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Masheb RM, Snow JL, Siegel SE, Munro LF, Huggins J, Hamilton AB, Maguen S. US Military Veteran Perspectives on Eating Disorder Screening, Diagnosis, and Treatment: A Qualitative Study. Int J Eat Disord 2024. [PMID: 38989608 DOI: 10.1002/eat.24255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVE We aimed to explore US veteran perspectives on eating disorder screening, diagnosis, patient-provider conversations, and care in the Veterans Health Administration (VHA). METHOD Rapid qualitative analysis of 30-45 min phone interviews with 16 (N = 16) veterans with an electronic health record ICD-10 eating disorder diagnosis, who received care at one of two VHA healthcare systems in Connecticut or California. Topics covered included: conversations with providers about eating disorder symptoms, diagnosis, and referral to treatment; feedback about an eating disorder screener, and; reflections on eating disorders among veterans and VHA's effort to address them. RESULTS Most veterans reported difficulty understanding and defining the problems they were experiencing and self-diagnosed their eating disorder before discussing it with a provider. Treatment referrals were almost universally for being overweight rather than for an eating disorder, often leading veterans to feel misunderstood or marginalized. Overall, veterans were enthusiastic about the screener, preferred screening to be conducted by primary care providers, and noted that conversations needed to be non-stigmatizing. There was consensus that VHA is not doing enough to address this issue, that group support and therapy could be beneficial, and that resources needed to be centralized and accessible. DISCUSSION For the most part, veterans felt that, at best, eating disorders and disordered eating are overlooked, and at worst, conflated with overweight. The majority of veterans got referred for weight loss or weight management services but would welcome the opportunity to be screened for, and referred to, eating disorder treatment.
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Affiliation(s)
- Robin M Masheb
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jennifer L Snow
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Sarah E Siegel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Lindsay F Munro
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Joy Huggins
- San Francisco VA Health Care System, Mental Health Service, San Francisco, California, USA
| | - Alison B Hamilton
- VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, California, USA
| | - Shira Maguen
- San Francisco VA Health Care System, Mental Health Service, San Francisco, California, USA
- Department of Psychiatry and Behavioral Sciences, University of California-San Francisco, San Francisco, California, USA
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Gaviria D, Ammerman A. Eating disorders and disordered eating in servicemen and women: A narrative review. J Clin Psychol 2023; 79:316-373. [PMID: 35938917 DOI: 10.1002/jclp.23424] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 06/09/2022] [Accepted: 07/14/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Eating disorders (EDs) are mental illnesses impacting all aspects of an individual's life. Recent research has examined EDs and disordered-eating behaviors in the military, a population subject to body composition standards, fitness requirements, and extreme stress. The purpose of this narrative review was to investigate ED and disordered-eating prevalence and their risk factors in ROTC (reserve officers' training corps), active-duty, and veteran servicemembers. The secondary purpose was to provide policy recommendations to reduce the burden of these conditions in the military. METHODS PubMed and PsycINFO were reviewed for relevant articles. All studies including data on EDs or disordered eating in U.S. active-duty, ROTC, or veteran populations were considered. RESULTS Results revealed a high burden of EDs and disordered eating with bulimic- and binge-type behaviors being the most common. Servicemembers exposed to trauma, including military sexual assault, and those with comorbidities like PTSD showed a higher prevalence. Body composition and fitness testing were also associated with a higher risk. Qualitative studies suggest these conditions serve as coping mechanisms for aspects of military life. CONCLUSIONS The high prevalence of EDs and disordered eating in the military points toward the importance of identification, treatment, and prevention. Policy change is necessary to protect servicemembers.
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Affiliation(s)
- David Gaviria
- Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alice Ammerman
- Center for Health Promotion and Disease Prevention, Department of Nutrition, Schools of Public Health and Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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3
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Relationships Between Dietary Intake and Weight-Related Experiential Avoidance Following Behavioral Weight-Loss Treatment. Int J Behav Med 2022; 29:104-109. [PMID: 33864234 PMCID: PMC8522188 DOI: 10.1007/s12529-021-09990-0] [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] [Accepted: 04/09/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Interventions targeting weight-related experiential avoidance (EA) and disinhibited eating (DE) may also improve diet quality. Participants with overweight/obesity and DE who recently completed a behavioral weight-loss program were randomized to receive acceptance and commitment therapy or continued behavioral weight-loss treatment. In this secondary analysis, we explored (1) change in diet quality from baseline to 6-month follow-up (FU) and (2) whether weight-related EA at baseline and (3) change in weight-related EA during treatment were related to change in diet quality from baseline to FU. METHOD Veterans (N = 68) completed food frequency questionnaires at baseline and FU, which were used to generate diet quality scores on the healthy eating index-15 (HEI-15). Weight-related EA was assessed using the Acceptance and Action Questionnaire for Weight-Related Difficulties-Revised (AAQW-R) at baseline, post-treatment, and FU. Aims were examined with mixed ANOVA analyses. RESULTS Across both treatment groups, HEI-15 scores declined from baseline to FU. Women's HEI-15 decreased by about 5 times that of men. Baseline AAWQ-R was negatively associated with change in HEI-15. Neither AAWQ-R at post-treatment nor change in AAQW-R from baseline to post-treatment was significantly associated with change in HEI-15 at FU. CONCLUSIONS Greater weight-related EA at baseline was associated with lower diet quality at FU, but change in weight-related EA during treatment did not predict change in diet quality at FU. Interventions targeting DE and weight-loss may require specific components to improve and sustain healthy dietary intake in Veterans with obesity and DE.
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Etuk R, Shirk SD, Klein KM, Masheb RM, Potenza MN, Park CL, Keeler K, Kraus SW. Examining the Clinical Correlates of Overeating and Binge-Eating Behaviors Among U. S. Veterans. Mil Med 2021; 187:297-303. [PMID: 34962274 DOI: 10.1093/milmed/usab533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/26/2021] [Accepted: 12/15/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Pressure to meet U.S. military weight requirements during service may predispose some service members to develop psychiatric disorders such as eating disorders or unhealthy eating behaviors, which may persist after military discharge. Specifically, research examining U.S. military veterans has found that in weight management programs, veterans with binge-eating behaviors have shown poor treatment outcomes. Overall, previous research suggests that veterans experience considerable and persistent disordered eating problems, and in addition may experience a higher prevalence of disordered eating in comparison to the general U.S. population. Research on Post-9/11 Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) veterans is needed as this group frequently presents with high rates of medical and psychiatric disorders. The current study used clinician-administered structured interviews to examine relationships between psychiatric, health, and demographic variables in a sample of Post-9/11 OEF/OIF/OND veterans with binge-eating or overeating behavior or neither. MATERIALS AND METHODS This article presents secondary analyses of the baseline phase from data obtained for the Survey of the Experiences of Returning Veterans. Using structured phone interviews, we cross-sectionally examined patterns of medical comorbidities between sociodemographic, health, eating, and psychiatric variables in 846 recently deployed U.S. veterans with binge-eating behaviors (reporting both overeating and loss of control [LOC] eating), overeating behaviors (overeating without LOC), or healthy controls (absence of any disordered eating). Study procedures were approved by the Department of Veterans Affairs (VA) Institutional Review Boards, and informed consent was obtained from the participants. A series of chi-square and analysis of variance tests revealed significant bivariate between-group differences in sociodemographic, health, eating, and psychiatric variables. Variables with significant group differences (P < .05) were entered into a multinomial logistic regression to examine relationships between psychiatric, health, and eating factors and binge-eating severity. RESULTS Results of the multinomial logistic regression analysis showed that women relative to men were less likely to overeat. When comparing the binge-eating group and controls, higher body mass index was associated with higher odds of binge eating. Furthermore, for the overeating group in comparison to controls, fasting behavior was associated with higher odds of overeating. For the psychiatric variables, the binge-eating and overeating groups were associated with higher rates of compulsive buying when compared to healthy controls. Additionally, the overeating group was associated with higher rates of alcohol dependence. Lastly, binge-eating and overeating behaviors were positively associated with specific psychiatric and health comorbidities. CONCLUSIONS Further research is needed to inform the development of effective treatments for disordered eating problems, as evidenced by an anticipated increase of veterans entering the VA healthcare system and the high rate of binge eating observed in our study and prior research in Post-9/11 veterans. Moreover, our study findings suggest the relevance of screening veterans for compulsive buying. This study was limited by its relatively small sample which only examined disordered eating behaviors. Future studies could simultaneously explore binge-eating behaviors and binge-eating disorder diagnoses in larger samples. Study strengths include a diverse sample of Post-9/11 veterans with sizable female representation.
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Affiliation(s)
- Repairer Etuk
- Department of Psychology, University of Nevada, Las Vegas, NV 89154-5030, USA
| | - Steven D Shirk
- VISN 1 New England MIRECC, Bedford Healthcare System, Bedford, MA 01730, USA.,Department of Psychiatry and Population and Quantitative Health Sciences Psychiatry, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Kelly M Klein
- Department of Veterans Affairs, Brockton Division, VA Boston Healthcare System, Boston, MA 02301, USA.,Department of Psychiatry, Harvard University Medical School, Boston, MA 02215, USA
| | - Robin M Masheb
- VA Connecticut Healthcare System, West Haven, CT, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA.,Department of Neuroscience, Yale University, New Haven, CT, USA
| | - Crystal L Park
- Department of Psychological Science, University of Connecticut, Storrs, CT 06269, USA
| | - Kerri Keeler
- Department of Veterans Affairs, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV 89154-5030, USA
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Wooldridge JS, Herbert MS, Dochat C, Afari N. Understanding relationships between posttraumatic stress disorder symptoms, binge-eating symptoms, and obesity-related quality of life: the role of experiential avoidance. Eat Disord 2021; 29:260-275. [PMID: 33459212 PMCID: PMC8285449 DOI: 10.1080/10640266.2020.1868062] [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] [Indexed: 10/22/2022]
Abstract
Obesity, binge-eating symptoms, and PTSD symptoms commonly co-occur. Avoidance, a key feature of PTSD and proposed mechanism of binge-eating, is one potential mechanism for explaining this clinical overlap. The purpose of the current study was to: 1) examine the associations between PTSD symptoms (PTSD Checklist-Civilian; PCL-C) and measures of bingeeating symptoms (Binge Eating Scale; BES) and obesity-related quality of life (Obesity Related Well-Being Questionnaire-97; ORWELL-97) in a sample of veterans with overweight or obesity (N = 89), and 2) determine whether experiential avoidance (The Acceptance and Action Questionnaire-II; AAQ-II) explains the relationship between PTSD symptoms and binge-eating symptoms, and PTSD symptoms and obesity-related quality of life, respectively. Scores on the PCL-C, BES, ORWELL-97, and AAQ-II were all significantly correlated. Linear regression analyses indicated that higher PCL-C scores were related to higher scores on the BES and ORWELL-97 after controlling for potentially confounding factors (BMI and race). Effect sizes were in the medium-large range. Further, AAQ-II mediated the relationship between PCL-C and ORWELL-97, but did not mediate the relationship between PCL-C and BES. These findings suggest that experiential avoidance should be considered in interventions addressing co-occurring PTSD, binge-eating, and poor obesity-related well-being. Longitudinal research is needed to better understand directionality of these relationships and changes over time.
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Affiliation(s)
- Jennalee S Wooldridge
- VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, California, USA.,Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California, USA
| | - Matthew S Herbert
- VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, California, USA.,Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California, USA
| | - Cara Dochat
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, California, San Diego, USA
| | - Niloofar Afari
- VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, California, USA.,Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California, USA
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Christian A, Parekh B, Koritzky G. Bias and discrimination against men with overweight in the military. Health Psychol Open 2021; 7:2055102920985374. [PMID: 33489302 PMCID: PMC7768582 DOI: 10.1177/2055102920985374] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Research on weight-bias against men and/or in the military is scarce. Such a bias might cause some military members, who are otherwise fit to perform their duties, to suffer from discrimination and undue stress. We showed military personnel a picture of a soldier who had either normal weight or overweight. In both conditions, the description of the soldier stated that his physical fitness and job-related skills were good. Nonetheless, the soldier’s suitability for promotion was rated lower in the overweight condition. These findings improve our understanding of the impact of bias on the mental and physical health of men with overweight.
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Affiliation(s)
| | - Bina Parekh
- The Chicago School of Professional Psychology, USA
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Factors associated with psychological stress and distress among Korean adults: the results from Korea National Health and Nutrition Examination Survey. Sci Rep 2020; 10:15134. [PMID: 32934275 PMCID: PMC7492217 DOI: 10.1038/s41598-020-71789-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 08/13/2020] [Indexed: 01/16/2023] Open
Abstract
The prevalence of stress and distress has been increasing and being important public health issues; nevertheless, few studies have assessed the factors associated at the population level. This study identified factors associated and how they differentially influence stress and distress. A total of 35,105 individuals aged 19 years and older using nationally representative data from the Korea National Health and Nutrition Examination Survey (2007-2012) were included in the study. Subjects were differentiated by gender and psychological state (no symptoms, stress, distress). The associations of socio-demographics, psychosocial factors, health behaviours, and chronic illness with psychological states were analysed by gender. Socio-demographics and psychosocial factors such as lower household income, lower education level, living alone or negative outcome of marriage, and unemployment were associated with distress in both genders. Male and female educated higher and with short sleep duration, male living alone and with higher household income, and female married and with a lower household income was associated with stress. A perceived body image of slim or fat was associated with distress and stress in both genders. Behavioural factors, such as smoking, higher alcohol consumption, and abnormal calorie intake, were associated with stress and distress in both genders, with the exception of alcohol consumption in distress and abnormal calorie intake in stress of male. Socio-economic deprivation and negative psychosocial and behavioural factors were differently associated with psychological distress or stress by gender. Intervention strategies for distress and stress should be specifically tailored regarding these differences.
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8
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Matsumoto A, Rodgers RF. A review and integrated theoretical model of the development of body image and eating disorders among midlife and aging men. Clin Psychol Rev 2020; 81:101903. [PMID: 32829288 DOI: 10.1016/j.cpr.2020.101903] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/11/2020] [Accepted: 08/10/2020] [Indexed: 01/26/2023]
Abstract
Etiological models of the development of eating disorders among midlife and aging men are lacking. The present study provides a review and integration of existing theoretical frameworks and empirical data relevant to the examination of eating pathology in this population and introduces an integrated model of risk and protective factors for the development of eating disorder symptoms. Several etiological models of eating pathology that have gained some empirical support, or present relevance to this population, are briefly reviewed including sociocultural theory, objectification theory, social identity theory, positive body image and the developmental theory of embodiment, and existential and terror management theory, and finally biologically based theories. In addition, these frameworks were extended to account for developmental and gender-specific factors that may influence the development of eating disorders. An integrated model of risk and protective factors that brings together critical elements of these extended theoretical frameworks is presented, with the goal of guiding and stimulating research in this neglected group.
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Affiliation(s)
- Atsushi Matsumoto
- Department of Counseling and Applied Educational Psychology, Northeastern University, Boston, USA
| | - Rachel F Rodgers
- Department of Counseling and Applied Educational Psychology, Northeastern University, Boston, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France.
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Afari N, Herbert MS, Godfrey KM, Cuneo JG, Salamat JS, Mostoufi S, Gasperi M, Ober K, Backhaus A, Rutledge T, Wetherell JL. Acceptance and commitment therapy as an adjunct to the MOVE! programme: a randomized controlled trial. Obes Sci Pract 2019; 5:397-407. [PMID: 31687165 PMCID: PMC6819973 DOI: 10.1002/osp4.356] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/25/2019] [Accepted: 06/29/2019] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE The current study tested the efficacy of an acceptance and commitment therapy (ACT) group intervention for disinhibited eating behaviour as an adjunct to the Veterans Affairs MOVE!© weight management programme. METHODS Veterans (N = 88) with overweight or obesity who completed the MOVE! weight management programme and self-identified as having problems with 'stress-related eating' were randomized to four 2-h weekly ACT sessions or a continued behavioural weight-loss (BWL) intervention. Assessments were completed at baseline, post-treatment and 3- and 6-month follow-up on outcomes of interest including measures of disinhibited eating patterns, obesity-related quality of life, weight-related experiential avoidance and weight. RESULTS The BWL group exhibited significantly greater reductions in binge eating behaviour at post-treatment compared with the ACT group. Significant improvements in other outcomes were found with minimal differences between groups. In both groups, decreases in weight-related experiential avoidance were related to improvements in binge eating behaviour. CONCLUSIONS Taken together, the continued BWL intervention resulted in larger improvements in binge eating behaviour than the ACT intervention. The two groups showed similar improvements in other disinhibited eating outcomes. Future studies are encouraged to determine if more integrated or longer duration of ACT treatment may maximize eating outcomes in MOVE.Trial Registration Number: This trial was registered with ClinicalTrials.gov database (NCT01757847).
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Affiliation(s)
- N. Afari
- VA San Diego Healthcare SystemSan DiegoCAUSA
- Department of PsychiatryUniversity of California, San DiegoLa JollaCAUSA
- Center of Excellence for Stress and Mental Health (CESAMH)San DiegoCAUSA
| | - M. S. Herbert
- VA San Diego Healthcare SystemSan DiegoCAUSA
- Department of PsychiatryUniversity of California, San DiegoLa JollaCAUSA
- Center of Excellence for Stress and Mental Health (CESAMH)San DiegoCAUSA
| | - K. M. Godfrey
- Drexel University Center for Weight, Eating, and Lifestyle SciencePhiladelphiaPAUSA
| | - J. G. Cuneo
- VA San Diego Healthcare SystemSan DiegoCAUSA
- Department of PsychiatryUniversity of California, San DiegoLa JollaCAUSA
| | | | - S. Mostoufi
- Behavior Therapy Center of Greater WashingtonSilver SpringMDUSA
| | - M. Gasperi
- Department of PsychiatryUniversity of California, San DiegoLa JollaCAUSA
- Center of Excellence for Stress and Mental Health (CESAMH)San DiegoCAUSA
| | - K. Ober
- VA San Diego Healthcare SystemSan DiegoCAUSA
| | - A. Backhaus
- VA San Diego Healthcare SystemSan DiegoCAUSA
- Department of PsychiatryUniversity of California, San DiegoLa JollaCAUSA
| | - T. Rutledge
- VA San Diego Healthcare SystemSan DiegoCAUSA
- Department of PsychiatryUniversity of California, San DiegoLa JollaCAUSA
| | - J. L. Wetherell
- VA San Diego Healthcare SystemSan DiegoCAUSA
- Department of PsychiatryUniversity of California, San DiegoLa JollaCAUSA
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10
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Dochat C, Godfrey KM, Golshan S, Cuneo JG, Afari N. Dietary restraint and weight loss in relation to disinhibited eating in obese Veterans following a behavioral weight loss intervention. Appetite 2019; 140:98-104. [PMID: 31078701 PMCID: PMC6581621 DOI: 10.1016/j.appet.2019.05.013] [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] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 05/04/2019] [Accepted: 05/08/2019] [Indexed: 01/21/2023]
Abstract
Ability to restrain one's dietary intake is a necessary skill for weight loss. However, dietary restraint has been shown to paradoxically increase disinhibited eating in certain populations, thereby negatively impacting weight loss and leading to worse overall health outcomes. The aim of this study was to address gaps in the literature regarding the relationships between separate facets of dietary restraint (intention; behavior) with weight loss and various types of disinhibited eating (binge eating, external eating, emotional eating) in overweight and obese adults who recently completed a weight loss intervention. A sample of mostly male Veterans with overweight and obesity (N = 88) self-reported their dietary restraint intention, restraint behavior, and current disinhibited eating following completion of an 8-week behavioral weight loss treatment. Greater dietary restraint intention was related to greater dietary restraint behavior, p < .05. Greater dietary restraint behavior was significantly related to greater recent weight loss, p < .05, while restraint intention was not, p > .05. Greater dietary restraint intention was related to greater current binge eating and external eating, while greater self-reported restraint behavior was related to less binge eating, p < .05. Thus, dietary restraint behavior appears to be adaptive for this population, whereas rigid dietary restraint intention may increase risk for disinhibited eating. To decrease disinhibited eating and improve weight loss outcomes in Veterans, interventions might specifically address rigid rule-following associated with abandonment of weight loss goals and help Veterans develop specific yet flexible eating plans. Future research should examine whether dietary restraint intention and behavior differentially predict disinhibited eating and weight loss outcomes prospectively.
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Affiliation(s)
- Cara Dochat
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA
| | - Kathryn M Godfrey
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Shahrokh Golshan
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Jessica Gundy Cuneo
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Niloofar Afari
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, San Diego, CA, USA; VA Center of Excellence for Stress and Mental Health, USA.
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Abstract
PURPOSE OF REVIEW The purpose of this review was to examine different forms of disordered eating among individuals with excess weight, including their rates, correlates, and psychosocial treatments. RECENT FINDINGS Binge eating/binge eating disorder, loss of control eating, emotional eating, and food addiction are all fairly prevalent among individuals with excess weight. They appear to share many of the same correlates, including broader eating disorder psychopathology, body/shape/weight concerns, depression, anxiety, and low self-esteem. Behavioral, cognitive-behavioral, and third-wave (e.g., acceptance, mindfulness) therapies appear effective in improving binge eating, loss of control eating, emotional eating, associated features (e.g., weight and shape concerns), and psychological distress (e.g., depression). Certain forms of disordered eating are elevated among individuals with excess weight, and psychosocial interventions have been found effective in improving symptomatology. Empirical research examining the efficacy of treatments for food addiction is lacking, and greatly needed given both its rate and controversy.
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Affiliation(s)
- Bethany A Nightingale
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
| | - Stephanie E Cassin
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Centre for Mental Health, University Health Network, Toronto, ON, Canada.
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Barber JA, Ivezaj V, Barnes RD. Comparing physical activity in individuals with overweight/obesity with and without binge eating disorder. Obes Sci Pract 2018; 4:134-140. [PMID: 29670751 PMCID: PMC5893463 DOI: 10.1002/osp4.154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/21/2017] [Accepted: 12/22/2017] [Indexed: 01/14/2023] Open
Abstract
Objective Differential participation in physical activity (PA) may partially explain the health discrepancies between individuals with or without binge-eating disorder (BED). Yet, little is known about the PA habits of individuals with overweight/obesity and how those patterns may differ based on BED status. PA patterns and exercise self-efficacy were examined in individuals with overweight/obesity, with and without BED. Design Ninety-seven participants with overweight/obesity self-reported their PA via the Godin Leisure-Time Questionnaire and the Paffenbarger PA Questionnaire. Exercise self-efficacy was assessed with the Marcus 5-item Exercise Self-Efficacy scale. Based on the Eating Disorder Examination, 27.8% (n = 27) of the participants met BED criteria. Participants were primarily female (n = 75, 77.3%), on average 47.5 years old (standard deviation = 10.4), and predominantly White/Not Hispanic (n = 67, 69.1%) or African-American/Not Hispanic (n = 18, 18.6%). Results Hierarchical regressions, accounting for significant differences in body mass index between those with and without BED, showed that the Marcus 5-item Exercise Self-Efficacy Scale (but not BED status) was significantly related to PA. BED status also was unrelated to likelihood of reaching Centres for Disease Control PA guidelines, and 44.3% of all participants reported no participation in weekly sports/recreation activities. Conclusions Both groups participated in relatively little purposeful and moderate/strenuous PA. Exercise self-efficacy may be important to assess and address among treatment seeking individuals with and without BED who struggle with excess weight.
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Affiliation(s)
- J. A. Barber
- Psychology 116BVA Connecticut Healthcare SystemWest HavenCTUSA
- Department of PsychiatryYale University School of MedicineNew HavenCTUSA
| | - V. Ivezaj
- Department of PsychiatryYale University School of MedicineNew HavenCTUSA
| | - R. D. Barnes
- Department of PsychiatryYale University School of MedicineNew HavenCTUSA
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Arditte Hall KA, Bartlett BA, Iverson KM, Mitchell KS. Military-related trauma is associated with eating disorder symptoms in male veterans. Int J Eat Disord 2017; 50:1328-1331. [PMID: 28940217 PMCID: PMC5944843 DOI: 10.1002/eat.22782] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 08/30/2017] [Accepted: 09/04/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Eating disorders are understudied among male veterans, who may be at increased risk due to the high rates of trauma exposure and experiences of multiple traumatization in this population. This study sought to examine the associations between specific types of trauma (i.e., childhood physical abuse, adult physical assault, childhood sexual abuse, adult sexual assault, and military-related trauma) and eating disorder symptoms in a large, nationally-representative sample of trauma-exposed male veterans. METHOD Survey data were collected from N = 642 male veterans. Traumatic experiences in childhood and adulthood were assessed using the Trauma History Screen and the National Stressful Events Survey. Eating disorder symptoms were assessed with the Eating Disorder Diagnostic Scale. Analyses also controlled for age and body mass index. RESULTS Multiple traumatization was associated with increased eating disorder symptoms. However, military-related trauma was the only trauma type that was uniquely associated with eating disorder symptoms when controlling for other trauma types. Examination of different types of military-related trauma indicated that this association was not driven by exposure to combat. DISCUSSION Noncombat, military-related trauma was associated with eating disorder symptom severity in male veterans. Results highlight the need for better assessment of eating disorder symptoms in this population.
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Affiliation(s)
- Kimberly A. Arditte Hall
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | | | - Katherine M. Iverson
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Karen S. Mitchell
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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Dorflinger LM, Ruser CB, Masheb RM. Night eating among veterans with obesity. Appetite 2017; 117:330-334. [DOI: 10.1016/j.appet.2017.07.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 12/20/2022]
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15
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Dorflinger LM, Ruser CB, Masheb RM. A brief screening measure for binge eating in primary care. Eat Behav 2017; 26:163-166. [PMID: 28402901 DOI: 10.1016/j.eatbeh.2017.03.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 03/27/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Binge eating disorder (BED) is associated with medical and psychiatric issues commonly seen and managed in primary care; however, the disorder typically goes undetected as there are no assessment tools feasible for use in primary care. The objective was to examine the validity of the VA Binge Eating Screener (VA-BES), a single-item screening measure for binge eating. METHOD The sample consisted of 116 veterans referred to a primary care-based weight management program. Participants had a mean age of 61.66years (SD=8.73) and average BMI of 37.90 (SD=7.35). Frequency of binge eating ranged from zero to 21 episodes per week. The prevalence of BED was 7.76%. All participants completed the Questionnaire of Eating and Weight Patterns - Revised (QEWP-R) to assess for BED. They also completed the VA-BES, and measures of disordered eating and depressive symptoms. RESULTS The VA-BES was compared to the QEWP-R to determine the sensitivity, specificity, positive predictive value, and negative predictive value for each cutpoint. Analyses revealed one cutpoint (≥2 binge eating episodes per week) maximized these values, demonstrated excellent agreement with the QEWP-R (χ2=24.79, p<0.001), and had significant associations with other variables commonly associated with binge eating. DISCUSSION This study demonstrates the utility and validity of a single-item measure to screen for binge eating in primary care. The item can quickly and easily identify binge eating, thus facilitating referral to treatment and potentially subsequent improvements in related medical and mental health comorbidities treated in primary care.
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Affiliation(s)
- Lindsey M Dorflinger
- VA Connecticut Healthcare System, United States; Yale School of Medicine, United States.
| | - Christopher B Ruser
- VA Connecticut Healthcare System, United States; Yale School of Medicine, United States
| | - Robin M Masheb
- VA Connecticut Healthcare System, United States; Yale School of Medicine, United States
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16
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Hoerster KD, Wilson S, Nelson KM, Reiber GE, Masheb RM. Diet quality is associated with mental health, social support, and neighborhood factors among Veterans. Eat Behav 2016; 23:168-173. [PMID: 27816854 DOI: 10.1016/j.eatbeh.2016.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 10/17/2016] [Accepted: 10/18/2016] [Indexed: 12/13/2022]
Abstract
United States Veterans have a higher prevalence of overweight and related chronic conditions compared to the general population. Although diet is a primary and modifiable contributor to these conditions, little is known about factors influencing diet quality among Veterans. The goal of this study is to examine individual, social environment, and physical environment correlates of general diet quality among Veterans. Study participants (N=653) received care at an urban VA Medical Center in Seattle, WA and completed a mailed survey in 2012 and 2013. Diet quality was assessed with Starting the Conversation, an instrument that measures consumption of unhealthy snacks, fast food, desserts, sugar-sweetened beverages, and fats; fruits and vegetables; and healthy proteins. Variables significantly (p<0.05) associated with diet quality in bivariate analyses were included in a multivariate regression. In the multivariate model, higher level of depressive symptom severity (Diff=0.05; CI=0.01, 0.09; p=0.017); not having others eat healthy meals with the Veteran (Diff=-0.81; CI=-1.5, -0.1; p=0.022); and reduced availability of low-fat foods in neighborhood stores where the Veteran shops (Diff=-0.37; CI=-0.6, -0.2; p<0.001) were associated with poorer diet quality. Consistent with prior research in the general population, this study identified multiple domains associated with Veterans' diet quality, including psychological comorbidity, the social environment, and the physical environment. Findings from this study suggest that interventions aimed at mental health, social support, and neighborhood access to healthy foods are needed to improve Veteran diet quality.
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Affiliation(s)
- Katherine D Hoerster
- VA Puget Sound Healthcare System, Seattle Division, Research and Development Service, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States; University of Washington, Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific St, Seattle, WA 98195, United States.
| | - Sarah Wilson
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, 508 Fulton Street (Mail Stop: MIRECC), Durham, NC 27705, United States; Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC 27705, United States.
| | - Karin M Nelson
- VA Puget Sound Healthcare System, Seattle Division, Research and Development Service, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States; VA Puget Sound Healthcare System, General Internal Medicine Service, 1660 South Columbian Way, Seattle, WA 98108, United States; University of Washington Department of Medicine, 1959 NE Pacific St, Seattle, WA 98195, United States.
| | - Gayle E Reiber
- VA Puget Sound Healthcare System, Seattle Division, Research and Development Service, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States; University of Washington School of Public Health, Departments of Health Services and Epidemiology, 1959 NE Pacific St, Seattle, WA 98195, United States.
| | - Robin M Masheb
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, United States; Yale School of Medicine, 301 Cedar Street, New Haven, CT 06520, United States.
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Haibach JP, Haibach MA, Hall KS, Masheb RM, Little MA, Shepardson RL, Dobmeyer AC, Funderburk JS, Hunter CL, Dundon M, Hausmann LR, Trynosky SK, Goodrich DE, Kilbourne AM, Knight SJ, Talcott GW, Goldstein MG. Military and veteran health behavior research and practice: challenges and opportunities. J Behav Med 2016; 40:175-193. [DOI: 10.1007/s10865-016-9794-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 09/09/2016] [Indexed: 12/01/2022]
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18
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Chao A, Grey M, Whittemore R, Reuning-Scherer J, Grilo CM, Sinha R. Examining the mediating roles of binge eating and emotional eating in the relationships between stress and metabolic abnormalities. J Behav Med 2015; 39:320-32. [PMID: 26686376 DOI: 10.1007/s10865-015-9699-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 11/24/2015] [Indexed: 12/31/2022]
Abstract
To test whether binge eating and emotional eating mediate the relationships between self-reported stress, morning cortisol and the homeostatic model of insulin resistance and waist circumference. We also explored the moderators of gender and age. Data were from 249 adults (mean BMI = 26.9 ± 5.1 kg/m(2); mean age = 28.3 ± 8.3 years; 54.2% male; 69.5% white) recruited from the community who were enrolled in a cross-sectional study. Participants completed a comprehensive assessment panel of psychological and physiological assessments including a morning blood draw for plasma cortisol. We found negative relationships between stress and morning cortisol (r = -0.15 to -0.21; p < 0.05), and cortisol and the homeostatic model of insulin resistance and waist circumference (r = -0.16, -0.25, respectively; p < 0.05). There was not statistical support for binge eating or emotional eating as mediators and no support for moderated mediation for either gender or age; however, gender moderated several paths in the model. These include the paths between perceived stress and emotional eating (B = 0.009, p < 0.001), perceived stress and binge eating (B = 0.01, p = 0.003), and binge eating and increased HOMA-IR (B = 0.149, p = 0.018), which were higher among females. Among women, perceived stress may be an important target to decrease binge and emotional eating. It remains to be determined what physiological and psychological mechanisms underlie the relationships between stress and metabolic abnormalities.
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Affiliation(s)
- Ariana Chao
- Yale University School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA.
| | - Margaret Grey
- Yale University School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
| | - Robin Whittemore
- Yale University School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
| | | | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Department of Psychology, Yale University, New Haven, CT, USA.,CASAColumbia, Yale University School of Medicine, New Haven, CT, USA
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Yale Stress Center, New Haven, CT, USA
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19
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Bartlett BA, Mitchell KS. Eating disorders in military and veteran men and women: A systematic review. Int J Eat Disord 2015; 48:1057-69. [PMID: 26310193 DOI: 10.1002/eat.22454] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Eating disorders (EDs) have serious consequences for psychological and physical health. They have high mortality rates and are among the most costly disorders to treat. However, EDs remain understudied in military and veteran populations. The aim of this review was to examine prevalence estimates and associated symptomatology of EDs among military and veteran men and women and to identify factors that may put these individuals at risk for the development of an ED for the purposes of improving detection, intervention, and treatment. METHOD A thorough literature review was conducted using the databases PsycINFO and PubMed. All articles with a focus on EDs in military/veteran samples were considered. RESULTS Studies reveal high prevalence estimates of EDs among military/veteran men and women. Unique features of military life may increase the risk for development of an ED, including: military sexual trauma, strict weight and physical fitness requirements, and combat exposure. A history of trauma was common in individuals diagnosed with an ED in military and veteran samples. DISCUSSION The high rates of EDs among military and veteran samples underscore the importance of further research, as well as the importance of screening and intervention efforts, in these understudied populations.
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Affiliation(s)
- Brooke A Bartlett
- Women's Health Sciences Division, National Center for PTSD At the VA Boston Healthcare System, Boston, Massachusetts.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Karen S Mitchell
- Women's Health Sciences Division, National Center for PTSD At the VA Boston Healthcare System, Boston, Massachusetts.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
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20
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Podfigurna-Stopa A, Czyzyk A, Katulski K, Smolarczyk R, Grymowicz M, Maciejewska-Jeske M, Meczekalski B. Eating disorders in older women. Maturitas 2015; 82:146-52. [DOI: 10.1016/j.maturitas.2015.06.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 06/22/2015] [Accepted: 06/23/2015] [Indexed: 11/26/2022]
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Hoerster KD, Jakupcak M, Hanson R, McFall M, Reiber G, Hall KS, Nelson KM. PTSD and depression symptoms are associated with binge eating among US Iraq and Afghanistan veterans. Eat Behav 2015; 17:115-8. [PMID: 25687231 DOI: 10.1016/j.eatbeh.2015.01.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/25/2014] [Accepted: 01/28/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE US Iraq and Afghanistan Veterans with post-traumatic stress disorder (PTSD) and depression are at increased risk for obesity. Understanding the contribution of health behaviors to this relationship will enhance efforts to prevent and reduce obesity. Therefore, we examined the association of PTSD and depression symptoms with binge eating, a risk factor for obesity, among Iraq/Afghanistan Veterans. METHOD Iraq/Afghanistan Veterans were assessed at intake to the VA Puget Sound Healthcare System-Seattle post-deployment clinic (May 2004-January 2007). The Patient Health Questionnaire was used to measure depression and binge eating symptoms, and the PTSD Checklist-Military Version assessed PTSD symptoms. RESULTS The majority of the sample (N=332) was male (91.5%) and Caucasian (72.6%), with an average age of 31.1 (SD=8.5) years; 16.3% met depression screening criteria, 37.8% met PTSD screening criteria, and 8.4% met binge eating screening criteria. In adjusted models, those meeting depression (odds ratio (OR)=7.53; 95% CI=2.69, 21.04; p<.001) and PTSD (OR=3.37; 95% CI=1.34, 8.46; p=.01) screening criteria were more likely to meet binge eating screening criteria. Continuous measures of PTSD and depression symptom severity were also associated with meeting binge eating screening criteria (ps<.05). CONCLUSION PTSD and depression are common conditions among Iraq/Afghanistan Veterans. In the present study, PTSD and depression symptoms were associated with meeting binge eating screening criteria, identifying a possible pathway by which psychiatric conditions lead to disproportionate burden of overweight and obesity in this Veteran cohort. Tailored dietary behavior interventions may be needed for Iraq/Afghanistan Veterans with co-morbid obesity and psychiatric conditions.
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Affiliation(s)
- Katherine D Hoerster
- VA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; University of Washington, Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific Street, Box 356560, Rm BB1644, Seattle, WA 98195, United States.
| | - Matthew Jakupcak
- VA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; University of Washington, Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific Street, Box 356560, Rm BB1644, Seattle, WA 98195, United States.
| | - Robert Hanson
- VA Puget Sound Healthcare System, Seattle Division, Research and Development Service, 1660 S. Columbian Way, Seattle, WA 98108, United States.
| | - Miles McFall
- VA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; University of Washington, Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific Street, Box 356560, Rm BB1644, Seattle, WA 98195, United States.
| | - Gayle Reiber
- VA Puget Sound Healthcare System, Seattle Division, Research and Development Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; University of Washington School of Public Health, Departments of Health Services and Epidemiology, 1959 NE Pacific Street, Box 356560, Rm BB1644, Seattle, WA 98195, United States.
| | - Katherine S Hall
- Durham Veterans Affairs Medical Center Geriatric Research, Education, and Clinical Center, 508 Fulton St., Durham, NC 27705, United States; Duke University Medical Center, Department of Medicine, 201 Trent Drive, Box 3003 DUMC, Rm 3502 Busse Building, Durham, NC 27710, United States.
| | - Karin M Nelson
- VA Puget Sound Healthcare System, Seattle Division, Research and Development Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; VA Puget Sound Healthcare System, General Internal Medicine Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; University of Washington Department of Medicine, 1959 N.E. Pacific St. Seattle, WA 98195, United States.
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Dietary Adherence, Glycemic Control, and Psychological Factors Associated with Binge Eating Among Indigenous and Non-Indigenous Chileans with Type 2 Diabetes. Int J Behav Med 2015; 22:792-8. [PMID: 25786595 DOI: 10.1007/s12529-015-9478-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Despite the strong association between obesity and binge eating, limited research has examined the implications of binge eating on dietary adherence and psychological factors in ethnically diverse type 2 diabetes patients. PURPOSE This study investigated the prevalence of binge eating and its association with dietary adherence, glycemic control, and psychological factors among indigenous and non-indigenous type 2 diabetes patients in Chile. METHOD Participants were 387 indigenous (Mapuche) and non-indigenous (non-Mapuche) adults with type 2 diabetes. Self-report measures of binge eating, dietary adherence, diet self-efficacy, body image dissatisfaction, and psychological well-being were administered. Participants' weight, height, and glycemic control (HbA(1c)) were also obtained. RESULTS Approximately 8 % of the type 2 diabetes patients reported binge eating. The prevalence among Mapuche patients was 4.9 %, and among non-Mapuche patients, it was 9.9 %. Compared to non-binge eaters, binge eating diabetes patients had greater body mass index values, consumed more high-fat foods, were less likely to adhere to their eating plan, and reported poorer body image and emotional well-being. CONCLUSION Results of this study extend previous research by examining the co-occurrence of binge eating and type 2 diabetes as well as the associated dietary behaviors, glycemic control, and psychological factors among indigenous and non-indigenous patients in Chile. These findings may increase our understanding of the health challenges faced by indigenous populations from other countries and highlight the need for additional research that may inform interventions addressing binge eating in diverse patients with type 2 diabetes.
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Luca A, Luca M, Calandra2 C. Eating Disorders in Late-life. Aging Dis 2015; 6:48-55. [PMID: 25657852 PMCID: PMC4306473 DOI: 10.14336/ad.2014.0124] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 01/23/2014] [Accepted: 01/24/2014] [Indexed: 12/16/2022] Open
Abstract
Eating disorders are a heterogeneous group of complex psychiatric disorders characterized by abnormal eating behaviours that lead to a high rate of morbidity, or even death, if underestimated and untreated. The main disorders enlisted in the chapter of the Diagnostic and Statistic Manual of Mental Disorders-5 dedicated to "Feeding and Eating Disorders" are: anorexia nervosa, bulimia nervosa and binge eating disorder. Even though these abnormal behaviours are mostly diagnosed during childhood, interesting cases of late-life eating disorders have been reported in literature. In this review, these eating disorders are discussed, with particular attention to the diagnosis and management of those cases occurring in late-life.
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Affiliation(s)
- Antonina Luca
- Department “G.F. Ingrassia” Section of Neuroscience, University of Catania (Sicily), Italy
| | - Maria Luca
- Department of Medical and Surgery Specialties, Psychiatry Unit of the University Hospital “Policlinico-Vittorio Emanuele” of Catania (Sicily), Italy. Via S. Sofia 78, 95100 Catania
| | - Carmela Calandra2
- Department of Medical and Surgery Specialties, Psychiatry Unit of the University Hospital “Policlinico-Vittorio Emanuele” of Catania (Sicily), Italy. Via S. Sofia 78, 95100 Catania
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Masheb RM, Lutes LD, Kim HM, Holleman RG, Goodrich DE, Janney CA, Kirsh S, Richardson CR, Damschroder LJ. High-frequency binge eating predicts weight gain among veterans receiving behavioral weight loss treatments. Obesity (Silver Spring) 2015; 23:54-61. [PMID: 25385705 DOI: 10.1002/oby.20931] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 09/22/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess for the frequency of binge eating behavior and its association with weight loss in an overweight/obese sample of veterans. METHODS This study is a secondary analysis of data from the ASPIRE study, a randomized effectiveness trial of weight loss among veterans. Of the 481 enrolled veterans with overweight/obesity, binge eating frequency was obtained by survey for 392 (82%). RESULTS The majority (77.6%) reported binge eating, and 6.1% reported high-frequency binge eating. Those reporting any binge eating lost 1.4% of body weight, decreased waist circumference by 2.0 cm, and had significantly worse outcomes than those reporting never binge eating who lost about double the weight (2.7%) and reduced waist circumference by twice as much (4.2 cm). The high-frequency binge group gained 1.4% of body weight and increased waist circumference by 0.3 cm. CONCLUSIONS High rates of binge eating were observed in an overweight/obese sample of veterans enrolled in weight loss treatment. The presence of binge eating predicted poorer weight loss outcomes. Furthermore, high-frequency binge eating was associated with weight gain. These findings have operational and policy implications for developing effective strategies to address binge eating in the context of behavioral weight loss programs for veterans.
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Affiliation(s)
- Robin M Masheb
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA; VA Connecticut Healthcare System, West Haven, Connecticut, USA
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