Diagnostic Issues of Binge Eating in Eating Disorders: DIAGNOSTIC ISSUES OF BINGE EATING IN EATING DISORDERS

Determining the relationship between anxiety levels, stress coping styles, and emotional eating of women in the COVID-19 pandemic

PURPOSE

This study aimed to determine the relationship between women's anxiety levels and their style of coping with stress and emotional eating in the COVID-19 pandemic.

METHODS

This is a cross-sectional study and data were collected using online surveys. The sample of the study consisted of 450 women between the ages of 18-65, who have no understanding and perception problems, and who are willing to participate in the study. The data were obtained using the "Introductory Information Form", "Coronavirus Anxiety Scale", "Stress Coping Styles Scale" and "Emotional Eating Scale". Descriptive statistics, Pearson correlation analysis and multiple regression analysis were used to analyze the data.

RESULTS

Increased emotional eating was increased helpless approach, submissive approach and Coronavirus anxiety increase while decreasing the self-confident approach. Increased Coronavirus anxiety was increased the total scores of helpless approach, submissive approach, disinhibition, guilt, and emotional eating increased while decreasing the scores of the self-confident approach and optimistic approach. BMI, weight change in pandemic, age, self-confident approach to coping with stress and helpless approach score explained emotional eating 30.8 %.

CONCLUSION

Considering the emotional eating score average (11-20), women were emotional eating, and their Coronavirus anxiety score was below the average. In minimizing emotional eating in women, first of all, emotional eating awareness should be created, and it is recommended to increase their awareness of stress coping styles for the stress that causes this situation.

Perfectionism in Eating Disorders: Are Long-Term Outcomes Influenced by Extent and Changeability in Initial Perfectionism?

Purpose

Perfectionism has been found to predict outcomes in the treatment of eating disorders (ED). In the present study, we took advantage of longitudinal data to: a) investigate whether there are different patterns of perfectionism during the first six months after admission in a clinical sample of patients with ED, and b) describe how these patterns are related to long-term outcome.

Methods

A sample of patients (N=294) from the Coordinated Evaluation and Research at Specialized Units for Eating Disorders database was divided into clusters according to perfectionism patterns measured with the EDI-2 perfectionism scale at baseline, and six months in treatment. Cluster analysis was performed on the extent and perseverance/changeability of self-oriented and socially described perfectionism. Outcome was measured with the EDI-2 and the SCL-63. Frequencies of eating disorder diagnoses were investigated.

Results

Five clusters were identified. Low perfectionism was associated with lower levels of ED and psychiatric symptomatology at baseline. There were no significant differences between clusters on outcome variables at 36-month follow-up.

Conclusions

Results indicated better psychiatric and psychological health three years after the initial measure. Patterns of relations between the extent and possible changes of perfectionism, measured with the EDI-P at baseline and after six months, did not appear to be associated with long-term outcomes on psychiatric health ratings.

Are loss of control while eating and overeating valid constructs? A critical review of the literature

BACKGROUND

Binge eating is a marker of weight gain and obesity, and a hallmark feature of eating disorders. Yet its component constructs - overeating and loss of control (LOC) while eating - are poorly understood and difficult to measure.

OBJECTIVE

The objective of this study is to critically review the human literature concerning the validity of LOC and overeating across the age and weight spectrum.

DATA SOURCES

English-language articles addressing the face, convergent, discriminant and predictive validity of LOC and overeating were included.

RESULTS

Loss of control and overeating appear to have adequate face validity. Emerging evidence supports the convergent and predictive validity of the LOC construct, given its unique cross-sectional and prospective associations with numerous anthropometric, psychosocial and eating behaviour-related factors. Overeating may be best conceptualized as a marker of excess weight status.

LIMITATIONS

Binge eating constructs, particularly in the context of subjectively large episodes, are challenging to measure reliably. Few studies addressed overeating in the absence of LOC, thereby limiting conclusions about the validity of the overeating construct independent of LOC. Additional studies addressing the discriminant validity of both constructs are warranted.

DISCUSSION

Suggestions for future weight-related research and for appropriately defining binge eating in the eating disorders diagnostic scheme are presented.

Incremental validity of the episode size criterion in binge-eating definitions: An examination in women with purging syndromes

OBJECTIVE

Of the two primary features of binge eating, loss of control (LOC) eating is well validated while the role of eating episode size is less clear. Given the ICD-11 proposal to eliminate episode size from the binge-eating definition, the present study examined the incremental validity of the size criterion, controlling for LOC.

METHOD

Interview and questionnaire data come from four studies of 243 women with bulimia nervosa (n = 141) or purging disorder (n = 102). Hierarchical linear regression tested if the largest reported episode size, coded in kilocalories, explained additional variance in eating disorder features, psychopathology, personality traits, and impairment, holding constant LOC eating frequency, age, and body mass index (BMI). Analyses also tested if episode size moderated the association between LOC eating and these variables.

RESULTS

Holding LOC constant, episode size explained significant variance in disinhibition, trait anxiety, and eating disorder-related impairment. Episode size moderated the association of LOC eating with purging frequency and depressive symptoms, such that in the presence of larger eating episodes, LOC eating was more closely associated with these features. Neither episode size nor its interaction with LOC explained additional variance in BMI, hunger, restraint, shape concerns, state anxiety, negative urgency, or global functioning.

DISCUSSION

Taken together, results support the incremental validity of the size criterion, in addition to and in combination with LOC eating, for defining binge-eating episodes in purging syndromes. Future research should examine the predictive validity of episode size in both purging and nonpurging eating disorders (e.g., binge eating disorder) to inform nosological schemes. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:651-662).

Comparing symptomatic and functional outcomes over 5 years in two nonclinical cohorts characterized by binge eating with and without objectively large episodes

OBJECTIVE

The aim was to compare symptomatic and functional outcomes over 5 years in women with regular subjective (SBEs), objective (OBEs), and no regular binge eating episodes.

METHOD

Data were derived from two cohorts of 330 women with high levels of eating disorders symptoms followed over 5 years. Three groups were formed: (a) regular SBEs but no regular OBEs (N = 68), (b) regular OBEs with or without regular SBEs (N = 154), and (c) with no regular binge eating episodes (N = 108).

RESULTS

At baseline, the groups did not differ significantly in restraint scores and quality of life. People in the OBE group scored higher than those in the SBE group in body mass index (BMI). Those who had no regular binge eating had lower global Eating Disorder Examination Questionnaire (EDE-Q) and weight and shape concern scores than those with regular SBEs, and lower eating concern scores than either binge eating groups. Across the follow-up, there were no significant effects of being in either binge eating or the nonbinge eating group on the rates of change in BMI, general psychological distress, quality of life, or EDE-Q scores with the exception that OBE group had a significantly different rate of change in eating concern and psychological distress compared to the group without regular binge eating.

DISCUSSION

Individuals that report regular SBEs without regular OBEs represent a group with similar mental hardship and outcomes to those with regular OBEs. The findings support inclusion of regular SBEs in criteria for eating disorder diagnostic categories characterized by recurrent binge eating.

Evaluating reliable and clinically significant change in eating disorders: comparisons to changes in DSM-IV diagnoses

Assessing clinically meaningful change is valuable for treatment planning, monitoring course of illness and evaluating outcome. Although DSM eating disorder (ED) diagnoses have been criticized for poor clinical utility, instability, and uncertainty, remission/change of diagnosis is often the standard for evaluating outcome. We tested the validity of the clinically significant reliable change index (CS/RCI) compared to change in DSM-IV ED-diagnoses. We investigated if CS/RCI was concordant to diagnostic change and compared explained variance on measures at follow-up. Using a database for specialized ED treatment in Sweden the sample contained 1042 female patients (246 adolescents/796 adults). CS/RCI was calculated for the Clinical Impairment Assessment (CIA) and the Eating Disorder Examination Questionnaire (EDE-Q). CS/RCI explained more variance in gain scores for psychopathology measures than diagnostic change (DSM-IV). Average agreement between diagnostic change and CS/RCI was 62% and 60% for CIA and EDE-Q, respectively. Diagnostic change always resulted in more positive outcome than CS/RCI. Together with clinical judgment, CS/RCI is a valuable method for determining clinically significant changes in clinical practice and research. It is economically sound and results are easily interpreted and communicated to patients.

Binge eating behavior and weight loss maintenance over a 2-year period

OBJECTIVE

To investigate the relationship between binge eating behavior and weight loss maintenance over a two-year period in adults.

DESIGN

Secondary data analysis using the Keep It Off study, a randomized trial evaluating an intervention to promote weight loss maintenance.

PARTICIPANTS

419 men and women (ages: 20 to 70 y; BMI: 20-44 kg/m2) who had intentionally lost ≥10% of their weight during the previous year.

MEASUREMENTS

Body weight was measured and binge eating behavior over the past 6 months was reported at baseline, 12 months and 24 months. Height was measured at baseline.

RESULTS

Prevalence of binge eating at baseline was 19.4% (n = 76). Prevalence of binge eating at any time point was 30.1% (n = 126). Although rate of weight regain did not differ significantly between those who did or did not report binge eating at baseline, binge eating behavior across the study period (additive value of presence or absence at each time point) was significantly associated with different rates of weight regain.

CONCLUSION

Tailoring weight loss maintenance interventions to address binge eating behavior is warranted given the prevalence and the different rates of weight regain experienced by those reporting this behavior.