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Carmassi C, Musetti L, Cambiali E, Violi M, Simoncini M, Fantasia S, Massoni L, Massimetti G, Nannipieri M, Dell'Osso L. Exploring the relationship between problematic eating behaviors and bipolar disorder: A study on candidates for bariatric surgery. J Affect Disord 2024; 368:564-572. [PMID: 39293606 DOI: 10.1016/j.jad.2024.09.094] [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: 03/06/2024] [Revised: 09/09/2024] [Accepted: 09/14/2024] [Indexed: 09/20/2024]
Abstract
BACKGROUND Obesity is a major concern in patients with bipolar disorder (BD) and problematic eating behaviors have been suggested to mediate their relationship. The association between problematic eating behaviors and obesity has been studied but limited data have explored the role of BD. We investigated problematic eating behaviors among patients with BD compared with candidates for bariatric surgery (BS), with or without BD, and explored the possible correlations between mood spectrum, impulsivity, body mass index (BMI). METHODS 50 euthymic patients with BD and 200 subjects eligible for BS, 48 with BD (BS + BD) and 152 without BD (BS-BD), were recruited at the Psychiatric Clinic of University of Pisa. Assessments included: Structured Clinical Interview (SCID-5), Emotional Eating Scale (EES), Yale Food Addiction Scale (YFAS), Eating Disorder Inventory (EDI-2), Eating Disorder Questionnaire (EDE-Q), Night Eating Scale (NES), Grazing Questionnaire (GQ), Mood Spectrum Self-Report (MOOD-SR), Barratt Impulsivity Scale (BIS). RESULTS BS + BD reported significantly higher EDI-2 and EDE-Q scores than the other groups. BD and BS + BD showed significantly higher BIS-11 scores than BS-BD. Among BS, EES and YFAS were associated with mood spectrum symptoms. LIMITATIONS Small BD sample size, BS may have underreported psychiatric symptoms to get approved for surgery, the interview didn't inquire about BS receiving GLP-1 agonists therapy. CONCLUSIONS Results showed a high prevalence of problematic eating behaviors among patients with BD and severely obese. Problematic eating behaviors may aggravate BD symptoms. Mood spectrum symptoms in obese subjects need to be carefully researched in as relate to severity and post-surgical course of BS.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Laura Musetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Erika Cambiali
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Miriam Violi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marly Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Fantasia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Leonardo Massoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Monica Nannipieri
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Bourque C, Legendre M, Iceta S, Bégin C. Validity of the Addiction-like Eating Behavior Scale among Patients with Compulsive Eating. Nutrients 2024; 16:2932. [PMID: 39275248 PMCID: PMC11396783 DOI: 10.3390/nu16172932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/16/2024] Open
Abstract
Food addiction (FA) and binge eating disorder (BED) co-occur and share compulsive eating symptoms. When using an FA measure, it is important to evaluate its performance in a population presenting compulsive eating. The study aims to validate the Addiction-like Eating Behavior Scale (AEBS) among a clinical sample characterized by compulsive eating and overweight/obesity and to evaluate its incremental validity over the Yale Food Addiction Scale 2.0 (YFAS). Patients seeking help for compulsive eating (n = 220), between January 2020 and July 2023, completed online questionnaires, including FA, compulsive eating, and BMI evaluations. The factor structure, internal consistency, and convergent, divergent, and incremental validity were tested. The sample had a mean age of 44.4 years old (SD = 12.7) and a mean BMI of 38.2 (SD = 8.0). The two-factor structure provided a good fit for the data, with factor loadings from 0.55 to 0.82 (except for item 15) and the internal consistency was high (ω = 0.84-0.89). The AEBS was positively correlated with the YFAS (r = 0.66), binge eating (r = 0.67), grazing (r = 0.47), craving (r = 0.74), and BMI (r = 0.26), and negatively correlated with dietary restraint (r = -0.37), supporting good convergent and divergent validity. For each measure of compulsive eating, linear regression showed that the AEBS "appetite drive" subscale had a unique contribution over the YFAS. This study provided evidence that the AEBS is a valid measure among a clinical sample of patients with compulsive eating and overweight/obesity. However, questions remain as to whether the AEBS is a measure of FA or compulsive eating.
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Affiliation(s)
- Camille Bourque
- Research Center of the Quebec Heart and Lung Institute, Quebec City, QC G1V 4G5, Canada
| | - Maxime Legendre
- School of Psychology, Laval University, Quebec City, QC G1V 0A6, Canada
- Centre d'Expertise Poids, Image et Alimentation (CEPIA), Laval University, Quebec City, QC G1V 0A6, Canada
| | - Sylvain Iceta
- Research Center of the Quebec Heart and Lung Institute, Quebec City, QC G1V 4G5, Canada
- Department of Psychiatry and Neurosciences, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Catherine Bégin
- School of Psychology, Laval University, Quebec City, QC G1V 0A6, Canada
- Centre d'Expertise Poids, Image et Alimentation (CEPIA), Laval University, Quebec City, QC G1V 0A6, Canada
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Mantzios M, McAtamney K, Regan H, Kokocinska K, Kauser S, Kalika E, Hussain M, Keyte R, Wood J, Wallis D, Egan H. Does controlling for epicurean eating or the tendency to supersize food portions change the relationship between mindful eating and grazing? Heliyon 2024; 10:e24823. [PMID: 38352731 PMCID: PMC10861966 DOI: 10.1016/j.heliyon.2024.e24823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/03/2024] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
The study examines the potential for Epicurean eating to offer fresh perspectives on the predictive value of mindful eating. This research seeks to ascertain whether accounting for Epicurean eating (or its antithesis, supersizing), could influence the previously identified negative relationship between mindful eating and grazing habits. In a cross-sectional study, 419 participants completed questionnaires on epicurean eating, grazing, and mindful eating. The findings suggested mindful eating and epicurean eating were significantly associated with grazing, with both variables accounting for a significant amount of variance in grazing. Further analysis of the mindful eating subscales showed that eating without distraction, eating with awareness, and hunger and satiety cues accounted for this association with grazing when epicurean eating was included. Finally, whilst eating without distraction, eating with awareness, and hunger and satiety cues were associated with grazing, preference for supersizing did not account for a significant amount of variance in the relationship with grazing. The complex interplay between grazing and mindful eating becomes more apparent when considering the influence of epicurean eating. Exploring cross-cultural factors through additional research could provide valuable insights into the dynamics of epicurean eating and grazing. Simultaneously, incorporating alternative mindful eating scales may yield a more nuanced interpretation of mindful eating. Collectively, these avenues of inquiry warrant further investigation. Limitations and future directions are discussed.
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Affiliation(s)
- Michail Mantzios
- College of Psychology, Birmingham City University, United Kingdom
| | | | - Harvey Regan
- College of Psychology, Birmingham City University, United Kingdom
| | | | - Sophia Kauser
- College of Psychology, Birmingham City University, United Kingdom
| | - Eliza Kalika
- College of Psychology, Birmingham City University, United Kingdom
| | - Misba Hussain
- College of Psychology, Birmingham City University, United Kingdom
| | - Rebecca Keyte
- College of Psychology, Birmingham City University, United Kingdom
| | - Jeffrey Wood
- College of Psychology, Birmingham City University, United Kingdom
| | - Deborah Wallis
- College of Psychology, Birmingham City University, United Kingdom
| | - Helen Egan
- College of Psychology, Birmingham City University, United Kingdom
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Marques CC, Palmeira L, Castilho P, Rodrigues D, Mayr A, Pina TS, Pereira AT, Castelo-Branco M, Goss K. Online Compassion Focused Therapy for overeating: Feasibility and acceptability pilot study. Int J Eat Disord 2024; 57:410-422. [PMID: 38124655 DOI: 10.1002/eat.24118] [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: 10/18/2023] [Revised: 12/08/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This pilot study aims to investigate the feasibility, acceptability, and potential effectiveness of online Compassion Focused Therapy for overeating (CFT-OE). METHOD Eighteen Portuguese women seeking treatment for overeating were enrolled in this study, and 15 participants completed the CFT-OE. This was a single-arm study. Participants were assessed at pre- and post-intervention and 3-month follow-up. All participants completed measures assessing binge eating, cognitive restraint, uncontrolled eating, emotional eating, general eating psychopathology, general and body shame, self-criticism, self-compassion, and fears of self-compassion. RESULTS The treatment attrition rate was 16.7%, which is relatively low compared to other similar online interventions. Participants gave positive feedback on the program and indicated they would recommend it to people with similar difficulties. CFT-OE improved self-compassion and reduced eating psychopathology symptoms, general and body shame, self-criticism, and fears of self-compassion. Clinical significance analysis showed that the majority of participants were classified as in recovery in all measures at post-intervention and 3-month follow-up. DISCUSSION Preliminary results suggest that the online CFT-OE program is an acceptable and feasible intervention. Results also suggest that CFT-OE is beneficial for the treatment of women with difficulties with overeating. A future randomized controlled trial is necessary to establish the effectiveness of the CFT-OE. PUBLIC SIGNIFICANCE This study indicates that online CFT-OE is a feasible and adequate intervention for women who struggle with overeating. This therapy showed promising results in reducing eating disorder symptoms, shame, and self-criticism and improving self-compassion. As an online intervention, CFT-OE may be more accessible and offer an alternative to in-person therapy.
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Affiliation(s)
- Cristiana C Marques
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, Institute of Psychological Medicine, University of Coimbra, Coimbra, Portugal
| | - Lara Palmeira
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- Portucalense Psychology Institute (I2P), Portucalense University, Porto, Portugal
| | - Paula Castilho
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Dírcea Rodrigues
- Department of Endocrinology, Diabetes and Metabolism, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Andreas Mayr
- Department of Medical Biometrics, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Tiago Soares Pina
- Department of Nutrition and Dietetics, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Ana Telma Pereira
- Faculty of Medicine, Institute of Psychological Medicine, University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Kenneth Goss
- Coventry & Warwickshire Partnership Trust, Coventry Eating Disorder Service, Coventry, UK
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Hussain M, Egan H, Keyte R, Strachan R, Tahrani AA, Mantzios M. Exploring the association between self-compassion, mindfulness and mindful eating with eating behaviours amongst patients with obesity. Nutr Health 2023; 29:683-693. [PMID: 35538911 DOI: 10.1177/02601060221094671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: People who have obesity often experience problematic eating behaviours, contributing towards their excessive weight gain. Aims: Understanding problematic eating behaviours and their association to self-compassion, mindfulness and mindful eating is important for the development of future interventions that improve weight-loss and weight-regulation. Methods: One hundred and one participants attending their first session of a 6-session dietetic programme within a Tier 3 medical weight management service in the West Midlands, UK were recruited to complete questionnaires on self-compassion, mindfulness, mindful eating and eating behaviours, such as, emotional, restrained, external, fat and sugar consumption and grazing. Results: The findings suggested all three constructs, self-compassion, mindfulness and mindful eating were significantly and negatively associated with grazing and emotional eating, but mindful eating was the only construct that also displayed a significant and negative association with other eating behaviours that are often barriers to successful weight regulation, such as external eating and fat consumption. Further investigation suggested mindful eating had an indirect effect on fat consumption and grazing via external eating. Conclusion: Whilst, self-compassion, mindfulness and mindful eating displayed a negative relationship with grazing and emotional eating, mindful eating also displayed a negative relationship with fat consumption and external eating. Possible explanations and directions for future work are discussed with an emphasis on the need for more empirical work.
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Affiliation(s)
- Misba Hussain
- Department of Psychology, Birmingham City University, UK
| | - Helen Egan
- Department of Psychology, Birmingham City University, UK
| | - Rebecca Keyte
- Department of Psychology, Birmingham City University, UK
| | | | - Abd A Tahrani
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Department of Endocrinology and Diabetes, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
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Graungaard S, Christensen TL, Soendergaard LN, Telléus GK. Prevalence of eating disorder symptomatology among outpatients referred to health promotion from somatic hospital departments. BMC Psychiatry 2023; 23:841. [PMID: 37968579 PMCID: PMC10652435 DOI: 10.1186/s12888-023-05331-5] [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: 08/24/2023] [Accepted: 10/30/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND AND AIMS All eating disorders (EDs) lead to a significant decrease of health status, psychosocial functioning and quality of life (QoL). Individuals with untreated binge eating disorder (BED) tend to gain weight over time, which may contribute to serious health issues. In somatic hospital departments, some outpatients have reduced compliance with lifestyle changes. This may, to some extent, be due to patients with an undiagnosed ED receiving the incorrect treatment. In this cross-sectional study, we aimed to investigate the prevalence of EDs among patients referred to lifestyle courses. RESULTS A total of 136 patients referred from somatic hospital departments to lifestyle changes in a specialized hospital unit were included in the study. The response rate was 69.4%. Self-reported ED or sub-clinical symptoms of ED according to the Eating Disorder Examination Questionnaire (EDE-Q) were found in 17.65%. Of these, 11.03% fulfilled the self-reported criteria for an ED (BED, 7.35%; bulimia nervosa, 3.68%). Patients with an ED or subclinical ED symptoms had elevated grazing behaviour compared to those without ED symptomatology. A statistically significant difference in QoL was also found. DISCUSSION AND CONCLUSIONS The prevalence of self-reported ED or subclinical ED symptoms in patients referred to a lifestyle course is substantial. This ED group had reduced QoL and larger grazing behaviour compared to patients without ED symptomatology. Thus, the prevalence of undiagnosed EDs among patients within somatic hospital departments may be substantial, underlining the importance of screening and further research within this topic. LEVEL OF EVIDENCE Level III, well-designed cohort study. SIGNIFICANCE What is already known on this subject? In a review including populations from Scandinavia, the USA and South America, the estimated BED prevalence in individuals with higher body weight seeking help to lose weight is 13-27% [22]. Dawes et al. (2016) conducted a meta-analysis investigating the prevalence of mental health conditions among bariatric surgery candidates and recipients. They included 25 studies with a total of 13,769 patients and found that the prevalence of BED was 17% (13-21%) [10]. What this study adds? We have identified a group of patients who may be receiving inappropriate treatment with weight loss intervention instead of specialized ED intervention. It appears that this issue is valid in various somatic hospital departments. Thus, this is a field that requires further attention and investigation.
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Affiliation(s)
- Signe Graungaard
- Department of Health Promotion, Aalborg University Hospital, Hobrovej 18-22, Aalborg, 9000, Denmark.
| | - Tobias Lund Christensen
- Department of Health Promotion, Aalborg University Hospital, Hobrovej 18-22, Aalborg, 9000, Denmark
| | | | - Gry Kjaersdam Telléus
- Unit for Psychiatric Research, Aalborg University Hospital, Mølleparkvej 10, Aalborg, 9000, Denmark
- Institute of Communication and Psychology, Psychology, Aalborg University, Aalborg, Denmark
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Mantzios M. Development and initial validation of the trait and state Mindful Eating Behaviour Scales. Eat Weight Disord 2023; 28:88. [PMID: 37878168 PMCID: PMC10600279 DOI: 10.1007/s40519-023-01614-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 10/15/2023] [Indexed: 10/26/2023] Open
Abstract
PURPOSE The quantitative assessment of mindful eating has been challenging, even with the latest additions to the field of multifactorial mindful eating psychometric tools. This manuscript presents the development, validity and reliability assessment of a trait and state Mindful Eating Behaviour Scale across four studies driven by recent theory (Mantzios in Nutr Health 27: 1-5, 2021). METHODS Study 1 assessed the content validity of the scale through ratings of clinical and research experts in the field. Study 2 inspected the scale through exploratory and confirmatory factor, parallel, correlation, and reliability analyses. Study 3 assessed the temporal stability through a test-retest in a 2-week interval. Study 4 assessed the scale in a randomized control experimental design, where a mindful eating (vs. control group) received the trait scale before consuming chocolate, and an equivalent state scale was modified to assess state changes during the 10-min eating session. RESULTS Study 1 yielded items to be reflective and concise of the definition of mindful eating behaviour. Study 2 indicated 2 potential factors through exploratory factor analyses, which were further verified through a parallel analysis, while subscales correlation indicated one-dimensionality, which was further verified through confirmatory factor analysis. In addition, the internal consistency of the scale and subscales was good. Study 3 certified the reliability of the scale over time, while Study 4 indicated that both the trait and state scales were significant indicators of eating mindfully. CONCLUSIONS Together, all studies signal the utility of theoretically sound and empirically validated measurements for the replicable assessment of mindful eating behaviour. LEVEL OF EVIDENCE No level of evidence: basic science.
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Affiliation(s)
- Michail Mantzios
- College of Psychology, Birmingham City University, Room C332, The Curzon Building, 4 Cardigan St, Birmingham, B4 7BD, UK.
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Mantzios M, Zervos K, Koletsi M, Giannou K. Mindful eating and eating behaviours in Greece: exploring the validity and reliability of two mindful eating scales and other eating behaviours for Greek-speaking populations. Eat Weight Disord 2023; 28:85. [PMID: 37864641 PMCID: PMC10590293 DOI: 10.1007/s40519-023-01615-7] [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: 11/29/2022] [Accepted: 10/15/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND Mindful eating has seen an increase in clinical and non-clinical practices of changing health outcomes. Meanwhile, the restriction of not having validated scales in other languages proposes a barrier to exploring the impact of mindful eating cross-culturally, and specific to the present project, across Greek-speaking populations, limiting the potential of exploring the association with Mediterranean dieting. METHODS In the present research, volunteers (n = 706) completed online the Mindful Eating Behaviour Scale and the Mindful Eating Scale. A forward-backwards translation, leading to face validity, and was assessed for internal consistency (Cronbach's Alpha) and followed up by an assessment of the factorial structure of the scales. Divergent and convergent validity was explored using motivations to eat palatable foods, grazing, craving, Dusseldorf orthorexia, Salzburg emotional eating, and the Salzburg stress eating scales. RESULTS Results indicated that both scales displayed good internal consistency, and the assessment of the factorial structure of the scales was equally good and semi-consistent with the English versions, with parallel analyses and item loadings proposing problems that have been shown in critical review literature. Associations of mindful eating scales to other eating behaviours were replicated to previously established findings with English-speaking populations. CONCLUSIONS Findings that deviated from the expected outcomes are central to the discussion on the measurement of mindful eating, and further direction highlights the way forward for researchers and clinicians. LEVEL V Descriptive studies.
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Affiliation(s)
- Michail Mantzios
- College of Psychology, Birmingham City University, C332, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK.
| | | | - Marsha Koletsi
- Department of Psychology, New York College, Athens, Greece
| | - Kyriaki Giannou
- Department of Psychology, De Montfort University, Leicester, UK
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Ben-Porat T, Alberga A, Audet MC, Belleville S, Cohen TR, Garneau PY, Lavoie KL, Marion P, Mellah S, Pescarus R, Rahme E, Santosa S, Studer AS, Vuckovic D, Woods R, Yousefi R, Bacon SL. Understanding the impact of radical changes in diet and the gut microbiota on brain function and structure: rationale and design of the EMBRACE study. Surg Obes Relat Dis 2023; 19:1000-1012. [PMID: 37088645 DOI: 10.1016/j.soard.2023.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 01/18/2023] [Accepted: 02/24/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Bariatric surgery leads to profound changes in gut microbiota and dietary patterns, both of which may interact to impact gut-brain communication. Though cognitive function improves postsurgery, there is a large variability in outcomes. How bariatric surgery-induced modifications in the gut microbiota and dietary patterns influence the variability in cognitive function is still unclear. OBJECTIVES To elucidate the associations between bariatric surgery-induced changes in dietary and gut microbiota patterns with cognition and brain structure. SETTING University hospital. METHODS A total of 120 adult patients (≥30 years) scheduled to undergo a primary bariatric surgery along with 60 age-, sex-, and body mass index-matched patients on the surgery waitlist will undergo assessments 3-months presurgery and 6- and 12-month postsurgery (or an equivalent time for the waitlist group). Additionally, 60 age-and sex-matched nonbariatric surgery eligible individuals will complete the presurgical assessments only. Evaluations will include sociodemographic and health behavior questionnaires, physiological assessments (anthropometrics, blood-, urine-, and fecal-based measures), neuropsychological cognitive tests, and structural magnetic resonance imaging. Cluster analyses of the dietary and gut microbiota changes will define the various dietary patterns and microbiota profiles, then using repeated measures mixed models, their associations with global cognitive and structural brain alterations will be explored. RESULTS The coordinating study site (Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, QC, Canada), provided the primary ethical approval (Research Ethics Board#: MP-32-2022-2412). CONCLUSIONS The insights generated from this study can be used to develop individually-targeted neurodegenerative disease prevention strategies, as well as providing critical mechanistic information.
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Affiliation(s)
- Tair Ben-Porat
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Angela Alberga
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada
| | - Marie-Claude Audet
- School of Nutrition Sciences, University of Ottawa, Ontario, Canada; The Royal's Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Sylvie Belleville
- Research centre of the Institut Universitaire de Gériatrie de Montréal (CRIUGM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal (CIUSSS-CSMTL), Montreal, Quebec, Canada; Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Tamara R Cohen
- Faculty of Land and Food Systems, University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Pierre Y Garneau
- Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada; Department of Surgery, Université de Montréal, Montréal, Canada
| | - Kim L Lavoie
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada; Department of Psychology, Université du Québec a Montréal (UQAM), Montreal, Quebec, Canada
| | - Patrick Marion
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Samira Mellah
- Research centre of the Institut Universitaire de Gériatrie de Montréal (CRIUGM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal (CIUSSS-CSMTL), Montreal, Quebec, Canada
| | - Radu Pescarus
- Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada; Department of Surgery, Université de Montréal, Montréal, Canada
| | - Elham Rahme
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada
| | - Sylvia Santosa
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Metabolism, Obesity and Nutrition Lab, PERFORM Centre, Concordia University, Montreal, Quebec, Canada; Research Centre, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Anne-Sophie Studer
- Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada; Department of Surgery, Université de Montréal, Montréal, Canada
| | - Dajana Vuckovic
- Department of Chemistry and Biochemistry, Concordia University, Montreal, Quebec, Canada
| | - Robbie Woods
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada; Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Reyhaneh Yousefi
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Simon L Bacon
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada.
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Teodoro MC, Conceição EM, Sinval J, de Lourdes M, Neufeld CB. Adaptation, confirmatory factor analysis, and psychometric properties of the Brazilian version of the Repetitive Eating Questionnaire. Int J Eat Disord 2023; 56:747-757. [PMID: 36965138 DOI: 10.1002/eat.23943] [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: 07/16/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/27/2023]
Abstract
OBJECTIVE The Repetitive Eating Questionnaire (Rep(eat)-Q) is a brief self-report measure developed to assess grazing behavior-an understudied problematic eating behavior associated with eating disorder psychopathology and poor weight management. This study aimed to adapt and test the psychometric properties and factor structure of the Rep(eat)-Q in a Brazilian community sample. METHOD We used the International Test Commission guidelines for the adaptation of psychological measures between cultures. Participants were recruited from the community and on a university campus and completed a set of questionnaires including the Rep(eat)-Q, psychological measures, and sociodemographic data. RESULTS A total of 718 (86.4% female) completed the Rep(eat)-Q and were eligible for the confirmatory factor analysis (CFA). Only 542 completed the entire survey (Rep(eat)-Q and other psychological measures) and were eligible for the analysis of the validity evidence based on the relations to other variables. CFA revealed support for a two first-order model as originally proposed, however, a hierarchical (i.e., second-order) model is proposed. We found support for second-order scalar invariance across sex. Both first- and second-order internal consistency estimates presented very good evidence. Analysis (n = 542) revealed moderate to strong correlations (≥.58 to .77) between grazing (total score and subscales) and binge eating and other psychological measures, presenting good convergent evidence. DISCUSSION This study reports good psychometric properties of the Rep(eat)-Q for the Brazilian community sample. PUBLIC SIGNIFICANCE Grazing is a problematic eating behavior and the Rep(eat)-Q is one of the measures to assess grazing. The article aimed to adapt and test the psychometric properties of the Rep(eat)-Q in a Brazilian community sample. The results support a two-factor structure and suggest that the Rep(eat)-Q possesses good psychometric properties to be used with the Brazilian populations.
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Affiliation(s)
- Marília C Teodoro
- Psychology Department, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Eva M Conceição
- Psychology Department, Universidade do Minho-Braga, Braga, Portugal
| | - Jorge Sinval
- Business Research Unit (BRU-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
- Faculty of Philosophy, Sciences and Languages of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Evidence-Based Health, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- William James Center for Research, ISPA-Instituto Universitário, Lisbon, Portugal
| | - Marta de Lourdes
- Psychology Department, Universidade do Minho-Braga, Braga, Portugal
| | - Carmem B Neufeld
- Psychology Department, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
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11
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Legendre M, Bégin C. Group therapy to reduce maladaptive eating behaviors in people with overweight or obesity: Does food addiction impact the treatment response? Eat Behav 2023; 49:101720. [PMID: 36931049 DOI: 10.1016/j.eatbeh.2023.101720] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/25/2023] [Accepted: 03/09/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Given that the presence of food addiction worsens the clinical portrait in people with overweight or obesity, it could also impact the treatment response. The objective was to explore the moderating effect of baseline food addiction (FA) on the treatment response. The associations between changes in FA symptoms and other maladaptive eating behaviors were also examined. METHODS Sixty adults with overweight or obesity were recruited and took part in a 12-session group therapy for compulsive eating. They completed questionnaires on FA and three treatment outcomes (binge eating, grazing, and depressive symptoms). Participants were split into two groups according to their number of baseline FA symptoms (no/mild FA vs. moderate/severe FA) and were compared on all outcomes at four measurement points (baseline, mid-treatment, post-treatment, and 6-month follow-up). Correlations between changes in FA symptoms and all three outcomes from pre- to post-treatment were performed. RESULTS Group and treatment effects were significant for binge eating and grazing but not for depressive symptoms. Interaction effects were not significant for the three outcomes. The reduction in FA symptoms from pre- to post-treatment was positively associated with the reduction in binge eating (r = 0.49) and grazing (r = 0.55). CONCLUSIONS People with moderate/severe FA maintained higher maladaptive eating behaviors than people with no/mild FA from the beginning to the end of the treatment. Progression through treatment followed the same pattern for both groups, suggesting that baseline FA did not have a moderating effect. People with moderate/severe FA would likely benefit from a longer treatment.
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Affiliation(s)
- Maxime Legendre
- School of Psychology, Pavillon Félix-Antoine-Savard, 2325, rue des Bibliothèques, Laval University, Quebec G1V 0A6, QC, Canada.
| | - Catherine Bégin
- School of Psychology, Pavillon Félix-Antoine-Savard, 2325, rue des Bibliothèques, Laval University, Quebec G1V 0A6, QC, Canada.
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12
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Catania J, Spirou D, Gascoigne M, Raman J. Loss of control as a transdiagnostic feature in obesity-related eating behaviours: A systematic review. EUROPEAN EATING DISORDERS REVIEW 2023; 31:24-45. [PMID: 35801968 PMCID: PMC10084033 DOI: 10.1002/erv.2936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/24/2022] [Accepted: 06/10/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Emerging evidence suggests that loss of control (LOC) may present as a common feature across disordered eating behaviours. However, there has been limited research on the transdiagnostic nature of LOC in this area. The primary aim of this study was to systematically review disordered eating behaviours and measures of LOC in clinical and non-clinical populations. METHOD Electronic searches of the relevant databases were conducted. Selected articles were screened for eligibility and assessed for methodological quality. RESULTS Thirty-four studies met inclusion criteria. Findings demonstrated that LOC was associated with disordered eating behaviours across bariatric populations, eating disorder populations, and community populations. Specifically, LOC was associated with binge eating (subjective and objective episodes), grazing, night eating, and emotional or stress eating. Findings also revealed that LOC was inconsistently operationalised across studies, with varied approaches to measuring the construct. CONCLUSION Overall, the findings from this review provide support for LOC as a transdiagnostic feature of disordered eating behaviours. Future studies should utilise robust multi-method assessments to measure the severity of LOC, which may provide greater insight into how LOC manifests across different eating disorder presentations.
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Affiliation(s)
- Justin Catania
- Australian College of Applied Professions, Sydney, New South Wales, Australia
| | - Dean Spirou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia.,School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Michael Gascoigne
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Jayanthi Raman
- School of Psychological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
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13
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Pekin C, McHale M, Seymour M, Strodl E, Hopkins G, Mitchell D, Byrne GJ. Psychopathology and eating behaviour in people with type 2 diabetes referred for bariatric surgery. Eat Weight Disord 2022; 27:3627-3635. [PMID: 36495463 PMCID: PMC9803743 DOI: 10.1007/s40519-022-01502-7] [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: 07/28/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Psychopathology and disordered eating behaviours are putative pre-operative risk factors for suboptimal outcomes post-bariatric surgery. Documented psychopathology prevalence rates vary in bariatric candidate samples. Further, less attention has been paid to vulnerable subgroups such as people with diabetes who might be at an elevated risk. For these reasons, this study aimed to investigate the rates of psychopathology and disordered eating in pre-surgical candidates with type 2 diabetes mellitus (T2DM). METHODS Participants were 401 consecutive patients from a state-wide bariatric surgery service for people with T2DM. Psychopathology was measured using multi-modal assessment including diagnostic interview and battery of validated questionnaires. The mean age of the sample was 51 years with a mean BMI of 46 kg/m2. The majority of the sample was female (60.6%), born in Australia (87%) and 18.2% identified as Aboriginal and/or Torres Strait Islander. RESULTS Rates of current psychopathology in this sample included: major depressive disorder (MDD; 16.75%), generalised anxiety disorder (GAD; 20.25%), insomnia (17.75%) and binge eating disorder (BED; 10.75%). There were no significant differences on measures between people who endorsed Aboriginal and/or Torres Strait Islander status compared to those who did not endorse. The mean total score on the BES was 21.82 ± 10.40 (range 0-39), with 8.2% of participants meeting criteria for severe binge eating. Presence of an eating disorder was not significantly associated with degree of glycemic compensation. Average emotional eating scores were significantly higher in this study, compared to reference samples. Significantly increased binge eating severity and emotional eating severity was revealed for people with T2DM and comorbid MDD, social anxiety and eating disorders. Binge eating severity was associated with GAD, food addiction, substance use disorders, and history of suicide attempt but not emotional eating severity. CONCLUSION Amongst people with T2DM seeking bariatric surgery, MDD, GAD and emotional eating were common. Psychopathology in a sample of people with T2DM seeking bariatric surgery was significantly associated with severity of disordered eating. These findings suggest people with T2DM seeking bariatric surgery may be vulnerable to psychopathology and disordered eating with implications for early identification and intervention. LEVEL OF EVIDENCE Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- C Pekin
- Faculty of Medicine, Academy of Psychiatry, University of Queensland, Brisbane, QLD, Australia.
- Department of Psychology, Royal Brisbane & Women's Hospital and School of Psychology, University of Queensland, Brisbane, QLD, Australia.
| | - M McHale
- Department of Psychology, Royal Brisbane & Women's Hospital and School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - M Seymour
- Faculty of Medicine, Department of Endocrinology and Diabetes, Royal Brisbane & Women's Hospital, University of Queensland, Brisbane, QLD, Australia
| | - E Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - G Hopkins
- Division of Surgery Metro North Hospital and Health Service, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - D Mitchell
- Division of Surgery Metro North Hospital and Health Service, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - G J Byrne
- Faculty of Medicine, Academy of Psychiatry, University of Queensland, Brisbane, QLD, Australia
- Mental Health Service, Royal Brisbane & Women's Hospital, Brisbane, Australia
- Centre for Clinical Research, University of Queensland, Brisbane, Australia
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Associations Between Food Addiction and Substance-Use Disorders: A Critical Overview of their Overlapping Patterns of Consumption. CURRENT ADDICTION REPORTS 2022; 9:326-333. [PMID: 36277991 PMCID: PMC9579607 DOI: 10.1007/s40429-022-00443-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/30/2022]
Abstract
Purpose of Review Research on patterns of overconsumption in individuals with food addiction (FA) has focused largely on binge eating. However, compulsive overeating can be varied and dimensional. This review focuses on the similarities between the patterns of consumption in FA and in other clinically established substance-use disorders, such as alcohol and nicotine dependence. It also highlights features that make FA unique to other addiction disorders. Recent Findings Overall, there is substantial evidence that binge-like overconsumption is a characteristic of various substance-use and eating disorders. Likewise, it appears that different overeating patterns can reflect addictive-like eating. One pattern may be compulsive grazing — defined as the repetitive inability to resist consumption of small amounts of food. Summary This review adds to the increasingly compelling picture that FA and binge-eating disorder are unique conditions, and that FA resembles other substance-use disorders. We conclude that a variety of overeating patterns can reflect addictive eating behaviours in vulnerable individuals, one of which may be compulsive grazing.
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15
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Ralph AF, Brennan L, Byrne S, Caldwell B, Farmer J, Hart LM, Heruc GA, Maguire S, Piya MK, Quin J, Trobe SK, Wallis A, Williams-Tchen AJ, Hay P. Management of eating disorders for people with higher weight: clinical practice guideline. J Eat Disord 2022; 10:121. [PMID: 35978344 PMCID: PMC9386978 DOI: 10.1186/s40337-022-00622-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The prevalence of eating disorders is high in people with higher weight. However, despite this, eating disorders experienced by people with higher weight have been consistently under-recognised and under-treated, and there is little to guide clinicians in the management of eating disorders in this population. AIM The aim of this guideline is to synthesise the current best practice approaches to the management of eating disorders in people with higher weight and make evidence-based clinical practice recommendations. METHODS The National Eating Disorders Collaboration Steering Committee auspiced a Development Group for a Clinical Practice Guideline for the treatment of eating disorders for people with higher weight. The Development Group followed the 'Guidelines for Guidelines' process outlined by the National Health and Medical Research Council and aim to meet their Standards to be: 1. relevant and useful for decision making; 2. transparent; 3. overseen by a guideline development group; 4. identifying and managing conflicts of interest; 5. focused on health and related outcomes; 6. evidence informed; 7. making actionable recommendations; 8. up-to-date; and, 9. accessible. The development group included people with clinical and/or academic expertise and/or lived experience. The guideline has undergone extensive peer review and consultation over an 18-month period involving reviews by key stakeholders, including experts and organisations with clinical academic and/or lived experience. RECOMMENDATIONS Twenty-one clinical recommendations are made and graded according to the National Health and Medical Research Council evidence levels. Strong recommendations were supported for psychological treatment as a first-line treatment approach adults (with bulimia nervosa or binge-eating disorder), adolescents and children. Clinical considerations such as weight stigma, interprofessional collaborative practice and cultural considerations are also discussed. CONCLUSIONS This guideline will fill an important gap in the need to better understand and care for people experiencing eating disorders who also have higher weight. This guideline acknowledges deficits in knowledge and consequently the reliance on consensus and lower levels of evidence for many recommendations, and the need for research particularly evaluating weight-neutral and other more recent approaches in this field.
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Affiliation(s)
| | - Leah Brennan
- School of Psychology and Public Health, La Trobe University, Wodonga, Australia
| | - Sue Byrne
- Department of Psychology, University of Western Australia, Perth, Australia
| | | | - Jo Farmer
- Lived Experience Advocate, Melbourne, Australia
| | - Laura M. Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Gabriella A. Heruc
- Eating Disorders and Nutrition Research Group (ENRG), School of Medicine, Western Sydney University, Sydney, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia
- Sydney Local Health District, NSW Health, Sydney, Australia
| | - Milan K. Piya
- School of Medicine, Western Sydney University, Macarthur Clinical School, Sydney, Australia
- Camden and Campbelltown Hospitals, Sydney, Australia
| | - Julia Quin
- Lived Experience Advocate, Melbourne, Australia
| | - Sarah K. Trobe
- National Eating Disorders Collaboration, Sydney, Australia
| | - Andrew Wallis
- Sydney Children’s Hospitals Network, The Children’s Hospital Westmead, Sydney, Australia
| | | | - Phillipa Hay
- Eating Disorders and Body Image (EDBI), Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- South Western Sydney Local Health District, Sydney, Australia
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Development, validation and clinical use of the Eating Behaviors Assessment for Obesity (EBA-O). Eat Weight Disord 2022; 27:2143-2154. [PMID: 35092002 PMCID: PMC8799412 DOI: 10.1007/s40519-022-01363-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/08/2022] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Obesity is a major health problem with an increasing risk of mortality, associated with comorbidities and high rates of dropout. Research demonstrated that pathological eating behaviors could help to phenotype obese patients thus tailoring clinical interventions. Therefore, our aim was to develop (study 1), validate (study 2), and test in a clinical setting (study 3) the Eating Behaviors Assessment for Obesity (EBA-O). METHOD Study 1 included the exploratory factor analysis (EFA) and McDonald's ω in a general population sample (N = 471). Study 2 foresaw the confirmatory factor analysis (CFA) and convergent validity in 169 participants with obesity. Study 3 tested the capability of the EBA-O to characterize eating behaviors in a clinical sample of 74 patients with obesity. RESULTS Study 1. EFA identified five factors (i.e., food addiction, night eating, binge eating, sweet eating, and prandial hyperphagia), explaining 68.3% of the variance. The final EBA-O consisted of 18 items. McDonald's ω ranged between 0.80 (hyperphagia) and 0.92 (binge eating), indicating very good reliability. STUDY 2 A second-order five-factor model, through CFA, showed adequate fit: relative chi-square (χ2/df) = 1.95, CFI = 0.93, TLI = 0.92, RMSEA = 0.075, and SRMR = 0.06, thus suggesting the appropriateness of the EBA-O model. Significant correlations with psychopathological questionnaires demonstrated the convergent validity. Study 3. Significant associations between EBA-O factors and emotional-related eating behaviors emerged. CONCLUSION The EBA-O demonstrated to be a reliable and easy-to-use clinical tool to identify pathological eating behaviors in obesity, particularly useful for non-experts in eating disorders. LEVEL OF EVIDENCE Level V, descriptive research.
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17
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Food Addiction: a Deep Dive into ‘Loss of Control’ and ‘Craving’. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00431-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Abstract
Purpose of Review
The majority of existing research discusses food addiction (FA) classification, which provides information for different groups and which groups may or may not be affected to differing degrees. Fewer studies report FA symptom scores, and fewer still report on individual symptoms. This paper discusses the symptoms of craving and loss of control as they are common FA symptoms that demonstrate similarities with both substance use disorders and some eating disorder pathology.
Recent Findings
Loss of control presents parallels with disordered eating, particularly binge eating disorder. Craving refers to the powerful or strong desire for something and, in contrast to lack of control, presents most overlap with substance use disorders.
Summary
While not the most common symptoms reported in published research, loss of control and craving attract attention because of parallels with substance use and eating disorder pathology, and research has increasingly focused on these symptoms in recent years.
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Legendre M, Sabourin S, Bégin C. Maladaptive Eating Behaviors and Childhood Trauma: A Focus on Food Addiction. Cureus 2022; 14:e26966. [PMID: 35989855 PMCID: PMC9382990 DOI: 10.7759/cureus.26966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/05/2022] Open
Abstract
Background Many studies have highlighted the clinical relevance of food addiction (FA) by showing its association with psychopathological severity and even more when co-occurring with binge eating disorder. It was suggested that the association between FA and greater psychopathological severity could be accounted for by a history of traumatic experiences. The present study examined the relationship between childhood trauma (including peer victimization, abuse, and neglect) and maladaptive eating behaviors (FA, binge eating, and grazing) and explored whether childhood trauma predicts FA when controlling for binge eating, grazing, and other confounding variables. Methods One hundred fourteen adult women seeking psychological help for problems related to eating or weight completed questionnaires measuring FA, binge eating, grazing, depressive symptoms, peer victimization, and childhood abuse and neglect. Results FA showed significantly small to moderate positive correlations with all measures of childhood trauma, except for physical neglect. A hierarchical regression, including binge eating, grazing, depressive symptoms, age, and childhood trauma explained 55% of FA variance, with 7% of variance explained uniquely by childhood trauma. Conclusions This study supports that FA is related to childhood trauma and provides a potential explanation for the association of FA with greater psychopathological severity. From a clinical perspective, FA provides an accurate and quick assessment of psychopathological severity and represents an essential complement to the evaluation of eating disorders related to overweight. Future studies should attempt to estimate the impact of childhood trauma on treatment outcomes.
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Felske AN, Williamson TM, Rash JA, Telfer JA, Toivonen KI, Campbell T. Proof of Concept for a Mindfulness-Informed Intervention for Eating Disorder Symptoms, Self-Efficacy, and Emotion Regulation among Bariatric Surgery Candidates. Behav Med 2022; 48:216-229. [PMID: 33052762 DOI: 10.1080/08964289.2020.1828255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Up to 64% of patients seeking bariatric (weight-loss) surgery report eating disorder (ED) symptoms (addictive-like eating, binge eating, emotional eating, grazing) that can interfere with post-surgical weight loss. This prospective proof-of-concept study aimed to evaluate the impact of a pre-surgical mindfulness-informed intervention (MII) on ED symptoms and potential mechanisms-of-action to inform optimization of the intervention. Surgery-seeking adults attended four, 2-hour, MII sessions held weekly. Participants completed validated questionnaires assessing ED symptoms, eating self-efficacy, emotion regulation, and mindful eating pre-MII, post-MII, and at a 12-week follow-up. The MII consisted of mindfulness training, with cognitive, behavioral, and psychoeducational components. Fifty-six patients (M = 47.41 years old, 89.3% female) participated. Improvements in addictive-like eating, binge eating, emotional eating, and grazing were observed from pre- to post-MII. ED symptom treatment gains were either maintained or improved further at 12-week follow-up. Eating self-efficacy and emotion regulation improved from pre-MII to follow-up. Scores on the mindful eating questionnaire deteriorated from pre-MII to follow-up. In mediation analyses, there was a combined indirect effect of emotion regulation, eating self-efficacy, and mindful eating on grazing and binge eating, and an indirect effect of emotion regulation on emotional eating and addictive-like eating. Participation in the MII was associated with improvements in ED symptoms and some mechanisms-of-action, establishing proof-of-concept for the intervention. Future work to establish the MII's efficacy in a randomized controlled trial is warranted.
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Affiliation(s)
- Ashley N Felske
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | - Joshua A Rash
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Jo Ann Telfer
- Calgary Adult Bariatric Surgery Clinic, Alberta Health Services, Richmond Road Diagnostic and Treatment Services, Calgary, AB, Canada
| | - Kirsti I Toivonen
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Tavis Campbell
- Department of Psychology, University of Calgary, Calgary, AB, Canada
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Spirou D, Raman J, Leith M, Collison J, Bishay RH, Ahlenstiel G, Hay P, Smith E. The psychometric properties of the grazing questionnaire in an obesity sample with and without binge eating disorder. J Eat Disord 2022; 10:82. [PMID: 35710487 PMCID: PMC9202494 DOI: 10.1186/s40337-022-00604-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite being the first validated measure of grazing, the Grazing Questionnaire (GQ) has not been investigated among individuals with obesity. Therefore, the current study aimed to examine the psychometric properties of the GQ in an obesity sample. METHODS Participants (N = 259) were recruited from community and clinical settings in Australia. The sample comprised adults with normal weight (n = 77) and obesity (n = 182). A portion of individuals with obesity (n = 102) had binge eating disorder (BED). Data from the obesity group was examined to establish the factor structure, validity, and reliability of the GQ. A one-way ANOVA with planned contrasts was conducted to compare scores on the GQ across groups. RESULTS Confirmatory factor analysis revealed that the 2-factor model of the GQ was the best model fit for individuals with obesity. The GQ demonstrated high internal consistency, test-retest reliability over 3 months, and convergent and divergent validity. As hypothesised, the obesity group had significantly higher scores on the GQ than the normal weight group, while the obesity with BED group had significantly higher scores than the obesity without BED group. CONCLUSION This was the first study to investigate the psychometric properties of the GQ in an obesity sample. Overall, findings indicated that the GQ is a psychometrically sound measure of grazing among individuals with obesity. These findings provide further support for two distinct subtypes of grazing and highlight the importance of increased assessment and management of grazing behaviours for individuals with obesity and eating disorders. Maintaining a healthy weight is one of the greatest challenges for individuals with obesity. Certain eating patterns such as grazing may contribute to difficulties in weight management. Grazing is the repetitive and unplanned eating of small amounts of food that is not related to feeling hungry. Researchers and clinicians often use self-report questionnaires to measure grazing. However, the first validated questionnaire of grazing has not been investigated among individuals with obesity. Therefore, the goal of this study was to examine and validate the Grazing Questionnaire in individuals with obesity. Overall, our results showed that the Grazing Questionnaire is a valid and reliable self-report measure of grazing in individuals with obesity. Similar to previous research, we found that there are two subtypes of grazing. The first subtype involves continuous, unplanned eating. The second subtype is associated with a sense of loss of control over eating. We also found that people with obesity and binge eating disorder graze more than people with obesity that do not have binge eating disorder, while both groups graze more than individuals with normal weight. We recommend that clinicians routinely assess and treat unhelpful grazing patterns when working with individuals with obesity and eating disorders.
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Affiliation(s)
- Dean Spirou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia. .,Blacktown Metabolic and Weight Loss Program, Department of Endocrinology and Diabetes, Blacktown Hospital, Blacktown, Sydney, NSW, Australia. .,School of Medicine, Western Sydney University, Sydney, NSW, Australia.
| | - Jayanthi Raman
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Mimi Leith
- School of Psychology, Western Sydney University, Sydney, NSW, Australia
| | - James Collison
- Australian College of Applied Professions, Sydney, NSW, Australia
| | - Ramy H Bishay
- Blacktown Metabolic and Weight Loss Program, Department of Endocrinology and Diabetes, Blacktown Hospital, Blacktown, Sydney, NSW, Australia.,School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Golo Ahlenstiel
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Storr Liver Centre, Westmead Millennium Institute, Westmead Hospital, University of Sydney, Sydney, NSW, Australia.,Department of Gastroenterology and Hepatology, Blacktown and Mount Druitt Hospitals, WSLHD, Sydney, NSW, Australia
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Evelyn Smith
- School of Psychology, Western Sydney University, Sydney, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
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Cheng D, Wei M. Modified Dual Pathway Model for Binge Eating: The Role of Emotion Dysregulation. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000221077936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We tested a modification of the dual pathway model using two sequential mediators between body dissatisfaction and binge eating: restricted eating and difficulties in emotion regulation replacing negative affect. A total of 435 college students completed an online survey. Results from path analyses indicated that the relationship between body dissatisfaction and binge eating was not mediated by restricted eating for neither women nor men. However, this relationship was mediated first by restricted eating and then by difficulties in emotion regulation for women only. Moreover, this relationship was mediated by difficulties in emotion regulation for both women and men. A post hoc analysis indicated that the above mediation results were still significant after adding negative affect into the model. No mediations through negative affect were significant. Clinical implications include the conceptualization and intervention of eating concerns within an emotion dysregulation framework.
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Affiliation(s)
- Davelle Cheng
- Department of Psychology, Iowa State University, Ames, IA, USA
| | - Meifen Wei
- Department of Psychology, Iowa State University, Ames, IA, USA
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Heriseanu AI, Hay P, Touyz S. A cross-sectional examination of executive function and its associations with grazing in persons with obesity with and without eating disorder features compared to a healthy control group. Eat Weight Disord 2021; 26:2491-2501. [PMID: 33515403 DOI: 10.1007/s40519-021-01105-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/09/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The current study aimed to investigate associations between grazing and different facets of executive functioning in persons with obesity with and without significant eating disorder psychopathology, compared to a healthy-weight control group. METHODS Eighty-nine participants (of which 20 had obesity and marked eating disorder symptomatology, 25 had obesity but without marked eating disorder symptoms, and 44 were healthy-weight age- and sex-matched participants; N = 89; 66.3% female, age = 28.59 (8.62); 18.18-58.34 years) completed a battery of neuropsychological tests and demographic and eating disorder-related questionnaires. Poisson, Negative Binomial, and Ordinary Least Squares regressions were performed to examine group differences and the associations of grazing with executive functioning within the three groups. RESULTS Significantly lower inhibitory control and phonemic fluency were observed for the obesity group without ED features compared to healthy-weight controls. Increasing grazing severity was associated with improved performance in inhibitory control in both groups with obesity, and with phonemic fluency in the obesity group with marked eating disorder features. CONCLUSION Although there is mounting evidence that specific cognitive domains, especially inhibition, are affected in obesity, evidence of further detrimental effects of eating disorder psychopathology remains mixed; additionally, for persons with obesity, there may be a weak but positive link between executive functioning and grazing behaviour. LEVEL OF EVIDENCE III, comparative cross-sectional observational study with a concurrent control group.
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Affiliation(s)
- Andreea I Heriseanu
- eCentreClinic, Department of Psychology, Macquarie University, Macquarie Park, NSW, 2109, Australia.
- Clinical Psychology Unit, School of Psychology, University of Sydney, Level 3 M02F, 94 Mallett Street, Camperdown, NSW, 2050, Australia.
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Campbelltown Hospital, South West Sydney Local Health District (SWSLHD), PO Box 149, Campbelltown, NSW, 2560, Australia
| | - Stephen Touyz
- Clinical Psychology Unit, School of Psychology, University of Sydney, Level 3 M02F, 94 Mallett Street, Camperdown, NSW, 2050, Australia
- InsideOut Institute, Level 2, Charles Perkins Centre, University of Sydney, Johns Hopkins Drive, Camperdown, NSW, 2006, Australia
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The Assessment of Food Addiction and the Yale Food Addiction Scale in Bariatric Surgery Populations. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Food addiction (FA) appears among bariatric weight loss surgery candidates who struggle to control the intake of hyperpalatable/refined foods have high rates of psychopathology and related health problems. Despite this, prevalence rates of FA in the bariatric sector are reported as low or variable. We investigated the prevalence of FA and the applicability of conventionally used metrics for 166 pre-surgery candidates from a weight management centre (USA) and a major metropolitan hospital (Australia). Self-report measures assessed FA (Yale Food Addiction Scale (YFAS)), body mass index (BMI), disordered eating, addictive personality, psychopathology, and diet. Consistent with prior research, standard YFAS scoring, requiring the endorsement of a distress/impairment (D/I) criterion (FA + D/I), yielded a FA prevalence rate of 12.7%, compared to 37.3% when D/I was omitted (FA − D/I). We compared profiles for those with FA using each scoring method against those ‘without’, who did not meet a minimum of three YFAS symptoms (non-FA ≤ 2). Both methods differentiated those with and without FA on addictive traits, disordered eating and hyperpalatable food consumption. Only FA + D/I differentiated markers of psychological distress or impairment, including depression, anxiety and quality of life. Results indicate a need for further FA research in bariatric settings.
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Teodoro MC, Conceição EM, de Lourdes M, Alves JR, Neufeld CB. Grazing's frequency and associations with obesity, psychopathology, and loss of control eating in clinical and community contexts: A systematic review. Appetite 2021; 167:105620. [PMID: 34352352 DOI: 10.1016/j.appet.2021.105620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 12/01/2022]
Abstract
The term grazing is generally described as the repetitive and nonplanned consumption of small amounts of food, not in response to hunger/satiety sensations. The present study aims to identify and critically review studies examining the frequency of grazing in both clinical and community samples, as well as, to investigate its relationship with eating disorder psychopathology, Loss of Control eating (LOC), psychological impairment, and weight-related variables. This systematic review followed the PRISMA recommendations for reporting systematic reviews and meta-analysis. A total of 138 articles were initially retrieved from the database search. In the end, 18 articles were considered for this systematic review. The results were separated in Grazing and Grazing-like behavior (picking and nibbling). Results of studies of grazing-like behaviors displays that, in these studies, the results are sometimes inconsistent and controversial. On the other hand, studies of Grazing behavior showed more consistent results. These results show that the use of different definitions across the literature makes it difficult to establish comparisons across studies. In this literature review, the studies selected used five different definitions of grazing and five different instruments to assess this eating behavior which reinforces the requirement for standardized definition and evaluation. More, the studies hereby revised suggested that LOC eating was considered in association with grazing, being significantly associated with higher levels of psychopathology and psychological impairment. In accordance, a growing body of research argues that LOC eating was a stronger predictor of eating disorder psychopathology than the amounts of food consumed. Furthermore, the results found by studies show an advance to literature with an accordance about LOC, supported by evidences in studies of this review.
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Affiliation(s)
- Marília Consolini Teodoro
- Cognitive-Behavioral Intervention and Research Laboratory - LaPICC-USP, Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil.
| | - Eva M Conceição
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Jéssika Rodrigues Alves
- Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Carmem Beatriz Neufeld
- Cognitive-Behavioral Intervention and Research Laboratory - LaPICC-USP, Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil
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Legendre M, Bégin C. French validation of the addiction-like eating behavior scale and its clinical implication. Eat Weight Disord 2021; 26:1893-1902. [PMID: 33048328 DOI: 10.1007/s40519-020-01039-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 09/29/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The first conception of food addiction (FA) as substance addiction, measured by the Yale Food Addiction Scale (YFAS), is controversial. Some proposed that FA would be better conceptualized with a behavioral approach. In accordance with this conceptualization, Ruddock and colleagues published a new self-reported scale for food addiction, the Addiction-like Eating Behavior Scale (AEBS). Overall, preliminary validation of the scale demonstrated good psychometric properties with a community sample. The aim of the present study is twofold, to validate the French-Canadian version of the AEBS with a community sample and to examine how well the instrument fits into a clinical sample with overweight/obesity. METHODS A community sample (N = 466) and a clinical sample with overweight/obesity seeking help for their eating difficulties (N = 126) completed an online survey regarding FA, binge eating, dietary restraint, depression, and BMI. Factor analysis, internal consistency, and construct validity were assessed. RESULTS With the community sample, factorial structure, and psychometric properties of the AEBS were replicated. With the clinical sample, proper convergent validity was demonstrated with the YFAS 2.0 and binge eating, and proper divergent validity was demonstrated with dietary restraint. Among the clinical sample, AEBS explain similar variance of BMI and depression level when compared to YFAS 2.0. CONCLUSION This study provided evidence that the French-Canadian version of the AEBS is a valid measure of food addiction, but it did not permit to establish advantages over YFAS 2.0 with a clinical sample. Clinical implications of the AEBS and FA characteristic are discussed. LEVEL OF EVIDENCE Level V, cross-sectional, descriptive study.
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Affiliation(s)
- Maxime Legendre
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada
| | - Catherine Bégin
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada.
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Berber LCL, Melendez-Araújo MS, Nakano EY, de Carvalho KMB, Dutra ES. Grazing Behavior Hinders Weight Loss in Long-Term Post Bariatric Surgery: a Cross-Sectional Study. Obes Surg 2021; 31:4076-4082. [PMID: 34215973 DOI: 10.1007/s11695-021-05533-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Grazing behavior is common in patients undergoing bariatric surgery (BS); however, little is known about grazing behavior in operated patients in the long term. We aimed to estimate grazing frequency and its association with weight loss and surgery response in patients who had undergone BS. METHODS This cross-sectional study included 109 patients who had undergone Roux-en-Y gastric bypass at least 5 years previously. They answered questions about socioeconomic factors, surgical information, and adherence to treatment/follow-up. The Rep(eat) questionnaire was used for grazing assessment. Student's t-test and Pearson's chi-square test were used to evaluate differences between groups. Analysis of covariance and partial correlation were used to investigate grazing behavior, and weight loss outcomes were controlled for the elapsed time since BS, healthcare service type, current psychologist care status, and the presence of a constriction ring. RESULTS The mean elapsed time since BS was 9.97 ± 2.39 years. Patients with grazing behavior (67%) comprised fewer surgery responders (p = 0.019), had lower total (%TWL, p = 0.005) and excess weight loss (%EWL, p = 0.029), and received less psychological counseling (45.5% vs. 54.5%, p = 0.042). Correlations were found between the presence of grazing and its subtypes and %EWL and %TWL (T = - 0.382, T = - 0.361, p < 0.001; compulsive grazing: T = - 0.358, T = - 0.342, p < 0.001, p = 0.001; non-compulsive grazing: T = - 0.333, T = - 0.311, p = 0.001, p = 0.003). No significant difference between patients with and without grazing behavior was found for previous/current diagnoses of psychological diseases or dietitian counseling. CONCLUSION Grazing behavior is common in the long-term among patients who have undergone BS and is negatively related to weight loss parameters.
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Affiliation(s)
- Larissa Cristina Lins Berber
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil
| | - Mariana Silva Melendez-Araújo
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil.
| | - Eduardo Yoshio Nakano
- Department of Statistics, Institute of Exact Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, DF, 70910-900, Brazil
| | - Kênia Mara Baiocchi de Carvalho
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil
| | - Eliane Said Dutra
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil
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Rumination, mood, and maladaptive eating behaviors in overweight and healthy populations. Eat Weight Disord 2021; 26:273-285. [PMID: 32072571 PMCID: PMC7895787 DOI: 10.1007/s40519-020-00857-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/24/2020] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The literature suggests that rumination (i.e., repetitive thinking about 1 or more negative concerns that is perceived as difficult to control) is linked to impaired emotional regulation and increases negative affect. Not only individuals suffering from overweight or obesity, but also healthy individuals might use emotional eating as a coping strategy to deal with negative affect caused by rumination. The aim of the present study was to determine the link between rumination and maladaptive eating strategies in participants with normal weight and overweight/obesity using trait and ecological momentary measures. METHOD In Study 1, 88 individuals from overweight/obese (N = 33) and control group (N = 50) filled in a series of questionnaires assessing trait rumination, and eating behaviors. In Study 2 momentary affect, rumination and eating behavior of 26 participants were assessed using ecological momentary assessment (EMA) methodology. RESULTS In Study 1, the moderated mediation model revealed that emotional eating mediates the link between rumination and uncontrolled eating or snacking, but only in healthy participants and not in the participants with overweight. The results of Study 2 suggest that when both momentary rumination and sad mood are entered into the model predicting momentary daily emotional eating, only rumination remains a significant predictor of emotional eating. This relationship is not modified by the fact that the participants are from healthy controls or the overweight/obese group. DISCUSSION Study 1 provided evidence on the differential role of emotional eating in participants with normal weight and with overweight. Study 2 provided initial insights into the role of momentary mood and momentary repetitive thinking in the use of emotional eating in participants' everyday lives. The differences in group effect in trait and EMA measures indicated also the importance of considering the consciousness of using rumination and emotional eating, while studying those processes in individuals with overweight. LEVEL OF EVIDENCE Level III, case-control analytic study.
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de Lourdes M, Pinto-Bastos A, Machado PP, Conceição E. Problematic eating behaviors in patients undergoing bariatric surgery: Studying their relationship with psychopathology. J Health Psychol 2021; 27:1535-1546. [PMID: 33406896 DOI: 10.1177/1359105320986889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study explored the associations between individuals presenting different problematic eating behaviors (Objective/Subjective binge-eating-OBE/SBE-and Compulsive/Non-compulsive grazing-C_Grazing/NC_Grazing) and eating disorder related symptoms. About 163 pre- and 131 post-bariatric patients were assessed. Assessment included: Face-to-face clinical interview to assess binge-eating and grazing episodes, and self-report measures to assess eating disorder symptomatology, psychological distress, and negative urgency. OBE and NC_Grazing were the problematic eating behaviors most and least associated with psychopathology, respectively. OBE and C_Grazing uniquely accounted for the significant variance in the most disordered eating variables. Our findings emphasize the need for the conceptualization of grazing behavior in the spectrum of disordered eating.
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Heriseanu AI, Hay P, Corbit L, Touyz S. Relating goal-directed behaviour to grazing in persons with obesity with and without eating disorder features. J Eat Disord 2020; 8:48. [PMID: 33014370 PMCID: PMC7528325 DOI: 10.1186/s40337-020-00324-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 09/09/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Both obesity and eating disorders (ED) have been associated with reductions in purposeful, flexible goal-directed behaviour, and with an overreliance on more rigid habitual behaviour. It is currently unknown whether grazing, an eating style which is common in both conditions, is related to goal-directed behaviour. The current study therefore aimed to relate grazing to goal-directed behaviour in a group of participants with obesity with and without ED features, compared to a healthy-weight control group. METHODS Participants (N = 87; 67.8% women, mean age 28.57 years), of whom 19 had obesity and significant eating disorder features, 25 had obesity but without marked eating disorder features, and 43 were age- and sex-matched healthy-weight controls, completed two instrumental learning tasks assessing action-outcome contingency sensitivity and devaluation sensitivity, as well as demographic and eating disorder-related questionnaires. Gamma and Ordinary Least Squares regressions were performed to examine the effect of group and grazing on goal-directed behaviour. RESULTS Lower action-outcome contingency sensitivity was found in the group with obesity and with eating disorder features than in the group with obesity but without eating disorder features or in healthy controls. No group differences in devaluation sensitivity were found. A small but significant relationship was found between grazing severity and contingency sensitivity in the group with obesity and eating disorder features, such that increasing grazing severity was associated with less diminished contingency sensitivity. CONCLUSIONS There is some indication that in persons with obesity and eating disorder features instrumental behaviour is less flexible and adaptive; furthermore, within this group grazing may represent a goal-directed behaviour, despite unhelpful long-term implications of grazing.
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Affiliation(s)
- Andreea I. Heriseanu
- Clinical Psychology Unit, School of Psychology, University of Sydney, Level 3, Building M02F, 94 Mallett St, Camperdown, NSW 2050 Australia
- eCentreClinic, Department of Psychology, Macquarie University, Macquarie Park, NSW 2109 Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
- Campbelltown Hospital, South West Sydney Local Health District (SWSLHD), PO Box 149, Campbelltown, NSW 2560 Australia
| | - Laura Corbit
- Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON M5S 3G3 Canada
| | - Stephen Touyz
- Clinical Psychology Unit, School of Psychology, University of Sydney, Level 3, Building M02F, 94 Mallett St, Camperdown, NSW 2050 Australia
- Inside Out Institute, Charles Perkins Centre, University of Sydney, Johns Hopkins Drive, Camperdown, NSW 2006 Australia
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Linking Grazing to Inhibition and Goal-Directed Behaviour in Obesity With and Without Eating Disorder Features. BEHAVIOUR CHANGE 2020. [DOI: 10.1017/bec.2020.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractRecent models of obesity and eating behaviour have implicated both automatic responding to food-related cues and executive functioning in driving dietary choice. This study aimed to relate grazing severity to high weight with and without significant eating disorder features via the effects of inhibition and degree of goal-directed behaviour, in persons with obesity with and without significant eating disorder features compared to healthy controls. Forty-four participants with obesity (43.1% endorsing marked eating disorder features), and 43 healthy-weight age- and sex-matched participants (N = 87; 67.8% female, age = 28.57 (8.70; 18.18–58.34) years, BMI = 29.18 (7.80; 18.65–51.95) kg/m2) completed demographic and eating disorder-related questionnaires, a neuropsychological task of inhibition and an instrumental decision-making task. Bootstrapped serial mediation analyses were performed to examine the effect of group on grazing via goal-directed behaviour and inhibition. While significant differences existed between the groups in terms of inhibition, goal-directed behaviour and grazing severity, the effect of group on grazing severity was not found to be mediated by the degree of behavioural goal-directedness and inhibition. Therefore, :in persons with obesity with or without eating disorder symptoms, putative relationships between a reduced inhibitory profile and/or behaviour that is less flexible and goal-directed and eating behaviours such as grazing, remain unclear.
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Heriseanu AI, Hay P, Touyz S. Grazing behaviour and associations with obesity, eating disorders, and health-related quality of life in the Australian population. Appetite 2019; 143:104396. [PMID: 31386867 DOI: 10.1016/j.appet.2019.104396] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/23/2019] [Accepted: 08/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Grazing, including a compulsive subtype, represents an eating behaviour of recent interest in obesity and eating disorders (ED), however, there is little information regarding its prevalence and correlates in the general population. The current study aimed to report on the distribution of compulsive grazing (CG) and non-compulsive grazing (NCG) in the Australian population, and to assess associations with obesity, ED, and health-related functioning. METHODS A representative sample of 3047 individuals aged ≥15 years (50.8% female) completed a cross-sectional survey in 2016 assessing grazing, quality of life, BMI, and ED symptoms. Prevalence data were obtained, and logistic regressions and multivariate analyses were conducted to examine relationships between grazing and obesity, ED, and health-related quality of life. RESULTS The point prevalence of regular NCG was 38.04% (95% CI [36.33, 39.78]; n = 1159) and CG was 10.24% (95% CI [9.21, 11.37]; n = 312). Persons with regular CG had almost twice the odds of a BMI ≥ 30 than of a BMI in the "healthy" range compared to those with no grazing. CG presented stronger associations with ED features and binge-type ED diagnostic groups than NCG, with high rates found in BED-Broad and BN, although some associations with ED features were also present for NCG. Those with both ED and obesity had an 11-fold increase in the odds of engaging in CG than in no grazing, compared to those without. Mental health-related quality of life was lower in those who engaged in CG in the population, as well as in those with obesity. CONCLUSIONS Grazing, especially when associated with a more severe sense of loss of control, is a problematic eating behaviour in the general population, as well as in persons with high BMI, a binge-type ED, or both.
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Affiliation(s)
- Andreea I Heriseanu
- School of Psychology, University of Sydney, Australia, Clinical Psychology Unit, University of Sydney, Level 3 M02F, 94 Mallett Street, Camperdown, NSW, 2050, Australia.
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Australia, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia; Campbelltown Hospital, South West Sydney Local Health District (SWSLHD), Australia, PO Box 149, Campbelltown, NSW, 2560, Australia.
| | - Stephen Touyz
- School of Psychology, University of Sydney, Australia, Clinical Psychology Unit, University of Sydney, Level 3 M02F, 94 Mallett Street, Camperdown, NSW, 2050, Australia; InsideOut Institute, Level 2, The Charles Perkins Centre, The University of Sydney, Johns Hopkins Drive, Camperdown, NSW, 2006, Australia.
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Heriseanu AI, Hay P, Touyz S. The short inventory of grazing (SIG): development and validation of a new brief measure of a common eating behaviour with a compulsive dimension. J Eat Disord 2019; 7:4. [PMID: 30774954 PMCID: PMC6366119 DOI: 10.1186/s40337-019-0234-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 01/11/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Grazing, the repetitious and unplanned eating of small amounts of food with or without a sense of loss of control (LOC), is an eating pattern of recent interest which is highly prevalent in eating disorders and obesity. The current study aimed to (1) assess psychometric properties of a short inventory of grazing (SIG), consisting of a "grazing in general" item and a "compulsive/LOC grazing" item and (2) examine associations between compulsive and non-compulsive grazing and body mass index (BMI), eating disorder psychopathology, distress and health-related quality of life. METHODS Participants recruited from a university and the community (n = 227; 75.3% female; age = 25.00 (9.88; 17.58-57.17) years; BMI = 23.24 (4.91, 14.20-46.06) kg/m2) completed an online test battery including the SIG. Parametric and non-parametric statistics were computed to assess internal consistency, test-retest reliability and construct validity, to test associations between the SIG and the other study variables, and to examine between-group differences. RESULTS The SIG demonstrated appropriate psychometric properties. Results indicated that both grazing in general and low-frequency LOC grazing are common; however, LOC grazing of moderate-severe frequency and/or associated with marked distress is unusual. Frequency of LOC grazing, but not grazing in general, was significantly associated with higher BMI, psychological distress, compensatory behaviours and lower mental health-related quality of life. The presence of compulsive grazing was also associated with eating disorder caseness and binge-type eating disorder diagnostic groups. CONCLUSIONS Results support the positioning of "compulsive" LOC grazing on a continuum of problematic eating. The SIG is a parsimonious measure of this eating pattern of emergent interest.
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Affiliation(s)
- Andreea I Heriseanu
- 1School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, 2751 NSW Australia.,2School of Psychology, University of Sydney, Level 3, Building M02F, 94 Mallett St, Camperdown, 2050 NSW Australia
| | - Phillipa Hay
- 2School of Psychology, University of Sydney, Level 3, Building M02F, 94 Mallett St, Camperdown, 2050 NSW Australia
| | - Stephen Touyz
- 1School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, 2751 NSW Australia
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Reas DL, Lindvall Dahlgren C, Wonderlich J, Syversen G, Lundin Kvalem I. Confirmatory factor analysis and psychometric properties of the Norwegian version of the Repetitive Eating Questionnaire: Further evidence for two distinct subtypes of grazing behaviour. EUROPEAN EATING DISORDERS REVIEW 2018; 27:205-211. [DOI: 10.1002/erv.2631] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/30/2018] [Accepted: 07/04/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Deborah Lynn Reas
- Regional Department of Eating Disorders, Division of Mental Health and Addiction; Oslo University Hospital-Ullevål; Oslo Norway
- Institute of Psychology, Faculty of Social Sciences; University of Oslo; Oslo Norway
| | - Camilla Lindvall Dahlgren
- Regional Department of Eating Disorders, Division of Mental Health and Addiction; Oslo University Hospital-Ullevål; Oslo Norway
| | - Joseph Wonderlich
- Regional Department of Eating Disorders, Division of Mental Health and Addiction; Oslo University Hospital-Ullevål; Oslo Norway
- Department of Psychology; George Mason University; Fairfax Virginia
| | - Gro Syversen
- Regional Department of Eating Disorders, Division of Mental Health and Addiction; Oslo University Hospital-Ullevål; Oslo Norway
| | - Ingela Lundin Kvalem
- Institute of Psychology, Faculty of Social Sciences; University of Oslo; Oslo Norway
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Zimmerman AR, Johnson L, Brunstrom JM. Assessing “chaotic eating” using self-report and the UK Adult National Diet and Nutrition Survey: No association between BMI and variability in meal or snack timings. Physiol Behav 2018; 192:64-71. [DOI: 10.1016/j.physbeh.2018.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/10/2018] [Accepted: 03/21/2018] [Indexed: 11/26/2022]
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Grazing, motives to eat palatable foods, and fat and sugar consumption: an exploratory investigation. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-018-0944-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Mantzios M, Egan H, Bahia H, Hussain M, Keyte R. How does grazing relate to body mass index, self-compassion, mindfulness and mindful eating in a student population? Health Psychol Open 2018; 5:2055102918762701. [PMID: 29552351 PMCID: PMC5846935 DOI: 10.1177/2055102918762701] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Contemporary research investigating obesity has focused on grazing (i.e. an uncontrolled and repetitive consumption of small amounts of food). Meanwhile, constructs such as mindfulness, mindful eating and self-compassion have received much attention in assisting individuals with eating behaviours and weight regulation. The association between those constructs and grazing, however, has not been explored. In a cross-sectional study, university students (n = 261) were recruited to explore the relationship of mindfulness, mindful eating and self-compassion with current weight and grazing. Results indicated that all constructs were negatively related to grazing, but only mindful eating related negatively to current weight. In addition, mindful eating mediated the relationship between grazing and current weight. Possible explanations and future directions are discussed further with an emphasis on the need for more empirical work.
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Affiliation(s)
- Michail Mantzios
- Department of Psychology and Faculty of Business, Law and Social Sciences, Birmingham City University, Birmingham, UK
| | - Helen Egan
- Department of Psychology and Faculty of Business, Law and Social Sciences, Birmingham City University, Birmingham, UK
| | - Henna Bahia
- Department of Psychology and Faculty of Business, Law and Social Sciences, Birmingham City University, Birmingham, UK
| | - Misba Hussain
- Department of Psychology and Faculty of Business, Law and Social Sciences, Birmingham City University, Birmingham, UK
| | - Rebecca Keyte
- Department of Psychology and Faculty of Business, Law and Social Sciences, Birmingham City University, Birmingham, UK
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Heriseanu AI, Hay P, Corbit L, Touyz S. Grazing in adults with obesity and eating disorders: A systematic review of associated clinical features and meta-analysis of prevalence. Clin Psychol Rev 2017; 58:16-32. [DOI: 10.1016/j.cpr.2017.09.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/18/2017] [Accepted: 09/12/2017] [Indexed: 02/06/2023]
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38
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A commentary on the associations among ‘food addiction’, binge eating disorder, and obesity: Overlapping conditions with idiosyncratic clinical features. Appetite 2017; 115:3-8. [DOI: 10.1016/j.appet.2016.11.001] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 10/16/2016] [Accepted: 11/01/2016] [Indexed: 02/07/2023]
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The relationship between emotional regulation and eating behaviour: a multidimensional analysis of obesity psychopathology. Eat Weight Disord 2017; 22:105-115. [PMID: 27068173 PMCID: PMC5334401 DOI: 10.1007/s40519-016-0275-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/16/2016] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The aim of this study is to show that the differences among eating behaviours are related to the emotional dysregulation connected to the mental dimensions being part of the obese psychopathology. Eating behaviours can be considered a diagnostic feature at the initial screening for determining the obesity treatment: nutritional or bariatric surgery. METHODS 1828 Obese subjects underwent psychiatric assessment before entering obesity nutritional treatment or bariatric surgery following the multidisciplinary programme. 1121 subjects were selected and enrolled in this study: 850 were inpatients visited or hospitalised at the Obesity Centre or at the Bariatric Surgery Units, 271 were outpatients visited at the Eating Disorder and Obesity Unit. Psychiatric examination was used to exclude psychiatric disorders and investigate eating behaviours distinguished on the basis of food intake rhythm in: gorging, snacking, grazing and binge. They are related to the mental dimensions: impulsiveness, body image, mood and anxiety, taking part in the emotional regulation system. Specific psychometric tools were used to investigate the different mental dimensions of the single eating behaviours and their differences. Statistical analysis of the psychopathological features was performed using ANOVA, ANCOVA, Levene test, Bonferroni's and Tamhane post hoc test. Significance was set at p < 0.05. RESULTS Data analysis shows significant differences of psychopathology among all the eating behaviours and an increase in the emotional dysregulation determining maladaptive behaviours. DISCUSSION Eating behaviours are connected to the balance of the different features of mental dimensions implicated in the emotional regulation system. They could provide significant clinical information and therefore be part of the obesity diagnostic criteria and therapeutic programme.
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Smith E, Whittingham C. Cognitive remediation therapy plus behavioural weight loss compared to behavioural weight loss alone for obesity: study protocol for a randomised controlled trial. Trials 2017; 18:42. [PMID: 28126015 PMCID: PMC5270361 DOI: 10.1186/s13063-017-1778-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 12/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Current research indicates that obese individuals have cognitive deficits in executive function, leading to difficulties with planning, impulse control and decision-making. High levels of inflammation have been proposed to contribute to executive function deficits in individuals with obesity. METHODS/DESIGN One hundred and seventy-six obese participants will be randomly assigned to one of two groups: (1) behavioural weight loss alone (BWL) group = 8 sessions of individual BWL sessions plus 12 group BWL sessions or (2) Cognitive Remediation Therapy for Obesity (CRT-O) plus BWL group (CRT-O + BWL) = 8 sessions of individual CRT-O plus 12 group BWL sessions. The study is double blind - participants will only be told that two weight-loss treatments are being compared and research assistants conducting outcome assessments will not know participants' group allocation. Blood tests will be conducted to measure inflammatory markers. Measurement points will be at baseline, post treatment and 1-year follow-up. The primary outcomes will be differences between treatment groups in percentage weight loss, executive function, binge eating and an examination of whether changes in executive function predict changes in weight and binge eating. Secondary outcome measures will examine changes on inflammation, quality of life, and grazing behaviour and whether these predict changes in executive function and weight. DISCUSSION If CRT-O + BWL is more effective in assisting people to lose weight long term than BWL alone it should significantly improve treatment outcomes. This study expands upon our recent trial which showed that CRT-O enhanced executive function and weight loss in obese adults. The current study is strengthened by several factors: it is double-blind, it uses an active control, has a larger sample size, and measures inflammation to examine the mechanisms. TRIAL REGISTRATION The RCT is registered with the Australian New Zealand Registry of Clinical Trial, trial identifier: ACTRN12616000658415 . Registered on 20 May 2016.
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Affiliation(s)
- Evelyn Smith
- Eating Disorders and Obesity Psychology Research Clinic, School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1747, Penrith 2751, Sydney, NSW Australia
- Clinical and Health Psychology Research Initiative, School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1747, Penrith 2751, Sydney, NSW Australia
| | - Charlotte Whittingham
- Eating Disorders and Obesity Psychology Research Clinic, School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1747, Penrith 2751, Sydney, NSW Australia
- Clinical and Health Psychology Research Initiative, School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1747, Penrith 2751, Sydney, NSW Australia
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Opozda M, Chur-Hansen A, Wittert G. Changes in problematic and disordered eating after gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy: a systematic review of pre-post studies. Obes Rev 2016; 17:770-92. [PMID: 27296934 DOI: 10.1111/obr.12425] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 04/15/2016] [Accepted: 04/18/2016] [Indexed: 12/31/2022]
Abstract
Despite differences in their mechanisms and outcomes, little is known about whether postsurgical changes in eating behaviours also differ by bariatric procedure. Following a systematic search, 23 studies on changes in binge eating disorder (BED) and related behaviours, bulimia nervosa and related behaviours, night eating syndrome, grazing and emotional eating after Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) and vertical sleeve gastrectomy (VSG) were reviewed. Significant methodological problems and a dearth of literature regarding many behaviours and VSG were seen. Regarding BED and related behaviours, although later re-increases were noted, short to medium-term reductions after RYGB were common, and reported changes after AGB were inconsistent. Short to medium-term reductions in emotional eating, and from a few studies, short to long-term reductions in bulimic symptoms, were reported after RYGB. Reoccurrences and new occurrences of problem and disordered eating, especially BED and binge episodes, were apparent after RYGB and AGB. Further conclusions and comparisons could not be made because of limited or low-quality evidence. Long-term comparison studies of changes to problematic and disordered eating in RYGB, AGB and VSG patients are needed. It is currently unclear whether any bariatric procedure leads to long-term improvement of any problematic or disordered eating behaviours.
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Affiliation(s)
- M Opozda
- School of Psychology, University of Adelaide, Adelaide, Australia.,Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
| | - A Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - G Wittert
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, Australia, and Centre for Nutrition and Gastro-Intestinal Diseases, South Australian Health and Medicine Research Institute, Adelaide, Australia
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Opolski M, Chur-Hansen A, Wittert G. The eating-related behaviours, disorders and expectations of candidates for bariatric surgery. Clin Obes 2015; 5:165-97. [PMID: 26173752 DOI: 10.1111/cob.12104] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 05/13/2015] [Accepted: 05/21/2015] [Indexed: 12/17/2022]
Abstract
It is important that clinicians and researchers understand the possible eating-related difficulties experienced by pre-bariatric surgery candidates, as well as their expectations of how their eating and hunger will change after surgery. This review examines English-language publications related to the eating-related behaviours, disorders and expectations of bariatric candidates. Seventy-five articles related to binge eating disorder, grazing, night eating syndrome, emotional eating, food cravings and addiction, and pre-surgical expectations of post-surgical eating in this population were critically reviewed. A variety of often problematic eating behaviours appear more common in bariatric candidates than in non-obese populations. The literature suggests that 4-45% of candidates may have binge eating disorder, 20-60% may graze, 2-42% may have night eating syndrome, 38-59% may engage in emotional eating and 17-54% may fit criteria for food addiction. Binge eating may also be more prevalent in bariatric candidates than in similarly obese non-surgical individuals. Expectations of surgery are high, with pre-surgical candidates believing their bariatric procedure will virtually guarantee significantly improved eating behaviours. Study replications are needed, and further investigation into prevalence, impacts and candidate characteristics related to disordered eating behaviours, as well as candidates' expectations of eating after surgery, will be important. Further comparisons of bariatric candidates to similarly obese non-bariatric populations will be important to understand eating-related characteristics of candidates beyond those related to their weight. Future research may be improved by the use of validated measures, replicable methodologies, minimization of data collected in circumstances where respondents may been motivated to 'fake good', use of prospective data and consistent definitions of key terminology.
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Affiliation(s)
- M Opolski
- School of Psychology, University of Adelaide, Adelaide, Australia
- Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
| | - A Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - G Wittert
- Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
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Comment on: What is ‘grazing’? Reviewing its definition, frequency, clinical characteristics, and impact on bariatric surgery outcomes, and proposing a standardized definition. Surg Obes Relat Dis 2015; 11:267. [DOI: 10.1016/j.soard.2014.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 10/21/2014] [Indexed: 11/22/2022]
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Raman J, Hay P, Smith E. Manualised Cognitive Remediation Therapy for adult obesity: study protocol for a randomised controlled trial. Trials 2014; 15:426. [PMID: 25370364 PMCID: PMC4230366 DOI: 10.1186/1745-6215-15-426] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 10/15/2014] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Research has shown that obese individuals have cognitive deficiencies in executive function, leading to poor planning and impulse control, and decision-making difficulties. An intervention that could help reduce these deficits and in turn help weight loss maintenance is Cognitive Remediation Therapy for Obesity (CRT-O). We aim to examine the efficacy of manualised CRT-O, which is intended to improve executive function, enhance reflective practice and help weight loss maintenance. METHODS/DESIGN A randomised controlled trial (registered with the Australian New Zealand Clinical Trials Registry) will be conducted. First, 90 obese adults (body mass index >30 kg/m2) in the community will receive three weekly sessions of a group Behaviour Weight Loss Treatment (BWLT), and then will be randomised either to receive CRT-O or to enter a no-treatment control group. CRT-O training will comprise twice-weekly sessions of 45 minutes over a 4 to 6 week period, for a total of eight sessions. Measurement points will be at baseline, post CRT-O (or 4 to 6 weeks after BWLT for the no-treatment control), 3 months post treatment and 1 year post treatment. The primary outcome will be executive function and secondary outcome measures will include participants' body mass index, hip to waist ratio, eating behaviours and quality of life. DISCUSSION This is the first study of its kind to examine the efficacy of Cognitive Remediation Therapy for obese adults through a randomised controlled trial. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry number: 12613000537752. Date of registration: 14 May 2013.
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Affiliation(s)
| | - Phillipa Hay
- Centre for Health Research, School of Medicine, University of Western Sydney, Locked Bag 1747, Penrith, NSW 2751, Australia.
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Corrigendum: Uncontrolled, Repetitive Eating of Small Amounts of Food or ‘Grazing’: Development and Evaluation of a New Measure of Atypical Eating. BEHAVIOUR CHANGE 2014. [DOI: 10.1017/bec.2014.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Characterization of eating patterns among individuals with eating disorders: What is the state of the plate? Physiol Behav 2014; 134:92-109. [DOI: 10.1016/j.physbeh.2014.02.045] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/15/2014] [Accepted: 02/17/2014] [Indexed: 12/28/2022]
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What is "grazing"? Reviewing its definition, frequency, clinical characteristics, and impact on bariatric surgery outcomes, and proposing a standardized definition. Surg Obes Relat Dis 2014; 10:973-82. [PMID: 25312671 DOI: 10.1016/j.soard.2014.05.002] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 04/17/2014] [Accepted: 05/05/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Grazing, characterized by a repetitive eating pattern, has received increased attention among bariatric surgery patients. However, different definitions and terminology have been used, preventing the accurate measurement of this phenomenon and comparison of data across studies. OBJECTIVE To review existing definitions and associated clinical features of grazing among different samples and to propose a standardized definition that will allow for consistency in future work. SETTING University and Clinical Research Institute. METHODS Of the 39 studies found, 9 provided an original definition and 12 provided data of its association with weight outcomes. Six were studies of nonbariatric surgery populations. Based on this literature review, the most common criteria used in previous studies to define grazing were included in a survey that was sent to 24 individuals who have published work in the field. These experts were asked to provide their opinion on what should constitute grazing. RESULTS Grazing is a frequent behavior in the bariatric surgery population as well as in eating disordered and community samples. Its association with psychopathology is not clear, but its negative impact on weight outcomes after bariatric surgery generally has been supported. Survey data provided a consensus regarding the definition of grazing as an eating behavior characterized by the repetitive eating (more than twice) of small/modest amounts of food in an unplanned manner, with what we characterize as compulsive and noncompulsive subtypes. CONCLUSIONS Given the clinical relevance of grazing among bariatric surgery patients, a unique definition is crucial to better study its associated features and impact on different populations.
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