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Lammers MW, Vroling MS, Crosby RD, van Strien T. Dialectical behavior therapy adapted for binge eating compared to cognitive behavior therapy in obese adults with binge eating disorder: a controlled study. J Eat Disord 2020; 8:27. [PMID: 32528681 PMCID: PMC7285554 DOI: 10.1186/s40337-020-00299-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 05/18/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Current guidelines recommend cognitive behavior therapy (CBT) as the treatment of choice for binge eating disorder (BED). Although CBT is quite effective, a substantial number of patients do not reach abstinence from binge eating. To tackle this problem, various theoretical conceptualizations and treatment models have been proposed. Dialectical behavior therapy (DBT), focusing on emotion regulation, is one such model. Preliminary evidence comparing DBT adapted for BED (DBT-BED) to CBT is promising but the available data do not favor one treatment over the other. The aim of this study is to evaluate outcome of DBT-BED, compared to a more intensive eating disorders-focused form of cognitive behavior therapy (CBT+), in individuals with BED who are overweight and engage in emotional eating. METHODS Seventy-four obese patients with BED who reported above average levels of emotional eating were quasi-randomly allocated to one of two manualized 20-session group treatments: DBT-BED (n = 41) or CBT+ (n = 33). Intention-to-treat outcome was examined at post-treatment and at 6-month follow-up using general or generalized linear models with multiple imputation. RESULTS Overall, greater improvements were observed in CBT+. Differences in number of objective binge eating episodes at end of treatment, and eating disorder psychopathology (EDE-Q Global score) and self-esteem (EDI-3 Low Self-Esteem) at follow-up reached statistical significance with medium effect sizes (Cohen's d between .46 and .59). Of the patients in the DBT group, 69.9% reached clinically significant change at end of the treatment vs 65.0% at follow-up. Although higher, this was not significantly different from the patients in the CBT+ group (52.9% vs 45.8%). CONCLUSIONS The results of this study show that CBT+ produces better outcomes than the less intensive DBT-BED on several measures. Yet, regardless of the dose-difference, the data suggest that DBT-BED and CBT+ lead to comparable levels of clinically meaningful change in global eating disorder psychopathology. Future recommendations include the need for dose-matched comparisons in a sufficiently powered randomized controlled trial, and the need to determine mediators and moderators of treatment outcome. TRIAL REGISTRATION Nederlands Trial Register: NL3982 (NTR4154). Date of registration: 2013 August 28, retrospectively registered.
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Affiliation(s)
- Mirjam W Lammers
- Amarum, Expertise Centre for Eating Disorders, GGNet Network for Mental Health Care, Den Elterweg 75, 7207 AE Zutphen, The Netherlands.,Radboud University, Behavioural Science Institute, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands
| | - Maartje S Vroling
- Amarum, Expertise Centre for Eating Disorders, GGNet Network for Mental Health Care, Den Elterweg 75, 7207 AE Zutphen, The Netherlands.,Radboud University, Behavioural Science Institute, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands
| | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, North Dakota USA.,University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota USA
| | - Tatjana van Strien
- Radboud University, Behavioural Science Institute, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands
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2
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Potential psychological & neural mechanisms in binge eating disorder: Implications for treatment. Clin Psychol Rev 2018; 60:32-44. [DOI: 10.1016/j.cpr.2017.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 02/08/2023]
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Nakai Y, Nin K, Noma S, Teramukai S, Fujikawa K, Wonderlich SA. The impact of DSM-5 on the diagnosis and severity indicator of eating disorders in a treatment-seeking sample. Int J Eat Disord 2017; 50:1247-1254. [PMID: 28857236 DOI: 10.1002/eat.22777] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 08/18/2017] [Accepted: 08/20/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To examine the impact of the DSM-5 on the diagnoses and severity indicators of eating disorders, we conducted a comparative study on the classification of eating disorders including subtypes of anorexia nervosa (AN) between the DSM-IV and DSM-5 criteria. In addition, we studied the association of the DSM-5 severity criteria and clinical variables. METHOD Participants were 304 outpatients, aged 16-45 years, with eating disorders, diagnosed using semi-structured clinical interviews and the eating disorder examination questionnaire (EDE-Q). The severity of AN, bulimia nervosa (BN), and binge-eating disorder (BED) was rated from mild to extreme using the DSM-5 severity criteria. RESULTS The DSM-5 remarkably reduced the number of diagnoses in the residual category from 37.5% to 9.2% and effectively differentiated the diagnostic groups in eating disorder psychopathology. Unexpectedly, however, the scores of all the EDE-Q subscales significantly decreased as severity ratings increased in the DSM-5 AN. Furthermore, while the AN binge-eating/purging group reported significantly lower severity ratings than the AN restricting group, the former displayed more severe eating disorder psychopathology than the latter. In the BN and BED groups, the level of eating concern increased as severity ratings increased, but the severity groups did not differ on other eating pathology variables. DISCUSSION The DSM-5 effectively reduced the reliance on residual categories and differentiated the diagnostic groups in eating disorder psychopathology. However, our findings show limited support for the DSM-5 severity specifiers for eating disorders. It is necessary to test additional clinical or functional variables for severity specifiers across eating disorders.
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Affiliation(s)
| | - Kazuko Nin
- School of Health Sciences, Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Shun'ichi Noma
- Department of Psychiatry, School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Teramukai
- Department of Biostatistics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Kei Fujikawa
- The Center for Quality Assurance in Research and Development, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Stephen A Wonderlich
- Department of Clinical Neuroscience, University of North Dakota, School of Medicine and Health Sciences, Fargo, North Dakota
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Arlt JM, Smutzer GS, Chen EY. Taste assessment in normal weight and overweight individuals with co-occurring Binge Eating Disorder. Appetite 2017; 113:239-245. [PMID: 28242311 DOI: 10.1016/j.appet.2017.02.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/17/2017] [Accepted: 02/22/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND Taste perception influences food choice, and may contribute to both weight status and disordered eating. Relatively little work has attempted to disentangle contributions of weight status and Binge Eating Disorder (BED) to human taste perception. We predicted weight status and BED would interact, showing difference in taste perception from non-eating disorder matched groups. METHODS The four study groups included: normal weight BED (NW BED), normal weight healthy controls (NW HC), overweight BED (OW BED), and overweight healthy controls (OW HC) (N = 60). Groups were matched for age (±5 years), ethnicity, and weight status. Participants were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders, the Eating Disorder Examination Version 16.0, and the NIH Toolbox Gustatory Assessment with additional taste solutions and taste stimulus delivered with edible taste strips. RESULTS Interactions were found between weight status and diagnosis on measures of regional taste intensity for quinine hydrochloride (CI 95% [44.61, 56.31], p = 0.018), sucrose (CI 95% [46.79, 56.45], p = 0.003), and 6-n-propylthiouracil (CI 95% [25.557, 39.269], p = 0.015). OW BED participants perceived these taste stimuli significantly less intensely than OW HC and NW BED. Whole mouth taste intensity tests at suprathreshold amounts did not reveal group differences. All four groups reported similar hedonic response to taste stimuli. Edible taste strips had medium to large significant correlations with NIH Gustatory Assessment taste stimuli. CONCLUSIONS There were significant differences in the taste perception of OW BED relative to the other three groups. These findings may provide partial explanation as to why previous studies correlating taste and weight status have mixed results. Replication in larger samples assessed longitudinally is needed to extend this work.
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Affiliation(s)
- Jean M Arlt
- Temple Eating Disorders Program, Department of Clinical Psychology, Temple University, 1701 North 13th Street, Philadelphia, PA 19122, USA.
| | - Gregory S Smutzer
- Department of Biology, Temple University, 1900 North 12th Street, Philadelphia, PA 19122, USA
| | - Eunice Y Chen
- Temple Eating Disorders Program, Department of Clinical Psychology, Temple University, 1701 North 13th Street, Philadelphia, PA 19122, USA
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5
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Applicability of the dual pathway model in normal and overweight binge eaters. Body Image 2016; 18:162-7. [PMID: 27479739 DOI: 10.1016/j.bodyim.2016.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 06/19/2016] [Accepted: 06/22/2016] [Indexed: 12/30/2022]
Abstract
Binge eating is a significant problem in both eating disordered and community populations alike. Extensive support exists for the dual pathway model of binge eating in both adolescent and adult clinical and nonclinical populations. However, the restrained eating pathway to binge eating in particular has failed to be confirmed in some studies. In particular, the dual pathway model may not be applicable to overweight binge eaters. The current study examined the applicability of the dual pathway model in a sample of healthy and overweight binge eaters. A total of 260 (115 healthy weight; 145 overweight or obese) adult binge eaters completed an online survey. Mediation analyses indicated support for both the dietary restraint and negative affect pathways in the healthy weight sample but only the latter pathway was supported in the overweight sample. Therefore, the full dual pathway model may only be applicable to healthy weight binge eaters.
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Davis C, Levitan RD, Kaplan AS, Carter-Major JC, Kennedy JL. Sex differences in subjective and objective responses to a stimulant medication (methylphenidate): Comparisons between overweight/obese adults with and without binge-eating disorder. Int J Eat Disord 2016; 49:473-81. [PMID: 26691428 DOI: 10.1002/eat.22493] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 11/21/2015] [Accepted: 11/22/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to examine sex differences in response to a single dose of a psychomotor-stimulant medication (methylphenidate: MP) and to assess whether expected differences were moderated by binge-eating disorder (BED) status. It is anticipated that findings will shed light on factors that contribute to response variation in the use of stimulant pharmacotherapy to treat BED. METHOD The study employed a double-blind, drug-placebo, cross-over design in overweight/obese adults with BED (n = 90) and without BED (n = 108). Emotional/mood ratings were assessed every 15 minutes after oral administration of the drug/placebo, and appetite, cravings, and consumption were assessed during a laboratory-based snack-food challenge. RESULTS Women reported earlier and more sustained "overall" effects of the drug-including "feeling high"-than the men. There was also a significantly greater suppression in appetite ratings, food cravings, and food consumption from the placebo to the drug condition among the women. Indeed, among men there were no significant differences between the two conditions on any of the food-related variables. BED status also did not moderate any of the drug-placebo differences. DISCUSSION These findings are relevant to the use of stimulant pharmacotherapy for BED, and raise the possibility that overweight/obese men may be relatively less responsive to this form of treatment. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:473-481).
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Affiliation(s)
- Caroline Davis
- Kinesiology & Health Sciences, York University, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada
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Wilfley DE, Citrome L, Herman BK. Characteristics of binge eating disorder in relation to diagnostic criteria. Neuropsychiatr Dis Treat 2016; 12:2213-23. [PMID: 27621631 PMCID: PMC5010172 DOI: 10.2147/ndt.s107777] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included "binge eating disorder," DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and "shape and weight concerns." Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors' knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive-compulsive, and impulsive disorders) and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes) comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional eating). Future revisions of the BED diagnostic criteria should consider the inclusion of BED subtypes, perhaps based on the overvaluation of shape/weight, and an evidence-based reassessment of severity criteria.
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Affiliation(s)
- Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO
| | - Leslie Citrome
- Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla, NY
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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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Macpherson-Sánchez AE. Integrating fundamental concepts of obesity and eating disorders: implications for the obesity epidemic. Am J Public Health 2015; 105:e71-85. [PMID: 25713933 PMCID: PMC4358173 DOI: 10.2105/ajph.2014.302507] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2014] [Indexed: 12/12/2022]
Abstract
Physiological mechanisms promote weight gain after famine. Because eating disorders, obesity, and dieting limit food intake, they are famine-like experiences. The development of the concept of meeting an ideal weight was the beginning of increasing obesity. Weight stigma, the perception of being fat, lack of understanding of normal growth and development, and increased concern about obesity on the part of health providers, parents, and caregivers have reinforced each other to promote dieting. Because weight suppression and disinhibition provoke long-term weight increase, dieting is a major factor producing the obesity epidemic. The integrated eating disorder-obesity theory included in this article emphasizes that, contrary to dieters, lifetime weight maintainers depend on physiological processes to control weight and experience minimal weight change.
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Affiliation(s)
- Ann E Macpherson-Sánchez
- Ann E. Macpherson-Sánchez is with the Department of Agricultural Education, University of Puerto Rico, Mayagüez
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10
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Fernández-Aranda F, Sauchelli S, Pastor A, Gonzalez ML, de la Torre R, Granero R, Jiménez-Murcia S, Baños R, Botella C, Fernández-Real JM, Fernández-García JC, Frühbeck G, Gómez-Ambrosi J, Rodríguez R, Tinahones FJ, Arcelus J, Fagundo AB, Agüera Z, Miró J, Casanueva FF. Moderate-vigorous physical activity across body mass index in females: moderating effect of endocannabinoids and temperament. PLoS One 2014; 9:e104534. [PMID: 25101961 PMCID: PMC4125187 DOI: 10.1371/journal.pone.0104534] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 07/10/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Endocannabinoids and temperament traits have been linked to both physical activity and body mass index (BMI) however no study has explored how these factors interact in females. The aims of this cross-sectional study were to 1) examine differences among distinct BMI groups on daytime physical activity and time spent in moderate-vigorous physical activity (MVPA), temperament traits and plasma endocannabinoid concentrations; and 2) explore the association and interaction between MVPA, temperament, endocannabinoids and BMI. METHODS Physical activity was measured with the wrist-worn accelerometer Actiwatch AW7, in a sample of 189 female participants (43 morbid obese, 30 obese, and 116 healthy-weight controls). The Temperament and Character Inventory-Revised questionnaire was used to assess personality traits. BMI was calculated by bioelectrical impedance analysis via the TANITA digital scale. Blood analyses were conducted to measure levels of endocannabinoids and endocannabinoid-related compounds. Path-analysis was performed to examine the association between predictive variables and MVPA. RESULTS Obese groups showed lower MVPA and dysfunctional temperament traits compared to healthy-weight controls. Plasma concentrations of 2-arachidonoylglyceryl (2-AG) were greater in obese groups. Path-analysis identified a direct effect between greater MVPA and low BMI (b = -0.13, p = .039) and high MVPA levels were associated with elevated anandamide (AEA) levels (b = 0.16, p = .049) and N-oleylethanolamide (OEA) levels (b = 0.22, p = .004), as well as high Novelty seeking (b = 0.18, p<.001) and low Harm avoidance (b = -0.16, p<.001). CONCLUSIONS Obese individuals showed a distinct temperament profile and circulating endocannabinoids compared to controls. Temperament and endocannabinoids may act as moderators of the low MVPA in obesity.
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Affiliation(s)
- Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
- * E-mail: (FF-A); (FFC)
| | - Sarah Sauchelli
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Antoni Pastor
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Pharmacology, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Human Pharmacology and Clinical Neurosciences Research Group, Neuroscience Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Rafael de la Torre
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Human Pharmacology and Clinical Neurosciences Research Group, Neuroscience Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Rosa Baños
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Psychological, Personality, Evaluation and Treatment of the University of Valencia, Valencia, Spain
| | - Cristina Botella
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Basic Psychology, Clinic and Psychobiology of the University Jaume I, Castelló, Spain
| | - Jose M. Fernández-Real
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Diabetes, Endocrinology and Nutrition, Institut d’Investigació Biomèdica de Girona (IdlBGi) Hospital Dr Josep Trueta, Girona, Spain
| | - Jose C. Fernández-García
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain
| | - Gema Frühbeck
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Javier Gómez-Ambrosi
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Roser Rodríguez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Diabetes, Endocrinology and Nutrition, Institut d’Investigació Biomèdica de Girona (IdlBGi) Hospital Dr Josep Trueta, Girona, Spain
| | - Francisco J. Tinahones
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain
| | - Jon Arcelus
- Eating Disorders Service, Glenfield University Hospital, Leicester, United Kingdom
| | - Ana B. Fagundo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Zaida Agüera
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Jordi Miró
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Felipe F. Casanueva
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Medicine, Endocrinology Division, Santiago de Compostela University, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
- * E-mail: (FF-A); (FFC)
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Lapidoth JDM, von Hausswolff-Juhlin Y. Eating disorder symptoms, psychiatric correlates and self-image in normal, overweight and obese eating disorder patients. Eat Weight Disord 2014; 19:233-40. [PMID: 24639071 DOI: 10.1007/s40519-014-0112-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 02/22/2014] [Indexed: 11/29/2022] Open
Abstract
The impression from Swedish eating disorder (ED) units is that there has been an increase in the number of overweight or obese patients. There is, however, no research studying whether these patients differ from normal-weight ED patients in other aspects than weight. Differences between normal-weight and overweight or obese ED patients could indicate that these groups of patients need different treatment approaches. The aim of this study was to investigate possible differences between normal-weight and overweight or obese ED patients in psychiatric and psychological pre-treatment variables. The study was based on data from a Swedish quality assurance system for ED care. In total, data from 3,798 adult patients with body mass index ≥ 18.5 were used. The sample included all normal-weight ED diagnoses. Significant differences between normal-weight, overweight and obese patients were found for five of eight self-image variables, for all eating disorder examination questionnaire subscales and for most key diagnostic symptoms. However, effect sizes were mostly small or very small. Overweight or obese patients did not display greater levels of psychiatric psychopathology than normal-weight patients. They did, however, show a tendency towards more negative self-image and more severe ED symptoms than normal-weight patients. Overweight and obesity in ED patients are thus not only associated with physical health problems, but also with mental health issues. Further studies are required to investigate the clinical relevance of these findings.
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Affiliation(s)
- Joakim de Man Lapidoth
- Stockholm Centre for Eating Disorders and Karolinska Institutet, Wollmar Yxkullsgatan 25, 2 tr, 11850, Stockholm, Sweden,
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12
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Mason TB, Lewis RJ. Profiles of binge eating: the interaction of depressive symptoms, eating styles, and body mass index. Eat Disord 2014; 22:450-60. [PMID: 24983654 DOI: 10.1080/10640266.2014.931766] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Binge eating is associated with depressive symptoms, eating styles, and obesity. However, less is known about interactions between these variables and binge eating. This study examined the relationship between depressive symptoms, eating styles, body mass index, and binge eating. Individuals with a higher body mass index, who reported more depressive symptoms and more external eating, reported the greatest binge eating. Similarly, individuals with a higher body mass index who reported more depressive symptoms and more emotional eating reported the greatest binge eating. These findings demonstrate possible profiles of individuals most at risk for binge eating and associated eating disorders.
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Affiliation(s)
- Tyler B Mason
- a Department of Psychology , Old Dominion University , Norfolk , Virginia , USA
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Agüera Z, Riesco N, Jiménez-Murcia S, Islam MA, Granero R, Vicente E, Peñas-Lledó E, Arcelus J, Sánchez I, Menchon JM, Fernández-Aranda F. Cognitive behaviour therapy response and dropout rate across purging and nonpurging bulimia nervosa and binge eating disorder: DSM-5 implications. BMC Psychiatry 2013; 13:285. [PMID: 24200085 PMCID: PMC4226246 DOI: 10.1186/1471-244x-13-285] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 06/21/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND With the imminent publication of the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there has been a growing interest in the study of the boundaries across the three bulimic spectrum syndromes [bulimia nervosa-purging type (BN-P), bulimia nervosa-non purging type (BN-NP) and binge eating disorder (BED)]. Therefore, the aims of this study were to determine differences in treatment response and dropout rates following Cognitive Behavioural Therapy (CBT) across the three bulimic-spectrum syndromes. METHOD The sample comprised of 454 females (87 BED, 327 BN-P and 40 BN-NP) diagnosed according to DSM-IV-TR criteria who were treated with 22 weekly outpatient sessions of group CBT therapy. Patients were assessed before and after treatment using a food and binging/purging diary and some clinical questionnaires in the field of ED. "Full remission" was defined as total absence of binging and purging (laxatives and/or vomiting) behaviors and psychological improvement for at least 4 (consecutive). RESULTS Full remission rate was found to be significantly higher in BED (69.5%) than in both BN-P (p < 0.005) and BN-NP (p < 0.001), which presented no significant differences between them (30.9% and 35.5%). The rate of dropout from group CBT was also higher in BED (33.7%) than in BN-P (p < 0.001) and BN-NP (p < 0.05), which were similar (15.4% and 12.8%, respectively). CONCLUSIONS Results suggest that purging and non-purging BN have similar treatment response and dropping out rates, whereas BED appears as a separate diagnosis with better outcome for those who complete treatment. The results support the proposed new DSM-5 classification.
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Affiliation(s)
- Zaida Agüera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Nadine Riesco
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Mohammed Anisul Islam
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain,Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Enrique Vicente
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Eva Peñas-Lledó
- CICAB Clinical Research Centre, Extremadura University Hospital and Medical School, Badajoz, Spain
| | - Jon Arcelus
- Leicester Eating Disorder Service, Brandon Mental Health Unit, Leicester General Hospital, Leicester, UK
| | - Isabel Sánchez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Jose Manuel Menchon
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,CIBER Salud Mental (CIBERSAM), Instituto Salud Carlos III, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.
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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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Nakai Y, Fukushima M, Taniguchi A, Nin K, Teramukai S. Comparison of DSM-IV Versus Proposed DSM-5 Diagnostic Criteria for Eating Disorders in a Japanese Sample. EUROPEAN EATING DISORDERS REVIEW 2012; 21:8-14. [DOI: 10.1002/erv.2203] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Mitsuo Fukushima
- Division of Clinical Nutrition and Internal Medicine; Okayama Prefectural University; Okayama; Japan
| | | | - Kazuko Nin
- School of Health Sciences, Faculty of Medicine; Kyoto University; Japan
| | - Satoshi Teramukai
- Department of Clinical Trial Design and Management Translational Research Center; Kyoto University Hospital; Kyoto; Japan
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