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Arend AK, Blechert J, Yanagida T, Voderholzer U, Reichenberger J. Emotional food craving across the eating disorder spectrum: an ecological momentary assessment study. Eat Weight Disord 2024; 29:58. [PMID: 39264507 DOI: 10.1007/s40519-024-01690-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 08/30/2024] [Indexed: 09/13/2024] Open
Abstract
PURPOSE Emotional eating during negative emotions might underlie disordered eating behavior (i.e., binge eating and food restriction). Positive emotions, by contrast, seem to promote healthier eating behavior. Naturalistic research on the links between emotions and eating across individuals with binge-eating disorder (BED), bulimia nervosa (BN), binge-purge anorexia nervosa (AN-BP), and restrictive anorexia nervosa (AN-R) is, however, lacking. METHODS Individuals without eating disorders (comparison group, CG, n = 85), and patients with BED (n = 41), BN (n = 50), AN-BP (n = 26), and AN-R (n = 29) participated in an ecological momentary assessment study. Six daily notifications over eight days prompted ratings of momentary food craving and emotional states differing in valence and arousal. RESULTS Results supported specific emotion-food-craving patterns in each group. Compared to the CG, arousing negative emotions and higher cravings co-occurred in patients with BN. In patients with AN-BP (at trend level also in patients with AN-R) less arousing negative emotions and lower cravings co-occurred. In patients with AN, positive emotions and higher cravings co-occurred whereas in patients with BED less arousing positive emotions and lower cravings co-occurred. CONCLUSION The found emotion-craving associations may underlie group-specific (dys-)functional eating behaviors, i.e., binge eating and food restriction during negative emotions in patients with BN and AN, and normalized appetitive responses during positive emotions in patients with BED and AN. Therapeutic efforts could target arousing negative emotions in patients with BN, and less arousing negative emotions in patients with AN. Positive emotions could be used in a salutogenetic approach in patients with BED and AN.
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Affiliation(s)
- Ann-Kathrin Arend
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron University of Salzburg, Salzburg, Austria.
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron University of Salzburg, Salzburg, Austria
| | - Takuya Yanagida
- School of Applied Health and Social Sciences, University of Applied Sciences Upper Austria, Linz, Austria
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital of the LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg, Germany
| | - Julia Reichenberger
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron University of Salzburg, Salzburg, Austria
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Wardzinski EK, Richter J, Moenikes S, Duysen KU, Oltmanns KM. Nondietary psychological app program leads to sustained weight loss due to trained physiological satiety perception. Appl Psychol Health Well Being 2024. [PMID: 39095995 DOI: 10.1111/aphw.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 07/15/2024] [Indexed: 08/04/2024]
Abstract
Obese people are mostly unable to maintain successful weight loss after the end of a dietary change. One reason is that conventional weight reduction concepts neglect physiological hunger and satiety perception, leading to a relapse to previous eating habits on the long run. We examined the long-term efficacy of a psychological smartphone weight loss program, which avoids any dietary instructions and aims at relearning of satiety perception. Parameters of body weight alterations and psychological features, for example, satiety perception, food cravings, and emotional eating, were explored in a nonrandomized experimental study comprising 75 obese participants. Measurements occurred at baseline, two times during program application, as well as at 6- and 12-month follow-up. Participants displayed significant weight loss during the entire study period (p = .029) and showed an improved body composition at the 6-month follow-up (p = .018). These effects were associated with increased satiety perception, as well as reduced food cravings, and emotional eating habits. Notably, all improvements in measured parameters significantly sustained between the end of the program and the 12-month follow-up (p < .005 for all). Psychological relearning of satiety perception may outclass dietary approaches in terms of long-term efficiency.
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Affiliation(s)
- Ewelina K Wardzinski
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Juliane Richter
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Sophia Moenikes
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Kai U Duysen
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
| | - Kerstin M Oltmanns
- Section of Psychoneurobiology, Center of Brain, Behavior and Metabolism, University of Luebeck, Luebeck, Germany
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Di Sante J, Frayn M, Angelescu A, Knäuper B. Proof-of-concept testing of a brief virtual ACT workshop for emotional eating. Appetite 2024; 199:107386. [PMID: 38692511 DOI: 10.1016/j.appet.2024.107386] [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: 12/08/2023] [Revised: 04/08/2024] [Accepted: 04/28/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Emotional eating, or eating in response to negative emotions, is a commonly reported short-term emotion regulation strategy but has been shown to be ineffective in the long term. Most emotional eating interventions based on Acceptance and Commitment Therapy (ACT) have been delivered in the context of weight loss trials, highlighting a need for ACT-based emotional eating interventions in weight-neutral contexts. AIMS This proof-of-concept study aimed to test the acceptability and efficacy potential of a brief virtual ACT workshop for emotional eating in a small sample of adults identifying as emotional eaters. METHODS Twenty-six adult emotional eaters completed an ACT workshop delivered in two 1.5-h sessions over two weeks. The workshop targeted awareness and acceptance of emotions and eating urges, and valued actions around eating. RESULTS The acceptability of the workshop was demonstrated by high participant satisfaction. Significant improvements on all outcome measures were found and maintained up to 3 months follow-up. CONCLUSIONS These proof-of-concept findings suggest that a brief virtual ACT workshop may improve emotional eating and associated ACT processes. Results from this study can inform a future randomized controlled trial to test the efficacy of the workshop and the role of theoretical processes of change. TRIAL REGISTRATION ClinicalTrials.gov, NCT04457804. LEVEL OF EVIDENCE Level IV, evidence obtained from multiple time series with the intervention.
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Affiliation(s)
| | - Mallory Frayn
- Department of Psychology, McGill University, Quebec, Canada
| | | | - Bärbel Knäuper
- Department of Psychology, McGill University, Quebec, Canada
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Breton E, Khundrakpam B, Jeon S, Evans A, Booij L. Cortical thickness and childhood eating behaviors: differences according to sex and age, and relevance for eating disorders. Eat Weight Disord 2024; 29:47. [PMID: 39028377 PMCID: PMC11271398 DOI: 10.1007/s40519-024-01675-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 07/10/2024] [Indexed: 07/20/2024] Open
Abstract
PURPOSE This study investigated the association between childhood eating behaviors and cortical morphology, in relation to sex and age, in a community sample. METHODS Neuroimaging data of 71 children (mean age = 9.9 ± 1.4 years; 39 boys/32 girls) were obtained from the Nathan Kline Institute-Rockland Sample. Emotional overeating, food fussiness, and emotional undereating were assessed using the Children's Eating Behavior Questionnaire. Cortical thickness was obtained at 81,924 vertices covering the entire cortex. Generalized Linear Mixed Models were used for statistical analysis. RESULTS There was a significant effect of sex in the association between cortical thickness and emotional overeating (localized at the right postcentral and bilateral superior parietal gyri). Boys with more emotional overeating presented cortical thickening, whereas the opposite was observed in girls (p < 0.05). Different patterns of association were identified between food fussiness and cortical thickness (p < 0.05). The left rostral middle frontal gyrus displayed a positive correlation with food fussiness from 6 to 8 years, but a negative correlation from 12 to 14 years. Emotional undereating was associated with cortical thickening at the left precuneus, left middle temporal gyrus, and left insula (p < 0.05) with no effect of sex or age. CONCLUSIONS Leveraging on a community sample, findings support distinct patterns of associations between eating behaviors and cortical thickness, depending on sex and age.
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Affiliation(s)
- Edith Breton
- Department of Fundamental Sciences, Université du Québec à Chicoutimi, Saguenay, Canada
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada
| | - Budhachandra Khundrakpam
- Montreal Neurological Institute, McGill University, Montreal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Canada
| | - Seun Jeon
- Montreal Neurological Institute, McGill University, Montreal, Canada
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Alan Evans
- Montreal Neurological Institute, McGill University, Montreal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Canada
| | - Linda Booij
- Sainte-Justine Hospital Research Centre, Montreal, Canada.
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada.
- Douglas Mental Health University Institute, Montreal, Canada.
- Department of Psychiatry, McGill University, Montreal, Canada.
- Eating Disorders Continuum, Douglas Mental Health University Institute, 6605 Boul. LaSalle, Verdun, H4H1R3, Canada.
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5
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Barnhart WR, Kalantzis M, Gaggiano C, Braden AL. The relation between questionnaire-measured self-reported emotional eating and disordered eating behaviors: A meta-analysis of nearly three decades of research. Appetite 2024; 198:107343. [PMID: 38604382 DOI: 10.1016/j.appet.2024.107343] [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: 12/06/2023] [Revised: 03/15/2024] [Accepted: 04/04/2024] [Indexed: 04/13/2024]
Abstract
Extensive research exists on the association between self-reported emotional eating (EE) and disordered eating (DE) behaviors. Heterogeneity exists by type (e.g., unidimensional vs. multidimensional) and valence (e.g., negative vs. positive) of self-reported EE, and no previous meta-analyses have examined the association between self-reported EE and DE behaviors. A total of 67 studies (N = 26,289; 43 reporting relations in one model, and 24 reporting relations in more than one model) met inclusion criteria; ranges for age and publication date were 18.0-61.8 years old and 1995 to 2022. Five models quantified relations between DE behaviors and 1) broad negative EE, 2) EE in response to depression, 3) EE in response to anger and anxiety, 4) EE in response to boredom, and 5) EE in response to positive emotions. Using random-effects models, pooled Cohen's d effect sizes suggested small, positive relations between DE behaviors and self-reported broad negative EE (d = 0.40, p < 0.001), EE-depression (d = 0.41, p < 0.001), EE-anger/anxiety (d = 0.35, p < 0.001), and EE-boredom (d = 0.38, p < 0.001). A significant, but very small, positive relation was observed between DE behaviors and self-reported EE-positive (d = 0.08, p = 0.01). Subgroup analyses suggested a medium, positive relation between self-reported broad negative EE and binge eating (d = 0.53, p < 0.001) and a small, positive relation between self-reported broad negative EE and dietary restraint (d = 0.20, p < 0.001). Significant heterogeneity was identified across all models except for the EE-boredom and DE behaviors model. Higher BMI, but not age, clinical status, or type of DE behavior strengthened the positive relation between self-reported broad negative EE and DE behaviors. Findings support previous research suggesting that negative and positive EE are distinct constructs, with negatively valenced EE being more closely associated with DE behaviors, especially binge eating.
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Affiliation(s)
- Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA.
| | - Maria Kalantzis
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Christina Gaggiano
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Abby L Braden
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
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Nguyen N, Woodside DB, Lam E, Quehenberger O, German JB, Shih PAB. Fatty Acids and Their Lipogenic Enzymes in Anorexia Nervosa Clinical Subtypes. Int J Mol Sci 2024; 25:5516. [PMID: 38791555 PMCID: PMC11122126 DOI: 10.3390/ijms25105516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/11/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Disordered eating behavior differs between the restricting subtype (AN-R) and the binging and purging subtype (AN-BP) of anorexia nervosa (AN). Yet, little is known about how these differences impact fatty acid (FA) dysregulation in AN. To address this question, we analyzed 26 FAs and 7 FA lipogenic enzymes (4 desaturases and 3 elongases) in 96 women: 25 AN-R, 25 AN-BP, and 46 healthy control women. Our goal was to assess subtype-specific patterns. Lauric acid was significantly higher in AN-BP than in AN-R at the fasting timepoint (p = 0.038) and displayed significantly different postprandial changes 2 h after eating. AN-R displayed significantly higher levels of n-3 alpha-linolenic acid, stearidonic acid, eicosapentaenoic acid (EPA), docosapentaenoic acid, and n-6 linoleic acid and gamma-linolenic acid compared to controls. AN-BP showed elevated EPA and saturated lauric acid compared to controls. Higher EPA was associated with elevated anxiety in AN-R (p = 0.035) but was linked to lower anxiety in AN-BP (p = 0.043). These findings suggest distinct disordered eating behaviors in AN subtypes contribute to lipid dysregulation and eating disorder comorbidities. A personalized dietary intervention may improve lipid dysregulation and enhance treatment effectiveness for AN.
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Affiliation(s)
- Nhien Nguyen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92037, USA
| | - D. Blake Woodside
- Centre for Mental Health, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Eileen Lam
- Centre for Mental Health, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Oswald Quehenberger
- Department of Pharmacology, University of California, San Diego, La Jolla, CA 92093, USA
| | - J. Bruce German
- Department of Food Science & Technology, University of California, Davis, Davis, CA 95616, USA;
| | - Pei-an Betty Shih
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92037, USA
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7
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Kudlek L, Jones RA, Hughes C, Duschinsky R, Hill A, Richards R, Thompson M, Vincent A, Griffin SJ, Ahern AL. Experiences of emotional eating in an Acceptance and Commitment Therapy based weight management intervention (SWiM): A qualitative study. Appetite 2024; 193:107138. [PMID: 38016600 DOI: 10.1016/j.appet.2023.107138] [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: 08/07/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Emotional eating is a barrier to weight management. Interventions based on Acceptance and Commitment Therapy (ACT) promote the acceptance of uncomfortable feelings, which can reduce the urge to use food as a coping mechanism. We aimed to explore how participants of an ACT-based weight management intervention (WMI) experience emotional eating and relevant intervention content. METHODS We conducted semi-structured telephone interviews with participants of a digital ACT-based guided self-help WMI. Fifteen participants were purposefully selected to represent a range of demographic characteristics and emotional eating scores. We used reflexive thematic analysis to explore experiences of emotional eating. RESULTS We generated five themes. Participants improved emotional eating by disconnecting emotions from behaviours though increased self-awareness (theme 1) and by implementing alternative coping strategies, including preparation, substitution, and acceptance (theme 2). Most participants maintained improvements in emotional eating over time but wished for more opportunities to re-engage with intervention content, including more immediate support in triggering situations (theme 3). Participants who struggled to engage with emotional eating related intervention content often displayed an external locus of control over emotional eating triggers (theme 4). The perceived usefulness of the intervention depended on participants' prior experiences of emotional eating, and was thought insufficient for participants with complex emotional experiences (theme 5). DISCUSSION This ACT-based WMI helped participants with emotional eating by improving self-awareness and teaching alternative coping strategies. Intervention developers may consider adding ongoing forms of intervention that provide both real-time and long-term support. Additionally, a better understanding of how to support people with an external locus of control and people with complex experiences of emotional eating is needed. Future research may explore ways of personalising WMIs based on participants' emotional needs.
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Affiliation(s)
- Laura Kudlek
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
| | - Rebecca A Jones
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Carly Hughes
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Robbie Duschinsky
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Andrew Hill
- Division of Psychological & Social Medicine, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Rebecca Richards
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Megan Thompson
- Obesity Voices, Obesity Institute, Leeds Beckett University, Leeds, United Kingdom
| | - Ann Vincent
- Obesity Voices, Obesity Institute, Leeds Beckett University, Leeds, United Kingdom
| | - Simon J Griffin
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom; Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Amy L Ahern
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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Xiao M, Luo Y, Ding C, Chen X, Liu Y, Tang Y, Chen H. Social support and overeating in young women: The role of altering functional network connectivity patterns and negative emotions. Appetite 2023; 191:107069. [PMID: 37837769 DOI: 10.1016/j.appet.2023.107069] [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: 03/16/2023] [Revised: 09/20/2023] [Accepted: 09/29/2023] [Indexed: 10/16/2023]
Abstract
Research suggests that social support has a protective effect on emotional health and emotionally induced overeating. Women are especially more sensitive to benefits from social support when facing eating problems. Although it has been demonstrated that social support can affect the neural processes of emotion regulation and reward perception, it is unclear how social support alters synergistic patterns in large-scale brain networks associated with negative emotions and overeating. We used a large sample of young women aged 17-22 years (N = 360) to examine how social support influences the synchrony of five intrinsic networks (executive control network [ECN], default mode network, salience network [SN], basal ganglia network, and precuneus network [PN]) and how these networks influence negative affect and overeating. Additionally, we explored these analyses in another sample of males (N = 136). After statistically controlling for differences in age and head movement, we observed significant associations of higher levels of social support with increased intra- and inter-network functional synchrony, particularly for ECN-centered network connectivity. Subsequent chain-mediated analyses showed that social support predicted overeating through the ECN-SN and ECN-PN network connectivity and negative emotions. However, these results were not found in men. These findings suggest that social support influences the synergistic patterns within and between intrinsic networks related to inhibitory control, emotion salience, self-referential thinking, and reward sensitivity. Furthermore, they reveal that social support and its neural markers may play a key role in young women's emotional health and eating behavior.
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Affiliation(s)
- Mingyue Xiao
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Yijun Luo
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Cody Ding
- Department of Educational Psychology, Research, and Evaluation, University of Missouri, St. Louis, USA
| | - Ximei Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Yong Liu
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Yutian Tang
- Faculty of Arts, University of British Columbia, Canada
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China; Research Center of Psychology and Social Development, Southwest University, Chongqing, China.
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Eichin KN, Georgii C, Schnepper R, Voderholzer U, Blechert J. Emotional food-cue-reactivity in anorexia nervosa and bulimia nervosa: An electroencephalography study. Int J Eat Disord 2023; 56:2096-2106. [PMID: 37565581 PMCID: PMC10946739 DOI: 10.1002/eat.24028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Food-cue-reactivity entails neural and experiential responses to the sight and smell of attractive foods. Negative emotions can modulate such cue-reactivity and this might be central to the balance between restrictive versus bulimic symptomatology in Anorexia Nervosa (AN) and Bulimia Nervosa (BN). METHOD Pleasantness ratings and electrocortical responses to food images were measured in patients with AN (n = 35), BN (n = 32) and matched healthy controls (HC, n = 35) in a neutral state and after idiosyncratic negative emotion induction while electroencephalography (EEG) was recorded. The EEG data were analyzed using a mass testing approach. RESULTS Individuals with AN showed reduced pleasantness for foods compared to objects alongside elevated widespread occipito-central food-object discrimination between 170 and 535 ms, indicative of strong neural cue-reactivity. Food-object discrimination was further increased in the negative emotional condition between 690 and 1200 ms over centroparietal regions. Neither of these effects was seen in individuals with BN. DISCUSSION Emotion modulated food-cue-reactivity in AN might reflect a decreased appetitive response in negative mood. Such specific (emotion-)regulatory strategies require more theoretical work and clinical attention. The absence of any marked effects in BN suggests that emotional cue-reactivity might be less prominent in this group or quite specific to certain emotional contexts or food types. PUBLIC SIGNIFICANCE Negative affectivity is a risk factor for the development of eating disorders and individuals with eating disorders experience problems with emotion regulation. To better understand the effects of negative emotions, the present study investigated how they affected neural correlates of food perception in anorexia nervosa and bulimia nervosa.
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Affiliation(s)
- Katharina Naomi Eichin
- Department of Psychology and Centre for Cognitive NeuroscienceUniversity of SalzburgSalzburgAustria
- Department of PsychologyJohannes Kepler UniversityLinzAustria
| | - Claudio Georgii
- Department of Psychology and Centre for Cognitive NeuroscienceUniversity of SalzburgSalzburgAustria
| | - Rebekka Schnepper
- Department of Psychology and Centre for Cognitive NeuroscienceUniversity of SalzburgSalzburgAustria
- Department of Psychosomatic MedicineUniversity Hospital BaselBaselSwitzerland
| | | | - Jens Blechert
- Department of Psychology and Centre for Cognitive NeuroscienceUniversity of SalzburgSalzburgAustria
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10
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Schnepper R, Blechert J, Arend AK, Yanagida T, Reichenberger J. Emotional eating: elusive or evident? Integrating laboratory, psychometric and daily life measures. Eat Weight Disord 2023; 28:74. [PMID: 37702801 PMCID: PMC10499733 DOI: 10.1007/s40519-023-01606-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023] Open
Abstract
PURPOSE Emotional eating (EE) refers to eating in response to (negative) emotions. Evidence for the validity of EE is mixed: some meta-analyses find EE only in eating disordered patients, others only in restrained eaters, which suggest that only certain subgroups show EE. Furthermore, EE measures from lab-based assessments, ecological momentary assessment (EMA), and psychometric measures often diverge. This paper tested whether the covariance of these three different EE methods can be modeled through a single latent variable (factorial validity), and if so, how this variable would relate to restrained eating (construct validity), Body-Mass-Index (BMI), and subclinical eating disorder symptomatology (concurrent validity). METHODS 102 non-eating disordered female participants with a wide BMI range completed EE measures from three methods: psychometric questionnaires, a laboratory experiment (craving ratings of food images in induced neutral vs. negative emotion) and EMA questionnaires (within-participant correlations of momentary negative emotions and momentary food cravings across 9 days). Two measures for each method were extracted and submitted to confirmatory factor analysis. RESULTS A one-factor model provided a good fit. The resulting EElat factor correlated positively with subclinical eating disorder symptoms and BMI but not with restrained eating. CONCLUSIONS The one-factor solution shows that the EE construct can validly be assessed with three different methods. Individual differences in EE are supported by the data and are related to eating and weight problem symptomatology but not to restrained eating. This supports learning accounts of EE and underscores the relevance of the EE construct to physical and mental health. LEVEL OF EVIDENCE II (Evidence obtained from well-designed controlled trials without randomization).
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Affiliation(s)
- Rebekka Schnepper
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria
- Department of Psychosomatics, University Hospital Basel, Hebelstr. 2, 4056, Basel, Switzerland
| | - Jens Blechert
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria
| | - Ann-Kathrin Arend
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria
| | - Takuya Yanagida
- Faculty of Psychology, Department of Developmental and Educational Psychology, University of Vienna, Universitaetsstr. 7, 1010, Vienna, Austria
| | - Julia Reichenberger
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria.
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11
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Baboumian S, Puma L, Swencionis C, Astbury NM, Ho J, Pantazatos SP, Geliebter A. Binge Eating (BE) and Obesity: Brain Activity and Psychological Measures before and after Roux-En-Y Gastric Bypass (RYGB). Nutrients 2023; 15:3808. [PMID: 37686840 PMCID: PMC10490010 DOI: 10.3390/nu15173808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/10/2023] Open
Abstract
Brain activity in response to food cues following Roux-En-Y Gastric Bypass (RYGB) in binge eating (BE) or non-binge eating (NB) individuals is understudied. Here, 15 RYGB (8 BE; 7 NB) and 13 no treatment (NT) (7 BE; 6 NB) women with obesity underwent fMRI imaging while viewing high and low energy density food (HEF and LEF, respectively) and non-food (NF) visual cues. A region of interest (ROI) analysis compared BE participants to NB participants in those undergoing RYGB surgery pre-surgery and 4 months post. Results were corrected for multiple comparisons using liberal (p < 0.006 uncorrected) and stringent (p < 0.05 FDR corrected) thresholds. Four months following RYGB (vs. no treatment (NT) control), both BE and NB participants showed greater reductions in blood oxygen level-dependent (BOLD) signals (a proxy of local brain activity) in the dorsomedial prefrontal cortex in response to HEF (vs. LEF) cues (p < 0.006). BE (vs. NB) participants showed greater increases in the precuneus (p < 0.006) and thalamic regions (p < 0.05 corrected) to food (vs. NF). For RYGB (vs. NT) participants, BE participants, but not NB participants, showed lower BOLD signal in the middle occipital gyrus (p < 0.006), whilst NB participants, but not BE participants, showed lower signal in inferior frontal gyrus (p < 0.006) in response to HEF (vs. LEF). Results suggest distinct neural mechanisms of RGYB in BE and may help lead to improved clinical treatments.
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Affiliation(s)
- Shaunte Baboumian
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside, 1111 Amsterdam Ave, New York, NY 10025, USA
| | - Lauren Puma
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside, 1111 Amsterdam Ave, New York, NY 10025, USA
| | - Charles Swencionis
- Ferkauf Graduate School of Psychology, Yeshiva University, 500 West 185th Street, New York, NY 10033, USA
| | - Nerys M. Astbury
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford OX2 6GG, UK
| | - Jennifer Ho
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside, 1111 Amsterdam Ave, New York, NY 10025, USA
| | - Spiro P. Pantazatos
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Dr, New York, NY 10032, USA
| | - Allan Geliebter
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside, 1111 Amsterdam Ave, New York, NY 10025, USA
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12
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Głąbska D, Skolmowska D, Guzek D. Emotional Overeating during the COVID-19 Pandemic: Polish Adolescents' COVID-19 Experience (PLACE-19) Study. Nutrients 2023; 15:3818. [PMID: 37686850 PMCID: PMC10490068 DOI: 10.3390/nu15173818] [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: 08/04/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Emotional overeating is the most frequently noted type of emotional eating, being commonly associated with increased consumption of energy-dense products, as well as excessive body mass, and weight gain. Even though a number of studies assessed emotional overeating during the COVID-19 pandemic in adult populations, studies of children and adolescents are scarce. The aim of the present study was to assess emotional overeating background, including consumption in response to six emotions (anxiety, sadness, loneliness, tiredness, anger, and happiness), in the population of Polish adolescents within the PLACE-19 Study during the COVID-19 pandemic. The PLACE-19 Study is a national Polish population-based study of adolescents gathered upon recruitment based on a random quota sampling of secondary schools, conducted in a population of 1126 students (818 females and 308 males, a median of age 17.0 and 16.5 years, respectively). Emotional overeating was assessed while using the Emotional Overeating Questionnaire (EOQ), and as additional factors, the following were assessed: gender, body mass, body mass change during the COVID-19 pandemic, and declared tempting food products. Female participants declared a higher frequency of overeating in response to feelings of anxiety, sadness, loneliness, and happiness, and were characterized by a higher total score than male participants, while p ≤ 0.05 was interpreted as a statistical significance. Obese participants declared a higher frequency of overeating in response to feelings of sadness, and loneliness than normal weight participants. Participants gaining weight declared a higher frequency of overeating in response to feelings of anxiety, sadness, loneliness, tiredness, and anger, and were characterized by a higher total score than participants losing weight or maintaining a stable weight, while participants gaining weight declared a higher frequency of overeating in response to feelings of happiness than participants losing weight. Participants declaring both sweet and salty products as tempting declared a higher frequency of overeating in response to feelings of anxiety, and sadness than participants declaring no tempting products; participants declaring both sweet and salty products declared a higher frequency of overeating in response to feelings of tiredness than participants declaring only salty products and those declaring no tempting products, as well as declared a higher frequency of overeating in response to feelings of happiness than participants declaring only sweet products, and those declaring no tempting products; participants declaring sweet products declared a higher frequency of overeating in response to feelings of anger than participants declaring no tempting products, while participants declaring both sweet and salty products declared a higher frequency of overeating in response to feelings of loneliness, and were characterized by a higher total score than all other respondents. The sub-groups with the highest frequency of emotional overeating were the female respondents, obese participants, those gaining weight, and those declaring both sweet and salty products as tempting, while among the emotions most often causing emotional overeating, there were sadness and loneliness.
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Affiliation(s)
- Dominika Głąbska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland; (D.G.); (D.S.)
| | - Dominika Skolmowska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland; (D.G.); (D.S.)
| | - Dominika Guzek
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
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13
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Schag K, Sandler L, Zipfel S, Derntl B, Giel KE. Inhibitory control towards angry stimuli in patients with binge eating disorder: a pilot study. J Eat Disord 2023; 11:125. [PMID: 37525245 PMCID: PMC10388460 DOI: 10.1186/s40337-023-00848-2] [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: 08/04/2022] [Accepted: 07/22/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Emotion regulation theories and the negative urgency concept assume that negative mood increases binge eating. Negative emotions are considered as a trigger for binge eating, while binge eating itself is regarded as an impulsive behavior and should thus be increased within the negative urgency concept. Anger might be a specific negative emotion triggering binge eating in patients with binge eating disorder (BED). We investigated how inhibitory control as one main factor of impulsivity is influenced by anger stimuli in patients with BED and two control groups. METHODS We compared patients with BED (N = 20) with normal-weight healthy control participants (NW-CG, N = 20) and BMI-matched overweight and obese control participants (BMI-CG, N = 18). We used the emotional Stop Signal task (eSST) to investigate inhibitory control, where we presented angry facial expressions in comparison with neutral facial expressions as emotional stimuli. RESULTS All participants showed decreased inhibitory control in the angry versus neutral condition, i.e., a faster Stop Signal Reaction Time and a lower percentage of correct reactions. However, no significant group differences emerged in terms of performance. Performance in the eSST did not correlate with negative urgency, disorder- or emotion-related characteristics. CONCLUSIONS The current pilot study does not deliver evidence for decreased inhibitory control towards angry stimuli in patients with BED, as we detected a general and not disorder-related effect in all participants that might represent the conjunction of inhibitory control and anger. A direct mood induction technique might have led to different results. Further research in healthy and clinical groups is needed.
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Affiliation(s)
- Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Osianderstraße 5, 72076, Tübingen, Germany.
- Centre of Excellence for Eating Disorders Tübingen (KOMET), Tübingen, Germany.
| | - Lea Sandler
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Osianderstraße 5, 72076, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Osianderstraße 5, 72076, Tübingen, Germany
- Centre of Excellence for Eating Disorders Tübingen (KOMET), Tübingen, Germany
- DZPG (German Center for Mental Health), Tübingen, Germany
| | - Birgit Derntl
- DZPG (German Center for Mental Health), Tübingen, Germany
- Department for Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Osianderstraße 5, 72076, Tübingen, Germany
- Centre of Excellence for Eating Disorders Tübingen (KOMET), Tübingen, Germany
- DZPG (German Center for Mental Health), Tübingen, Germany
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14
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Mazzolani BC, Smaira FI, Esteves GP, Santini MH, Leitão AE, Santo André HC, Gualano B, Roschel H. Disordered Eating Attitudes and Food Choice Motives Among Individuals Who Follow a Vegan Diet in Brazil. JAMA Netw Open 2023; 6:e2321065. [PMID: 37382953 PMCID: PMC10311387 DOI: 10.1001/jamanetworkopen.2023.21065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/16/2023] [Indexed: 06/30/2023] Open
Abstract
Importance It remains controversial whether adhering to a vegan diet may be associated with a higher prevalence of disordered eating. Also, main food choice motives and their association with disordered eating in this population are still unknown. Objective To determine the association between disordered eating attitudes and food choice motives of individuals who follow a vegan diet. Design, Setting, and Participants This is a cross-sectional online survey conducted between September 2021 and January 2023. Individuals of both sexes, aged 18 years or older, following a vegan diet for at least 6 months, currently living in Brazil were recruited through advertisements on social media. Exposure Adherence to a vegan diet and food choice motives. Main Outcomes and Measures Disordered eating attitudes and food choice motives. Results Nine hundred seventy-one participants completed the online survey. Median (IQR) age and BMI of participants was 29 (24-36) years and 22.6 (20.3-24.9), respectively, and 800 participants (82.4%) were female. Most participants (908 respondents [94%]) were categorized with the lowest level of disturbed eating attitudes. "Need and hunger," "liking," "health," "habits," and "natural concerns" were the most important food choice motives in this population, while "affect regulation," "social norms," and "social image" were the less important ones. Adjusted models showed that "liking," "need and hunger," and "health" were associated with lower levels of disordered eating attitudes, while "price," "pleasure," "sociability," "traditional eating," "visual appeal," "social norms," "social image," "weight control," and "affect regulation" were associated with higher levels of disordered eating attitudes. Conclusions and Relevance In this cross-sectional study, as opposed to previous suggestions, levels of disordered eating were very low among vegans, although certain food choice motives were associated with disordered eating attitudes. Understanding the motivations of adhering to diets that may impose restrictions, which include vegan diets, may help tailor interventions focused on promoting healthy eating and preventing or treating disordered eating.
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Affiliation(s)
- Bruna Caruso Mazzolani
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | - Fabiana Infante Smaira
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | - Gabriel P. Esteves
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | - Martin Hindermann Santini
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | - Alice Erwig Leitão
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | | | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
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15
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Braden A, Barnhart WR, Kalantzis M, Redondo R, Dauber A, Anderson L, Tilstra-Ferrell EL. Eating when depressed, anxious, bored, or happy: An examination in treatment-seeking adults with overweight/obesity. Appetite 2023; 184:106510. [PMID: 36868313 DOI: 10.1016/j.appet.2023.106510] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/19/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
Emotions that differ in valence are uniquely associated with eating. In our previous study with an online sample of adults with overweight/obesity, eating in response to depression was the type of emotional eating most closely associated with negative psychosocial correlates (Braden et al., 2018). The current study extended this research by examining associations between emotional eating types (eating in response to depression, anxiety, boredom, happiness) and psychological correlates among treatment-seeking adults. The present study was a secondary analysis of adults (N = 63; 96.8% female) with overweight/obesity and self-identified emotional eating who completed a baseline assessment for a behavioral weight loss intervention. Emotional eating in response to depression (EE-depression), anxiety/anger (EE-anxiety/anger), and boredom (EE-boredom) were assessed with the revised Emotional Eating Scale (EES-R), and positive emotional eating (EE-positive) was assessed with the positive emotions subscale of the Emotional Appetite Questionnaire (EMAQ). The Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale (BES), Difficulties in Emotion Regulation Scale (DERS), and Patient Health Questionnaire-9 (PHQ-9; depressive symptoms) were also administered. Frequencies showed the most endorsed emotional eating type was EE-depression (44.4%; n = 28). Four multiple regression analyses examined associations between emotional eating (EE-depression, EE-anxiety/anger, EE-boredom, and EE-positive) and dependent variables (EDE-Q, BES, DERS, and PHQ-9). Results showed that depression was the emotional eating type most closely related to disordered eating, binge eating, and depressive symptoms. Eating in response to anxiety was closely related to emotion regulation difficulties. Positive emotional eating was related to less depressive symptoms. Exploratory analyses showed that lower levels of positive emotional eating were related to higher depressive symptoms among adults with greater emotion regulation difficulties. Researchers and clinicians may consider tailoring weight loss treatment based on unique emotions that trigger eating.
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Affiliation(s)
- Abby Braden
- Department of Psychology, Bowling Green State University, USA.
| | | | - Maria Kalantzis
- Department of Psychology, Bowling Green State University, USA
| | - Rachel Redondo
- Department of Psychology, Bowling Green State University, USA
| | - Aubrey Dauber
- Department of Psychology, Bowling Green State University, USA
| | - LaNaya Anderson
- Department of Psychology, Bowling Green State University, USA
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16
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Arend AK, Kaiser T, Pannicke B, Reichenberger J, Naab S, Voderholzer U, Blechert J. Toward Individualized Prediction of Binge-Eating Episodes Based on Ecological Momentary Assessment Data: Item Development and Pilot Study in Patients With Bulimia Nervosa and Binge-Eating Disorder. JMIR Med Inform 2023; 11:e41513. [PMID: 36821359 PMCID: PMC9999257 DOI: 10.2196/41513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Prevention of binge eating through just-in-time mobile interventions requires the prediction of respective high-risk times, for example, through preceding affective states or associated contexts. However, these factors and states are highly idiographic; thus, prediction models based on averages across individuals often fail. OBJECTIVE We developed an idiographic, within-individual binge-eating prediction approach based on ecological momentary assessment (EMA) data. METHODS We first derived a novel EMA-item set that covers a broad set of potential idiographic binge-eating antecedents from literature and an eating disorder focus group (n=11). The final EMA-item set (6 prompts per day for 14 days) was assessed in female patients with bulimia nervosa or binge-eating disorder. We used a correlation-based machine learning approach (Best Items Scale that is Cross-validated, Unit-weighted, Informative, and Transparent) to select parsimonious, idiographic item subsets and predict binge-eating occurrence from EMA data (32 items assessing antecedent contextual and affective states and 12 time-derived predictors). RESULTS On average 67.3 (SD 13.4; range 43-84) EMA observations were analyzed within participants (n=13). The derived item subsets predicted binge-eating episodes with high accuracy on average (mean area under the curve 0.80, SD 0.15; mean 95% CI 0.63-0.95; mean specificity 0.87, SD 0.08; mean sensitivity 0.79, SD 0.19; mean maximum reliability of rD 0.40, SD 0.13; and mean rCV 0.13, SD 0.31). Across patients, highly heterogeneous predictor sets of varying sizes (mean 7.31, SD 1.49; range 5-9 predictors) were chosen for the respective best prediction models. CONCLUSIONS Predicting binge-eating episodes from psychological and contextual states seems feasible and accurate, but the predictor sets are highly idiographic. This has practical implications for mobile health and just-in-time adaptive interventions. Furthermore, current theories around binge eating need to account for this high between-person variability and broaden the scope of potential antecedent factors. Ultimately, a radical shift from purely nomothetic models to idiographic prediction models and theories is required.
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Affiliation(s)
- Ann-Kathrin Arend
- Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Tim Kaiser
- Department of Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - Björn Pannicke
- Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Julia Reichenberger
- Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Silke Naab
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Ulrich Voderholzer
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg, Germany
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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Vasiliu O. An integrative model as a step toward increasing the awareness of eating disorders in the general population. Front Psychiatry 2023; 14:1184932. [PMID: 37205977 PMCID: PMC10188970 DOI: 10.3389/fpsyt.2023.1184932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 04/18/2023] [Indexed: 05/21/2023] Open
Abstract
Eating disorders (EDs) represent a contradictory chapter of clinical psychiatry, i.e., although they are associated with significant prevalence and risks in the long term (including vital risk, especially for anorexia nervosa), the therapeutic resources are minimal and based on low-quality data. Another contradiction arose in the last few decades, i.e., a variety of new EDs have been described, either by clinicians or signaled by mass media, but their systematic exploration is progressing very slowly. Entities like "food addiction," "orthorexia nervosa," or "emotional eating disorder" still require intensive exploration in order to find the most accurate diagnostic instruments, diagnosis criteria, prevalence data, vulnerability factors, and therapeutic approaches. This article is focused on integrating into a comprehensive model a variety of EDs not specified or loosely defined by the current international classifications of psychiatric disorders. This framework is intended as an instrument for stimulating clinical and epidemiological research, with potential favorable consequences for therapeutic research. The dimensional model suggested here includes four main categories that accommodate the already recognized EDs (i.e., anorexia nervosa, bulimia nervosa, and binge eating disorder) as well as ten EDs that still need intensive research to find their clinical and pathophysiological characteristics. More good-quality studies are urgently required regarding this topic, based on the mental and physical negative impact these EDs may have in the short and long term, especially in vulnerable populations (e.g., pregnant women, athletes, adolescents, etc.).
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18
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Emotional eating and disordered eating behaviors in children and adolescents with type 1 diabetes. Sci Rep 2022; 12:21854. [PMID: 36528643 PMCID: PMC9759523 DOI: 10.1038/s41598-022-26271-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Disordered eating behaviors (DEB) are more common in adolescents with type 1 diabetes (T1D) than in peers without diabetes. Emotional eating is a risk factor for binge eating in children and adolescents in the general population and is associated with increased intake of high energy-dense foods rich in sugars and fats. The primary objective is to evaluate whether emotional eating is associated with the metabolic control (glycated hemoglobin, plasma lipids and uric acid) in children and adolescents with type 1 diabetes and whether subjects with DEB (DEPS-R ≥ 20) have higher emotional eating than those without DEB. The secondary objective is to evaluate whether emotional eating is associated with the different symptoms of DEB. Emotional eating is positively correlated with HbA1c, total and LDL cholesterol values in children and adolescents with T1D. Subjects with DEB have a higher emotional eating score than subjects without DEB. Disinhibition is the most common disordered eating behavior in children and adolescents with T1D and is associated with a higher emotional eating score. Early identification and treatment of emotional eating could be tools for preventing DEB in people with type 1 diabetes. A total of 212 adolescents with T1D completed two self-administered questionnaires: the Diabetes Eating Problem Survey-Revised (DEPS-R) and the Emotional Eating Scale for Children and Adolescents (EES-C). Demographic (age, sex, duration of the disease), anthropometric (weight, height, BMI, BMI-SDS), therapeutic (type of insulin therapy, daily insulin dose) and metabolic (HbA1c, total cholesterol, HDL, LDL, triglycerides, uric acid) data were taken from the patients' medical records. The presence of other autoimmune diseases was also recorded.
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19
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Relationship between Mental Health and Emotional Eating during the COVID-19 Pandemic: A Systematic Review. Nutrients 2022; 14:nu14193989. [PMID: 36235642 PMCID: PMC9573278 DOI: 10.3390/nu14193989] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022] Open
Abstract
Obesity is one of the most dangerous epidemics of the 21st century. In 2019, the COVID-19 pandemic began and caused many deaths among patients with obesity with and without complications. Simultaneously, the lockdown related to the COVID-19 pandemic caused a host of emotional problems including anxiety, depression, and sleep disturbances. Many people began to cope with their emotions by increasing food (emotional eating) and alcohol consumption and in combination with decreased physical activity, promoted the development of overweight and obesity. Emotional eating, also known as stress eating, is defined as the propensity to eat in response to positive and negative emotions and not physical need. It should be noted that emotional eating may be the first step in the development of binge eating disorder and its extreme subtypes such as food addiction. Interestingly in some post-bariatric surgery patients, an increased frequency of addictive disorders has been observed, for example food addiction replaced by alcohol addiction called: “cross addiction” or “addiction transfer”. This data indicates that obesity should be treated as a psychosomatic disease, in the development of which external factors causing the formation of negative emotions may play a significant role. Currently, one of these factors is the COVID-19 pandemic. This manuscript discusses the relationships between the COVID-19 pandemic and development of emotional eating as well as potential implications of the viral pandemic on the obesity pandemic, and the need to change the approach to the treatment of obesity in the future.
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20
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Klein KM, Fitzgerald EH, Forney KJ, Kennedy GA, Keel PK. Evaluating the role of negative affect and negative interpretation biases in emotional eating behavior. Int J Eat Disord 2022; 55:914-922. [PMID: 35652275 DOI: 10.1002/eat.23751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 05/15/2022] [Accepted: 05/15/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The study of emotional eating, or (over)eating in response to emotions, may inform transdiagnostic interventions for eating pathology. Prior work has focused on the role of negative affect in promoting emotional eating. The present study sought to extend this work through examining the role of cognitive biases. METHOD Women who self-reported (n = 50) and did not self-report (n = 40) emotional eating completed self-report questionnaires of negative affect and negative interpretation biases, an implicit measure of cognitive bias, and a behavioral assay of emotional eating involving an ad lib test meal following a stress induction task. RESULTS The emotional eating group endorsed elevated trait negative affect, explicit shame biases, and implicit negative biases compared to controls. In addition, state negative affect increased after the stress induction task, and the emotional eating group endorsed greater state negative affect before and after the task and consumed more food following the stress induction. Only explicit cognitive shame biases demonstrated significant indirect effects in the association between group and food consumption. Specifically, elevated explicit shame biases were positively associated with amount of food consumed for the emotional eating group. DISCUSSION Future research should examine whether interventions that target cognitive biases related to shame reduce emotional eating. PUBLIC SIGNIFICANCE Individuals with emotional eating consumed more food than controls following a stress induction. Explicit shame cognitive biases were positively associated with amount of food consumed for the emotional eating group. Shame cogntiive biases may be fruitful targets for reducing emotional eating.
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Affiliation(s)
- Kelly M Klein
- Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Harvard University Medical School, Brockton, Massachusetts, USA
| | | | | | | | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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21
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Babbott KM, Mitchison D, Basten C, Thornton C, Hay P, Byrne S, Goldstein M, Heruc G, van der Werf B, Consedine NS, Roberts M. Intuitive Eating Scale-2: psychometric properties and clinical norms among individuals seeking treatment for an eating disorder in private practice. Eat Weight Disord 2022; 27:1821-1833. [PMID: 34797555 DOI: 10.1007/s40519-021-01326-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Intuitive Eating (IE) is an approach to eating designed to facilitate a positive relationship with food. Its use in clinical settings and in the community is rapidly growing in popularity. The Intuitive Eating Scale 2 (IES-2) is a widely used measure that indexes intuitive eating motivations and behaviour, however evidence of its validity in populations with clinical eating disorders remains scarce. The objective of the proposed study was thus to evaluate the factor structure of the IES-2 in a large sample of individuals seeking treatment for eating disorders in private practice. METHODS Data collected from 569 women and men aged 12-68 years seeking treatment for an eating disorder in one of eight specialist private outpatient eating disorder clinics were examined using confirmatory factor analysis (CFA). Relationships between IES-2 scores and measures of psychopathology were also examined. RESULTS Results were relatively consistent with the purported four-factor structure of the IES-2. The measure displayed strong construct validity and good internal consistency. Scores on the IES-2 were inversely associated with scores of depression, anxiety, and disordered eating, providing evidence for divergent validity of the measure. Clinical norms are provided for anorexia nervosa (AN) spectrum disorders and bulimia nervosa (BN) spectrum disorders, as well as for the clinical sample as a whole. CONCLUSION Findings suggest that the IES-2 may be an appropriate measure for evaluating behaviours relating to IE in community outpatient eating disorder settings, and provide further evidence for the association between IE and positive health outcomes. LEVEL OF EVIDENCE III, evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Katie M Babbott
- General Practice and Primary Healthcare, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Chris Basten
- Department of Psychology, Macquarie University, Sydney, Australia
| | | | - Phillipa Hay
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Sue Byrne
- University of Western Australia, Perth, Australia
| | - Mandy Goldstein
- Mandy Goldstein Psychology, Sydney, Australia
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Gabriella Heruc
- School of Medicine, Western Sydney University, Campbelltown, Australia
- Appetite for Change, Sydney, Australia
| | - Bert van der Werf
- Department of Biostatistics, University of Auckland, Auckland, New Zealand
| | - Nathan S Consedine
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Marion Roberts
- General Practice and Primary Healthcare, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
- Nurture Psychology, Auckland, New Zealand
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22
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Pannicke B, Blechert J, Reichenberger J, Kaiser T. Clustering individuals' temporal patterns of affective states, hunger, and food craving by latent class vector-autoregression. Int J Behav Nutr Phys Act 2022; 19:57. [PMID: 35597952 PMCID: PMC9123755 DOI: 10.1186/s12966-022-01293-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Eating plays an important role in mental and physical health and is influenced by affective (e.g., emotions, stress) and appetitive (i.e., food craving, hunger) states, among others. Yet, substantial temporal variability and marked individual differences in these relationships have been reported. Exploratory data analytical approaches that account for variability between and within individuals might benefit respective theory development and subsequent confirmatory studies. Methods Across 2 weeks, 115 individuals (83% female) reported on momentary affective states, hunger, and food craving six times a day. Based on these ecological momentary assessment (EMA) data we investigated whether latent class vector-autoregression (LCVAR) can identify different clusters of participants based on similarities in their temporal associations between these states. Results LCVAR allocated participants into three distinct clusters. Within clusters, we found both positive and negative associations between affective states and hunger/food craving, which further varied temporally across lags. Associations between hunger/food craving and subsequent affective states were more pronounced than vice versa. Clusters differed on eating-related traits such as stress-eating and food craving as well as on EMA completion rates. Discussion LCVAR provides novel opportunities to analyse time-series data in affective science and eating behaviour research and uncovers that traditional models of affect-eating relationships might be overly simplistic. Temporal associations differ between subgroups of individuals with specific links to eating-related traits. Moreover, even within subgroups, differences in associations across time and specific affective states can be observed. To account for this high degree of variability, future research and theories should consider individual differences in direction and time lag of associations between affective states and eating behaviour, daytime and specific affective states. In addition to that, methodological implications for EMA research are discussed. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01293-1.
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Affiliation(s)
- Björn Pannicke
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria.
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Julia Reichenberger
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Tim Kaiser
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Greifswald, Greifswald, Germany
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23
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Dunn D, Keenan-Miller D, Isoldi KK, Sarcona A, Dolar V, Guiné RP. Measurement and Correlates of Food Selection Motivations in a United States Sample. Am J Health Behav 2022; 46:186-196. [PMID: 35501960 DOI: 10.5993/ajhb.46.2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: In this study, we explored the factors that motivate food choice, and evaluated the psychometric properties and demographic correlates of the Eating Motivation (EATMOT) questionnaire in adults in the United States (US). Methods: This cross-sectional survey involved 905 adults in 6 sites across the US. The EATMOT questionnaire measures participants' self-reported motivations for food selection, demographic, and anthropometric data. Analyses included exploratory and confirmatory factor analyses, correlations, Welch's t-tests, and logistic regressions. Results: We established a 3-factor model (health-related, emotional, and environmental/political motivations) as the best fit to the data (CFI = .983, RMSEA = .049, SRMR = .054). Gender differences were found within the 3 factors, as well as in the intercorrelations between factors. Higher levels of health-related motivations (B = .10, SE = .04, OR = 1.11 (95% CI: 1.03, 1.19), p = .006) were associated with increased reports of weight loss dieting, whereas higher levels of environmental/political motivations (B = -.09, SE = .04, OR = 0.91, p = .02) were associated with fewer reports of weight-loss dieting. Conclusion: An abbreviated version of the EATMOT scale is appropriate for use in a US sample and identifies 3 categories of factors that impact dietary choices. These factors may be important in building interventions to improve diets.
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Affiliation(s)
- Danielle Dunn
- Danielle Dunn, Research Coordinator, Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Danielle Keenan-Miller
- Danielle Keenan-Miller, Associate Adjunct Professor, Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States
| | - Kathy K. Isoldi
- Kathy K. Isoldi, Associate Professor, Department of Health Sciences and Administration , Long Island University Post, Brookville, NY, United States;,
| | - Alessandra Sarcona
- Alessandra Sarcona, Associate Professor, Department of Nutrition, West Chester University of Pennsylvania, West Chester, PA, United States
| | - Veronika Dolar
- Veronika Dolar, Assistant Professor, Department of Politics, Economics and Law, State University of New York (SUNY) at Old Westbury, Old Westbury, NY, United States
| | - Raquel P.F. Guiné
- Raquel P. F. Guiné, Coordinating Professor, CERNAS Research Centre and Department of Food Industry, Polytechnic Institute of Viseu, Campus Politécnico, Repeses, Viseu, Portugal
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24
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An Z, Kim KH, Kim M, Kim YR. Negative emotion-related eating behaviours in young women with underweight status, overweight status, anorexia nervosa, and bulimia nervosa in Korea. EUROPEAN EATING DISORDERS REVIEW 2022; 30:401-411. [PMID: 35384144 DOI: 10.1002/erv.2900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/22/2022] [Accepted: 03/17/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study aimed at investigating the negative emotion-related eating behaviours of young women with extreme weights or eating disorders (EDs). METHOD A total of 808 young women participated including 144 with underweight (UW), 364 with normal-weight (NW) and 137 with overweight (OW; including 27 with obesity) from universities, and 63 patients with anorexia nervosa (AN), and 100 patients with bulimia nervosa (BN) from a hospital. Participants were interviewed and completed questionnaires on eating behaviours related to negative emotions. RESULTS While both OW and BN groups ate more in response to negative emotions, UW and AN groups ate less compared to NW group. Negative feelings after overeating were prominent in OW group and patients with ED. In negative emotions, patients with EDs preferred sweet tastes, but BN group preferred spicy tastes less. Patients with EDs had increased external eating, and BN group also showed increased restrained eating. Neuroticism had indirect impacts on OW status via emotional eating unlike BN. CONCLUSIONS The results suggest that UW and OW status were on the spectrum of emotional eating, and AN and BN were on the extremes of external eating, which may be integrated into the development of interventions targeting each status.
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Affiliation(s)
- Zhen An
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
| | - Kyung Hee Kim
- Department of Food and Nutrition, Duksung Women's University, Seoul, Republic of Korea
| | - Mirihae Kim
- Department of Psychology, Duksung Women's University, Seoul, Republic of Korea
| | - Youl-Ri Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea.,Department of Neuropsychiatry, Seoul Paik Hospital, Inje University, Seoul, Republic of Korea
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25
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Novel Approaches to Tackling Emotional Loss of Control of Eating Across the Weight Spectrum. Proc Nutr Soc 2022; 81:255-263. [PMID: 35260206 DOI: 10.1017/s0029665122000994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Emotional overeating is a process that is particularly relevant to people within the binge spectrum of eating disorders. Approximately a third of people with overweight share this phenotype. In addition, this behaviour may occur in neurodevelopmental disorders (attention-deficit hyperactivity disorder (ADHD)) and other psychiatric disorders. The biopsychosocial underpinnings of emotional eating include a genetic vulnerability to a higher weight and various cognitive and emotional traits. The environment also plays a key role. For example, the commodification of food and beauty and exposure to weight stigma, unpleasant eating experiences and general adversity can set the scene. The majority of people with binge-eating disorder do not seek treatment (perhaps related to internalised stigma and shame). Hence opportunities for early intervention and secondary prevention are lost. Most guidelines for binge-eating disorder (based on the limited available research) recommend forms of cognitive psychotherapies and antidepressants. However, novel treatments that target underlying mechanisms are in development. These include interventions to improve emotional regulation and inhibitory control using neuromodulation and/or brain training. New technologies have been applied to talking therapies, including apps which can offer ‘just-in-time interventions’ or virtual reality or avatar work which can deliver more personalised interventions using complex scenarios. Drugs used for the treatment of ADHD, psychiatric and metabolic disorders may have the potential to be repurposed for binge-eating disorder. Thus, this is an area of rapid change with novel solutions being applied to this problem.
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26
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Miranda-Olivos R, Testa G, Lucas I, Sánchez I, Sánchez-González J, Granero R, Jiménez-Murcia S, Fernández-Aranda F. Clinical factors predicting impaired executive functions in eating disorders: The role of illness duration. J Psychiatr Res 2021; 144:87-95. [PMID: 34601380 DOI: 10.1016/j.jpsychires.2021.09.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/08/2021] [Accepted: 09/22/2021] [Indexed: 01/30/2023]
Abstract
Poor performance in executive functions is observed in individuals with eating disorders (EDs). These impairments have usually been associated with the presence of comorbid psychopathology or with higher severity of EDs. However, few studies have explored the interaction between illness duration and deficits in executive functions. The present study investigates the association between ED duration and performance in decision-making, inhibitory control, and cognitive flexibility in the anorexia nervosa restrictive subtype (AN-R), bulimic/purging subtype (AN-BP), and binge spectrum disorders (BSDs) (namely, bulimia nervosa and binge eating disorder) among 116 women with EDs compared with 123 women healthy controls (HCs). Using cumulative survival analysis, we estimated the risk of deficits related to illness duration. Predictors of executive dysfunctions were assessed by regression analysis, including as potential predictors illness duration, severity of general psychopathology, and ED symptomatology. Results showed poor decision-making and cognitive flexibility in participants with EDs compared with HCs. ED duration was associated with poor inhibitory control in the AN-BP group and poor cognitive flexibility in the BSD group. The illness duration increased the risk of presenting early deficits in executive function. In decision-making and inhibitory control, the AN-R group showed the earliest deficits, whereas in cognitive flexibility it was the BSD group. ED duration predicted impaired cognitive flexibility in the BSD group and impaired inhibitory control in the AN-BP group, whereas the severity of general psychopathological symptoms was a predictor of impaired cognitive flexibility in individuals with AN-R. These results highlight the relevance of illness duration in executive dysfunctions in EDs.
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Affiliation(s)
- Romina Miranda-Olivos
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Giulia Testa
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Ignacio Lucas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Isabel Sánchez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Jessica Sánchez-González
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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27
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Reichenberger J, Schnepper R, Arend A, Richard A, Voderholzer U, Naab S, Blechert J. Emotional eating across different eating disorders and the role of body mass, restriction, and binge eating. Int J Eat Disord 2021; 54:773-784. [PMID: 33656204 PMCID: PMC8252459 DOI: 10.1002/eat.23477] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Different subtypes of eating disorders (ED) show dysfunctional eating behaviors such as overeating and/or restriction in response to emotions. Yet, systematic comparisons of all major EDs on emotional eating patterns are lacking. Furthermore, emotional eating correlates with body mass index (BMI), which also differs between EDs and thus confounds this comparison. METHOD Interview-diagnosed female ED patients (n = 204) with restrictive (AN-R) or binge-purge anorexia nervosa (AN-BP), bulimia nervosa (BN), or binge-eating disorder (BED) completed a questionnaire assessing "negative emotional eating" (sadness, anger, anxiety) and "happiness eating." ED groups were compared to BMI-matched healthy controls (HCs; n = 172 ranging from underweight to obesity) to exclude BMI as a confound. RESULTS Within HCs, higher BMI was associated with higher negative emotional eating and lower happiness eating. AN-R reported the lowest degree of negative emotional eating relative to other EDs and BMI-matched HCs, and the highest degree of happiness eating relative to other EDs. The BN and BED groups showed higher negative emotional eating compared to BMI-matched HCs. Patients with AN-BP occupied an intermediate position between AN-R and BN/BED and reported less happiness eating compared to BMI-matched HCs. DISCUSSION Negative emotional and happiness eating patterns differ across EDs. BMI-independent emotional eating patterns distinguish ED subgroups and might be related to the occurrence of binge eating versus restriction. Hence, different types of emotional eating can represent fruitful targets for tailored psychotherapeutic interventions. While BN and BED might be treated with similar approaches, AN-BP and AN-R would need specific treatment modules.
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Affiliation(s)
- Julia Reichenberger
- Department of Psychology, Centre for Cognitive NeuroscienceParis‐Lodron‐University of SalzburgSalzburgAustria
| | - Rebekka Schnepper
- Department of Psychology, Centre for Cognitive NeuroscienceParis‐Lodron‐University of SalzburgSalzburgAustria
| | - Ann‐Kathrin Arend
- Department of Psychology, Centre for Cognitive NeuroscienceParis‐Lodron‐University of SalzburgSalzburgAustria
| | | | - Ulrich Voderholzer
- Schoen Clinic RoseneckPrien am ChiemseeGermany
- Department of Psychiatry and PsychotherapyUniversity Hospital of the LMU MunichMunichGermany
- Department of Psychiatry and PsychotherapyUniversity Hospital FreiburgFreiburgGermany
| | - Silke Naab
- Schoen Clinic RoseneckPrien am ChiemseeGermany
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive NeuroscienceParis‐Lodron‐University of SalzburgSalzburgAustria
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28
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Chami R, Reichenberger J, Cardi V, Lawrence N, Treasure J, Blechert J. Characterising binge eating over the course of a feasibility trial among individuals with binge eating disorder and bulimia nervosa. Appetite 2021; 164:105248. [PMID: 33819528 DOI: 10.1016/j.appet.2021.105248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/10/2021] [Accepted: 03/28/2021] [Indexed: 01/01/2023]
Abstract
Binge eating disorder and bulimia nervosa are eating disorders that are characterized by recurrent binge eating episodes. The highly contextualized nature of binge eating makes naturalistic research a particularly suitable means of understanding the context within which binge eating occurs. The present study aimed to characterise binge eating days with regards to the frequency and probability of negative affect, food craving, meal skipping, and dietary restriction. In addition, it aimed to examine whether a combined intervention that targets the experience of 'loss of control' over eating can decrease these potential maintenance factors that often precede binge eating episodes. Seventy-eight participants with bulimia nervosa (N = 40) or binge eating disorder (n = 38), who were randomly allocated to a food-specific or general intervention combining inhibitory control training and implementation intentions, completed mood and food diaries over four weeks. Results suggest that negative affect and food craving were elevated on binge eating days, but that dietary restraint and meal skipping did not characterise binge eating days. Moreover, meal skipping, binge eating, restriction, and compensation decreased throughout the intervention period, while negative affect and food craving did not. This suggests that some interventions may successfully reduce binge eating frequency without necessarily decreasing negative affect or food craving, thus pointing to the different routes to targeting binge eating and providing implications for future interventions.
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Affiliation(s)
- Rayane Chami
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Julia Reichenberger
- Centre for Cognitive Neuroscience, Department of Psychology, Paris-Lodron University of Salzburg, Salzburg, Austria.
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of General Psychology, University of Padova, Italy
| | | | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jens Blechert
- Centre for Cognitive Neuroscience, Department of Psychology, Paris-Lodron University of Salzburg, Salzburg, Austria
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