negatively correlated with dietary restraint. Results are generally consistent with studies utilizing clinical and community samples. The findings extend such research by examining binge eating in a sample of overweight and obese college women and indicating that overall appearance satisfaction is lower among women with binge eating. Study findings also highlight potential issues to address in obesity and binge eating intervention efforts for college populations. Future research is needed to replicate these findings in additional samples of college women and men.
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Elran-Barak R, Accurso EC, Goldschmidt AB, Sztainer M, Byrne C, Le Grange D. Eating patterns in youth with restricting and binge eating/purging type anorexia nervosa. Int J Eat Disord 2014; 47:878-83. [PMID: 24777645 PMCID: PMC4337799 DOI: 10.1002/eat.22289] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2014] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To describe eating patterns in youth with restricting and binge/purge type anorexia nervosa (AN) and to examine whether eating patterns are associated with binge eating or purging behaviors. METHOD Participants included 160 children and adolescents (M = 15.14 ± 2.17 years) evaluated at The University of Chicago Eating Disorders Program who met criteria for DSM-5 restrictive type AN (AN-R; 75%; n = 120) or binge eating/purging type AN (AN-BE/P; 25%; n = 40). All participants completed the eating disorder examination on initial evaluation. RESULTS Youth with AN-R and AN-BE/P differed in their eating patterns, such that youth with AN-R consumed meals and snacks more regularly relative to youth with AN-BE/P. Among youth with AN-BE/P, skipping dinner was associated with a greater number of binge eating episodes (r = -.379, p < .05), while skipping breakfast was associated with a greater number of purging episodes (r = -.309, p < .05). DISCUSSION Youth with AN-R generally follow a regular meal schedule, but are likely consuming insufficient amounts of food across meals and snacks. In contrast, youth with AN-BE/P tend to have more irregular eating patterns, which may play a role in binge eating and purging behaviors. Adults monitoring of meals may be beneficial for youth with AN, and particularly those with AN-BE/P who engage in irregular eating patterns.
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Affiliation(s)
- Roni Elran-Barak
- The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL
| | - Erin C. Accurso
- The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL
| | - Andrea B. Goldschmidt
- The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL
| | - Maya Sztainer
- The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL
| | - Catherine Byrne
- The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL
| | - Daniel Le Grange
- The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL
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Characterization of eating patterns among individuals with eating disorders: What is the state of the plate? Physiol Behav 2014; 134:92-109. [DOI: 10.1016/j.physbeh.2014.02.045] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/15/2014] [Accepted: 02/17/2014] [Indexed: 12/28/2022]
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What is "grazing"? Reviewing its definition, frequency, clinical characteristics, and impact on bariatric surgery outcomes, and proposing a standardized definition. Surg Obes Relat Dis 2014; 10:973-82. [PMID: 25312671 DOI: 10.1016/j.soard.2014.05.002] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 04/17/2014] [Accepted: 05/05/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Grazing, characterized by a repetitive eating pattern, has received increased attention among bariatric surgery patients. However, different definitions and terminology have been used, preventing the accurate measurement of this phenomenon and comparison of data across studies. OBJECTIVE To review existing definitions and associated clinical features of grazing among different samples and to propose a standardized definition that will allow for consistency in future work. SETTING University and Clinical Research Institute. METHODS Of the 39 studies found, 9 provided an original definition and 12 provided data of its association with weight outcomes. Six were studies of nonbariatric surgery populations. Based on this literature review, the most common criteria used in previous studies to define grazing were included in a survey that was sent to 24 individuals who have published work in the field. These experts were asked to provide their opinion on what should constitute grazing. RESULTS Grazing is a frequent behavior in the bariatric surgery population as well as in eating disordered and community samples. Its association with psychopathology is not clear, but its negative impact on weight outcomes after bariatric surgery generally has been supported. Survey data provided a consensus regarding the definition of grazing as an eating behavior characterized by the repetitive eating (more than twice) of small/modest amounts of food in an unplanned manner, with what we characterize as compulsive and noncompulsive subtypes. CONCLUSIONS Given the clinical relevance of grazing among bariatric surgery patients, a unique definition is crucial to better study its associated features and impact on different populations.
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Conceição EM, Mitchell JE, Engel SG, Wonderlich SA, Simonich HK, Peterson CB, Crow SJ, Le Grange D, Le Grange D. Picking or nibbling: frequency and associated clinical features in bulimia nervosa, anorexia nervosa, and binge eating disorder. Int J Eat Disord 2013; 46:815-8. [PMID: 23922133 PMCID: PMC4009470 DOI: 10.1002/eat.22167] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 06/25/2013] [Accepted: 06/25/2013] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Picking or ribbling (P&N) is a newly studied eating behavior characterized by eating in an unplanned and repetitious manner in between meals and snacks. This behavior seems to be related to poorer weight loss outcomes after bariatric surgery for weight loss in severely obese patients, but clarification is still required regarding its value in other clinical samples. The purpose of this study was to investigate the frequency of P&N across different eating disorder samples, as well as to examine its association with psychopathological eating disorder features. METHOD Our sample included treatment-seeking adult participants, recruited for five different clinical trials: 259 binge eating disorder (BED); 264 bulimia nervosa (BN), and 137 anorexia nervosa (AN). Participants were assessed using the Eating Disorders Examination interview before entering the clinical trials. RESULTS P&N was reported by 44% of the BED; 57.6% of the BN; and 34.3% of the AN participants. No association was found between P&N and BMI, the presence of compensatory behaviors, binge eating, or any of the eating disorder examination subscales. DISCUSSION This study suggests that P&N behavior is highly prevalent across eating disorder diagnoses, but it is not associated with psychopathology symptoms or other eating disordered behaviors.
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Affiliation(s)
- Eva M. Conceição
- School of Psychology, University of Minho, Braga, Portugal,Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,
| | - James E. Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Clinical Neuroscience, University of North Dakota, North Dakota, Fargo, ND
| | - Scott G. Engel
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Clinical Neuroscience, University of North Dakota, North Dakota, Fargo, ND
| | - Stephen A. Wonderlich
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Clinical Neuroscience, University of North Dakota, North Dakota, Fargo, ND
| | - Heather K. Simonich
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND
| | | | - Scott J. Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL
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Masheb RM, Roberto CA, White MA. Nibbling and picking in obese patients with Binge Eating Disorder. Eat Behav 2013; 14:424-7. [PMID: 24183128 PMCID: PMC3817495 DOI: 10.1016/j.eatbeh.2013.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 06/16/2013] [Accepted: 07/15/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The goal of this study was to examine the clinical utility of nibbling behavior, defined as eating in an unplanned and repetitious manner between meals and snacks without a sense of loss of control, in obese patients with Binge Eating Disorder (BED). METHODS Two-hundred seventeen (N = 217) consecutive, treatment-seeking, obese patients with BED were assessed with the Eating Disorder Examination (EDE). Nibbling frequency was examined in relation to current weight, eating disorder psychopathology and eating patterns. RESULTS Results found that nibbling/picking was not related to body mass index, objective bulimic, subjective bulimic, or overeating episodes, food avoidance, sensitivity to weight gain, or any subscales of the EDE. However, nibbling/picking was significantly related to frequency of morning and afternoon snacking (r = .21, p = .002; r = .27, p < .001). DISCUSSION The assessment of nibbling/picking behaviors among individuals with BED might not provide clinically significant information.
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Affiliation(s)
- Robin M. Masheb
- Department of Psychiatry, Yale University School of Medicine
| | - Christina A. Roberto
- Christina A. Roberto is an RWJF Health & Society Scholar at Harvard University, Department of Social and Behavioral Sciences, Harvard School of Public Health
| | - Marney A. White
- Department of Psychiatry, Yale University School of Medicine,Yale University School of Public Health,Department of Psychology, Yale University
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Brown AW, Bohan Brown MM, Allison DB. Belief beyond the evidence: using the proposed effect of breakfast on obesity to show 2 practices that distort scientific evidence. Am J Clin Nutr 2013; 98:1298-308. [PMID: 24004890 PMCID: PMC3798081 DOI: 10.3945/ajcn.113.064410] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Various intentional and unintentional factors influence beliefs beyond what scientific evidence justifies. Two such factors are research lacking probative value (RLPV) and biased research reporting (BRR). OBJECTIVE We investigated the prevalence of RLPV and BRR in research about the proposition that skipping breakfast causes weight gain, which is called the proposed effect of breakfast on obesity (PEBO) in this article. DESIGN Studies related to the PEBO were synthesized by using a cumulative meta-analysis. Abstracts from these studies were also rated for the improper use of causal language and biased interpretations. In separate analyses, articles that cited an observational study about the PEBO were rated for the inappropriate use of causal language, and articles that cited a randomized controlled trial (RCT) about the PEBO were rated for misleadingly citing the RCT. RESULTS The current body of scientific knowledge indicates that the PEBO is only presumed true. The observational literature on the PEBO has gratuitously established the association, but not the causal relation, between skipping breakfast and obesity (final cumulative meta-analysis P value <10(-42)), which is evidence of RLPV. Four examples of BRR are evident in the PEBO literature as follows: 1) biased interpretation of one's own results, 2) improper use of causal language in describing one's own results, 3) misleadingly citing others' results, and 4) improper use of causal language in citing others' work. CONCLUSIONS The belief in the PEBO exceeds the strength of scientific evidence. The scientific record is distorted by RLPV and BRR. RLPV is a suboptimal use of collective scientific resources.
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Affiliation(s)
- Andrew W Brown
- Office of Energetics (AWB and DBA), the Nutrition Obesity Research Center (AWB, MMBB, and DBA), the School of Public Health (AWB and DBA), and the Department of Nutrition Sciences (MMBB and DBA), University of Alabama at Birmingham, Birmingham, AL
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Davis C. From passive overeating to "food addiction": a spectrum of compulsion and severity. ISRN OBESITY 2013; 2013:435027. [PMID: 24555143 PMCID: PMC3901973 DOI: 10.1155/2013/435027] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 04/16/2013] [Indexed: 01/17/2023]
Abstract
A psychobiological dimension of eating behaviour is proposed, which is anchored at the low end by energy intake that is relatively well matched to energy output and is reflected by a stable body mass index (BMI) in the healthy range. Further along the continuum are increasing degrees of overeating (and BMI) characterized by more severe and more compulsive ingestive behaviours. In light of the many similarities between chronic binge eating and drug abuse, several authorities have adopted the perspective that an apparent dependence on highly palatable food-accompanied by emotional and social distress-can be best conceptualized as an addiction disorder. Therefore, this review also considers the overlapping symptoms and characteristics of binge eating disorder (BED) and models of food addiction, both in preclinical animal studies and in human research. It also presents this work in the context of the modern and "toxic" food environment and therein the ubiquitous triggers for over-consumption. We complete the review by providing evidence that what we have come to call "food addiction" may simply be a more acute and pathologically dense form of BED.
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Affiliation(s)
- Caroline Davis
- Kinesiology & Health Sciences, Faculty of Health, York University, 343 Bethune College, 4700 Keele Street, Toronto, ON, Canada M3J 1P3
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Matheson BE, Tanofsky-Kraff M, Shafer-Berger S, Sedaka NM, Mooreville M, Reina SA, Vannucci A, Shomaker LB, Yanovski SZ, Yanovski JA. Eating patterns in youth with and without loss of control eating. Int J Eat Disord 2012; 45:957-61. [PMID: 23015352 PMCID: PMC3502711 DOI: 10.1002/eat.22063] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To compare the characteristic meal patterns of adolescents with and without loss of control (LOC) eating episodes. METHOD The Eating Disorder Examination was administered to assess self-reported LOC and frequency of meals consumed in an aggregated sample of 574 youths (12-17 years; 66.6% female; 51.2% Caucasian; BMI-z: 1.38 ± 1.11), among whom 227 (39.6%) reported LOC eating. RESULTS Compared to those without LOC, youth with LOC were less likely to consume lunch and evening meals (p's < .05), but more likely to consume morning, afternoon, and nocturnal snacks (p's ≤ .05), accounting for age, sex, race, socio-economic status, BMI-z, and treatment-seeking status. DISCUSSION Adolescents with reported LOC eating appear to engage in different meal patterns compared to youth without LOC, and adults with binge eating. Further research is needed to determine whether the meal patterns that characterize adolescents with LOC play a role in worsening disordered eating and/or excessive weight gain.
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Affiliation(s)
- Brittany E. Matheson
- Uniformed Services University of the Health Sciences (USUHS), Department of Medical and Clinical Psychology
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Marian Tanofsky-Kraff
- Uniformed Services University of the Health Sciences (USUHS), Department of Medical and Clinical Psychology
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Sarah Shafer-Berger
- Uniformed Services University of the Health Sciences (USUHS), Department of Medical and Clinical Psychology
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Nicole M. Sedaka
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Mira Mooreville
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Samantha A. Reina
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Anna Vannucci
- Uniformed Services University of the Health Sciences (USUHS), Department of Medical and Clinical Psychology
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Lauren B. Shomaker
- Uniformed Services University of the Health Sciences (USUHS), Department of Medical and Clinical Psychology
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, DHHS, Bethesda, MD, 20814, USA Portions of this manuscript were presented at the 2012 International Conference on Eating Disorders, Austin, Texas
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
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Davis C, Levitan RD, Yilmaz Z, Kaplan AS, Carter JC, Kennedy JL. Binge eating disorder and the dopamine D2 receptor: genotypes and sub-phenotypes. Prog Neuropsychopharmacol Biol Psychiatry 2012; 38:328-35. [PMID: 22579533 DOI: 10.1016/j.pnpbp.2012.05.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Revised: 04/30/2012] [Accepted: 05/01/2012] [Indexed: 01/06/2023]
Abstract
OBJECTIVE While the study of binge eating disorder (BED) has burgeoned in the past decade, an understanding of its neurobiological underpinnings is still in the early stages. Previous research suggests that BED may be an overeating syndrome characterized by a hyper-responsiveness to reward, and a strong dopamine signaling in the neuro-circuitry that regulates pleasure and appetitive behaviors. We investigated the D2 receptors genes (DRD2/ANKK1) and their relation to the BED phenotype and four sub-phenotypes of BED that reflect an enhanced response to positive food stimuli. METHODS In a sample of 230 obese adults with and without BED, we genotyped five functional markers of the D2 receptor: rs1800497, rs1799732, rs2283265, rs12364283, and rs6277, and assessed binge eating, emotional eating, hedonic eating, and food craving from dimensionally-scored, self-report questionnaires. RESULTS Compared to weight-matched controls, BED was significantly related to the rs1800497 and rs6277 genotypes that reflect enhanced dopamine neurotransmission. BED participants were also less likely to carry the minor T allele of rs2283265. The same markers related to the sub-phenotypes of BED with rs1800497 showing the strongest effects in the predicted direction. CONCLUSIONS This study supports the view that BED may be a condition that has its causal origins in a hypersensitivity to reward - a predisposition that is likely to foster overeating in our current environment with abundant availability of highly palatable and calorically-dense processed foods.
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Affiliation(s)
- Caroline Davis
- Kinesiology & Health Sciences, York University, Toronto, Canada M3J1P3.
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