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Pasquale EK, Strong DR, Manzano MA, Eichen DM, Peterson CB, Boutelle KN. Exploring relationships among appetitive traits, negative affect, and binge eating in adults with overweight or obesity. Eat Behav 2024; 53:101871. [PMID: 38518632 PMCID: PMC11144099 DOI: 10.1016/j.eatbeh.2024.101871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/09/2024] [Accepted: 03/13/2024] [Indexed: 03/24/2024]
Abstract
Binge eating (BE) is a significant public health concern due to its prevalence and impact on mental and physical health. While research has suggested both negative affect and appetitive traits are associated with BE, few studies have investigated these constructs concurrently. Structural equation modeling (SEM) evaluated relationships between negative affect, reward-related appetitive traits, and BE among 293 adults with overweight or obesity (OW/OB) seeking treatment for BE, overeating, and weight management (m age = 46.6; m body mass index[BMI] = 34.5; 81.2 % female; 20.1 % Latinx, 60.8 % White non-Latinx). BE was related to negative affect (β = 0.53; p < 0.01) and appetitive traits (β = 1.53; p < 0.001). Negative affect and appetitive traits were related to one another (r = 0.42; p < 0.001), and the full model accounted for 77 % of the variance in BE. In an exploratory follow-up analysis, multigroup SEM evaluated the above relationships in models stratified by sex. Exploratory findings demonstrated both negative affect and appetitive traits were related to BE across sex, particularly when examining BE cognitions and behaviors. However, relationships in men depended upon BE assessment tool. These findings highlight that both negative affect and appetitive traits are related to BE, and jointly may represent significant risk and maintenance factors, particularly in adults with OW/OB. Our findings also highlight the importance of future investigation of sex differences in BE and the potential impact of assessment method.
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Affiliation(s)
- Ellen K Pasquale
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Michael A Manzano
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Dawn M Eichen
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West 2450 Riverside Ave, Minneapolis, MN 55454, USA
| | - Kerri N Boutelle
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
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Andersen ST, Strandberg-Larsen K, Skovgaard AM, Rimvall MK, Meyer LB, Olsen EM. Comparison of prevalence and mental health problems across symptom frequency of self-reported symptoms of binge-eating disorder in a community sample of adolescents. Int J Eat Disord 2023; 56:1947-1960. [PMID: 37458303 DOI: 10.1002/eat.24023] [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: 11/19/2022] [Revised: 06/30/2023] [Accepted: 07/01/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Binge-eating disorder (BED) and subthreshold BED (SBED) are prevalent in adults and associated with mental health problems including depression, non-suicidal self-injury, lower quality of life, and suicidality. There is solid evidence that binge-eating behaviors are also prevalent in adolescence, but knowledge about mental health in community adolescents with BED of different frequency thresholds is more limited. We aimed to investigate the prevalence and mental health problems associated with SBED of low frequency and/or limited duration compared with BED in a Danish community sample of adolescents. METHODS We included 2509 adolescents who completed the online survey of the 16-17-year follow-up of the Copenhagen Child Cohort (CCC2000), including items on BED symptoms approximating the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, and items on mental health and quality of life. RESULTS The 1-year prevalence of SBED was 2.7% (95% confidence interval [CI]: 2.0%-3.3%) with a male:female ratio of 1:3.7; comparable to previous findings on BED in the same sample. SBED was also comparable to BED concerning cross-sectional associations with overall mental health problems, lower health-related quality of life, depressive symptoms, and suicidal ideation, whereas no associations were seen with non-suicidal self-injury after Holm-Bonferroni correction. In both groups, thoughts and behaviors concerning food and weight interfered significantly with daily life. DISCUSSION SBED and BED were equally prevalent in this adolescent community sample, and similarly associated with indicators of poor mental health. The findings indicate that community adolescents reporting symptoms approximating clinical criteria of BED need intervention irrespectively of symptom frequency or duration. PUBLIC SIGNIFICANCE This study adds knowledge to the field by comparing BED of low frequency and/or limited duration ("subthreshold BED," SBED) with full-syndrome BED in adolescents and showing that SBED in adolescence is both prevalent and associated with poor mental health to a similar extent as that of BED. Findings indicate that self-reported symptoms according to clinical criteria of SBED and BED alike constitute a public health problem and point to youngsters in need of intervention.
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Affiliation(s)
- Sofie Thor Andersen
- The Danish Patient Association of Eating Disorders and Self-Harm, Valby, Denmark
| | - Katrine Strandberg-Larsen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Copenhagen, Denmark
| | - Martin Køster Rimvall
- Child and Adolescent Mental Health Center, Mental Health Services, The Capital Region, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital, Psychiatry Region Zealand, Roskilde, Denmark
| | - Lene Bomholt Meyer
- The Research Unit for General Practice, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Else Marie Olsen
- Section for Epidemiology, Center for Clinical Research and Prevention, The Capital Region, Copenhagen, Denmark
- Outpatient Clinic for Eating Disorders in Adults, Psychiatric Centre Ballerup, The Capital Region, Copenhagen, Denmark
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Yoon C, Mai D, Kinariwala K, Ledoux T, Betts R, Johnston C. Sex and ethnic/racial differences in disordered eating behaviors and intuitive eating among college student. Front Psychol 2023; 14:1221816. [PMID: 37790230 PMCID: PMC10543694 DOI: 10.3389/fpsyg.2023.1221816] [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: 05/23/2023] [Accepted: 08/28/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction Eating behaviors encompass disordered eating behaviors (e.g., overeating, binge eating, and associated symptoms of binge eating) and intuitive eating. Certain disordered eating behaviors, including binge eating, are more prevalent among female and ethnic/racial-minority college students than male and/or non-Hispanic White college students. However, sex and ethnic/racial differences among college students with other disordered eating (e.g., associated symptoms of binge eating) and intuitive eating behaviors remain unclear. Methods In 2022, 887 college students (Mage = 20.9 ± 2.6 years) self-reported their sex, ethnicity/race, disordered eating behaviors (e.g., overeating, binge eating, associated symptoms of binge eating), and intuitive eating. To examine sex and ethnic/racial differences among these students, we used modified Poisson regressions for students who reported disordered eating and linear regressions for students who reported intuitive eating. Results Except for overeating, disordered eating behaviors were more prevalent among female [adjusted prevalence ratio (aPR) = 1.3-1.8] than male college students after adjusting for sociodemographic variables, whereas intuitive eating scores did not differ by sex. Across ethnic/racial groups, disordered eating was more prevalent among all ethnic/racial-minority college students (aPR = 1.2-2.3) than non-Hispanic White college students after adjusting for sociodemographic variables. Moreover, non-Hispanic Black or African American college students had higher intuitive eating scores than non-Hispanic White college students (adjusted β = 0.7, 95% CI = -0.2, 1.6). Conclusion In our sample, notable differences emerged in the prevalence of disordered eating behaviors and mean scores by sex and ethnicity/race, while differences in intuitive eating scores emerged based on ethnicity/race.
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Affiliation(s)
- Cynthia Yoon
- Department of Health and Human Performance, University of Houston, Houston, TX, United States
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Greene AK, Norling HN, Brownstone LM, Maloul EK, Roe C, Moody S. Visions of recovery: a cross-diagnostic examination of eating disorder pro-recovery communities on TikTok. J Eat Disord 2023; 11:109. [PMID: 37400909 DOI: 10.1186/s40337-023-00827-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 06/14/2023] [Indexed: 07/05/2023] Open
Abstract
Individuals seeking support or inspiration for eating disorder recovery may turn to pro-recovery content on social media sites such as TikTok. While research has thus far treated pro-recovery social media as a fairly homogeneous space, many pro-recovery hashtags single out particular eating disorder diagnoses. This exploratory study used codebook thematic analysis of 241 popular pro-recovery videos on TikTok to compare the presentation of eating disorders and eating disorder recovery across five different diagnosis-specific hashtags: #anarecovery, #arfidrecovery, #bedrecovery, #miarecovery, and #orthorexiarecovery. These hashtags refer to the following eating disorder diagnoses respectively: anorexia nervosa, avoidant restrictive food intake disorder, binge eating disorder, bulimia nervosa, and orthorexia nervosa. Our analysis generated the following qualitative themes across the entire dataset: (1) centrality of food to eating disorders and recovery, (2) what eating disorders look and feel like, (3) recovery as a process, (4) getting and giving help, and (5) negotiating diet culture in recovery. To supplement our qualitative findings and facilitate cross-diagnostic comparisons, we also conducted one-way ANOVAs and chi-square tests to probe for statistically significant differences in audience engagement and code prevalence across the different hashtags. Our results indicate that there are clear differences in how recovery is envisioned on TikTok based on which diagnostic hashtags are employed. Such variations in how different eating disorders are imagined on popular social media demand further investigation and clinical consideration.
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Affiliation(s)
- Amanda K Greene
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, 2800 Plymouth Road, Bldg. 14, G016, Ann Arbor, MI, 48109, USA.
| | - Hannah N Norling
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, 1999 East Evans Avenue, Denver, CO, 80208-1700, USA
| | - Lisa M Brownstone
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, 1999 East Evans Avenue, Denver, CO, 80208-1700, USA
| | - Elana K Maloul
- Department of English Language and Literature, University of Michigan, 435 South State Street, Ann Arbor, MI, 48104, USA
| | - Caity Roe
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, 1999 East Evans Avenue, Denver, CO, 80208-1700, USA
| | - Sarah Moody
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, 1999 East Evans Avenue, Denver, CO, 80208-1700, USA
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Schuller J, Koch M. Investigating a role of orexin and ‘cocaine- and amphetamine-regulated transcript’ in the nucleus accumbens shell in binge eating of male rats and the relationship with impulsivity. Physiol Behav 2022; 257:114000. [DOI: 10.1016/j.physbeh.2022.114000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
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Horvath S, Cox S, Tabone J, Tabone L, Szoka N, Abunnaja S, Aylward L. Binge Eating in Patients Pursuing Bariatric Surgery: Understanding Relationships with Food Insecurity and Adverse Childhood Experiences. Surg Obes Relat Dis 2022; 19:484-490. [PMID: 36528545 DOI: 10.1016/j.soard.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/30/2022] [Accepted: 11/03/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Positive relationships exist between adult food insecurity and binge eating, and between adverse childhood experiences and binge eating. However, the nature of these relationships remains to be determined. OBJECTIVES The current study sought to examine the association between binge eating and childhood abuse and/or neglect and household dysfunction and to explore whether the strength of the relationship between adverse childhood experiences and binge eating differs across levels of food insecurity in patients seeking bariatric surgery. SETTING University Hospital in the Appalachian region of United States. METHODS A total of 366 adults seeking bariatric surgery completed validated questionnaires as a component of a routine psychological evaluation prior to surgery. RESULTS Only childhood experiences of abuse and/or neglect were positively related to adult binge eating, r(363) = .13, P = .011. Food insecurity moderated the relationship between adverse childhood experiences and binge eating, F(4, 358) = 242.98, P < .001, such that the relationship was stronger for individuals who endorsed the presence of both food insecurity and adverse childhood experiences (M = 15.90; standard deviation [SD] = 8.38), relative to individuals who endorsed the absence of both food insecurity and adverse childhood experiences (M = 11.19; SD = 7.91; Tukey P = .005; d = .58). CONCLUSIONS Food insecurity strengthens the relationship between adverse childhood experiences and adult binge eating. Results suggest that healthcare providers should include assessments of both adverse childhood experiences and food insecurity to identify patients who may be at risk for disordered eating prior to surgery, as these individuals may require additional interventions to address binge eating and related factors.
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Affiliation(s)
- Sarah Horvath
- West Virginia University School of Medicine, Department of Behavioral Medicine and Psychiatry, Morgantown, West Virginia.
| | - Stephanie Cox
- West Virginia University School of Medicine, Department of Behavioral Medicine and Psychiatry, Morgantown, West Virginia
| | - Jiyoung Tabone
- West Virginia University School of Social Work, Morgantown, West Virginia
| | - Lawrence Tabone
- West Virginia University School of Medicine, Department of Surgery, Morgantown, West Virginia
| | - Nova Szoka
- West Virginia University School of Medicine, Department of Surgery, Morgantown, West Virginia
| | - Salim Abunnaja
- West Virginia University School of Medicine, Department of Surgery, Morgantown, West Virginia
| | - Laura Aylward
- West Virginia University School of Medicine, Department of Behavioral Medicine and Psychiatry, Morgantown, West Virginia
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Bray B, Bray C, Bradley R, Zwickey H. Mental health aspects of binge eating disorder: A cross-sectional mixed-methods study of binge eating disorder experts' perspectives. Front Psychiatry 2022; 13:953203. [PMID: 36186859 PMCID: PMC9520774 DOI: 10.3389/fpsyt.2022.953203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Binge eating disorder has high comorbidity with a variety of mental health diagnoses and significantly impairs quality of life. This mixed-methods cross-sectional survey study aimed to collect information from experts in the field about mental health issues pertaining to adult binge eating disorder pathology. Fourteen expert binge eating disorder researchers and clinicians were identified based on history of NIH R01 funding, relevant PubMed-indexed publications, active practice in the field, leadership in related professional societies, and/or distinction in popular press. Semi-structured interviews were anonymously recorded and analyzed by ≥2 investigators using reflexive thematic analysis and quantification. The domains of depression, anxiety, attention deficit disorder (ADD)/attention deficit hyperactive disorder (ADHD), substance-related and addictive disorders (SRADs), obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) were addressed in relation to binge eating disorder pathology by 100, 100, 93, 79, 71, and 64% of participants, respectively. Depression and anxiety seem to be the most commonly recognized mental health comorbidities among experts participating in this study. These expert perceptions generally align with the most comprehensive and up-to-date information available on mental health comorbidity prevalence data in adult binge eating disorder, though updated surveys are warranted. The findings from this study highlight the importance of screening for binge eating disorder among individuals with Axis-I mental health diagnoses (e.g., depression and other mood disorders, anxiety disorders, ADD/ADHD, and SRADs). Research on underlying mechanisms that link various Axis-I disorders to binge eating disorder is also warranted and recommended by the experts.
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Affiliation(s)
- Brenna Bray
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, United States
| | - Chris Bray
- Wilder Research Division, Amherst H. Wilder Foundation, Saint Paul, MN, United States
| | - Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, United States
- Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United States
| | - Heather Zwickey
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, United States
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An exploratory study of associations between the ICD-11 personality disorder model and eating pathology. J Eat Disord 2022; 10:130. [PMID: 36045403 PMCID: PMC9429753 DOI: 10.1186/s40337-022-00658-y] [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: 04/25/2022] [Accepted: 08/24/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Recently, the International Classification of Diseases 11th Revision (ICD-11) has introduced a paradigm shift in personality disorder conceptualization. The novel ICD-11 personality disorder model comprises a dimensional assessment of personality dysfunction and five maladaptive personality trait domains. Maladaptive personality plays a central role in eating pathology. Yet, relations between the ICD-11 personality disorder model and eating pathology are, to date, unclear. Thus, this study aimed to explore the bivariate, incremental, and interactive associations of the ICD-11 personality disorder model components with eating pathology domains. METHODS A predominantly female (85%) sample of 888 German-speaking community adults completed validated self-report measures of personality dysfunction, the ICD-11 personality trait domains, and five eating pathology domains (drive for thinness, bulimia, body dissatisfaction, orthorexia, binge eating). Bivariate and hierarchical regressions models were used to investigate bivariate, incremental, and interactive relations between the ICD-11 personality disorder model components and eating pathology. RESULTS Personality dysfunction and the ICD-11 personality trait domains showed statistically significant bivariate relations with eating pathology. Additionally, personality dysfunction and most ICD-11 personality trait domains displayed incremental links with eating pathology. Finally, the relations of the ICD-11 personality trait domains with eating pathology were largely independent of the severity of personality dysfunction. CONCLUSIONS This study indicated that all ICD-11 personality disorder model components are uniquely linked to eating pathology. Beyond maladaptive personality trait domains, the strong and incremental relations of personality dysfunction with eating pathology have potential implications for theory building. Further research using longitudinal designs is needed to evaluate causal links between the ICD-11 personality disorder model components and eating pathology.
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Bernabéu-Brotóns E, Marchena-Giráldez C. Emotional Eating and Perfectionism as Predictors of Symptoms of Binge Eating Disorder: The Role of Perfectionism as a Mediator between Emotional Eating and Body Mass Index. Nutrients 2022; 14:nu14163361. [PMID: 36014866 PMCID: PMC9415756 DOI: 10.3390/nu14163361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/11/2022] [Accepted: 08/13/2022] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Perfectionism has been linked to eating disorders and might be a risk factor for the appearance of eating pathologies. The aims of this study are (a) to verify the relationship between perfectionism, emotional eating (EE), binge eating (BE), and body mass index (BMI); (b) to identify the variables that predict BE symptoms and BMI; (c) to study the role of perfectionism as a mediator between EE and BMI. (2) Methods: 312 adult participants answered a cross-sectional survey that included the Multidimensional Perfectionism Scale, the Emotional Eater Questionnaire (EEQ), the Binge Eating Scale (BES), and a sociodemographic questionnaire including BMI. (3) Results: The results suggest a direct correlation between EE, BE, and BMI, showing that EE is a powerful predictor of BE symptoms and BMI. Furthermore, two dimensions of perfectionism have a mediator role between EE and BMI, specifically doubts and actions and concern over mistakes: the presence of these two components of perfectionism reverses the relationship between EE and BMI. (4) Conclusions: These results have significant implications for the understanding of the two different (pathological) eating patterns: intake restriction and overeating and should be considered in intervention programs.
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Bray B, Bray C, Bradley R, Zwickey H. Binge Eating Disorder Is a Social Justice Issue: A Cross-Sectional Mixed-Methods Study of Binge Eating Disorder Experts' Opinions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6243. [PMID: 35627779 PMCID: PMC9141064 DOI: 10.3390/ijerph19106243] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Binge eating disorder is an autonomous DSM-V diagnosis characterized by discrete rapid consumption of objectively large amounts of food without compensation, associated with loss of control and distress. Environmental factors that contribute to binge eating disorder continue to evolve. This mixed-methods cross-sectional study assessed whether there is consensus among experts in the field about environmental factors that influence adult binge eating disorder pathology. METHODS Fourteen expert binge eating disorder researchers, clinicians, and healthcare administrators were identified internationally based on federal funding, PubMed-indexed publications, active practice in the field, leadership in relevant societies, and/or clinical and popular press distinction. Semi-structured interviews were recorded anonymously and analyzed by ≥2 investigators using reflexive thematic analysis and quantification. RESULTS Identified themes included: (1) systemic issues and systems of oppression (100%); (2) marginalized and under-represented populations (100%); (3) economic precarity and food/nutrition insecurity/scarcity (93%); (4) stigmatization and its psychological impacts (93%); (5) trauma and adversity (79%); (6) interpersonal factors (64%); (7) social messaging and social media (50%); (8) predatory food industry practices (29%); and (9) research/clinical gaps and directives (100%). CONCLUSIONS Overall, experts call for policy changes around systemic factors that abet binge eating and for greater public education about who can have binge eating disorder. There is also a call to take and account for the narratives and life experiences of individuals with binge eating disorder to better inform our current understanding of the diagnosis and the environmental factors that impact it.
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Affiliation(s)
- Brenna Bray
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (R.B.); (H.Z.)
| | - Chris Bray
- Wilder Research Division, Amherst H. Wilder Foundation, Saint Paul, MN 55104, USA;
| | - Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (R.B.); (H.Z.)
- Herbert Wertheim School of Public Health, University of California, San Diego, CA 97037, USA
| | - Heather Zwickey
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (R.B.); (H.Z.)
- Herbert Wertheim School of Public Health, University of California, San Diego, CA 97037, USA
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11
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Conceição EM, Moreira CS, de Lourdes M, Ramalho S, Vaz AR. Exploring Correlates of Loss of Control Eating in a Nonclinical Sample. Front Psychol 2022; 12:787558. [PMID: 35222152 PMCID: PMC8874330 DOI: 10.3389/fpsyg.2021.787558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
ObjectiveLoss of control (LOC) eating has been directly related to the core aspects of the psychopathology of eating disorders and to different dimensions of emotion and behavior regulation and self-criticism. This study investigates a model representing the interplay between these dimensions to understand LOC eating among a nonclinical sample.MethodsA total of 341 participants, recruited in a college campus (mean age 23.21, SD = 6.02), completed a set of self-report measures assessing LOC eating, weight suppression, psychopathology of eating disorders, depression, negative urgency, emotion regulation difficulties, and self-criticism. Path analysis modeling tested a hypothesized model with 3 paths for LOC eating as follows: (1) psychopathology of eating disorders; (2) emotion and behavior regulation; and (3) interplay between these paths.ResultsWe found goodness-of-fit indexes to our data: χ2 = 17.11, df = 10, Comparative Fit Index (CFI) = 0.99, Tucker-Lewis index (TLI) = 0.98, Root Mean Square Error Approximation (RMSEA) = 0.045, Standardized Root Mean Square Residual (SRMR) = 0.041, suggesting that: (1) participants with higher weight suppression showed higher degrees of the psychopathology of eating disorders, which was linked to higher levels of LOC eating; (2) self-criticism was a mediator between emotion regulation and depression/negative urgency; (3) self-criticism was a mediator between emotion regulation and disorder eating, which was significantly associated with LOC eating via increased negative urgency.ConclusionOur model shows that LOC eating occurs for individuals with the psychopathology of higher eating disorders who experience depressive symptoms and act rashly under distress for their inability to cope adequately with negative feelings of self-devaluation. These findings point to the importance of negative self-evaluations and feelings of inadequacy or worthlessness to understand LOC eating among college students.
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Affiliation(s)
- Eva M. Conceição
- Psychotherapy and Psychopathology Research Unit – Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- *Correspondence: Eva M. Conceição, ; orcid.org/0000-0002-1982-5796
| | - Célia S. Moreira
- Department of Mathematics and Center of Mathematics (FCUP-CMUP), University of Porto, Porto, Portugal
| | - Marta de Lourdes
- Psychotherapy and Psychopathology Research Unit – Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Sofia Ramalho
- Psychotherapy and Psychopathology Research Unit – Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Ana Rita Vaz
- Psychotherapy and Psychopathology Research Unit – Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
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12
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Hatoum AH, Burton AL, Abbott MJ. Assessing negative core beliefs in eating disorders: revision of the Eating Disorder Core Beliefs Questionnaire. J Eat Disord 2022; 10:18. [PMID: 35144689 PMCID: PMC8830168 DOI: 10.1186/s40337-022-00542-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/26/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Increased theoretical and empirical attention has been given to examining the role of core beliefs in both the development and maintenance of eating disorders (EDs). The Eating Disorder Core Beliefs Questionnaire (ED-CBQ) is self-report measure designed to assess five dimensions of core beliefs relating to eating disorders; self-loathing, unassertive/inhibited, demanding/needing help and support, abandoned/deprived, and high standards for the self. The present study aimed to evaluate the psychometric properties of the ED-CBQ and to develop a revised and improved version of the original measure after evaluating its factor structure and related properties. METHODS A sample of undergraduate university students (N = 763) completed an online test battery of questionnaires. Putative ED-symptomatic (n = 384) and non-ED (n = 379) subgroups were created from self-reported responses from the Eating Disorder Examination Questionnaire (EDEQ). Confirmatory factor analyses (CFAs) were performed, and internal consistency, construct validity, group differences and clinical utility was examined. RESULTS An initial CFA did not support the original five-factor 40-item ED-CBQ. A revised version was developed that possessed equal or superior psychometric properties to the original 40-item measure. The ED-CBQ-R demonstrated superior model fit, similar levels of reliability and construct validity, and the ability to discriminate between putative ED diagnostic groups. CONCLUSIONS Our results suggest that the ED-CBQ-R is a valid, reliable, but more importantly an efficient and accessible measure with the potential to be utilised both clinically and in research settings.
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Affiliation(s)
- Amaani H Hatoum
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia
| | - Amy L Burton
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.,Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.
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13
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Yoon C, Emery RL, Hazzard VM, Mason SM, Neumark-Sztainer D. Adverse experiences as predictors of maladaptive and adaptive eating: Findings from EAT 2018. Appetite 2022; 168:105737. [PMID: 34627979 PMCID: PMC9505995 DOI: 10.1016/j.appet.2021.105737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 01/03/2023]
Abstract
Adverse experiences, such as childhood abuse and other violence victimization, are associated with problematic eating. However, whether different types of adversity relate to both maladaptive and adaptive eating behaviors is unclear. This study examined the associations of different adverse experiences with maladaptive (i.e., overeating and binge eating) and adaptive (i.e., intuitive eating and mindful eating) eating by gender. Data were derived from the EAT-2018 (Eating and Activity over Time) study (N = 1411, aged 18-30 years in 2017-2018). Modified Poisson regressions were used to examine the associations between adverse experiences and the prevalence of maladaptive eating. Linear regressions were used to examine the associations between adverse experiences and adaptive eating scores. Each adverse experience was associated with greater prevalence of maladaptive eating and lower adaptive eating scores. Among women, intimate partner sexual violence was strongly associated with more overeating (PR = 2.1 [95% CI = 1.4-3.1]) and binge eating (PR = 2.4 [95% CI = 1.5-3.9]), and less mindful eating (β = -0.6, [95% CI = -0.8, -0.3]); being attacked, beaten, or mugged was most associated with less intuitive eating (β = -0.5, [95% CI = -0.8, -0.2]). Among men, being attacked, beaten, or mugged was strongly associated with more overeating (PR = 2.1 [95% CI = 1.2-3.5]) and binge eating (PR = 3.2 [95% CI = 1.6-6.5]); intimate partner physical violence was strongly associated with less intuitive eating (β = -0.6, [95% CI = -0.9, -0.2]); childhood emotional abuse was strongly associated with less mindful eating (β = -0.8, [95% CI = -1.0, -0.5]). To improve eating behaviors, adverse life experiences and the potential impact on maladaptive and adaptive eating should be considered.
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Affiliation(s)
- Cynthia Yoon
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454,University of Houston, Department of Health and Human Performance, Houston, TX 77006
| | - Rebecca L. Emery
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454
| | - Vivienne M. Hazzard
- Sanford Center for Biobehavioral Research, 120 Eight St S, Fargo, ND 58103, USA
| | - Susan M. Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454
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14
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Holmberg TT, Sainte-Marie M, Jensen EK, Linnet J, Runge E, Lichtenstein MB, Tarp K. An analysis of patient motivation for seeking online treatment for binge eating disorder-A mixed methods study combining systematic text condensation with sentiment analysis. Front Psychiatry 2022; 13:969115. [PMID: 36405908 PMCID: PMC9672086 DOI: 10.3389/fpsyt.2022.969115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Online treatment for binge eating disorder (BED) is an easily available option for treatment compared to most standard treatment procedures. However, little is known about how motivation types characterize this population and how these impact treatment adherence and effect in an online setting. Therefore, we aimed to investigate a sample of written motivation statements from BED patients, to learn more about how treatment and online treatment in particular, presents in this population. METHODS Using self-determination theory in a mixed methods context, we investigated which types of motivation were prevalent in our sample, how this was connected with patient sentiment, and how these constructs influence treatment and adherence. RESULTS Contrary to what most current literature suggests, we found that in our sample (n = 148), motivation type was not connected with treatment outcome. We did find a strong association between sentiment scores and motivation types, indicating the model is apt at detecting effects. We found that when comparing an adult and young adult population, they did not differ in motivation type and the treatment was equally effective in young adults and adults. In the sentiment scores there was a difference between sentiment score and adherence in the young adult group, as the more positive the young adults were, the less likely they were to complete the program. DISCUSSION Because motivation type does not influence online treatment to the same degree as it would in face-to-face treatment it indicates that the typical barriers to treatment may be less crucial in an online setting. This should be considered during intake; as less motivated patients may be able to adhere better to online treatment, because the latter imposes fewer barriers of the kind that only strong motivation can overcome. The fact that motivation type and sentiment score of the written texts are strongly associated, indicate a potential for automated models to detect motivation based on sentiment.
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Affiliation(s)
- Trine Theresa Holmberg
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Maxime Sainte-Marie
- Department of Political Science, Danish Center for Studies in Research and Research Policy, Aarhus University, Aarhus, Denmark
| | - Esben Kjems Jensen
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jakob Linnet
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.,Clinic on Gambling- and Binge Eating Disorder, Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark
| | - Eik Runge
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Mia Beck Lichtenstein
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Kristine Tarp
- Research Unit for Digital Psychiatry, Center for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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15
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Flynn M, Campbell I, Schmidt U. Does concurrent self-administered transcranial direct current stimulation and attention bias modification training improve symptoms of binge eating disorder? Protocol for the TANDEM feasibility randomized controlled trial. Front Psychiatry 2022; 13:949246. [PMID: 35990072 PMCID: PMC9382293 DOI: 10.3389/fpsyt.2022.949246] [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: 05/20/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Binge eating disorder (BED) is a common and disabling problem associated with impaired cognitive control. Preliminary studies show that brain-directed treatments, including transcranial direct current stimulation (tDCS) and attention bias modification training (ABMT), improve cognitive control and alleviate symptoms of BED. When combined, tDCS may enhance the effects of ABMT, and vice versa, thereby improving treatment outcomes. METHODS This protocol describes a feasibility single-blind randomized sham-controlled trial of concurrent self-administered tDCS and ABMT in adults with BED (The TANDEM Trial). Eighty adults with BED will be randomly assigned to one of four groups: ABMT with real or sham self-administered tDCS, ABMT only, or waiting list control. In the treatment arms, participants will complete 10-sessions of their allocated intervention over 2-3 weeks. Outcomes will be assessed at baseline (T0), immediately post treatment (T1), and 6 weeks after end of treatment (T2), and at comparable timepoints for participants in the waitlist control group. Feasibility will be evaluated by assessing recruitment/retention rates and blinding success. Acceptability will be assessed quantitatively via participant ratings and qualitatively via semi-structured interviews. Episodes of binge eating at follow-up will be the primary clinical outcome and rate ratios from Poisson regression will be reported. Secondary outcomes will assess changes in ED and general psychopathology, attention bias toward high calorie foods, and executive function. DISCUSSION It is hoped that data from the trial will contribute to the development of neurobiologically informed treatments for BED, provide insights into the potential use of at-home variants of tDCS, and inform the design of future large scale trials.
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Affiliation(s)
- Michaela Flynn
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Iain Campbell
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
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16
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Grol M, Cásedas L, Oomen D, Spronk DB, Fox E. Uncontrolled eating in healthy women has limited influence on food cue reactivity and food-related inhibitory control. Appetite 2022; 168:105767. [PMID: 34687826 DOI: 10.1016/j.appet.2021.105767] [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: 11/10/2020] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022]
Abstract
Uncontrolled eating-in the general population-is characterized by overeating, hedonic hunger and being drawn towards palatable foods. Theoretically, it is the result of a strong food reward signal in relation to a poor ability to exert inhibitory control. How food consumption influences inhibitory control and food cue sensitivity, and how this relates to the continued urge to eat, remains unclear. We used fMRI in order to investigate the neural mechanism underlying food cue reactivity and food-specific response inhibition (go-nogo task), by comparing women reporting high (n = 21) versus low/average (n = 19) uncontrolled eating across two sessions: during an inter-meal state and after consumption of a high-caloric snack. We found no effects of individual differences in uncontrolled eating, food consumption, nor their interaction on food cue reactivity. Differences in uncontrolled eating and food consumption did interact in modulating activity in an occipital-parietal network, extending from left lateral superior occipital cortex to visual cortex, cuneal cortex, and precuneus during response inhibition of non-food stimuli, areas previously associated with successful nogo-vs. go-trials. Yet, behavioural performance on the go-nogo task was not modulated by uncontrolled eating nor food consumption. Women with a low/average tendency for uncontrolled eating may need more cognitive resources to support successful response inhibition of non-food stimuli during food 'go' blocks in an inter-meal state, whereas women with a high tendency for uncontrolled eating showed this after food consumption. However, considering current and previous findings, it seems that individual differences in uncontrolled eating in healthy women have only limited influence on food cue reactivity and food-related inhibitory control.
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Affiliation(s)
- Maud Grol
- Department of Experimental Psychology, University of Oxford, UK.
| | - Luis Cásedas
- Department of Experimental Psychology, University of Oxford, UK
| | - Danna Oomen
- Department of Experimental Psychology, University of Oxford, UK
| | | | - Elaine Fox
- Department of Experimental Psychology, University of Oxford, UK
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17
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Mikhail ME, Anaya C, Culbert KM, Sisk CL, Johnson A, Klump KL. Gonadal Hormone Influences on Sex Differences in Binge Eating Across Development. Curr Psychiatry Rep 2021; 23:74. [PMID: 34613500 PMCID: PMC8576863 DOI: 10.1007/s11920-021-01287-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Binge eating is a transdiagnostic symptom that disproportionately affects females. Sexually dimorphic gonadal hormones (e.g., estradiol, testosterone) substantially impact eating behavior and may contribute to sex differences in binge eating. We examine recent evidence for the role of gonadal hormones in binge eating risk across development. RECENT FINDINGS Both organizational (long-lasting impact on the central nervous system (CNS)) and activational (transient influences on the CNS) hormone effects may contribute to sex differences in binge eating. Gonadal hormones also impact within-sex variability in binge eating, with higher estradiol levels in females and higher testosterone levels in males protective across development. Emerging evidence suggests that the impact of gonadal hormones may be greatest for people with other risk factors, including genetic, temperamental (e.g., high negative affect), and psychosocial (e.g., exposure to weight-based teasing) risk. Gonadal hormones contribute to sex differences and within-sex variability in binge eating across development.
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Affiliation(s)
- Megan E. Mikhail
- Department of Psychology, Michigan State University, 316 Physics Rd., Room 107B, East Lansing, MI, 48824-1116, USA
| | - Carolina Anaya
- Department of Psychology, Michigan State University, 316 Physics Rd., Room 107B, East Lansing, MI, 48824-1116, USA
| | - Kristen M. Culbert
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Cheryl L. Sisk
- Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Alexander Johnson
- Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, 316 Physics Rd., Room 107B, East Lansing, MI, 48824-1116, USA,Corresponding author:
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18
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Zakhour M, Haddad C, Sacre H, Tarabay C, Zeidan RK, Akel M, Hallit R, Kheir N, Obeid S, Salameh P, Hallit S. Differences in the Associations between Body Dissatisfaction and Eating Outcomes by Gender? A Lebanese Population Study. Rev Epidemiol Sante Publique 2021; 69:134-144. [PMID: 33965268 DOI: 10.1016/j.respe.2021.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 01/22/2021] [Accepted: 02/16/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The objective of this study was to evaluate the impact of the interaction between body dissatisfaction and gender on eating disorders (restrained eating, binge eating, orthorexia nervosa, and emotional eating) among a sample of Lebanese adults. METHODS This cross-sectional study, conducted between January and May 2018, enrolled 811 participants selected randomly from all Lebanese Mohafazat. The mean age of the participants was 27.6±11.8 years. The majority were females (66.5%), had a high level of education (73.2%), and low income (77.9%). This study used the following scales: body dissatisfaction subscale of the Eating Disorder Inventory-second version, binge eating scale, Dutch restrained eating scale, orthorexia nervosa scale (ORTHO-15 scale), emotional eating scale, perceived stress scale, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale. RESULTS Body dissatisfaction was positively correlated to restrained eating (r=0.293, P<0.001), emotional eating (r=0.073, P=0.042) and binge eating (r=0.250, P<0.001). The interaction between body dissatisfaction and gender was significantly associated with more restrained eating (Beta=0.01, P<0.001) and orthorexia nervosa (Beta=-0.09, P<0.001), but not with emotional (Beta=-0.43, P=0.103) and binge eating (Beta=-0.08, P=0.358). When stratifying the analysis by gender, the results revealed that higher body dissatisfaction was significantly associated with more restrained eating in both genders, but particularly among women. Body dissatisfaction was significantly associated with higher emotional eating in men only and with higher orthorexia nervosa tendencies and behaviors in females only. CONCLUSION The interaction between body dissatisfaction and gender was significantly associated with orthorexia nervosa and restrained eating but not with binge or emotional eating. Higher body dissatisfaction was significantly associated with higher restrained eating, more pronounced in women, while it was significantly associated with higher orthorexia tendencies (lower ORTO-15 scores) in women only. Body dissatisfaction was associated with emotional eating in men only.
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Affiliation(s)
- M Zakhour
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - C Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon,INSERM, Univ. Limoges, CH Esquirol Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France,INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - H Sacre
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - C Tarabay
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - R K Zeidan
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon,CERIPH: Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon,Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - M Akel
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon,School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - R Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - N Kheir
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - S Obeid
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon,INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - P Salameh
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon,University of Nicosia Medical School, Nicosia, Cyprus
| | - S Hallit
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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19
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Hollett KB, Carter JC. Separating binge-eating disorder stigma and weight stigma: A vignette study. Int J Eat Disord 2021; 54:755-763. [PMID: 33480447 DOI: 10.1002/eat.23473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Vignette research on binge-eating disorder (BED) stigma is limited and lacking methodological rigor. Existing studies lack control vignettes and typically present characters with overweight or obesity, introducing the confound of weight stigma. This study examined BED stigma while addressing these limitations. METHOD Participants (N = 421) were assigned to read one of six vignettes describing a woman with either BED or no BED as well as either no mention of weight, a recommended weight, or an obese weight. Four questionnaires examined personality stereotypes, emotional reactions to the character, desire for social distance from the character, and blame attributions. RESULTS The character with BED was ascribed more negative personality characteristics and faced less positive emotional reactions than the character without BED, regardless of weight status. However, BED stigma did not emerge for social distance or blame attributions. Regarding weight stigma, evidence was limited and moderated by the presence of BED, suggesting no additive effect between BED stigma and weight stigma. In fact, blame attributions toward the character with obesity were reduced by the presence of BED. DISCUSSION The results reveal that BED is a highly stigmatized eating disorder and suggest that weight stigma may be driven by assumptions about a person's eating behavior rather than their body size per se. Future studies must consider the relationship between BED stigma and weight stigma when assessing either form of stigma. The results also indicate new information to be integrated into anti-weight stigma campaigns as well as policy and public health initiatives.
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Affiliation(s)
- Kayla B Hollett
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Jacqueline C Carter
- Department of Psychology, Concordia University, Montreal, Quebec, Canada.,Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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20
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Hildebrandt BA, Ahmari SE. Breaking It Down: Investigation of Binge Eating Components in Animal Models to Enhance Translation. Front Psychiatry 2021; 12:728535. [PMID: 34484010 PMCID: PMC8414642 DOI: 10.3389/fpsyt.2021.728535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/19/2021] [Indexed: 12/28/2022] Open
Abstract
Binge eating (BE) is a core eating disorder behavior that is present across nearly all eating disorder diagnoses (e. g., bulimia nervosa, binge eating disorder, anorexia nervosa binge/purge subtype), and is also widely present in the general population. Despite the prevalence of BE, limited treatment options exist and there are often high rates of relapse after treatment. There is evidence showing that genetic factors contribute to the heritability of BE and support for biological contributions to BE. However, more work is needed to fully understand neurobiological mechanisms underlying BE. One approach to target this problem is to separate BE into its distinct clinical components that can be more easily modeled using pre-clinical approaches. To date, a variety of animal models for BE have been used in pre-clinical studies; but there have been challenges translating this work to human BE. Here, we review these pre-clinical approaches by breaking them down into three clinically-significant component parts (1) consumption of a large amount of food; (2) food consumption within a short period of time; and (3) loss of control over eating. We propose that this rubric identifies the most frequently used and effective ways to model components of BE behavior using pre-clinical approaches with the strongest clinical relevance. Finally, we discuss how current pre-clinical models have been integrated with techniques using targeted neurobiological approaches and propose ways to improve translation of pre-clinical work to human investigations of BE that could enhance our understanding of BE behavior.
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Affiliation(s)
- Britny A Hildebrandt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Susanne E Ahmari
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States
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21
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Richson BN, Forbush KT, Schaumberg K, Crosby RD, Peterson CB, Crow SJ, Mitchell JE. Are the Criterion B binge-eating symptoms interchangeable in understanding binge-eating severity? An item response theory analysis. Int J Eat Disord 2020; 53:1983-1992. [PMID: 32945003 DOI: 10.1002/eat.23383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/29/2020] [Accepted: 08/30/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The Criterion B binge-eating symptoms represent five symptoms associated with binge eating. Any three out of five symptoms can be used to meet Criterion B. However, Criterion B symptoms may not be interchangeable in terms of how binge-eating severity is associated with each symptom. Item response theory (IRT) can test how endorsing each symptom relates to the overall level (i.e., severity) of binge-eating measured by Criterion B. We used IRT to identify (a) how each Criterion B symptom corresponded with binge-eating severity in a transdiagnostic binge-eating sample and (b) how well each symptom differentiated individuals with differing levels of severity. METHOD Participants (N = 219) were adults (80.8% female) with a current ED that included objective binge-eating episodes assessed via semi-structured interview. A two-parameter logistic IRT model evaluated how endorsement of each Criterion B symptom corresponded with the level of latent binge-eating severity. RESULTS "Eating large amounts when not hungry" and "eating alone" reflected the highest binge-eating severity. "Eating alone" was the best discriminator across different binge-eating severity levels, whereas "uncomfortably full" was the poorest discriminator across binge-eating severity levels. DISCUSSION Criterion B symptoms were not interchangeable in terms of what level of binge-eating severity corresponded with symptom endorsement. "Eating large amounts when not hungry" or "eating alone" may signify elevated binge-eating severity, whereas "uncomfortably full" and "feeling disgusted/depressed/guilty" were not necessarily indicative of elevated severity. Results suggested that Criterion B may need to be revised to eliminate symptoms that are redundant with other binge-eating diagnostic criteria.
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Affiliation(s)
- Brianne N Richson
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Katherine Schaumberg
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
| | - James E Mitchell
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA.,Department of Psychiatry and Behavioral Science, University of North Dakota, Fargo, North Dakota, USA
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22
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Yoon C, Simone M, Mason SM, Neumark-Sztainer D. A single summative global scale of disordered eating attitudes and behaviors: Findings from Project EAT, a 15-year longitudinal population-based study. Eat Behav 2020; 39:101418. [PMID: 32866851 PMCID: PMC7704841 DOI: 10.1016/j.eatbeh.2020.101418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The Project EAT Disordered Eating Attitudes and Behaviors (DEAB) scale was created from disordered eating attitudes and behaviors that tend to interrelate. To examine the appropriateness of the scale, we assessed the fit (i.e., how well a single latent factor fits a set of interrelated disordered eating attitudes and behaviors) and the convergent validity over time. METHOD Five interrelated disordered eating attitudes and behaviors were assessed in a longitudinal cohort (Project EAT, age 11 to 18 in 1998-1999, N = 1492). Confirmatory factor analysis examined the appropriateness of the DEAB scale. To examine whether individual variables function differently in relation to the latent construct across time, two models were compared: one requiring indicator-level factor loadings to remain equivalent across three time points (baseline [EAT-I], five-year follow-up [EAT-II], and 15-year follow-up [EAT-IV]), and the second allowing the factor loadings to vary over time. To examine the convergent validity, Pearson correlation with body satisfaction, self-esteem, depressive symptoms, and BMI was compared across time. RESULTS The fit indices for a single factor structure supported the use of the DEAB scale over time (standardized loadings: 0.60-0.87, 0.67-0.89, 0.59-0.77 at EAT-I, II, and IV respectively). As hypothesized, compared to fewer number of disordered eating attitudes and behaviors, greater number of attitudes and behaviors was associated with lower body satisfaction and self-esteem, and greater depressive symptoms and BMI (p < .01). DISCUSSION The Project EAT DEAB scale can be used as a proxy to measure the severity of disordered eating attitudes and behaviors over time in population-based studies.
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Affiliation(s)
- Cynthia Yoon
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
| | - Melissa Simone
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota 55454, USA
| | - Susan M. Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454, USA
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Ostinelli EG, Cavallotti S, Fanti V, Demartini B, Gambini O, D'Agostino A. The reMAP project: A retrospective, 15-year register study on inpatient care for youth with mental disorders. Early Interv Psychiatry 2020; 14:705-713. [PMID: 31769192 DOI: 10.1111/eip.12899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 08/21/2019] [Accepted: 10/20/2019] [Indexed: 12/30/2022]
Abstract
AIM We aimed to characterize youth hospitalization trends in a psychiatric inpatient unit from a large, public university hospital with a broad catchment area in Milan, Italy. METHODS Hospitalization data of patients with an age at admission ≤ 35 were retrospectively retrieved over a time span of 15 years. The sample was comprised of 1982 admissions to a psychiatric ward, aggregated into ICD-10 diagnostic clusters and then analysed. We investigated the epidemiological trends with a focus on age at admission, gender, nationality and hospitalization rates, length of stay and "revolving door" readmissions within a year. RESULTS Hospitalization rates increased for eating Disorders and decreased for non-affective psychotic disorders; median length of stay generally decreased; hospitalization rates for foreign youth increased, in particular for those diagnosed with non-affective psychotic disorders, personality disorders, and substance-related and addictive disorders. The revolving door phenomenon was also associated with non-affective psychoses and neurodevelopmental disorders, while found to increase for eating disorders. CONCLUSIONS Hospitalization patterns reflect the general increase of foreign youth in the suburban tissue of a large metropolitan area like Milan. However, our data might underestimate the constant growth of mental health problems in foreign youth due to a generally lower access to services. Novel pharmacological treatments and early intervention programs might explain the decrease of hospitalization duration and hospitalization rate for youth with non-affective psychoses. The observed increase in hospitalization for young patients with eating disorders sustains the development of adequate policies tailored towards specialty wards.
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Affiliation(s)
- Edoardo G Ostinelli
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy
| | | | - Valentina Fanti
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy
| | - Benedetta Demartini
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy
| | - Orsola Gambini
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy
| | - Armando D'Agostino
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy
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Hanson JA, Phillips LN, Hughes SM, Corson K. Attention-deficit hyperactivity disorder symptomatology, binge eating disorder symptomatology, and body mass index among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:543-549. [PMID: 31009328 DOI: 10.1080/07448481.2019.1583651] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 11/13/2018] [Accepted: 02/07/2019] [Indexed: 06/09/2023]
Abstract
Objective: To explore the relationship between symptoms of attention-deficit hyperactivity disorder (ADHD), symptoms of binge eating disorder, and body mass index (BMI) among students at a southern university. Participants: Two hundred seventy-seven college students. Methods: Between January 31, 2013 and March 27, 2013, participants completed the Adult ADHD Self-Report Scale (ASRS) Screener and the Binge Eating Scale (BES) in addition to permitting researchers to measure their height and weight. Results: Higher ASRS scores, higher BMIs, and lower BES scores were observed among men. Among both men and women, BES scores were positively correlated with BMI and ASRS scores; however, the correlation between ASRS and BMI was not significant. Conclusion: Binge eating disorder symptomatology was associated with increased ADHD symptomatology and a higher BMI among both men and women. Among students presenting with obesity or ADHD, screening for binge eating may assist with the identification of problematic eating behaviors.
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Affiliation(s)
- Jennifer A Hanson
- Department of Food, Nutrition, Dietetics, and Health, Kansas State University, Manhattan, Kansas, USA
| | - Lisa N Phillips
- School of Human Ecology, Louisiana Tech University, Ruston, Louisiana, USA
| | - Susan M Hughes
- School of Human Ecology, Louisiana Tech University, Ruston, Louisiana, USA
- Overton Brooks VA Medical Center, Longview Community Based Outpatient Clinic, Longview, Texas, USA
| | - Kimberly Corson
- School of Humanities & Social Sciences, Penn State Erie, The Behrend College, Erie, Pennsylvania, USA
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25
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Yoon C, Mason SM, Hooper L, Eisenberg ME, Neumark-Sztainer D. Disordered Eating Behaviors and 15-year Trajectories in Body Mass Index: Findings From Project Eating and Activity in Teens and Young Adults (EAT). J Adolesc Health 2020; 66:181-188. [PMID: 31630924 PMCID: PMC6980455 DOI: 10.1016/j.jadohealth.2019.08.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/09/2019] [Accepted: 08/09/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Disordered eating behaviors are prevalent among adolescents. Understanding how these behaviors link to body mass index (BMI) across different stages of development and over an extended period may provide insight for designing interventions around eating and weight. This study had two objectives: (1) to assess the distribution of disordered eating behaviors and develop a global score of disordered eating behaviors among adolescents and (2) to examine the association between the number of disordered eating behaviors in adolescence and BMI trajectory over 15 years. METHODS Project Eating and Activity in Teens and Young Adults (EAT), a longitudinal study of weight-related health and behavior comprising four waves (EAT-I to EAT-IV), measured seven disordered eating behaviors (importance of weight and shape, frequent dieting, extreme unhealthy weight control behaviors, overeating, distress about overeating, loss of control while overeating, and frequency of overeating and loss of control) at baseline (N = 1,230, ages 11 to 18 years, 1998-1999). These behaviors were summed to create a disordered eating behavior score. BMI was self-reported at all four waves (up to age 27-33 years at EAT-IV). Repeated measures with random slope and intercept examined the association between disordered eating behaviors and BMI trajectories over 15 years. RESULTS At baseline, 50.7% and 33.7% of females and males endorsed disordered eating behaviors. Throughout 15 years of follow-up, sociodemographic-adjusted BMI was higher among adolescents who engaged in disordered eating behaviors. The association remained significant after further adjustment for baseline BMI (p < .05). CONCLUSIONS Among adolescents, regardless of the type of disordered eating behaviors, engagement in disordered eating behavior predicted higher BMI in a dose-response fashion.
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Affiliation(s)
- Cynthia Yoon
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
| | - Susan M. Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Laura Hooper
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Marla E. Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55454, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
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26
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Tang KTY, Kim HS, Hodgins DC, McGrath DS, Tavares H. Gambling disorder and comorbid behavioral addictions: Demographic, clinical, and personality correlates. Psychiatry Res 2020; 284:112763. [PMID: 31951870 DOI: 10.1016/j.psychres.2020.112763] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/09/2019] [Accepted: 01/04/2020] [Indexed: 11/15/2022]
Abstract
Gambling disorder (GD) frequently co-occurs with substance use disorders. However, the extent to which GD co-occurs with behavioral addictions (BAs) and the demographic, clinical, and personality correlates of comorbid GD and BA is largely unknown. The aims of the present research were to address this gap among people seeking treatment for GD (N = 458) in São Paulo, Brazil. Structured clinical interviews diagnosed individuals with GD and other psychiatric disorders. The Shorter PROMIS questionnaire was used to identify BAs (work, exercise, food bingeing, sex, and shopping). Questionnaires assessed demographic characteristics, gambling behavior, and personality. Of the total sample, 206 (45.0%) participants met the criteria of having at least one behavioral addiction (GD+BA). The most common comorbid BA was food bingeing (8.1%) with the least common being exercise (3.6%). In a multivariate logistic regression, individuals with GD+BA tended to be younger, and had greater rates of comorbid post-traumatic stress disorder and bulimia nervosa compared to participants who did not present with a comorbid BA. Taken together, individuals with GD+BA present with increased psychopathology. These results may have important implications for the assessment and treatment of individuals with GD and comorbid BAs.
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Affiliation(s)
- Karen T Y Tang
- Department of Psychology & Neuroscience, Dalhousie University, Canada.
| | - Hyoun S Kim
- Department of Psychology, University of Calgary, Canada
| | | | | | - Hermano Tavares
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil
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27
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Tanofsky-Kraff M, Schvey NA, Grilo CM. A developmental framework of binge-eating disorder based on pediatric loss of control eating. AMERICAN PSYCHOLOGIST 2020; 75:189-203. [PMID: 32052994 PMCID: PMC7027731 DOI: 10.1037/amp0000592] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although binge-eating disorder may manifest in childhood, a significantly larger proportion of youth report episodes involving a loss of control while eating, the hallmark feature of binge eating that predicts excess weight gain and obesity. Adults with binge-eating disorder often report that symptoms emerged during childhood or adolescence, suggesting that a developmental perspective of binge eating may be warranted. Thus, loss of control eating may be a marker of prodromal binge-eating disorder among certain susceptible youth. The present article offers a broad developmental framework of binge-eating disorder and proposes areas of future research to determine which youths with loss of control eating are at risk for persistent and exacerbated behavior that may develop into binge-eating disorder and adult obesity. To this end, this article provides an overview of loss of control eating in childhood and adolescence, including its characterization, etiology, and clinical significance, with a particular focus on associations with metabolic risk, weight gain, and obesity. A conceptual model is proposed to further elucidate the mechanisms that may play a role in determining which youths with loss of control are at greatest risk for binge-eating disorder and obesity. Ways in which treatments for adult binge-eating disorder may inform approaches to reduce loss of control eating and prevent excess weight gain in youth are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine
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28
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Maston G, Gibson AA, Kahlaee HR, Franklin J, Manson E, Sainsbury A, Markovic TP. Effectiveness and Characterization of Severely Energy-Restricted Diets in People with Class III Obesity: Systematic Review and Meta-Analysis. Behav Sci (Basel) 2019; 9:E144. [PMID: 31817943 PMCID: PMC6960910 DOI: 10.3390/bs9120144] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 11/24/2019] [Accepted: 12/03/2019] [Indexed: 12/17/2022] Open
Abstract
Severely energy-restricted diets are used in obesity management, but their efficacy in people with class III obesity (body mass index ≥40 kg/m2) is uncertain. The aims of this systematic review and meta-analysis were to determine the effectiveness and characteristics of severely energy-restricted diets in people with class III obesity. As there was a lack of publications reporting long-term dietary interventions and randomised controlled trial designs, our original publication inclusion criteria were broadened to include uncontrolled study designs and a higher upper limit of energy intake. Eligible publications reported studies including adults with class III obesity and that assessed a diet with daily energy intake ≤5000 kJ for ≥4 weeks. Among 572 unique publications from 4 databases, 11 were eligible and 10 were suitable for meta-analysis. Our original intention was to classify comparison arms into short-term (<6 months) and long-term (>1 year) interventions. Due to the lack of long-term data found, comparison arms were classified according to the commonalities in dietary intervention length among the included publications, namely dietary interventions of 4 weeks' duration and those of ≥6 weeks' duration. After a 4-week severely energy-restricted diet intervention, the pooled average weight loss was 9.81 (95% confidence interval 10.80, 8.83) kg, with a 95% prediction interval of 6.38 to 13.25 kg, representing a loss of approximately 4.1 to 8.6% of initial body weight. Diets ≥6 weeks' duration produced 25.78 (29.42, 22.15) kg pooled average weight loss, with a 95% prediction interval of 13.77 to 37.80 kg, representing approximately 10.2 to 28.0% weight loss. Daily dietary prescriptions ranged from 330 to 5000 kJ (mean ± standard deviation 2260 ± 1400 kJ), and had wide variations in macronutrient composition. The diets were administered mostly via liquid meal replacement products. While the included publications had a moderate risk of bias score, which may inflate reported weight loss outcomes, the published data to date suggest that severely energy-restricted diets, delivered via diets of varying composition, effectively produce clinically relevant weight loss (≥10% of initial body weight) when used for 6 weeks or more in people with class III obesity.
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Affiliation(s)
- Gabrielle Maston
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
| | - Alice A. Gibson
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
| | - H. Reza Kahlaee
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney 2006, Australia;
- School of Life, and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia
| | - Janet Franklin
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
| | - Elisa Manson
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
| | - Amanda Sainsbury
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
| | - Tania P. Markovic
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
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29
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FinnTwin16: A Longitudinal Study from Age 16 of a Population-Based Finnish Twin Cohort. Twin Res Hum Genet 2019; 22:530-539. [PMID: 31796134 DOI: 10.1017/thg.2019.106] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The purpose of this review is to provide a detailed and updated description of the FinnTwin16 (FT16) study and its future directions. The Finnish Twin Cohort comprises three different cohorts: the Older Twin Cohort established in the 1970s and the FinnTwin12 and FT16 initiated in the 1990s. FT16 was initiated in 1991 to identify the genetic and environmental precursors of alcoholism, but later the scope of the project expanded to studying the determinants of various health-related behaviors and diseases in different stages of life. The main areas addressed are alcohol use and its consequences, smoking, physical activity, overall physical health, eating behaviors and eating disorders, weight development, obesity, life satisfaction and personality. To date, five waves of data collection have been completed and the sixth is now planned. Data from the FT16 cohort have contributed to several hundred studies and many substudies, with more detailed phenotyping and collection of omics data completed or underway. FT16 has also contributed to many national and international collaborations.
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30
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Rantala MJ, Luoto S, Krama T, Krams I. Eating Disorders: An Evolutionary Psychoneuroimmunological Approach. Front Psychol 2019; 10:2200. [PMID: 31749720 PMCID: PMC6842941 DOI: 10.3389/fpsyg.2019.02200] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 09/12/2019] [Indexed: 12/18/2022] Open
Abstract
Eating disorders are evolutionarily novel conditions. They lead to some of the highest mortality rates of all psychiatric disorders. Several evolutionary hypotheses have been proposed for eating disorders, but only the intrasexual competition hypothesis is extensively supported by evidence. We present the mismatch hypothesis as a necessary extension to the current theoretical framework of eating disorders. This hypothesis explains the evolutionarily novel adaptive metaproblem that has arisen when mating motives conflict with the large-scale and easy availability of hyper-rewarding but obesogenic foods. This situation is exacerbated particularly in those contemporary environments that are characterized by sedentary lifestyles, ever-present junk foods, caloric surplus and the ubiquity of social comparisons that take place via social media. Our psychoneuroimmunological model connects ultimate-level causation with proximate mechanisms by showing how the adaptive metaproblem between mating motives and food rewards leads to chronic stress and, further, to disordered eating. Chronic stress causes neuroinflammation, which increases susceptibility to OCD-like behaviors that typically co-occur with eating disorders. Chronic stress upregulates the serotonergic system and causes dysphoric mood in anorexia nervosa patients. Dieting, however, reduces serotonin levels and dysphoric mood, leading to a vicious serotonergic-homeostatic stress/starvation cycle whereby cortisol and neuroinflammation increase through stringent dieting. Our psychoneuroimmunological model indicates that between-individual and within-individual variation in eating disorders partially arises from (co)variation in gut microbiota and stress responsivity, which influence neuroinflammation and the serotonergic system. We review the advances that have been made in recent years in understanding how to best treat eating disorders, outlining directions for future clinical research. Current evidence indicates that eating disorder treatments should aim to reduce the chronic stress, neuroinflammation, stress responsivity and gut dysbiosis that fuel the disorders. Connecting ultimate causes with proximate mechanisms and treating biopsychosocial causes rather than manifest symptoms is expected to bring more effective and sophisticated long-term interventions for the millions of people who suffer from eating disorders.
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Affiliation(s)
| | - Severi Luoto
- English, Drama and Writing Studies, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Tatjana Krama
- Department of Biotechnology, Daugavpils University, Daugavpils, Latvia
| | - Indrikis Krams
- Department of Biotechnology, Daugavpils University, Daugavpils, Latvia
- Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
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31
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Salas-Wright CP, Vaughn MG, Miller DP, Hahm HC, Scaramutti C, Cohen M, Delva J, Schwartz SJ. Overeating and binge eating among immigrants in the United States: new terrain for the healthy immigrant hypothesis. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1007-1017. [PMID: 30806725 PMCID: PMC6675658 DOI: 10.1007/s00127-019-01677-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: 07/17/2018] [Accepted: 02/12/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Prior research indicates that, compared to individuals born in the United States (US), immigrants are less likely to experience mental health and inhibitory control problems. However, our understanding of overeating and binge eating-both related to mental health and inhibitory control-among immigrants in the US remains limited. Drawing from a large national study, we report the prevalence of overeating and binge eating among immigrants vis-à-vis the US-born. METHODS The data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012-2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and key outcomes. RESULTS The prevalence of any (immigrants = 7.8%, US-born = 17.0%) and recurrent overeating (immigrants = 2.9%, US-born = 5.3%) was lower among immigrants than US-born individuals. Among those reporting recurrent overeating, the prevalence of binge eating with loss of control was comparable among immigrant (37.2%) and US-born participants (39.9%), in general. However, stratified analyses revealed that risk of binge eating with loss of control was lower among immigrant women compared to US-born women (AOR 0.54, 95% CI 0.29-0.98). CONCLUSIONS Findings from the present study provide clear results that immigrants are substantially less likely to overeat as compared to US-born individuals and that, among women but not men, immigrant status is associated with lower risk of binge eating with loss of control.
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Affiliation(s)
| | - Michael G Vaughn
- School of Social Work, Saint Louis University, St. Louis, MO, USA
- Yonsei University, Seoul, Republic of Korea
| | - Daniel P Miller
- School of Social Work, Boston University, 264 Bay State Road, Boston, MA, 02215, USA
| | - Hyeouk Chris Hahm
- School of Social Work, Boston University, 264 Bay State Road, Boston, MA, 02215, USA
| | | | - Mariana Cohen
- School of Social Work, Boston University, 264 Bay State Road, Boston, MA, 02215, USA
| | - Jorge Delva
- School of Social Work, Boston University, 264 Bay State Road, Boston, MA, 02215, USA
| | - Seth J Schwartz
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
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32
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Escrivá-Martínez T, Galiana L, Rodríguez-Arias M, Baños RM. The Binge Eating Scale: Structural Equation Competitive Models, Invariance Measurement Between Sexes, and Relationships With Food Addiction, Impulsivity, Binge Drinking, and Body Mass Index. Front Psychol 2019; 10:530. [PMID: 30967808 PMCID: PMC6440315 DOI: 10.3389/fpsyg.2019.00530] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/22/2019] [Indexed: 12/18/2022] Open
Abstract
Introduction: The Binge Eating Scale (BES) is a widely used self-report questionnaire to identify compulsive eaters. However, research on the dimensions and psychometric properties of the BES is limited. Objective: The aim of this study was to examine the properties of the Spanish version of the BES. Methods: Confirmatory Factor Analyses (CFAs) were carried out to verify the BES factor structure in a sample of Spanish college students (N = 428, 75.7% women; age range = 18–30). An invariance measurement routine was carried out across sexes, the latent means were compared, and estimates of reliability and convergent and discriminant validity were presented. Results: A one-factor model fit the data best and was also equivalent between sexes. The scalar invariance model showed statistically significant differences across sexes, with a higher prevalence in women. Regarding reliability, the results were excellent. Finally, high statistically significant correlations were obtained with other measures of binge eating (BE), food addiction, impulsivity, binge drinking, and body mass index (BMI). Conclusion: The Spanish 16-item BES is a valid and reliable scale to evaluate BE in the youth population.
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Affiliation(s)
- Tamara Escrivá-Martínez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,Polibienestar Institute, University of Valencia, Valencia, Spain
| | - Laura Galiana
- Department of Methodology for the Behavioral Sciences, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Marta Rodríguez-Arias
- Department of Psychobiology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Rosa M Baños
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,Polibienestar Institute, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto Carlos III, Madrid, Spain
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33
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Abstract
Most theories emphasize the role of sociocultural factors in the etiology of eating disorders (EDs). This article uses a broad search strategy to identify current etiologic studies. Women with an ED outnumber men in each diagnosis, but gender differences vary by diagnosis. Men were underrepresented in study samples, and information about variable risk factors in men is sparse. Findings suggest transdiagnostic risk factors and disorder-specific risk factors. Extracting data from population-based registers represents a major advance. Novel analytic approaches suggest complex pathways to ED. Although used in several studies, reliance on a transdiagnostic ED category (vs diagnosis-specific groupings) is premature.
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Affiliation(s)
- Ruth Striegel Weissman
- Department of Psychology, Wesleyan University, 207 High Street, Middletown, CT 06359, USA.
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34
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Burton AL, Abbott MJ. Processes and pathways to binge eating: development of an integrated cognitive and behavioural model of binge eating. J Eat Disord 2019; 7:18. [PMID: 31183111 PMCID: PMC6554957 DOI: 10.1186/s40337-019-0248-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/12/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There are a number of factors commonly believed to be important to the development and maintenance of binge eating that have been identified across multiple models and theories in the psychological literature. In the present study, we sought to develop and test a psychological model for binge eating that incorporated the main variables identified in the literature to drive binge eating behaviour; specifically, core low self-esteem, negative affect, difficulty with emotional regulation, restricted eating and beliefs about eating. METHODS Questionnaire data was collected from 760 unselected participants. The proposed model of binge eating was developed, bivariate relationships between the included variables were assessed, and the goodness-of-fit of this new model was evaluated using structural equations modelling. RESULT The results identified significant bivariate relationships between all the included variables. While the originally proposed model did not provide a good fit to the data, the revised version of the model provided a good fit to the data. CONCLUSIONS Supporting, integrating and building upon the current existing psychological models of binge eating, this study presents a new integrated cognitive and behavioural model of binge eating. The dual-pathway to binge eating identified in the new model provides a different way to understand transdiagnostic binge eating.
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Affiliation(s)
- Amy L Burton
- School of Psychology, The University of Sydney, Camperdown, NSW Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Camperdown, NSW Australia
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Determinants of binge eating disorder among normal weight and overweight female college students in Korea. Eat Weight Disord 2018; 23:849-860. [PMID: 30196529 DOI: 10.1007/s40519-018-0574-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE The aim of the present study was to describe the clinical features of binge eating disorder (BED) in normal weight and overweight undergraduate Korean women. METHODS 117 overweight (BMI ≥ 25 kg/m2) and 346 normal weight (18 kg/m2 ≤ BMI < 25 kg/m2) undergraduate Korean women completed questionnaires to assess for BED. Their emotional eating behaviors, binge eating-related behaviors, a spectrum of compulsive behaviors such as substance abuse and obsessive-compulsive disorder, and psychological profiles were evaluated through personal interviews and questionnaires. The features of those with BED were compared to those without BED in the overweight and normal weight groups. RESULTS Both normal weight and overweight BED women had higher levels of functional impairment, eating disorder psychopathology including emotional and external eating behaviors, and neuroticism than their non-BED counterparts. In the normal weight group, BED women had more frequent alcohol consumption and obsessive-compulsive symptoms than non-BED women. In the overweight group, BED women had higher levels of depression and lower extraversion than non-BED women. CONCLUSIONS BED is associated with global functional impairment and mental health problems. Thus, the association with high functional impairments and psychiatric comorbidities suggest that people with BED may benefit from treatment. LEVEL III Evidence obtained from well-designed case-control analytic studies, from more than one center.
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Naish KR, Laliberte M, MacKillop J, Balodis IM. Systematic review of the effects of acute stress in binge eating disorder. Eur J Neurosci 2018; 50:2415-2429. [DOI: 10.1111/ejn.14110] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/03/2018] [Accepted: 08/07/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Katherine R. Naish
- Peter Boris Centre for Addictions Research Department of Psychiatry and Behavioural Neurosciences McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
| | - Michele Laliberte
- Peter Boris Centre for Addictions Research Department of Psychiatry and Behavioural Neurosciences McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
- Eating Disorders Clinic St. Joseph's Healthcare Hamilton Hamilton ON Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research Michael G. DeGroote School of Medicine McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research Department of Psychiatry and Behavioural Neurosciences McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research Michael G. DeGroote School of Medicine McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
| | - Iris M. Balodis
- Peter Boris Centre for Addictions Research Department of Psychiatry and Behavioural Neurosciences McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research Michael G. DeGroote School of Medicine McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
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Beyond the tip of the iceberg: Adolescent weight development of women and men with features of binge eating disorder. Eat Behav 2018; 30:83-87. [PMID: 29933124 DOI: 10.1016/j.eatbeh.2018.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Binge eating disorder (BED) is a clinical eating disorder that is strongly and bidirectionally related to overweight and obesity. Little is known about how subclinical features of BED relate to weight development in adolescence and young adulthood. METHOD Women (n = 2825) and men (n = 2423) from the community-based longitudinal FinnTwin16 cohort participated. Seven eating-related cognitions and behaviors similar to the defining features of BED were extracted from the Eating Disorder Inventory-2 and were assessed at a mean age of 24. We used linear mixed models to assess the association of features of BED with BMI trajectories across four waves of data collection (mean ages 16, 17, 18, and 24). RESULTS The number of features of BED at wave 4 (age 24) was significantly associated with BMI from age 16 years onwards. Those reporting more features of BED had gained more weight throughout adolescence and into their twenties. CONCLUSIONS Features of BED in young adulthood were preceded by steeper BMI trajectories in adolescence. A higher number of features were consistently associated with higher BMI and more weight gain.
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Conceição EM, de Lourdes M, Pinto-Bastos A, Vaz AR, Brandão I, Ramalho S. Problematic eating behaviors and psychopathology in patients undergoing bariatric surgery: The mediating role of loss of control eating. Int J Eat Disord 2018; 51:507-517. [PMID: 29663468 DOI: 10.1002/eat.22862] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/10/2018] [Accepted: 03/11/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study compares different problematic eating behaviors (PEBs; objective [OBE]/subjective [SBE] binge-eating and compulsive [CG]/noncompulsive [NCG] grazing) in relation to the severity of loss of control (LOC) and psychopathology. We also investigate LOC as a mediator between PEBs and psychopathology. METHOD This cross-sectional study assessed a group of patients before bariatric surgery (n = 163), and a group of bariatric patients 12 months or more after surgery (n = 131). Face-to-face assessment: Eating Disorders Examination for binge-eating episodes; Rep(eat) for grazing. LOC was measured by five questions answered in a 5-point Likert scale. Self-report measures: disordered eating, grazing, negative urgency, depression, anxiety, and stress. RESULTS OBEs were reported by 26(8.8%), SBE by 29(9.8%), CG by 35(11.9%), and NCG by 36(12.2%) of patients. The different PEBs differed significantly in the severity of LOC (F(3,120)= 25.81, p < .001). Patients reporting OBEs scored higher and patients with NCG scored lower in most measures than patients with other PEBs. Patients with any PEBs scored higher in all self-report measures than those not reporting any PEBs, with statistical significance reached for uncontrolled eating (F(4,288)= 20.21, p < .001), emotional eating (F(4,288)= 23.10, p < .001), repetitive eating F(4,288)= 18.34, p < .001), and compulsive grazing (F(4,288)= 27.14, p < .001). LOC was found to be a full mediator between PEBs and psychopathology. DISCUSSION There is no evidence that the different PEBs differ in the psychopathology severity, independently of the experience of LOC eating during the eating episodes. We show evidence for the conceptualization of different PEB, including grazing, on a continuous scale of LOC and psychopathology.
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Affiliation(s)
- Eva M Conceição
- School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Ana Pinto-Bastos
- School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Ana Rita Vaz
- School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Isabel Brandão
- Faculty of Medicine, University of Porto, Centro Hospitalar de São João, Porto, Portugal
| | - Sofia Ramalho
- School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
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Prinz P, Stengel A. Deep Brain Stimulation-Possible Treatment Strategy for Pathologically Altered Body Weight? Brain Sci 2018; 8:brainsci8010019. [PMID: 29361753 PMCID: PMC5789350 DOI: 10.3390/brainsci8010019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 12/11/2022] Open
Abstract
The treatment of obesity and eating disorders such as binge-eating disorder or anorexia nervosa is challenging. Besides lifestyle changes and pharmacological options, bariatric surgery represents a well-established and effective-albeit invasive-treatment of obesity, whereas for binge-eating disorder and anorexia nervosa mostly psychotherapy options exist. Deep brain stimulation (DBS), a method that influences the neuronal network, is by now known for its safe and effective applicability in patients with Parkinson’s disease. However, the use does not seem to be restricted to these patients. Recent preclinical and first clinical evidence points towards the use of DBS in patients with obesity and eating disorders as well. Depending on the targeted area in the brain, DBS can either inhibit food intake and body weight or stimulate energy intake and subsequently body weight. The current review focuses on preclinical and clinical evidence of DBS to modulate food intake and body weight and highlight the different brain areas targeted, stimulation protocols applied and downstream signaling modulated. Lastly, this review will also critically discuss potential safety issues and gaps in knowledge to promote further studies.
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Affiliation(s)
- Philip Prinz
- Department for Psychosomatic Medicine, Charité Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 12200 Berlin, Germany.
| | - Andreas Stengel
- Department for Psychosomatic Medicine, Charité Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 12200 Berlin, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany.
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Yoon C, Jacobs DR, Duprez DA, Dutton G, Lewis CE, Neumark-Sztainer D, Steffen LM, West DS, Mason SM. Questionnaire-based problematic relationship to eating and food is associated with 25 year body mass index trajectories during midlife: The Coronary Artery Risk Development In Young Adults (CARDIA) Study. Int J Eat Disord 2018; 51:10-17. [PMID: 29215750 DOI: 10.1002/eat.22813] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Problematic eating behaviors and attitudes are of public health concern. Questionnaire-based assessment of these behaviors is important for large-scale research on eating behaviors. The questionnaire on eating and weight patterns-revised (QEWP-R) measures potential problematic behaviors and attitudes toward food (including anxieties, compensatory actions, overeating and loss of control, dieting, and shape concerns) that in aggregate may indicate diagnosable eating disorders. An important question regards the prevalence of these issues and their longitudinal associations with body mass index (BMI) in generally healthy middle aged adults. METHOD Based on eight constructs measured on QEWP-R, we created a new problematic relationship to eating and food (PREF) scale by assigning a point for each construct endorsed. Analyses were conducted in 3,892 black and white men and women participating in the community-based Coronary Artery Risk Development in Young Adults (CARDIA) Study. The QEWP-R was administered in CARDIA year 10, when participants were aged 27-41 years. We used linear regression to model the relationship of individual constructs and the PREF scale to BMI over CARDIA follow-up. RESULTS Fifty-five percent of participants had 1-5 points and 4% had 6-8 points on the PREF scale. Each separate construct was positively associated with BMI, except concern about weight and shape. Adjusting for age, race, sex, education, and study center, mean BMI at CARDIA year 10, the time of PREF assessment, was approximately 1.0-2.5 kg/m2 higher per PREF category. CONCLUSION In middle age, problematic behaviors and attitudes toward food were common and associated with higher BMI.
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Affiliation(s)
| | | | | | | | | | | | | | - Delia S West
- University of South Carolina, Columbia, South Carolina
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Bodell LP, Wildes JE, Goldschmidt AB, Lepage R, Keenan KE, Guyer AE, Hipwell AE, Stepp SD, Forbes EE. Associations Between Neural Reward Processing and Binge Eating Among Adolescent Girls. J Adolesc Health 2018; 62:107-113. [PMID: 29054735 PMCID: PMC5742026 DOI: 10.1016/j.jadohealth.2017.08.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/14/2017] [Accepted: 08/14/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE Neuroimaging studies suggest that altered brain responses to food-related cues in reward-sensitive regions characterize individuals who experience binge-eating episodes. However, the absence of longitudinal data limits the understanding of whether reward-system alterations increase vulnerability to binge eating, as theorized in models of the development of this behavior. METHODS Adolescent girls (N = 122) completed a functional magnetic resonance imaging monetary reward task at age 16 years as part of an ongoing longitudinal study. Self-report of binge eating was assessed using the Eating Attitudes Test at ages 16 and 18 years. Regression analyses examined concurrent and longitudinal associations between the blood-oxygenation-level-dependent response to anticipating and winning monetary rewards and the severity of binge eating while controlling for age 16 depressive symptoms and socioeconomic status. RESULTS Greater ventromedial prefrontal cortex and caudate responses to winning money were correlated with greater severity of binge eating concurrently but not prospectively. CONCLUSIONS This study is the first to examine longitudinal associations between reward responding and binge eating in community-based, mostly low-socioeconomic status adolescent girls. Ventromedial prefrontal cortex response to reward outcome-possibly reflecting an enhanced subjective reward value-appears to be a state marker of binge-eating severity rather than a predictor of future severity.
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Affiliation(s)
- Lindsay P. Bodell
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago
| | - Jennifer E. Wildes
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago
| | - Andrea B. Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital
| | | | - Kate E. Keenan
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago
| | - Amanda E. Guyer
- Department of Human Ecology and Center for Mind and Brain, University of California, Davis
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Castellini G, Lo Sauro C, Ricca V, Rellini AH. Body Esteem as a Common Factor of a Tendency Toward Binge Eating and Sexual Dissatisfaction Among Women: The Role of Dissociation and Stress Response During Sex. J Sex Med 2017; 14:1036-1045. [PMID: 28666657 DOI: 10.1016/j.jsxm.2017.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/31/2017] [Accepted: 06/02/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Several studies have suggested a relevant overlap between eating disorders and sexual dysfunction involving the emotional component of body image esteem and dissociative experiences. AIM To evaluate the common maintaining factors of sexual dysfunction and vulnerability to pathologic eating behaviors and their relation to a physiologic stress response. METHODS In the present cross-sectional study, we evaluated a non-clinical sample of 60 heterosexual women (25-35 years old) for dissociation during sex with a partner, body image disturbance, and tendency toward pathologic eating behaviors. We also evaluated the stress-induced hypothalamic-pituitary-adrenal axis activation in response to a sexual stimulus and its association with binge eating and dissociation. OUTCOMES Participants completed the Clinician-Administered Dissociative States Scale, the Sexual Satisfaction Scale-Women, the Body Esteem Scale for Adolescents and Adults, and the Eating Attitudes Test Short Version. Furthermore, we assessed cortisol levels before, during, and after exposure to explicit sexual stimuli shown within a laboratory setting. RESULTS Dysfunctional body image esteem and a tendency toward binge-eating behaviors were associated with greater sexual distress in women. In particular, body esteem was significantly associated with greater dissociation during sex with a partner. Moreover, women who reported greater dissociation during sex with a partner and a tendency toward binge-eating behaviors showed higher levels of cortisol in response to sexual stimuli. CLINICAL IMPLICATIONS These results support further research based on trans-diagnostic treatments targeted to dissociation and body image esteem, which could lessen sexual dysfunction and vulnerability to pathologic eating behaviors. STRENGTHS AND LIMITATIONS Despite the small sample and self-reported questionnaires, this is the first study to consider the association of the stress response during sexual stimuli with sexual distress and with pathologic eating behaviors adopting a dimensional approach. CONCLUSION Body uneasiness and dissociation represented factors underlying pathologic eating behaviors and sexual dysfunction. Women reporting a tendency toward binge-eating episodes and dissociation during sexual experiences represented a subpopulation with a higher stress response during sexual stimuli. Castellini G, Lo Sauro C, Ricca V, Rellini AH. Body Esteem as a Common Factor of a Tendency Toward Binge Eating and Sexual Dissatisfaction Among Women: The Role of Dissociation and Stress Response During Sex. J Sex Med 2017;14:1036-1045.
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Affiliation(s)
- Giovanni Castellini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy; Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy.
| | - Carolina Lo Sauro
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Valdo Ricca
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
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