1
|
Matheson BE. Bulimia Nervosa and Binge-Eating Disorder Across the Lifespan. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2024; 22:278-287. [PMID: 38988471 PMCID: PMC11231461 DOI: 10.1176/appi.focus.20240001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
This article aims to review the current evidence-based psychotherapy and psychopharmacological treatments for adults and youths with bulimia nervosa (BN) and binge-eating disorder (BED). Treatments for adults and for children and adolescents are discussed separately, including developmental considerations in the management of these disorders among youths. Although several evidence-based psychotherapy and psychopharmacological treatment options have been established for adults with BN or BED, there is much less empirical support for the management of these eating disorders among children and adolescents. This review concludes by discussing promising modalities and innovations, highlighting the potential utility of integrating technology into treatment approaches. Despite decades of treatment development and testing, a sizable proportion of individuals with BN or BED do not respond to the current evidence-based treatments, highlighting the need for continued research in these domains. Future research should focus on testing psychotherapy treatments among diverse samples in large, randomized controlled trials, as well as on treatments that can be easily scaled and implemented in community settings.
Collapse
Affiliation(s)
- Brittany E Matheson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| |
Collapse
|
2
|
LaFata EM, Allison KC, Audrain-McGovern J, Forman EM. Ultra-Processed Food Addiction: A Research Update. Curr Obes Rep 2024; 13:214-223. [PMID: 38760652 PMCID: PMC11150183 DOI: 10.1007/s13679-024-00569-w] [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] [Accepted: 04/22/2024] [Indexed: 05/19/2024]
Abstract
PURPOSE OF REVIEW Detail recent advancements in the science on ultra-processed food (UPF) addiction, focusing on estimated prevalence rates and emerging health disparities; progress towards identifying biological underpinnings and behavioral mechanisms; and implications for weight management. RECENT FINDINGS Notable developments in the field have included: (1) estimating the global prevalence of UPF addiction at 14% of adults and 15% of youths; (2) revealing health disparities for persons of color and those with food insecurity; (3) observing altered functioning across the brain-gut-microbiome axis; (4) providing early evidence for UPF withdrawal; and (5) elucidating poorer weight management outcomes among persons with UPF addiction. The breadth of recent work on UPF addiction illustrates continued scientific and public interest in the construct and its implications for understanding and treating overeating behaviors and obesity. One pressing gap is the lack of targeted interventions for UPF addiction, which may result in more optimal clinical outcomes for this underserved population.
Collapse
Affiliation(s)
- Erica M LaFata
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States.
| | - Kelly C Allison
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, United States
| | - Janet Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, United States
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States
- Department of Psychological and Brain Sciences, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States
| |
Collapse
|
3
|
Krug I, Dang AB, Hughes EK. There is nothing as inconsistent as the OSFED diagnostic criteria. Trends Mol Med 2024; 30:403-415. [PMID: 38395717 DOI: 10.1016/j.molmed.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
Atypical anorexia nervosa (AAN), purging disorder (PD), night eating syndrome (NES), and subthreshold bulimia nervosa and binge-eating disorder (Sub-BN/BED) are the five categories that comprise the 'Other Specified Feeding or Eating Disorder' (OSFED) category in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). In this review, we examine problems with the diagnostic criteria that are currently proposed for the five OSFED types. We conclude that the existing diagnostic criteria for OSFED are deficient and fall short of accurately describing the complexity and individuality of those with these eating disorders (EDs). Therefore, to enhance the quality of life of people with OSFED, diagnostic criteria for the condition should be applied uniformly in clinical and research settings.
Collapse
Affiliation(s)
- Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.
| | - An Binh Dang
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Elizabeth K Hughes
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| |
Collapse
|
4
|
Matheson BE, Bohon C, Le Grange D, Lock JD. Family-based treatment (FBT) for loss of control (LOC) eating in youth: Current knowledge and future directions. Eat Disord 2024; 32:1-12. [PMID: 38149636 PMCID: PMC10753090 DOI: 10.1080/10640266.2023.2229091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Loss of control (LOC) eating in youth is a common disordered eating behavior and associated with negative health and psychological sequalae. Family-based treatment (FBT) is an efficacious treatment for adolescent anorexia nervosa and bulimia nervosa (BN) but has not been formally evaluated for adolescents with LOC eating. This study is a secondary data analysis from a randomized controlled clinical trial (NCT00879151) testing FBT for 12-18-year-olds with BN. Data were reanalyzed to examine outcomes for LOC eating episodes, regardless of episode size. Abstinence rates, defined as zero LOC eating episodes (objective or subjective binge episodes) in the previous month, were calculated at the end-of-treatment (EOT), 6-month, and 12-month follow-up time points. Among 51 adolescent participants (M + SD: 15.94 + 1.53 y; 92% female; 23.5% Hispanic; 76.5% Caucasian), FBT significantly reduced LOC eating episodes, with 49% achieving LOC eating abstinence at EOT. At 6-month follow-up, 41% achieved LOC eating abstinence. Of those providing 12-month follow-up data, 73% achieved abstinence. This preliminary exploration suggests that FBT may be effective for youth with LOC eating, regardless of episode size. Additional research is needed to replicate these findings and extend treatments with developmental adaptations for younger children with LOC eating.
Collapse
Affiliation(s)
- Brittany E. Matheson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Cara Bohon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Equip Health, Inc., Carlsbad, CA, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago (Emeritus)
| | - James D. Lock
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
5
|
Carbone EA, Aloi M, Rania M, de Filippis R, Quirino D, Fiorentino TV, Segura-Garcia C. The relationship of food addiction with binge eating disorder and obesity: A network analysis study. Appetite 2023; 190:107037. [PMID: 37714336 DOI: 10.1016/j.appet.2023.107037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/17/2023]
Abstract
Food addiction (FA) has been associated with binge eating disorder (BED) and obesity at varying levels of severity and treatment outcomes. Despite much debate and scientific interest in FA, the mechanisms that underlie its co-occurrence with both conditions are not yet well understood. In order to understand this relationship, this study explores FA in a clinical sample of individuals with BED and obesity using network analysis (NA). A total of 303 patients (151 with BED and 152 with obesity) completed a battery of tests that investigated eating psychopathology, eating behaviours, emotional dysregulation, depression and FA. Two different NAs were conducted to investigate the interaction between these variables and FA. The BED and obesity groups were comparable in age (38 ± 14 vs. 42 ± 13 years), body mass index (38.8 ± 8.5 vs 42.4 ± 7.8), sex and demographics. According to the expected influence values, binge eating severity and depression were identified as the central nodes in both networks. In the BED group, binge eating severity was the central node and showed strong connections to both FA and grazing. In contrast, in the obesity group, depression was the central node, but its connections were weak, with only marginal associations to FA. These results suggest that FA represents an important and distinct construct of the two populations. In patients with BED, FA is intimately connected to other loss-of-control-related eating behaviours, such as binge eating and grazing. Conversely, in those with obesity, depression explains the relationship of FA with pathological eating behaviours. The presence of FA seems to be a distinguishing characteristic in the psychopathology of patients suffering from obesity with and without BED, and this could have implications for the prevention, treatment and management of these disorders.
Collapse
Affiliation(s)
- Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Matteo Aloi
- Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy; Department of Health Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Marianna Rania
- Center for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, 88100, Catanzaro, Italy
| | - Renato de Filippis
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Daria Quirino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy; Center for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, 88100, Catanzaro, Italy.
| |
Collapse
|
6
|
Salameh-Dakwar R, Elran-Barak R, Zahra-Zeitoun Y, Soroka G, Froylich D, Assalia A, Latzer Y. Interpersonal Characteristics and Binge Eating among Patients Pursuing Bariatric Surgery. Healthcare (Basel) 2023; 11:2836. [PMID: 37957980 PMCID: PMC10647538 DOI: 10.3390/healthcare11212836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Preoperative binge eating behavior has been associated with difficulties in weight loss maintenance among patients pursuing bariatric surgery. However, limited data exists on the relationship between interpersonal difficulties and binge eating. OBJECTIVES To identify interpersonal factors linked with binge eating among bariatric surgery candidates. SETTING One hundred and seventeen adult bariatric surgery candidates (BMI = 42.2 ± 5.2) from three different hospitals completed questionnaires on the day of their bariatric committee meeting for operation approval. METHODS Binge eating was assessed using the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) as a dichotomous variable. Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES), and interpersonal characteristics were evaluated using the short version of the Inventory of Interpersonal Problems (IIP-32). Sociodemographic variables (age, gender, income, education) and BMI were considered as confounders. RESULTS Approximately 25% of bariatric surgery candidates reported experiencing binge eating episodes within the previous three months. Participants with binge eating exhibited significantly lower self-esteem and more interpersonal difficulties, particularly in the domains of aggressiveness and dependence, compared to those without binge eating. Logistic regression analysis revealed that aggressiveness was a significant predictor of binge eating in this sample. CONCLUSIONS This study is the first, to the best of our knowledge, to investigate the relationship between interpersonal difficulties and binge eating among bariatric surgery candidates. The findings highlight the significant contribution of aggressiveness to binge eating and emphasize the importance of clinicians assessing patients' interpersonal functioning, particularly with regard to aggressiveness, as a factor that may contribute to the maintenance and occurrence of binge eating behaviors.
Collapse
Affiliation(s)
| | - Roni Elran-Barak
- School of Public Health, University of Haifa, Haifa 3498838, Israel
| | | | | | | | | | - Yael Latzer
- School of Public Health, University of Haifa, Haifa 3498838, Israel
- Rambam Medical Center, Haifa 3109601, Israel
| |
Collapse
|
7
|
Davis HA, Smith GT. Examining the role of urgency in predicting binge size in bulimia nervosa. Front Psychol 2023; 14:1166119. [PMID: 37325755 PMCID: PMC10264643 DOI: 10.3389/fpsyg.2023.1166119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/02/2023] [Indexed: 06/17/2023] Open
Abstract
Greater binge size within bulimia nervosa is associated with elevated distress and impairment. Theoretical models posit that emotion dysregulation predicts binge eating, but little research has investigated the potential for dispositional traits that reflect difficulty in emotion regulation to predict binge size among women with bulimia nervosa. Research supports that negative urgency, the tendency to act rashly when feeling distressed, is associated with binge eating behavior among individuals with bulimia nervosa. Relatively fewer studies have explored associations between binge eating and positive urgency, the tendency to act rashly when feeling extreme positive affect. The urgency traits may predict greater binge size within bulimia nervosa. The current study sought to examine negative urgency and positive urgency as predictors of test meal intake in a sample of 50 women, n = 21 with bulimia nervosa and n = 29 healthy controls. Dispositional levels of positive urgency, negative urgency, positive affect, and negative affect were measured prior to a laboratory binge eating paradigm. Participants in the bulimia nervosa group scored higher on negative urgency, positive urgency, and negative affect than participants in the control group. Across participants, lower levels of negative affect were associated with greater test meal intake. Elevated levels of positive urgency predicted significantly greater test meal intake, but only for participants with bulimia nervosa. No other dispositional traits predicted test meal intake when the interaction of positive urgency and group was included in the model. Findings suggest positive urgency is an underappreciated, but potentially important, risk factor for greater binge size in bulimia nervosa.
Collapse
Affiliation(s)
- Heather A. Davis
- Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Gregory T. Smith
- Department of Psychology, University of Kentucky, Lexington, KY, United States
| |
Collapse
|
8
|
Food Addiction: a Deep Dive into ‘Loss of Control’ and ‘Craving’. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00431-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Abstract
Purpose of Review
The majority of existing research discusses food addiction (FA) classification, which provides information for different groups and which groups may or may not be affected to differing degrees. Fewer studies report FA symptom scores, and fewer still report on individual symptoms. This paper discusses the symptoms of craving and loss of control as they are common FA symptoms that demonstrate similarities with both substance use disorders and some eating disorder pathology.
Recent Findings
Loss of control presents parallels with disordered eating, particularly binge eating disorder. Craving refers to the powerful or strong desire for something and, in contrast to lack of control, presents most overlap with substance use disorders.
Summary
While not the most common symptoms reported in published research, loss of control and craving attract attention because of parallels with substance use and eating disorder pathology, and research has increasingly focused on these symptoms in recent years.
Collapse
|