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Tomba E, Tecuta L, Gardini V, Tomei G, Lo Dato E. Staging models in eating disorders: A systematic scoping review of the literature. Compr Psychiatry 2024; 131:152468. [PMID: 38460478 DOI: 10.1016/j.comppsych.2024.152468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/28/2024] [Accepted: 03/02/2024] [Indexed: 03/11/2024] Open
Abstract
Eating Disorders (ED) are characterized by low remission rates, treatment drop-out, and residual symptoms. To improve assessment and treatment of ED, the staging approach has been proposed. This systematic scoping review is aimed at mapping the existing staging models that explicitly propose stages of the progression of ED. A systematic search of PubMed, PsycINFO, Scopus was conducted with the terms staging, anorexia nervosa, bulimia nervosa, binge-eating disorders, eating disorders. Eleven studies met inclusion criteria presenting nine ED staging models, mostly for anorexia nervosa. Three were empirically tested, one of which was through an objective measure specifically developed to differentiate between stages. Most staging models featured early stages in which the exacerbation of EDs unfolds and acute phases are followed by chronic stages. Intermediate stages were not limited to acute stages, but also residual phases, remission, relapse, and recovery. The criteria for stage differentiation encompassed behavioral, psychological, cognitive, and physical features including body mass index and illness duration. One study recommended stage-oriented interventions. The current review underscores the need to empirically test the available staging models and to develop and test new proposals of staging models for other ED populations. The inclusion of criteria based on medical features and biomarkers is recommended. Staging models can potentially guide assessment and interventions in daily clinical settings.
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Affiliation(s)
- E Tomba
- Department of Psychology, University of Bologna, Bologna, Italy.
| | - L Tecuta
- Department of Psychology, University of Bologna, Bologna, Italy
| | - V Gardini
- Department of Psychology, University of Bologna, Bologna, Italy
| | - G Tomei
- Department of Psychology, University of Bologna, Bologna, Italy
| | - E Lo Dato
- Department of Psychology, University of Bologna, Bologna, Italy
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Charrat JP, Massoubre C, Gay A, Ravey B, Germain N, Galusca B. The value of a multidisciplinary consensus meeting in achieving agreement on eating disorders diagnosis at a specialized referral center. Int J Eat Disord 2024; 57:463-469. [PMID: 38135878 DOI: 10.1002/eat.24114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE This study aimed to evaluate the concordance of eating disorders (EDs) diagnoses within a multidisciplinary team in a specialized hospital unit dedicated to the medical care of ED. METHODS The study analyzed data from 608 female patients who sought consultation at the Eating Disorders Referral Center between 2017 and 2021. The diagnoses were established according to the DSM-5 criteria by endocrinologists, psychiatrists, and finally confirmed or discussed within a monthly multidisciplinary consensus meeting (MCM). Fleiss' Kappa tests were conducted to assess inter-raters' agreement. RESULTS Overall, substantial agreement was observed between endocrinologists and psychiatrists and the MCM. A more detailed analysis revealed variations in agreement across different disorders. Certain EDs demonstrated substantial agreement (e.g., anorexia nervosa restrictive subtype), while others approached near-perfect agreement (e.g., binge-eating disorder). In contrast, agreement was fair to poor for anorexia nervosa binge-purge subtype (ANBP) and slight for other specified feeding and ED. A period of temporary disagreement was noted for ANBP, partially attributed to practitioner turnover. An improvement in interdisciplinary agreement was observed for all ED diagnoses by the end of the study period. DISCUSSION Variations or lower levels of inter-rater agreement may stem from atypical cases that fall on the border between two diagnoses or complex cases, as well as fluctuating symptoms. The progress observed throughout the study can be attributed in part to interdisciplinary learning, particularly facilitated by the MCM. The findings underscore the significance of striving for optimal concordance among different medical specialties to enhance patient care in ED treatment. PUBLIC SIGNIFICANCE This study scrutinizes the agreement levels of ED diagnoses among endocrinologists and psychiatrists within a multidisciplinary team at an Eating Disorders Referral Center. While substantial overall agreement was achieved, disparities or lower agreement levels were evident for certain diagnoses such as anorexia nervosa binge-purge subtype. However, collaborative meetings led to a progressive enhancement in agreement over time. This research underscores the crucial role of a multidisciplinary team working collectively to ensure precise diagnoses and improved care for patients with EDs.
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Affiliation(s)
- Jean Philippe Charrat
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
| | - Catherine Massoubre
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
- Psychiatry Department, Saint Etienne University Hospital, Saint Etienne, France
- Referral Center for Eating Disorders, Saint Etienne University Hospital, Saint Etienne, France
| | - Aurelia Gay
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
- Psychiatry Department, Saint Etienne University Hospital, Saint Etienne, France
| | - Baptiste Ravey
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
- Psychiatry Department, Saint Etienne University Hospital, Saint Etienne, France
- Referral Center for Eating Disorders, Saint Etienne University Hospital, Saint Etienne, France
| | - Natacha Germain
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
- Referral Center for Eating Disorders, Saint Etienne University Hospital, Saint Etienne, France
- Endocrinology Department, Saint Etienne University Hospital, Saint Etienne, France
| | - Bogdan Galusca
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
- Referral Center for Eating Disorders, Saint Etienne University Hospital, Saint Etienne, France
- Endocrinology Department, Saint Etienne University Hospital, Saint Etienne, France
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Gearhardt AN, Bueno NB, DiFeliceantonio AG, Roberto CA, Jiménez-Murcia S, Fernandez-Aranda F. Social, clinical, and policy implications of ultra-processed food addiction. BMJ 2023; 383:e075354. [PMID: 37813420 PMCID: PMC10561019 DOI: 10.1136/bmj-2023-075354] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Affiliation(s)
- Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nassib B Bueno
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
| | - Alexandra G DiFeliceantonio
- Fralin Biomedical Research Institute at VTC, Department of Human, Nutrition Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Susana Jiménez-Murcia
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, Barcelona, Spain
| | - Fernando Fernandez-Aranda
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, Barcelona, Spain
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Chan WS, Lai TT. Pavlovian-instrumental transfer effects in individuals with binge eating. J Eat Disord 2023; 11:113. [PMID: 37415257 PMCID: PMC10327350 DOI: 10.1186/s40337-023-00824-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 06/14/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND The food addiction model of binge-eating postulates that hyperpalatable food can sensitize the reward processing system and lead to elevated cue-elicited motivational biases towards food, which eventually become habitual and compulsive. However, previous research on food reward conditioning in individuals with binge-eating is scarce. The present study examined the Pavlovian-instrumental transfer (PIT) effects in individuals with recurrent binge-eating. It was hypothesized that hyperpalatable food would elicit specific transfer effects, i.e., biased responding for the signaled food even after satiation on that food, and this effect would be stronger in individuals with binge-eating compared to healthy controls. METHODS Fifty-one adults with recurrent binge-eating and 50 weight-matched healthy controls (mean age: 23.95 [SD = 5.62]; % female = 76.2%) completed the PIT paradigm with food rewards. Participants also completed measures of hunger, mood, impulsivity, response disinhibition, and working memory. Mixed ANOVAs were conducted to examine transfer effects and if they differed between individuals with binge-eating and those without. RESULTS The group by cue interaction effect was not significant, suggesting that the specific transfer effect did not differ between groups. The main effect of cue was significant, indicating that the outcome-specific cue biased instrumental responding towards the signaled hyperpalatable food. However, the biased instrumental responding was attributable to suppressed responding in the presence of the cue predicting no reward, rather than enhanced responding in the presence of the specific food-predicting cues. CONCLUSIONS The present findings did not support the hypothesis that individuals with binge-eating would be more vulnerable to specific transfer effects elicited by hyperpalatable food, as measured by the PIT paradigm.
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Affiliation(s)
- Wai Sze Chan
- Department of Psychology, The University of Hong Kong, Rm 664, The Jockey Club Tower, Centennial Campus, Pokfulam, Hong Kong SAR.
| | - Tsun Tak Lai
- Department of Psychology, The University of Hong Kong, Rm 664, The Jockey Club Tower, Centennial Campus, Pokfulam, Hong Kong SAR
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Skinner JA, Whatnall M, Leary M, Collins RA, Pursey KM, Verdejo-García A, Hay PJ, Baker AL, Hides L, Paxton SJ, Wood LG, Colyvas K, Collins CE, Burrows TL. Examining the efficacy of a telehealth intervention targeting addictive eating in Australian adults (the TRACE Programme): a randomised controlled trial protocol. BMJ Open 2023; 13:e064151. [PMID: 37280025 PMCID: PMC10255192 DOI: 10.1136/bmjopen-2022-064151] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/16/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION Approximately 15%-20% of the adult population self-report symptoms of addictive eating. There are currently limited options for management. Motivational interviewing-based interventions, containing personalised coping skills training, have been found to be effective for behaviour change in addictive disorders (eg, alcohol). This project builds upon foundations of an addictive eating feasibility study previously conducted and co-design process involving consumers. The primary aim of this study is to examine the efficacy of a telehealth intervention targeting addictive eating symptoms in Australian adults compared with passive intervention and control groups. METHODS AND ANALYSIS This three-arm randomised controlled trial will recruit participants 18-85 years, endorsing ≥3 symptoms on the Yale Food Addiction Scale (YFAS) 2.0, with body mass index >18.5 kg/m2. Addictive eating symptoms are assessed at baseline (pre-intervention), 3 months (post-intervention) and 6 months. Other outcomes include dietary intake and quality, depression, anxiety, stress, quality of life, physical activity and sleep hygiene. Using a multicomponent clinician-led approach, the active intervention consists of five telehealth sessions (15-45 min each) delivered by a dietitian over 3 months. The intervention uses personalised feedback, skill-building exercises, reflective activities and goal setting. Participants are provided with a workbook and website access. The passive intervention group receives the intervention via a self-guided approach with access to the workbook and website (no telehealth). The control group receives personalised written dietary feedback at baseline and participants advised to follow their usual dietary pattern for 6 months. The control group will be offered the passive intervention after 6 months. The primary endpoint is YFAS symptom scores at 3 months. A cost-consequence analysis will determine intervention costs alongside mean change outcomes. ETHICS AND DISSEMINATION Human Research Ethics Committee of University of Newcastle, Australia provided approval (H-2021-0100). Findings will be disseminated via publication in peer-reviewed journals, conference presentations, community presentations and student theses. TRIAL REGISTRATION NUMBER Australia New Zealand Clinical Trials Registry (ACTRN12621001079831).
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Affiliation(s)
- Janelle A Skinner
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Megan Whatnall
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Mark Leary
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Rebecca A Collins
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Kirrilly M Pursey
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Antonio Verdejo-García
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Phillipa J Hay
- Translational Health Research Institute and School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Amanda L Baker
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Lisa G Wood
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, New South Wales, Australia
- Viruses, Infections / Immunity, Vaccines and Asthma Research Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Kim Colyvas
- School of Mathematical and Physical Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare E Collins
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Tracy L Burrows
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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Preuss-van Viersen H, Kirschbaum-Lesch I, Eskic J, Lukes S, Pydd J, Derks L, Hammerle F, Legenbauer T. Modified cue exposure for adolescents with binge eating behaviour: study protocol of a randomised pilot trial called EXI (ea)T. BMJ Open 2023; 13:e067626. [PMID: 36963795 PMCID: PMC10039999 DOI: 10.1136/bmjopen-2022-067626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2023] Open
Abstract
INTRODUCTION Binge eating (BE) behaviour is highly prevalent in adolescents, and can result in serious metabolic derangements and overweight in the long term. Weakened functioning of the behavioural inhibition system is one potential pathway leading to BE. Food cue exposure focusing on expectancy violation (CEEV) is a short intervention for BE that has proven effective in adults but has never been tested in adolescents. Thus, the current randomised pilot trial evaluates the feasibility of CEEV for adolescents and its efficacy in reducing eating in the absence of hunger (EAH) of binge food items. METHODS AND ANALYSIS The trial will include N=76 female adolescents aged between 13 and 20 years with a diagnosis of bulimia nervosa, binge eating disorder (BED) or their subthreshold forms based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Participants will be randomly assigned to two sessions of CEEV or behavioural analysis (BA), a classical cognitive-behavioural therapy-based intervention. The primary endpoint is the change in EAH measured according to ad libitum consumption of personally preferred binge food in a bogus taste test at post-test based on the intention-to-treat population. Key secondary endpoints are changes in EAH of standardised binge food at post-test, in EAH at 3-month follow-up (FU) and in food craving after induction of food cue reactivity at post-test and FU. To identify further valid outcome parameters, we will assess effects of CEEV compared with BA on global ED psychopathology, BE frequency within the last 28 days, body weight, response inhibition and emotion regulation abilities. Treatment groups will be compared using analysis of covariance with intervention as fixed factor and body mass index at baseline as covariate. ETHICS AND DISSEMINATION This clinical trial has been approved by the Ethics Review Committee of the Medical Association of Rhineland-Palatinate and the Medical Faculty of the Ruhr-University Bochum. The collected data will be disseminated locally and internationally through publications in relevant peer-reviewed journals and will be presented at scientific and clinical conferences. Participants data will only be published in an anonymised form. TRIAL REGISTRATION NUMBER DRKS00024009.
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Affiliation(s)
- Hanna Preuss-van Viersen
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Inken Kirschbaum-Lesch
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Ruhr University Bochum, Hamm, Germany
| | - Jasmina Eskic
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sophie Lukes
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jana Pydd
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Ruhr University Bochum, Hamm, Germany
| | - Laura Derks
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Ruhr University Bochum, Hamm, Germany
| | - Florian Hammerle
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Tanja Legenbauer
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Ruhr University Bochum, Hamm, Germany
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Bodell LP, Racine SE. A mechanistic staging model of reward processing alterations in individuals with binge-type eating disorders. Int J Eat Disord 2023; 56:516-522. [PMID: 36519302 DOI: 10.1002/eat.23875] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
Altered reward processing is thought to characterize binge-type eating disorders, but the exact nature of these alterations is unclear. A more fine-grained understanding of whether specific aspects of reward processing contribute to the development or maintenance of binge eating may point to new therapeutic targets and personalized treatments. The incentive sensitization theory of addiction proposes that repeated use of a substance increases the desire to approach a reward ('wanting') but not pleasure when consuming the reward ('liking'), suggesting that reward processes driving addiction change over time. We hypothesize that the same may be true for binge eating. Further, consistent with the maladaptive scaling hypothesis, reward processing may be heightened for multiple reinforcers in at-risk individuals but become tuned toward food once binge eating is initiated. In this article, we propose a mechanistic staging model of reward processing in binge-type eating disorders that synthesizes existing data and posits that alterations of reward processing depend on illness stage and reward type. We outline translational methods for testing key hypotheses and discuss clinical implications. Considering reward processing alterations in relation to illness stage has the potential to improve treatment outcomes by ensuring that the mechanisms targeted are personalized to the individual patient. PUBLIC SIGNIFICANCE: Individuals with binge-type eating disorders experience alterations in their desire for, and pleasure from, food. We believe that the exact nature of these alterations in reward processing change over the course of illness-from the at-risk state to an established illness. If true, treatments for binge-type eating disorders that target reward processing should be personalized to the illness stage of the patient.
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Affiliation(s)
- Lindsay P Bodell
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - Sarah E Racine
- Department of Psychology, McGill University, Montreal, Quebec, Canada
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Linardon J, Greenwood CJ, Macdonald JA, Spry EA, Wertheim EH, Le Grange D, Letcher P, Olsson CA. Eating and Body Image Disturbances in Adolescence and Substance Use Throughout Young Adulthood: Findings from the Australian Temperament Project. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01023-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Abstract We investigated whether eating and body image disturbances in mid-adolescence were associated with substance use in young adulthood. Participants (n = 1566) completed the drive for thinness, bulimic behavior, and body dissatisfaction subscales from the Eating Disorder Inventory during adolescence (15–16 years), and reported frequencies of substance use (tobacco, cannabis, binge drinking, other illicit substances) across young adulthood (19–20, 23–24, and 27–28 years). Adolescent body dissatisfaction was associated with a 10% increase in the rate of binge drinking and tobacco smoking, with effects being of similar magnitude in men and women, and across young adulthood. The association between bulimic behavior and tobacco smoking was strongest in the earlier years of young adulthood (19–20 years). Relationships between cannabis use, bulimic behavior, and body dissatisfaction were evident in men only. Findings highlight important targets for prevention programs, as well as focused monitoring efforts to identify individuals at risk of later substance use.
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Kwag KH, Kim YR, Lee YK, Lee HR, Lee JY, Lee J, Kim J, Kim Y, Treasure J. Feasibility and acceptability of a digital tele-guided intervention targeting components of the addictive appetite model for bulimia nervosa and binge-eating disorder in Korea. Int J Eat Disord 2022; 55:977-982. [PMID: 35686716 DOI: 10.1002/eat.23754] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 01/23/2023]
Abstract
OBJECTIVE We aimed to evaluate the feasibility, acceptability, and potential impact of a tele-guided digital-based intervention based on the addictive appetite model of recurrent binge eating. METHOD Female college students with bulimia nervosa (BN) or binge-eating disorder (BED) (n = 22) received a 6-week guided intervention targeting addictive processes and emotion regulation. The feasibility of the intervention was evaluated, and the outcomes were assessed at baseline, the end of the intervention, and 1-month follow-up. RESULTS Of the participants, 86.4% (n = 19) completed the intervention. The self-help materials were viewed 6.03 ± 3.06 times per week, and the duration of using the self-help materials was 113.16 ± 160.19 min/week. The intervention group experienced a significant reduction with a moderate effect on binge eating at the end of the intervention (Hedges' g = 0.58), and the effects lasted through follow-up (Hedges' g = 0.82). DISCUSSION The results suggest that the digital intervention targeting a maintenance mechanism of recurrent binge eating was feasible and acceptable for patients with BN and BED, proving the potential for symptom improvement. PUBLIC SIGNIFICANCE The addictive appetite model provides the framework for new interventions to improve treatments for BN and BED. This study found that the digital intervention based on the model was feasible and acceptable for patients with BN and BED.
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Affiliation(s)
- Kyung Hwa Kwag
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Youl-Ri Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea.,Department of Psychiatry, Seoul Paik Hospital, Inje University, Seoul, South Korea
| | - You Kyung Lee
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Hye Rin Lee
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Ja Youn Lee
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Jihye Lee
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Jione Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Youngkeun Kim
- Department of Counseling and Psychotherapy, Inje University, Gimhae, South Korea
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Camacho-Barcia L, Munguía L, Gaspar-Pérez A, Jimenez-Murcia S, Fernández-Aranda F. Impact of Food Addiction in Therapy Response in Obesity and Eating Disorders. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00421-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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The effects of response inhibition training following binge memory retrieval in young adults binge eaters: a randomised-controlled experimental study. Sci Rep 2022; 12:9281. [PMID: 35661111 PMCID: PMC9166753 DOI: 10.1038/s41598-022-12173-w] [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: 11/05/2021] [Accepted: 04/20/2022] [Indexed: 11/09/2022] Open
Abstract
Binge eating is increasingly prevalent among adolescents and young adults and can have a lasting harmful impact on mental and physical health. Mechanistic insights suggest that aberrant reward-learning and biased cognitive processing may be involved in the aetiology of binge eating. We therefore investigated whether recently developed approaches to catalyse brief interventions by putatively updating maladaptive memory could also boost the effects of cognitive bias modification training on binge eating behaviour. A non-treatment-seeking sample of 90 binge eating young adults were evenly randomised to undergo either selective food response inhibition training, or sham training following binge memory reactivation. A third group received training without binge memory reactivation. Laboratory measures of reactivity and biased responses to food cues were assessed pre-post intervention and bingeing behaviour and disordered eating assessed up to 9 months post-intervention. The protocol was pre-registered at https://osf.io/82c4r/ . We found limited evidence of premorbid biased processing in lab-assessed measures of cognitive biases to self-selected images of typical binge foods. Accordingly, there was little evidence of CBM reducing these biases and this was not boosted by prior 'reactivation' of binge food reward memories. No group differences were observed on long-term bingeing behaviour, caloric consumption or disordered eating symptomatology. These findings align with recent studies showing limited impact of selective inhibition training on binge eating and do not permit conclusions regarding the utility of retrieval-dependent memory 'update' mechanisms as a treatment catalyst for response inhibition training.
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Clinical Considerations of Ultra-processed Food Addiction Across Weight Classes: an Eating Disorder Treatment and Care Perspective. CURRENT ADDICTION REPORTS 2022; 9:255-267. [PMID: 35531579 PMCID: PMC9058754 DOI: 10.1007/s40429-022-00411-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 12/27/2022]
Abstract
Purpose of Review To examine the prevalence rates of ultra-processed food addiction across different weight classes and offer guidelines for diagnosis and treatment. Clinicians are provided with practical considerations in the assessment of ultra-processed food addiction beyond the use of validated instruments. Recent Findings The weighted mean prevalence of ultra-processed food addiction is approximately 20% worldwide and varies widely based on the sample. At first glance, there appears a linear relationship between ultra-processed food addiction and BMI class. Further investigation indicates a J-shaped curve with heightened prevalence among the underweight. These findings highlight the need to assess for additional factors that may increase objective or subjective food addiction symptoms including eating disorders, dietary restraint, and other mental health diagnoses. Summary While clinical considerations across different weight classes vary, overemphasis on weight status may detract from the clinical utility of the ultra-processed food addiction construct. Considering weight status in conjunction with other psychiatric symptoms helps to better understand the various biopsychosocial mechanisms that influence eating behavior and can inform individualized treatment strategies.
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Wiss DA, Brewerton TD, Tomiyama AJ. Limitations of the protective measure theory in explaining the role of childhood sexual abuse in eating disorders, addictions, and obesity: an updated model with emphasis on biological embedding. Eat Weight Disord 2022; 27:1249-1267. [PMID: 34476763 DOI: 10.1007/s40519-021-01293-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/23/2021] [Indexed: 12/22/2022] Open
Abstract
In addition to its immediate negative consequences, childhood sexual abuse is associated with lifelong deleterious mental and physical health outcomes. This review employs a biopsychosocial perspective to better understand pathways from childhood sexual abuse to eating disorders, food and drug addictions, and obesity across the life course. Guided by an updated conceptual model, this review delineates how the biological embedding of childhood sexual abuse triggers a cascade of interrelated conditions that often result in failed attempts at weight suppression and eventually obesity. Such biological embedding involves pathways such as inflammation, allostatic load, reward sensitivity, activation of the hypothalamic-pituitary-adrenal axis, epigenetics, and structural and functional changes in the brain. These pathways are in turn theorized to lead to food addiction, substance use disorder, and eating disorders-each with potential pathways toward obesity over time. Predisposing factors to childhood sexual abuse including gender, culture, and age are discussed. This model calls into question the longstanding "protective measure" theory that purports individuals exposed to sexual abuse will deliberately or subconsciously gain weight in attempt to prevent future victimization. A more comprehensive understanding of the mechanisms by which childhood sexual abuse becomes biologically embedded may help clinicians and survivors normalize and/or address disordered eating and weight-related outcomes, as well as identify intervention strategies.Level of evidence: Level V: opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
- David A Wiss
- Community Health Sciences Department, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA.
| | - Timothy D Brewerton
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - A Janet Tomiyama
- Department of Psychology, University of California, Los Angeles, CA, 90095, USA
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14
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Sun Y, Ye Q, Wen Q, Liu XR, Sun R, Dai Y. Brain functional changes in individuals with bulimia nervosa: a protocol for systematic review and meta-analysis. BMJ Open 2022; 12:e052881. [PMID: 35383061 PMCID: PMC8984053 DOI: 10.1136/bmjopen-2021-052881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Bulimia nervosa (BN) is a disorder with high health and socioeconomic burdens that typically arises in late adolescence and early adulthood. Previous neuroimaging studies have found functional brain changes in patients with BN. This study aims to review the latest neurobiological evidence from studies of individuals with BN, examine the consistency of these findings and evaluate the food addiction hypothesis of the disease. METHODS AND ANALYSIS A systematic search will be performed using the Cochrane Library, PubMed, Embase and Web of Science databases, covering the period from database inception to 30 November 2021. Two researchers will be responsible for study selection, quality assessment and data extraction. The anisotropic effect size version of the signed differential mapping method will be used to conduct a coordinate-based meta-analysis. Publication bias will be examined with the Egger test. The quality of studies will be evaluated using the Newcastle-Ottawa Scale. ETHICS AND DISSEMINATION No ethics approval is required for this is a systematic review protocol and does not require the collection of primary data. Findings will be disseminated through peer-reviewed journal or related conferences. PROSPERO REGISTRATION NUMBER CRD42022307233.
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Affiliation(s)
- Yiming Sun
- TCM Department, Chengdu Eighth People's Hospital, Chengdu, Sichuan, China
| | - Q Ye
- TCM Department, Chengdu Eighth People's Hospital, Chengdu, Sichuan, China
| | - Q Wen
- TCM Department, Chengdu Eighth People's Hospital, Chengdu, Sichuan, China
| | - X R Liu
- TCM Department, Chengdu Eighth People's Hospital, Chengdu, Sichuan, China
| | - R Sun
- College of Acupuncture and Massage, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Y Dai
- TCM Department, Chengdu Eighth People's Hospital, Chengdu, Sichuan, China
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15
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Munguía L, Camacho-Barcia L, Gaspar-Pérez A, Granero R, Galiana C, Jiménez-Murcia S, Dieguez C, Gearhardt AN, Fernández-Aranda F. Food addiction in Bulimia Nervosa: Analysis of body composition, psychological and problematic foods profile. Front Psychiatry 2022; 13:1032150. [PMID: 36339881 PMCID: PMC9632855 DOI: 10.3389/fpsyt.2022.1032150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Food Addiction (FA) has been related with eating disorders (ED), especially Bulimia Nervosa (BN). BN + FA may have different physical characteristics than patients with BN without the comorbidity, such as body mass index (BMI) or body composition, and psychological as emotion regulation. However, the relationship between psychological and physical aspects, connected by problematic food and its influence on body composition, has been barely studied. Therefore, the aims of the present study are. AIMS (a) To explore the differences in body composition between FA positive (FA+) and negative (FA-) in women with BN; (b) to identify problematic relationship with certain food types, according with the foods mentioned in the YFAS scale questionnaire, between FA+ and FA- patients; (c) to know the psychological characteristic differences between FA+ and FA- patients, considering emotion regulation, personality traits and general psychopathological state; (d) to identify the relationship between physical and psychological traits, and the identified problematic foods, in patients with BN and FA. METHODOLOGY N = 81 BN women patients, with a mean age of 29.73 years ± 9.80 SD, who completed the questionnaires: Yale Food Addiction Scale V 1.0 (YFAS 1.0), Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90 Items-Revised (SCL-90-R), and Difficulties in Emotion Regulation Strategies (DERS). YFAS problematic foods were grouped considering their principal nutrients sources. Body composition and difference in metabolic age was determined using bioimpedance analyzer. RESULTS The 88% of patients with BN presented FA+. Patients with BN who were FA+ self-reported more problematic relationships with sweets and starches. Also presented higher emotion regulation difficulties, general psychopathology and eating symptomatology severity, than those without FA. Finally, emotional regulation difficulties were positively associated with higher eating disorder symptomatology and more types of foods self-reported as problematic, which increased indirectly fat mass. CONCLUSION The results suggest that BN + FA presented more eating and psychopathology symptomatology and higher problems with specific food types. As well, the path analysis emphasized that emotion regulation difficulties might be related with problematic food relationship in BN, impacting over the ED severity. IMPLICATIONS The results may impact the development of precise therapies for patients with BN + FA.
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Affiliation(s)
- Lucero Munguía
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Lucía Camacho-Barcia
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Anahí Gaspar-Pérez
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Roser Granero
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Carla Galiana
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Carlos Dieguez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Physiology, Centro Singular de Investigación en Medicina Molecular y Enfermedades Crónicas (CIMUS), Instituto de Investigación Sanitaria, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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16
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Legendre M, Bégin C. French validation of the addiction-like eating behavior scale and its clinical implication. Eat Weight Disord 2021; 26:1893-1902. [PMID: 33048328 DOI: 10.1007/s40519-020-01039-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 09/29/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The first conception of food addiction (FA) as substance addiction, measured by the Yale Food Addiction Scale (YFAS), is controversial. Some proposed that FA would be better conceptualized with a behavioral approach. In accordance with this conceptualization, Ruddock and colleagues published a new self-reported scale for food addiction, the Addiction-like Eating Behavior Scale (AEBS). Overall, preliminary validation of the scale demonstrated good psychometric properties with a community sample. The aim of the present study is twofold, to validate the French-Canadian version of the AEBS with a community sample and to examine how well the instrument fits into a clinical sample with overweight/obesity. METHODS A community sample (N = 466) and a clinical sample with overweight/obesity seeking help for their eating difficulties (N = 126) completed an online survey regarding FA, binge eating, dietary restraint, depression, and BMI. Factor analysis, internal consistency, and construct validity were assessed. RESULTS With the community sample, factorial structure, and psychometric properties of the AEBS were replicated. With the clinical sample, proper convergent validity was demonstrated with the YFAS 2.0 and binge eating, and proper divergent validity was demonstrated with dietary restraint. Among the clinical sample, AEBS explain similar variance of BMI and depression level when compared to YFAS 2.0. CONCLUSION This study provided evidence that the French-Canadian version of the AEBS is a valid measure of food addiction, but it did not permit to establish advantages over YFAS 2.0 with a clinical sample. Clinical implications of the AEBS and FA characteristic are discussed. LEVEL OF EVIDENCE Level V, cross-sectional, descriptive study.
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Affiliation(s)
- Maxime Legendre
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada
| | - Catherine Bégin
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada.
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17
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Rania M, Aloi M, de Filippis R, Carbone EA, Caroleo M, De Fazio P, Segura-Garcia C. Executive functions and depressive symptoms interplay in binge eating disorder: A structural equation model analysis. EUROPEAN EATING DISORDERS REVIEW 2021; 29:811-819. [PMID: 34254393 DOI: 10.1002/erv.2854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/30/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Executive functions (EF) have been so far investigated as potential endophenotypes for binge eating disorder (BED). However, major critical limitations in previous research, such as the influence of obesity and comorbid depression, prevented any consensus to be reached. The present study investigated the association between depressive symptoms, a broad range of EF and binge eating severity in individuals with obesity and with/without BED, and whether this association may be explained by a mediation or independency model. METHOD One hundred and seven participants completed clinical and psychometric examination. Associations between EF, depressive symptoms and binge eating severity were assessed through bivariate correlation analysis, and the magnitude, as well as the direction of associations between variables, was estimated with structural equation model. RESULTS Two reliable models were tested; results showed that depressive symptoms exhibited significant direct and indirect effects on the severity of binge eating; conversely, EF did not show either significant direct or indirect effect on binge eating severity. CONCLUSION Depression contributes more than EF to psychopathology of BED. Thus, clinicians should routinely assess and, eventually, tailor depressive symptoms in treatment to improve the outcomes of patients with BED.
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Affiliation(s)
- Marianna Rania
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital "Mater Domini", Catanzaro, Italy.,Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Matteo Aloi
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital "Mater Domini", Catanzaro, Italy.,Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Renato de Filippis
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital "Mater Domini", Catanzaro, Italy.,Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Elvira Anna Carbone
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital "Mater Domini", Catanzaro, Italy.,Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Mariarita Caroleo
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital "Mater Domini", Catanzaro, Italy.,Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital "Mater Domini", Catanzaro, Italy.,Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
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18
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Houghton B, Kouimtsidis C, Duka T, Paloyelis Y, Bailey A. Can intranasal oxytocin reduce craving in automated addictive behaviours? A systematic review. Br J Pharmacol 2021; 178:4316-4334. [PMID: 34235724 DOI: 10.1111/bph.15617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 12/24/2022] Open
Abstract
Existing pharmacotherapies for managing craving, a strong predictor of relapse to automated addictive behaviours, are limited in efficacy and characterised by increased health risks associated with their pharmacological profile. Preclinical studies have identified oxytocin as a promising pharmacotherapy with anticraving properties for addictive behaviours. Here, we provide the first systematic review of 17 human studies (n = 722; 30% female) investigating the efficacy of intranasal oxytocin to reduce craving or consumption in addictive behaviours. We identify intranasal oxytocin as a method that warrants further investigation regarding its capacity to decrease cue-induced, acute stress-induced or withdrawal-related craving and relapse related to alcohol, cannabis, opioids, cocaine or nicotine, including a potential role as ad hoc medication following exposure to drug-related cues. Future studies should investigate the role of factors such as treatment regimens and sample characteristics, including the role of the amygdala, which we propose as a distinct mechanism mediating oxytocin's anticraving properties.
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Affiliation(s)
- Ben Houghton
- Pharmacology Section, Institute of Medical and Biomedical Education, St George's University of London, London, UK
| | | | - Theodora Duka
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, Brighton, UK
| | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alexis Bailey
- Pharmacology Section, Institute of Medical and Biomedical Education, St George's University of London, London, UK
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19
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de Sa Nogueira D, Bourdy R, Filliol D, Awad G, Andry V, Goumon Y, Olmstead MC, Befort K. Binge sucrose-induced neuroadaptations: A focus on the endocannabinoid system. Appetite 2021; 164:105258. [PMID: 33864862 DOI: 10.1016/j.appet.2021.105258] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/24/2021] [Accepted: 04/06/2021] [Indexed: 12/26/2022]
Abstract
Binge eating, the defining feature of binge eating disorder (BED), is associated with a number of adverse health outcomes as well as a reduced quality of life. Animals, like humans, selectively binge on highly palatable food suggesting that the behaviour is driven by hedonic, rather than metabolic, signals. Given the links to both reward processing and food intake, this study examined the contribution of the endocannabinoid system (ECS) to binge-like eating in rats. Separate groups were given intermittent (12 h) or continuous (24 h) access to 10% sucrose and food over 28 days, with only the 12 h access group displaying excessive sucrose intake within a discrete period of time (i.e., binge eating). Importantly, this group also exhibited alterations in ECS transcripts and endocannabinoid levels in brain reward regions, including an increase in cannabinoid receptor 1 (CB1R) mRNA in the nucleus accumbens as well as changes in endocannabinoid levels in the prefrontal cortex and hippocampus. We then tested whether different doses (1 and 3 mg/kg) of a CB1R antagonist, Rimonabant, modify binge-like intake or the development of a conditioned place preference (CPP) to sucrose. CB1R blockade reduced binge-like intake of sucrose and blocked a sucrose CPP, but only in rats that had undergone 28 days of sucrose consumption. These findings indicate that sucrose bingeing alters the ECS in reward-related areas, modifications that exacerbate the effect of CB1R blockade on sucrose reward. Overall, our results broaden the understanding of neural alterations associated with bingeing eating and demonstrate an important role for CB1R mechanisms in reward processing. In addition, these findings have implications for understanding substance abuse, which is also characterized by excessive and maladaptive intake, pointing towards addictive-like properties of palatable food.
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Affiliation(s)
- David de Sa Nogueira
- Université de Strasbourg, Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), Centre de la Recherche Nationale Scientifique, 12 rue Goethe, F-67000, Strasbourg France; Current Address: Brain Health Institute, Rutgers University and Rutgers Biomedical and Health Sciences, Piscataway, NJ, USA
| | - Romain Bourdy
- Université de Strasbourg, Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), Centre de la Recherche Nationale Scientifique, 12 rue Goethe, F-67000, Strasbourg France
| | - Dominique Filliol
- Université de Strasbourg, Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), Centre de la Recherche Nationale Scientifique, 12 rue Goethe, F-67000, Strasbourg France
| | - Gaëlle Awad
- Université de Strasbourg, Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), Centre de la Recherche Nationale Scientifique, 12 rue Goethe, F-67000, Strasbourg France
| | - Virginie Andry
- Institut des Neurosciences Cellulaires et Intégratives (INCI), UPR 3212, CNRS, 8 Allée du Général Rouvillois, 67000, Strasbourg, France
| | - Yannick Goumon
- Institut des Neurosciences Cellulaires et Intégratives (INCI), UPR 3212, CNRS, 8 Allée du Général Rouvillois, 67000, Strasbourg, France
| | - Mary C Olmstead
- Department of Psychology, Center for Neuroscience Studies, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - Katia Befort
- Université de Strasbourg, Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), Centre de la Recherche Nationale Scientifique, 12 rue Goethe, F-67000, Strasbourg France.
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20
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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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21
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Horsager C, Faerk E, Lauritsen MB, Østergaard SD. Food addiction comorbid to mental disorders: A nationwide survey and register-based study. Int J Eat Disord 2021; 54:545-560. [PMID: 33458821 DOI: 10.1002/eat.23472] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Substance use disorder is highly prevalent among individuals with mental disorders. However, it remains largely unknown whether this is also the case for "food addiction"-a phenotype characterized by an addiction-like attraction to predominantly highly processed foods with a high content of refined carbohydrates and fat. Therefore, the primary aim of this study was to estimate the weighted prevalence of food addiction among individuals with mental disorders. METHOD A total of 5,000 individuals aged 18-62 were randomly drawn from eight categories of major mental disorders from the Danish Psychiatric Central Research Register and invited to participate in an online questionnaire-based survey, which included the Yale Food Addiction Scale 2.0. Data on health care and sociodemographics from the Danish registers were linked to all invitees-enabling comprehensive attrition analysis and calculation of the weighted prevalence of food addiction. RESULTS A total of 1,394 (27.9%) invitees participated in the survey. Across all diagnostic categories, 23.7% met the criteria for food addiction. The weighted prevalence of food addiction was highest among individuals with eating disorders (47.7%, 95%CI: 41.2-54.2), followed by affective disorders (29.4%, 95%CI: 22.9-36.0) and personality disorders (29.0%, 95%CI: 22.2-35.9). When stratifying on sex, the prevalence of food addiction was higher among women in most diagnostic categories. DISCUSSION Food addiction is highly prevalent among individuals with mental disorders, especially in those with eating disorders, affective disorders and personality disorders. Food addiction may be an important target for efforts aimed at reducing obesity among individuals with mental disorders.
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Affiliation(s)
- Christina Horsager
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Emil Faerk
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark
| | - Marlene Briciet Lauritsen
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Søren Dinesen Østergaard
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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22
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Todisco P, Meneguzzo P, Garolla A, Antoniades A, Vogazianos P, Tozzi F. Impulsive behaviors and clinical outcomes following a flexible intensive inpatient treatment for eating disorders: findings from an observational study. Eat Weight Disord 2021; 26:869-877. [PMID: 32430886 DOI: 10.1007/s40519-020-00916-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 05/02/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The aim of the study was to assess the differences between impulsive and non-impulsive patients in response to a multidisciplinary intensive inpatient treatment for eating disorders (EDs). METHODS 320 patients with EDs were consecutively recruited in an eating disorders unit (EDU). They were assessed by clinical interviews and self-reported questionnaires. The treatment was characterized by a patient-centric approach and included both an intensive and comprehensive standardized multidisciplinary program based on cognitive-behavioral therapy and a flexible and personalized component according to the needs and the history of each patient. RESULTS Impulsive ED patients showed greater improvement in specific psychopathological areas, in particular: interpersonal sensitivity of Symptom Checklist-90 (SCL-90) (p = 0.007); Eating Disorder Examination Questionnaire (EDE-Q) Global Score (p = 0.009), EDE-Q eating concern (p < 0.001) and EDE-Q shape concern (p = 0.025). The two groups also showed a different pattern on the Body Uneasiness Test, with impulsive patients uniquely showing improvement on Global Severity Index (p = 0.006), body image concern (p = 0.008), compulsive self monitoring (p = 0.002), and weight phobia (p = 0.037). DISCUSSION Results support the hypothesis that patients with impulsive behaviors might benefit from treatments characterized by a standardized cognitive behavioral therapy implemented by third-wave interventions according to each patient's clinical profile. Personalized treatment approaches could be an answer to the complexity of ED, addressing individual psychopathology. Further studies are needed to confirm these preliminary findings. LEVEL OF EVIDENCE III, cohort or case-control analytic studies.
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Affiliation(s)
- Patrizia Todisco
- Eating Disorders Unit, Casa di Cura "Villa Margherita", via Costacolonna 20, Arcugnano, VI, Italy
| | - Paolo Meneguzzo
- Eating Disorders Unit, Casa di Cura "Villa Margherita", via Costacolonna 20, Arcugnano, VI, Italy. .,Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padova, Italy.
| | - Alice Garolla
- Eating Disorders Unit, Casa di Cura "Villa Margherita", via Costacolonna 20, Arcugnano, VI, Italy
| | | | - Paris Vogazianos
- Behavioral Sciences Department, European University Cyprus, Engomi, Cyprus
| | - Federica Tozzi
- Research and Development, Stremble Ventures, Limassol, Cyprus
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Mestre-Bach G, Fernández-Aranda F, Jiménez-Murcia S, Potenza MN. Decision-Making in Gambling Disorder, Problematic Pornography Use, and Binge-Eating Disorder: Similarities and Differences. Curr Behav Neurosci Rep 2021; 7:97-108. [PMID: 33585161 DOI: 10.1007/s40473-020-00212-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose of Review The present review attempts to provide a comprehensive and critical overview of the neurocognitive mechanisms of gambling disorder (GD), problematic pornography use (PPU) and binge-eating disorder (BED), focusing specifically on decision-making processes. Recent findings GD, PPU and BED have been associated with decision-making impairments both under risk and ambiguity. Features such as intelligence, emotions, social variables, cognitive distortions, comorbidities, or arousal may condition decision-making processes in these individuals. Summary Impairments in decision-making seem to be a shared transdiagnostic feature of these disorders We also hypothesized the EG relative to the NEG group would demonstrate weaker relationships between problem-gambling severity and health/functioning measures (e.g., substance use) and gambling behaviors (e.g., more time spent gambling) given that EG would account for some of the variance in the relationships between ARPG and these measures. However, there is varying support for the degree to which different features may affect decision-making. Therefore, the study of decision-making processes can provide crucial evidence for understanding addictions and other disorders with addiction-like symptomatology.
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Affiliation(s)
- Gemma Mestre-Bach
- Universidad Internacional de La Rioja, La Rioja, Spain.,Department of Psychiatry. Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry. Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry. Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Marc N Potenza
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA.,Yale University School of Medicine, Department of Neuroscience, New Haven, CT, USA.,Yale University School of Medicine, Yale Child Study Center, New Haven, CT, USA.,Connecticut Mental Health Center, New Haven, CT, USA
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Food Addiction and Tobacco Use Disorder: Common Liability and Shared Mechanisms. Nutrients 2020; 12:nu12123834. [PMID: 33334010 PMCID: PMC7765398 DOI: 10.3390/nu12123834] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 02/07/2023] Open
Abstract
As food addiction is being more commonly recognized within the scientific community, parallels can be drawn between it and other addictive substance use disorders, including tobacco use disorder. Given that both unhealthy diets and smoking are leading risk factors for disability and death, a greater understanding of how food addiction and tobacco use disorder overlap with one another is necessary. This narrative review aimed to highlight literature that investigated prevalence, biology, psychology, and treatment options of food addiction and tobacco use disorder. Published studies up to August 2020 and written in English were included. Using a biopsychosocial lens, each disorder was assessed together and separately, as there is emerging evidence that the two disorders can develop concurrently or sequentially within individuals. Commonalities include but are not limited to the dopaminergic neurocircuitry, gut microbiota, childhood adversity, and attachment insecurity. In addition, the authors conducted a feasibility study with the purpose of examining the association between food addiction symptoms and tobacco use disorder among individuals seeking tobacco use disorder treatment. To inform future treatment approaches, more research is necessary to identify and understand the overlap between the two disorders.
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Hauck C, Schipfer M, Ellrott T, Cook B. The relationship between food addiction and patterns of disordered eating with exercise dependence: in amateur endurance athletes. Eat Weight Disord 2020; 25:1573-1582. [PMID: 31654288 PMCID: PMC7581610 DOI: 10.1007/s40519-019-00794-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/03/2019] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Examine the prevalence and potential relationships among food addiction (FA)-as measured by Yale Food Addiction Scale 2.0 (YFAS 2.0), eating disorders (ED)-as measured by Eating Disorder Diagnostic Scale (EDDS)-and exercise dependence (EXD)-as measured by Questionnaire to Diagnose Exercise Dependence in Endurance Sports (FESA), for the first time worldwide, in amateur endurance athletes. METHODS A total of 1022 German-speaking endurance athletes (44% male, Ø 36 years, Ø BMI 23 kg/m2) replied to an online questionnaire consisting of demographics, related parameters, and the German versions of YFAS 2.0, EDDS, and FESA. RESULTS Prevalence of FA, ED, and EXD was 6.2, 6.5, and 30.5%. The probability for FA increases with BMI, thoughts about food and EXD score, and decreases with age and when an ED is present. People with FA and people with ED vs. people with both, FA&ED, differed significantly in this cohort. Strong significant relationships were found between FA and EXD (X2 (1) = 15.117, p < 0.001, n = 1022). CONCLUSIONS A considerable number of amateur endurance athletes may suffer from FA. The association between FA and EXD is stronger than between ED and EXD, indicating FA as a potentially more relevant subject-than ED-for prevention or therapy in people with EXD. Further studies are needed to investigate parameters and relationships between the possibly involved types of ED, FA, and EXD. LEVEL OF EVIDENCE Level III, well-designed cohort analytic study.
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Affiliation(s)
- Carolin Hauck
- Institute for Nutrition and Psychology at the University of Goettingen, Humboldtallee 32, 37073, Göttingen, Germany.
| | - Melanie Schipfer
- Martin-Luther-University Halle-Wittenberg, Universitaetsplatz 10, 06108, Halle (Saale), Germany.,Profusa Inc., 345 Allerton Avenue, South San Francisco, CA, 94080, USA
| | - Thomas Ellrott
- Institute for Nutrition and Psychology at the University of Goettingen, Humboldtallee 32, 37073, Göttingen, Germany
| | - Brian Cook
- Alsana: An Eating Disorder Recovery Community, 2545 W Hillcrest Dr, Suite 205, Thousand Oaks, CA, 91320, USA
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26
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Tran H, Poinsot P, Guillaume S, Delaunay D, Bernetiere M, Bégin C, Fourneret P, Peretti N, Iceta S. FOOD ADDICTION AS A PROXY FOR ANOREXIA NERVOSA SEVERITY: NEW DATA BASED ON THE YALE FOOD ADDICTION SCALE 2.0. Psychiatry Res 2020; 293:113472. [PMID: 33007684 DOI: 10.1016/j.psychres.2020.113472] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/19/2020] [Indexed: 12/12/2022]
Abstract
The contribution of an addictive process to anorexia nervosa (AN) is an area of growing interest. Yet, little is known about how the food addiction concept (FA) may be of interest in understanding AN. This study investigates prevalence of FA diagnostic and its association with markers of severity in individuals with AN. We conducted a retrospective study in a sample of 73 patients with AN. We assessed FA with the Yale Food Addiction Scale 2.0, depressive and anxiety disorders, impulsivity (Beck Depression Inventory, STAI, BIS-11) and eating behavior (BITE, EDE-Q). Prevalence of FA in our sample was 47%. FA was significantly associated and positively correlated with the binge-eating/purging subtype of AN, higher levels of depression, anxiety and greater eating psychopathology. FA was not associated with level of impulsivity nor leptin and IGF-1 blood levels. The relationship between FA severity and AN severity was mediated by the severity of binge eating behaviors. Our results suggest that the presence of FA may represent a more severe variant of AN. Longitudinal studies are needed to better understand the etiologic process between FA and AN.
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Affiliation(s)
- Helene Tran
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France
| | - Pierre Poinsot
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France; Univ Lyon, CarMeN laboratory, INSERM, INRA, INSA Lyon, Université Claude Bernard Lyon 1, F-69310 Pierre-Benite, France; Departement of Pediatric Nutrition, Hôpital Femme Mère Enfant, Univ Lyon, Hospice Civil de Lyon, Bron, F-69002, France
| | - Sebastien Guillaume
- Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital CHRU Montpellier, Montpellier, F-34295, France; INSERM U1061, Montpellier, France; Université de Montpellier, Montpellier, F-34093 France
| | - Dominique Delaunay
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France
| | - Marion Bernetiere
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France
| | - Catherine Bégin
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, QC G1V 0A6, Canada; School of Psychology, Laval University, QC G1V 0A6, Canada.; Quebec Heart and Lung Institute (IUCPQ), Québec, QC G1V 4G5, Canada. School of Nutrition, Laval University, Québec, QC, G1V 0A6, Canada
| | - Pierre Fourneret
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France
| | - Noel Peretti
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France; Univ Lyon, CarMeN laboratory, INSERM, INRA, INSA Lyon, Université Claude Bernard Lyon 1, F-69310 Pierre-Benite, France; Departement of Pediatric Nutrition, Hôpital Femme Mère Enfant, Univ Lyon, Hospice Civil de Lyon, Bron, F-69002, France
| | - Sylvain Iceta
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France; Univ Lyon, CarMeN laboratory, INSERM, INRA, INSA Lyon, Université Claude Bernard Lyon 1, F-69310 Pierre-Benite, France; Quebec Heart and Lung Institute (IUCPQ), Québec, QC G1V 4G5, Canada. School of Nutrition, Laval University, Québec, QC, G1V 0A6, Canada.
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Wiss D, Brewerton T. Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint. Nutrients 2020; 12:E2937. [PMID: 32992768 PMCID: PMC7600542 DOI: 10.3390/nu12102937] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023] Open
Abstract
Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate regarding the value of a food addiction "diagnosis" among those with eating disorders such as anorexia nervosa binge/purge-type, bulimia nervosa, and binge eating disorder. Much of the food addiction research in eating disorder populations has failed to account for dietary restraint, which can increase addiction-like eating behaviors and may even lead to false positives. Some have argued that the concept of food addiction does more harm than good by encouraging restrictive approaches to eating. Others have shown that a better understanding of the food addiction model can reduce stigma associated with obesity. What is lacking in the literature is a description of a more comprehensive approach to the assessment of food addiction. This should include consideration of dietary restraint, and the presence of symptoms of other psychiatric disorders (substance use, posttraumatic stress, depressive, anxiety, attention deficit hyperactivity) to guide treatments including nutrition interventions. The purpose of this review is to help clinicians identify the symptoms of food addiction (true positives, or "the signal") from the more classic eating pathology (true negatives, or "restraint") that can potentially elevate food addiction scores (false positives, or "the noise"). Three clinical vignettes are presented, designed to aid with the assessment process, case conceptualization, and treatment strategies. The review summarizes logical steps that clinicians can take to contextualize elevated food addiction scores, even when the use of validated research instruments is not practical.
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Affiliation(s)
- David Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90025, USA
| | - Timothy Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA;
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28
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Cassin S, Leung S, Hawa R, Wnuk S, Jackson T, Sockalingam S. Food Addiction Is Associated with Binge Eating and Psychiatric Distress among Post-Operative Bariatric Surgery Patients and May Improve in Response to Cognitive Behavioural Therapy. Nutrients 2020; 12:nu12102905. [PMID: 32977459 PMCID: PMC7598202 DOI: 10.3390/nu12102905] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 12/11/2022] Open
Abstract
The current study examined clinical correlates of food addiction among post-operative bariatric surgery patients, compared the clinical characteristics of patients with versus without food addiction, and examined whether a brief telephone-based cognitive behavioural therapy (Tele-CBT) intervention improves food addiction symptomatology among those with food addiction. Participants (N = 100) completed measures of food addiction, binge eating, depression, and anxiety 1 year following bariatric surgery, were randomized to receive either Tele-CBT or standard bariatric post-operative care, and then, repeated the measure of food addiction at 1.25 and 1.5 years following surgery. Thirteen percent of patients exceeded the cut-off for food addiction at 1 year post-surgery, and this subgroup of patients reported greater binge eating characteristics and psychiatric distress compared to patients without food addiction. Among those with food addiction, Tele-CBT was found to improve food addiction symptomatology immediately following the intervention. These preliminary findings suggest that Tele-CBT may be helpful, at least in the short term, in improving food addiction symptomatology among some patients who do not experience remission of food addiction following bariatric surgery; however, these findings require replication in a larger sample.
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Affiliation(s)
- Stephanie Cassin
- Department of Psychology, Ryerson University, Toronto, ON M5B 2K3, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; (R.H.); (S.W.)
- Centre for Mental Health, University Health Network, Toronto, ON M5T 2S8, Canada;
- Correspondence: (S.C.); (S.S.); Tel.: +1-416-979-5000 (ext. 3007) (S.C.); +1-416-535-8501 (ext. 32178) (S.S.)
| | - Samantha Leung
- Centre for Mental Health, University Health Network, Toronto, ON M5T 2S8, Canada;
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada;
| | - Raed Hawa
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; (R.H.); (S.W.)
- Centre for Mental Health, University Health Network, Toronto, ON M5T 2S8, Canada;
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada;
| | - Susan Wnuk
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; (R.H.); (S.W.)
- Centre for Mental Health, University Health Network, Toronto, ON M5T 2S8, Canada;
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada;
| | - Timothy Jackson
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada;
- Division of General Surgery, University Health Network, University of Toronto, Toronto, ON M5T 2S8, Canada
| | - Sanjeev Sockalingam
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; (R.H.); (S.W.)
- Centre for Mental Health, University Health Network, Toronto, ON M5T 2S8, Canada;
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada;
- Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
- Correspondence: (S.C.); (S.S.); Tel.: +1-416-979-5000 (ext. 3007) (S.C.); +1-416-535-8501 (ext. 32178) (S.S.)
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Ayton A, Ibrahim A. The Western diet: a blind spot of eating disorder research?-a narrative review and recommendations for treatment and research. Nutr Rev 2020; 78:579-596. [PMID: 31846028 PMCID: PMC7682725 DOI: 10.1093/nutrit/nuz089] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Over the last 50 years, in parallel with the obesity epidemic, the prevalence of eating disorders has increased and presentations have changed. In this narrative review, we consider recent research exploring the implications of changing patterns of food consumption on metabolic and neurobiological pathways, a hitherto neglected area in eating disorder research. One of the major changes over this time has been the introduction of ultra-processed (NOVA-4) foods, which are gradually replacing unprocessed and minimally processed foods. This has resulted in the increased intake of various sugars and food additives worldwide, which has important metabolic consequences: triggering insulin and glucose response, stimulating appetite, and affecting multiple endocrine and neurobiological pathways, as well as the microbiome. A paradigm shift is needed in the conceptual framework by which the vulnerability to, and maintenance of, different eating disorders may be understood, by integrating recent knowledge of the individual metabolic responses to modern highly processed foods into existing psychological models. This could stimulate research and improve treatment outcomes.
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Affiliation(s)
- Agnes Ayton
- University of Oxford, Oxford, United Kingdom
| | - Ali Ibrahim
- South London and Maudsley NHS Foundation Trust, Snowsfields Adolescent Unit, Mapother House, Maudsley Hospital, London
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Chami R, Treasure J, Cardi V, Lozano-Madrid M, Eichin KN, McLoughlin G, Blechert J. Exploring Changes in Event-Related Potentials After a Feasibility Trial of Inhibitory Training for Bulimia Nervosa and Binge Eating Disorder. Front Psychol 2020; 11:1056. [PMID: 32536891 PMCID: PMC7269126 DOI: 10.3389/fpsyg.2020.01056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/27/2020] [Indexed: 12/11/2022] Open
Abstract
In a feasibility trial comparing two forms of combined inhibitory control training and goal planning (i.e., food-specific and general) among patients with bulimia nervosa (BN) and binge eating disorder (BED), we found evidence of symptomatic benefit, with stronger effects among participants receiving a food-specific intervention. The aim of the present study was to examine changes in behavioral outcomes and event-related potentials (ERPs; N2 and P3 amplitudes) from baseline to post-intervention that might suggest the mechanisms underpinning these effects. Fifty-five participants completed go/no-go tasks during two electroencephalography (EEG) sessions, at baseline and post-intervention. The go/no-go task included "go" cues to low energy-dense foods and non-foods, and "no-go" cues to high energy-dense foods and non-foods. Datasets with poor signal quality and/or outliers were excluded, leaving 48 participants (N = 24 BN; N = 24 BED) in the analyses. Participants allocated to the food-specific, compared to the general intervention group, showed significantly greater reductions in reaction time to low energy-dense foods, compared to non-foods, by post-intervention. Commission errors significantly increased from baseline to post-intervention, regardless of stimulus type (food vs. non-food) and intervention group (food-specific vs. general). There were no significant changes in omission errors. P3 amplitudes to "no-go" cues marginally, but non-significantly, decreased by post-intervention, but there was no significant interaction with stimulus type (high energy-dense food vs. non-food) or intervention group (food-specific vs. general). There were no significant changes in N2 amplitudes to "no-go" cues, N2 amplitudes to "go" cues, or P3 amplitudes to "go" cues from baseline to post-intervention. Training effects were only marginally captured by these event-related potentials. We discuss limitations to the task paradigm, including its two-choice nature, ease of completion, and validity, and give recommendations for future research exploring ERPs using inhibitory control paradigms.
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Affiliation(s)
- Rayane Chami
- Section of Eating Disorders, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-Institut d’Investigacio Biomedica de Bellvitge (IDIBELL), Barcelona, Spain
- CiberObn, Madrid, Spain
| | - Katharina Naomi Eichin
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Grainne McLoughlin
- Social, Genetic, and Developmental Psychiatry Department, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria
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Leslie M, Leppanen J, Paloyelis Y, Treasure J. A pilot study investigating the influence of oxytocin on attentional bias to food images in women with bulimia nervosa or binge eating disorder. J Neuroendocrinol 2020; 32:e12843. [PMID: 32202692 PMCID: PMC8650572 DOI: 10.1111/jne.12843] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 02/17/2020] [Accepted: 03/10/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Previous research has found that exogenous oxytocin administration has the potential to modulate attentional biases in women with anorexia nervosa. Recent work has indicated that attentional biases to food may reinforce the recurrent binge eating behaviour characterising bulimia nervosa and binge eating disorder. To date, however, no study has yet investigated the effect of oxytocin on attentional biases to palatable food in women with bulimia nervosa and binge eating disorder. METHODS The present study employed a single-session cross-over design to test the hypothesis that a divided dose of 64 IU of intranasal oxytocin, administered as one intranasal dose of 40 IU of oxytocin followed by a top-up of 24 IU of oxytocin 80 minutes later, vs placebo administration administered in the same dosing schedule would reduce attentional biases towards food images in a dot probe task. We hypothesised that oxytocin administration would reduce vigilance towards food to a greater degree in women with bulimia nervosa or binge eating disorder vs healthy comparison women. Twenty-five women with bulimia nervosa or binge eating disorder and 27 comparison women without history of an eating disorder were recruited to take part in the study. RESULTS In contrast to our hypothesis, there was no main effect of diagnosis on attentional bias to food (fixed effect = 5.70, P = 0.363), nor a significant interaction between diagnosis and drug condition (fixed effect =-14.80, P = 0.645). There was a main effect of drug condition, such that oxytocin increased vigilance towards food vs neutral images in the dot probe task (fixed effect = 10.42, P = 0.044). A correlation analysis revealed that this effect was moderated by attentional bias in the placebo condition, such that greater avoidance of food stimuli in the placebo condition was associated with a greater increase in vigilance induced by oxytocin. CONCLUSIONS The findings of the present study add to a mixed body of literature investigating the therapeutic effects of oxytocin in women. Future research would benefit from dose-response studies investigating the optimal dose of oxytocin for modulating the attentional processing of palatable food in populations with eating disorders.
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Affiliation(s)
- Monica Leslie
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN)King’s College London (KCL)LondonUK
| | - Jenni Leppanen
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN)King’s College London (KCL)LondonUK
| | - Yannis Paloyelis
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN)King’s College London (KCL)LondonUK
| | - Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN)King’s College London (KCL)LondonUK
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Abstract
Eating disorders are disabling, deadly, and costly mental disorders that considerably impair physical health and disrupt psychosocial functioning. Disturbed attitudes towards weight, body shape, and eating play a key role in the origin and maintenance of eating disorders. Eating disorders have been increasing over the past 50 years and changes in the food environment have been implicated. All health-care providers should routinely enquire about eating habits as a component of overall health assessment. Six main feeding and eating disorders are now recognised in diagnostic systems: anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant-restrictive food intake disorder, pica, and rumination disorder. The presentation form of eating disorders might vary for men versus women, for example. As eating disorders are under-researched, there is a great deal of uncertainty as to their pathophysiology, treatment, and management. Future challenges, emerging treatments, and outstanding research questions are addressed.
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Affiliation(s)
- Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Tiago Antunes Duarte
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Serviço de Psiquiatria e Saúde Mental, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
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34
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Cury MEG, Berberian A, Scarpato BS, Kerr-Gaffney J, Santos FH, Claudino AM. Scrutinizing Domains of Executive Function in Binge Eating Disorder: A Systematic Review and Meta-Analysis. Front Psychiatry 2020; 11:288. [PMID: 32362845 PMCID: PMC7181673 DOI: 10.3389/fpsyt.2020.00288] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 03/24/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Cognitive deficits are implicated in theoretical explanatory models for binge eating disorder (BED). Furthermore, evidence suggest that alterations in executive function may underlie symptoms in BED. The current systematic review and meta-analysis provides an update on executive functioning in individuals with BED. METHODS Literature searches (up to November 2019) were conducted in electronic databases combining binge eating or BED with executive functions. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines was used. Studies of any design comparing adults with BED with those without BED in executive function domains were selected. Methodological quality of studies was based on the Newcastle-Ottawa scale. RESULTS Of 1,983 citations identified, 28 case-control studies met inclusion criteria for this review. Six meta-analyses that examined four domains (decision-making, cognitive flexibility, inhibitory control, and working memory) were conducted. The only meta-analysis to show a significant difference in executive functioning between BED and obese controls was working memory (SMD = 0.32, 95% IC: -0.60, -0.03; p = 0.028), with an effect size of small magnitude. Qualitative inspection of the literature indicated mixed findings for control inhibition, decision making and cognitive flexibility in individuals with BED compared to controls (obese or normal weight). In addition, people with BED showed poorer problem solving performance, but similar planning abilities to obese controls. CONCLUSIONS Individuals with BED were found to show worse performance on working memory tasks compared to obese individuals without the disorder. The findings did not provide definitive evidence of alterations in other aspects of executive functioning. Interest in executive functioning in people with BED is increasing but is limited by insufficient data from small studies with varied methodology. Future studies should focus on using similar tests and outcome measures, in order to enable more pertinent comparisons across studies.
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Affiliation(s)
- Maria Elisa Gisbert Cury
- Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Arthur Berberian
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Bruno Sini Scarpato
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Jess Kerr-Gaffney
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Flavia H Santos
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Angélica Medeiros Claudino
- Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Abstract
ABSTRACT Objective This study was conducted with 370 undergraduate students to investigate the relationship between food intake, food addiction and disordered eating behavior. Methods The Yale Food Addiction Scale, Eating Attitude Test-26 and Food Frequency Questionnaire were used to assess food addiction, disordered eating behavior and food intake. Results A positive weak correlation was found between the Yale Food Addiction Scale and daily energy, carbohydrate and fat intake (r=0.228, p<0.001; r=0.222, p<0.001; r=0.225, p<0.001 respectively) whereas a negative weak correlation was found between Eating Attitude Test-26 and daily energy and carbohydrate intake (r=-0.105, p=0.044; r=-0.116, p=0.025 respectively). Conclusion Food intake is associated with food addiction and disordered eating behaviour. Further research should be conducted with a larger population also examining body composition, exercises and financial situation of the individuals because all of these factors have an influence on the nutritional status and eating behavior as well.
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Şengör G, Gezer C. Food addiction and its relationship with disordered eating behaviours and obesity. Eat Weight Disord 2019; 24:1031-1039. [PMID: 30850958 DOI: 10.1007/s40519-019-00662-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 02/24/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Food addiction, eating disorders and obesity are all mutually reinforcing factors, or factors that can trigger each other. The aim of this study was to determine the relationship between food addiction, disordered eating behaviours and obesity. METHODS The study was conducted with 370 university students. Food addiction was assessed using the Yale Food Addiction Scale (YFAS) and disordered eating behaviours were assessed with the Eating Attitude Test (EAT)-26. A digital scale was used to measure weight, while for the measurement of height, waist and hip circumferences a non-stretching tape measure was used according to standard techniques. RESULTS Among the participants, 35.7% scored high on the EAT-26, while 21.1% scored high on the YFAS. Females constituted a higher ratio of those who had high scores on the YFAS and EAT-26 (p < 0.05). Overall, the ratio of YFAS high scorers was higher in the case of EAT-26 high scorers (32.6%) than that of low scorers (14.7%) (p < 0.001). A positive weak relationship existed between YFAS and EAT-26 scores (r = 0.165, p = 0.001) and the same between YFAS scores, weight, and body mass index (r = 0.263, p < 0.001; r = 0.319, p < 0.001, respectively). CONCLUSION In summary, a positive relation was found between food addiction, disordered eating behaviours and body mass index. Females were shown to have a higher risk of food addiction and eating disorders than that of males. Further studies can be carried out to analyze these correlations using a wider range of controlling factors. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Gülhan Şengör
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus via Mersin 10, Turkey
| | - Ceren Gezer
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus via Mersin 10, Turkey.
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Food Addiction in Eating Disorders and Obesity: Analysis of Clusters and Implications for Treatment. Nutrients 2019; 11:nu11112633. [PMID: 31684127 PMCID: PMC6893652 DOI: 10.3390/nu11112633] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/30/2019] [Accepted: 10/14/2019] [Indexed: 12/30/2022] Open
Abstract
Food addiction (FA) has been associated with greater psychopathology in individuals with eating disorders (ED) and obesity (OBE). The current study aims to provide a better phenotypic characterization of the FA construct by conducting a clustering analysis of FA in both conditions (ED and OBE). The total sample was comprised of 234 participants that scored positive on the Yale Food Addiction Scale 2.0. (YFAS-2) (119 bulimia nervosa (BN), 50 binge eating disorder (BED), 49 other specified feeding or eating disorder (OSFED) and 16 OBE). All participants completed a comprehensive battery of questionnaires. Three clusters of FA participants were identified. Cluster 1 (dysfunctional) was characterized by the highest prevalence of OSFED and BN, the highest ED severity and psychopathology, and more dysfunctional personality traits. Cluster 2 (moderate) showed a high prevalence of BN and BED and moderate levels of ED psychopathology. Finally, cluster 3 (adaptive) was characterized by a high prevalence of OBE and BED, low levels of ED psychopathology, and more functional personality traits. In conclusion, this study identified three distinct clusters of ED-OBE patients with FA and provides some insight into a better phenotypic characterization of the FA construct when considering psychopathology, personality and ED pathology. Future studies should address whether these three food addiction categories are indicative of therapy outcome.
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Abstract
PURPOSE OF REVIEW The aim of this review is to describe animal models that simulate the features of eating disorders. The literature pertaining to animal models that are of relevance for clinical eating disorders and the possible underpinning mechanisms was reviewed using PubMed, Ovid database and Google Scholar. RECENT FINDINGS New refinements of the circuits regulated by neurotransmitters and neuropeptides which instigate eating behaviours and the various feedback pathways which monitor acute and chronic nutrient status continue to be discovered. Moreover, work with the animal models that simulate the behavioural features and risk factors related to eating disorders is flourishing and providing new insights into possible causal mechanisms. For example, rodents develop binge-eating behaviours if they are intermittently exposed to processed, palatable foods and/or sugar adulterated drinks. This led to the controversial conceptualization of binge eating as a form of food addiction. Self-starvation taken to a fatal consequence such as occurs in anorexia nervosa can emerge in rodents exposed to triggers like social exclusion and/or the opportunity to exercise. SUMMARY There are plausible animal models for both anorexia nervosa and binge-eating disorders. These can be used to elaborate the theoretical models to explain the mechanisms underpinning eating disorders.
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Leslie M, Leppanen J, Paloyelis Y, Treasure J. The influence of oxytocin on eating behaviours and stress in women with bulimia nervosa and binge eating disorder. Mol Cell Endocrinol 2019; 497:110354. [PMID: 30579958 DOI: 10.1016/j.mce.2018.12.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 12/12/2022]
Abstract
The current study aimed to test the influence of oxytocin on palatable food intake, 24-h caloric consumption, and stress in women with bulimia nervosa and binge eating disorder. We recruited 25 women with DSM-5 bulimia nervosa or binge eating disorder, and 27 weight-matched comparison women without history of an eating disorder. We employed a double-blind, placebo-controlled crossover design in which each participant attended the lab for two experimental sessions, receiving a divided dose of 64IU intranasal oxytocin in one session and equivalent volume of placebo nasal spray in the opposite session. The order of administration was pseudo-randomised across participants. We hypothesised that a divided dose of 64IU intranasal oxytocin administration would reduce subjective hunger, the immediate consumption of palatable food, 24-h calorie consumption, and the incidence of binge eating when compared to placebo. We also hypothesised that oxytocin administration would be associated with lower levels of stress and salivary cortisol, and that there would be an interaction with participant group such that oxytocin would reduce eating behaviour and stress to a greater degree in women with bulimia nervosa or binge eating disorder, compared to women without history of an eating disorder. We did not find a significant effect of oxytocin on any of the measurements of eating behaviour, subjective stress, or salivary cortisol. We recommend that future studies test the dose-response effect of oxytocin on eating behaviours and stress in human populations with eating disorders to further clarify the moderating factors for oxytocin's effect on eating.
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Affiliation(s)
- Monica Leslie
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN) - King's College London (KCL), London, United Kingdom.
| | - Jenni Leppanen
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN) - King's College London (KCL), London, United Kingdom
| | - Yannis Paloyelis
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN) - King's College London (KCL), London, United Kingdom
| | - Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN) - King's College London (KCL), London, United Kingdom
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40
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Preuss H, Leister L, Pinnow M, Legenbauer T. Inhibitory control pathway to disinhibited eating: A matter of perspective? Appetite 2019; 141:104297. [DOI: 10.1016/j.appet.2019.05.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 04/14/2019] [Accepted: 05/21/2019] [Indexed: 11/25/2022]
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Schell SE, Brassard SL, Racine SE. Extending the Acquired Preparedness model of binge eating: Testing the indirect effects of high-risk personality traits on binge eating via positive and negative reinforcement expectancies. Appetite 2019; 140:206-212. [DOI: 10.1016/j.appet.2019.05.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/21/2019] [Accepted: 05/14/2019] [Indexed: 11/24/2022]
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42
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Leslie M, Leppanen J, Paloyelis Y, Nazar BP, Treasure J. The influence of oxytocin on risk-taking in the balloon analogue risk task among women with bulimia nervosa and binge eating disorder. J Neuroendocrinol 2019; 31:e12771. [PMID: 31283053 DOI: 10.1111/jne.12771] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/09/2019] [Accepted: 07/03/2019] [Indexed: 12/12/2022]
Abstract
Previous theoretical models of bulimia nervosa (BN) and binge eating disorder (BED) have implicated cross-domain risk-taking behaviour as a significant maintenance factor in both disorders. The present study aimed to test this hypothesis by administering the Balloon Analogue Risk Task (BART) to 25 women with BN or BED and 27 healthy comparison women without a history of an eating disorder. Furthermore, we tested the effect of a divided dose of 64 IU of oxytocin on risk-taking behaviour in the BART. Contrary to our hypothesis, women with BN or BED did not exhibit baseline differences in performance on the BART in the placebo condition (t = 1.42, df = 50, P = 0.161, d = 0.39). Oxytocin did not have a main effect on performance in the BART (F = 0.01, df = 1, P = .907, η2partial < 0.001); however, there was an interaction, such that participants in the BN/BED participant group, compared to the healthy comparison group, demonstrated safer behaviour on the BART in the oxytocin condition, but not in the placebo condition (F = 4.29, df = 1, P = 0.044, η2partial = 0.082). These findings cast doubt on the common assumption that individuals with BN and BED exhibit greater risk-taking behaviour in all domains and add to the evidence that oxytocin plays a functional role in modulating behaviours that entail trade-offs between reward approach and risk in humans. We recommend that future dose-response studies investigate the effect of oxytocin on reward approach behaviour further in women with recurrent binge eating behaviour, as well as the clinical significance of this effect.
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Affiliation(s)
- Monica Leslie
- King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
| | - Jenni Leppanen
- King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
| | - Yannis Paloyelis
- King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
| | - Bruno Palazzo Nazar
- King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Janet Treasure
- King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
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43
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Towards a Translational Approach to Food Addiction: Implications for Bulimia Nervosa. CURRENT ADDICTION REPORTS 2019. [DOI: 10.1007/s40429-019-00264-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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44
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Chami R, Cardi V, Lautarescu A, Mallorquí-Bagué N, McLoughlin G. Neural responses to food stimuli among individuals with eating and weight disorders: a systematic review of event-related potentials. Int Rev Psychiatry 2019; 31:318-331. [PMID: 31246114 DOI: 10.1080/09540261.2019.1622515] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A systematic review was conducted to investigate event-related potentials (ERPs) in response to food and non-food stimuli among individuals with eating and weight disorders. Limiting the search to studies that have analysed ERPs relating to motivated attention and inhibitory control, 19 research papers were extracted from a systematic search in PubMed, Ovid, and Web of Science (2000-2018). An enhanced attentional bias towards food over non-food images (as indexed by P3(00) and LPP amplitudes) was evident for all populations. Individuals with binge eating disorder showed an enhanced attentional response to food cues compared to healthy controls. Inhibitory control-related ERP components (N2(00) and P3a) increased during food-specific no-go trials, but did not differentiate overweight from 'healthy' weight groups. The N2 amplitude to food pictures were positively correlated with caloric intake and food craving among individuals with obesity and binge eating disorder, respectively, while P3(00) was sensitive to hunger levels among overweight and obese females. The heterogeneity of stimuli/paradigms adopted, component timescales extracted, ERPs analysed, and data presented has challenged this review's ability to produce a robust synthesis of results. Some recommendations for future research are discussed.
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Affiliation(s)
- Rayane Chami
- a Department of Psychological Medicine, Section of Eating Disorders , Institute of Psychiatry, Psychology, & Neuroscience (IoPPN), King's College London , London , UK
| | - Valentina Cardi
- a Department of Psychological Medicine, Section of Eating Disorders , Institute of Psychiatry, Psychology, & Neuroscience (IoPPN), King's College London , London , UK
| | - Alexandra Lautarescu
- b Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, & Neuroscience (IoPPN) , King's College London , London , UK
| | - Nuria Mallorquí-Bagué
- c Department of Psychiatry , Bellvitge University Hospital-IDIBELL , Barcelona , Spain.,d Ciber Fisiopatología Obesidad y Nutrición , Istituto Salud Carlos III , Madrid , Spain.,e Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu I Sant Pau , Biomedical Research Institute Sant Pau , Barcelona , Spain
| | - Grainne McLoughlin
- f Social, Genetic, and Developmental Psychiatry Centre (SGDP) , King's College London , London , UK
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45
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Abstract
PURPOSE OF REVIEW Adopting an addiction perspective on eating disorders and obesity may have practical implications for diagnostic classification, prevention, and treatment of these disorders. The present article critically examines these implications derived from the food addiction concept. RECENT FINDINGS Introducing food addiction as a new disorder in diagnostic classification system seems redundant as most individuals with an addiction-like eating behavior are already covered by established eating disorder diagnoses. Food addiction may be a useful metaphor in the treatment of binge eating, but would be inappropriate for the majority of obese individuals. Implying an addiction to certain foods is not necessary when applying certain approaches inspired by the addiction field for prevention and treatment of obesity. The usefulness of abstinence models in the treatment of eating disorders and obesity needs to be rigorously tested in future studies. Some practical implications derived from the food addiction concept provide promising avenues for future research (e.g., using an addiction framework in the treatment of binge eating or applying abstinence models). For others, however, the necessity of implying an addiction to some foods needs to be scrutinized.
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Affiliation(s)
- Adrian Meule
- Department of Psychology, University of Salzburg, Hellbrunner Straße 34, 5020, Salzburg, Austria.
- Center for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.
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46
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Puttevils L, Vanderhasselt MA, Vervaet M. Investigating transdiagnostic factors in eating disorders: Does self-esteem moderate the relationship between perfectionism and eating disorder symptoms? EUROPEAN EATING DISORDERS REVIEW 2019; 27:381-390. [PMID: 30734402 DOI: 10.1002/erv.2666] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE According to Fairburns transdiagnostic model of eating disorders (EDs), high levels of perfectionism and low self-esteem are two core traits across EDs. This study investigates the role of self-esteem as a transdiagnostic moderator of the relationship between perfectionism and ED symptoms across EDs. METHOD A large group of patients (n = 732) completed several questionnaires measuring perfectionism, self-esteem, and disordered eating symptomatology, more specifically, drive for thinness (DFT) and body dissatisfaction (BD). RESULTS Across EDs, self-esteem served as a moderator for the association between perfectionism and DFT. However, by testing the model for DFT in each ED separately, the effect only remained in patients with anorexia nervosa and ED not otherwise specified. When testing the model for BD, no moderation effect was found in any of the included EDs. CONCLUSIONS This study found that the interaction between perfectionism and self-esteem on DFT can be seen as transdiagnostic, although this effect is not found in each ED separately. These results suggest that ED treatment should consider to not only focus on transdiagnostic factors but also look at the specific impairments of each individual ED.
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Affiliation(s)
- Louise Puttevils
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Marie-Anne Vanderhasselt
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium.,Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Myriam Vervaet
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
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47
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Maracle AC, Normandeau CP, Dumont ÉC, Olmstead MC. Dopamine in the oval bed nucleus of the stria terminalis contributes to compulsive responding for sucrose in rats. Neuropsychopharmacology 2019; 44:381-389. [PMID: 30030542 PMCID: PMC6300551 DOI: 10.1038/s41386-018-0149-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/06/2018] [Accepted: 07/04/2018] [Indexed: 12/29/2022]
Abstract
Binge eating disorder (BED) is characterized by periods of excessive food intake combined with subjective feelings of loss of control. We examined whether sucrose bingeing itself leads to uncontrolled or compulsive responding and whether this effect is magnified following a period of abstinence. We then assessed dopamine (DA) modulation of inhibitory synaptic transmission in the oval bed nucleus of the stria terminalis (ovBNST) as a neural correlate of compulsive responding and whether this behavioral effect could be disrupted by DA blockade in the ovBNST. Over 28 days, male Long-Evans rats (n = 8-16 per group) had access to 10% sucrose and food (12 or 24 h), 0.1% saccharin and food (12 h), or food alone (12 h). Compulsive responding was assessed following 1 or 28 days of sucrose abstinence using a conditioned suppression paradigm. Only rats given 12 h access to sucrose developed binge-like intake, manifested as copious intake within the first hour; compulsive responding was significantly elevated in this group following 28 days of abstinence. In parallel, the effect of DA on ovBNST inhibitory transmission switched from a reduction to a potentiation; the effect, although observable after 1 day, was more pronounced and sustained following 28 days of abstinence. Intra-ovBNST infusions of a DA D1 receptor antagonist (0.8 µg/µl SCH-23390) reversed the blockade of conditioned suppression, thereby confirming the causal relationship between ovBNST DA modulation of γ-aminobutyric acid transmission and alterations in conditioned suppression following binge-like intake of sucrose.
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Affiliation(s)
- Amanda C Maracle
- Department of Psychology, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Catherine P Normandeau
- Center for Neuroscience Studies, Queen's University, Kingston, ON, K7L 3N6, Canada
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Éric C Dumont
- Center for Neuroscience Studies, Queen's University, Kingston, ON, K7L 3N6, Canada
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Mary C Olmstead
- Department of Psychology, Queen's University, Kingston, ON, K7L 3N6, Canada.
- Center for Neuroscience Studies, Queen's University, Kingston, ON, K7L 3N6, Canada.
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, K7L 3N6, Canada.
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48
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The use of a positive mood induction video-clip to target eating behaviour in people with bulimia nervosa or binge eating disorder: An experimental study. Appetite 2018; 133:400-404. [PMID: 30529607 DOI: 10.1016/j.appet.2018.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/29/2018] [Accepted: 12/05/2018] [Indexed: 12/11/2022]
Abstract
Recent theoretical models and empirical research have indicated that momentary negative affect increases the likelihood of binge eating episodes for individuals with bulimia nervosa and binge eating disorder. However, relatively little research has explored the potential for positive mood to serve a protective effect in reducing the likelihood of overeating behaviour in bulimia nervosa and binge eating disorder. The current study included 30 women with bulimia nervosa or binge eating disorder in a within-subjects crossover design. Following exposure to a video designed to induce food craving, we found that a positive mood vodcast was associated with significantly lower levels of negative mood and food consumption in a taste test meal, when compared to a neutral vodcast (p = 0.002). These findings support a role for decreasing negative mood in reducing the likelihood of binge eating behaviour in women with bulimia nervosa and binge eating disorder.
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49
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Wiss DA, Avena N, Rada P. Sugar Addiction: From Evolution to Revolution. Front Psychiatry 2018; 9:545. [PMID: 30464748 PMCID: PMC6234835 DOI: 10.3389/fpsyt.2018.00545] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 10/12/2018] [Indexed: 12/12/2022] Open
Abstract
The obesity epidemic has been widely publicized in the media worldwide. Investigators at all levels have been looking for factors that have contributed to the development of this epidemic. Two major theories have been proposed: (1) sedentary lifestyle and (2) variety and ease of inexpensive palatable foods. In the present review, we analyze how nutrients like sugar that are often used to make foods more appealing could also lead to habituation and even in some cases addiction thereby uniquely contributing to the obesity epidemic. We review the evolutionary aspects of feeding and how they have shaped the human brain to function in "survival mode" signaling to "eat as much as you can while you can." This leads to our present understanding of how the dopaminergic system is involved in reward and its functions in hedonistic rewards, like eating of highly palatable foods, and drug addiction. We also review how other neurotransmitters, like acetylcholine, interact in the satiation processes to counteract the dopamine system. Lastly, we analyze the important question of whether there is sufficient empirical evidence of sugar addiction, discussed within the broader context of food addiction.
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Affiliation(s)
- David A. Wiss
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Nicole Avena
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Pedro Rada
- School of Medicine, University of Los Andes, Mérida, Venezuela
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50
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Guerrero Pérez F, Sánchez-González J, Sánchez I, Jiménez-Murcia S, Granero R, Simó-Servat A, Ruiz A, Virgili N, López-Urdiales R, Montserrat-Gil de Bernabe M, Garrido P, Monseny R, García-Ruiz-de-Gordejuela A, Pujol-Gebelli J, Monasterio C, Salord N, Gearhardt AN, Carlson L, Menchón JM, Vilarrasa N, Fernández-Aranda F. Food addiction and preoperative weight loss achievement in patients seeking bariatric surgery. EUROPEAN EATING DISORDERS REVIEW 2018; 26:645-656. [DOI: 10.1002/erv.2649] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/17/2018] [Accepted: 09/24/2018] [Indexed: 12/19/2022]
Affiliation(s)
| | | | - Isabel Sánchez
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn); Instituto de Salud Carlos III; Madrid Spain
- Clinical Sciences Department, School of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
| | - Roser Granero
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn); Instituto de Salud Carlos III; Madrid Spain
- Department of Psychobiology and Methodology; Autonomous University of Barcelona; Barcelona Spain
| | - Andreu Simó-Servat
- Department of Endocrinology; University Hospital of Bellvitge; Barcelona Spain
| | - Ana Ruiz
- Department of Endocrinology; Joan XXIII University Hospital; Tarragona Spain
| | - Nuria Virgili
- Department of Endocrinology; University Hospital of Bellvitge; Barcelona Spain
| | | | | | - Pilar Garrido
- Dietetics and Nutrition Unit; University Hospital of Bellvitge; Barcelona Spain
| | - Rosa Monseny
- Dietetics and Nutrition Unit; University Hospital of Bellvitge; Barcelona Spain
| | - Amador García-Ruiz-de-Gordejuela
- Bariatric and Metabolic Surgery Unit, Service of General and Gastrointestinal Surgery; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
| | - Jordi Pujol-Gebelli
- Bariatric and Metabolic Surgery Unit, Service of General and Gastrointestinal Surgery; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
| | - Carmen Monasterio
- Pneumology Department; University Hospital of Bellvitge; Barcelona Spain
- CIBER Enfermedades Respiratorias (CibeRes); Instituto de Salud Carlos III; Madrid Spain
| | - Neus Salord
- Pneumology Department; University Hospital of Bellvitge; Barcelona Spain
- CIBER Enfermedades Respiratorias (CibeRes); Instituto de Salud Carlos III; Madrid Spain
| | | | - Lily Carlson
- Department of Psychology; University of Michigan; Ann Arbor Michigan
| | - José M. Menchón
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Clinical Sciences Department, School of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
- CIBER de Salud Mental (CIBERSAM); Instituto de Salud Carlos III; Madrid Spain
| | - Nuria Vilarrasa
- Department of Endocrinology; University Hospital of Bellvitge; Barcelona Spain
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas; Instituto de Salud Carlos III; Madrid Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn); Instituto de Salud Carlos III; Madrid Spain
- Clinical Sciences Department, School of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
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