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Via E, Contreras-Rodríguez O. Binge-Eating Precursors in Children and Adolescents: Neurodevelopment, and the Potential Contribution of Ultra-Processed Foods. Nutrients 2023; 15:2994. [PMID: 37447320 DOI: 10.3390/nu15132994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Binge-eating disorder (BED) is a highly prevalent disorder. Subthreshold BED conditions (sBED) are even more frequent in youth, but their significance regarding BED etiology and long-term prognosis is unclear. A better understanding of brain findings associated with BED and sBED, in the context of critical periods for neurodevelopment, is relevant to answer such questions. The present narrative review starts from the knowledge of the development of emotional self-regulation in youth, and the brain circuits supporting emotion-regulation and eating behaviour. Next, neuroimaging studies with sBED and BED samples will be reviewed, and their brain-circuitry overlap will be examined. Deficits in inhibition control systems are observed to precede, and hyperactivity of reward regions to characterize, sBED, with overlapping findings in BED. The imbalance between reward/inhibition systems, and the implication of interoception/homeostatic processing brain systems should be further examined. Recent knowledge of the potential impact that the high consumption of ultra-processed foods in paediatric samples may have on these sBED/BED-associated brain systems is then discussed. There is a need to identify, early on, those sBED individuals at risk of developing BED at neurodevelopmental stages when there is a great possibility of prevention. However, more neuroimaging studies with sBED/BED pediatric samples are needed.
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Affiliation(s)
- Esther Via
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Spain
| | - Oren Contreras-Rodríguez
- Medical Imaging, Girona Biomedical Research Institute (IdIBGi), Parc Hospitalari Martí i Julià-Edifici M2, Salt, 17190 Girona, Spain
- Health Institute Carlos III (ISCIII) and CIBERSAM, 28029 Madrid, Spain
- Department of Psychiatry and Legal Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
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Schueler J, Philip SR, Vitus D, Engler S, Fields SA. Group differences in binge eating, impulsivity, and intuitive and mindful eating among intermittent fasters and non-fasters. Appetite 2023; 182:106416. [PMID: 36526039 DOI: 10.1016/j.appet.2022.106416] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
Intermittent fasting (IF) is an increasingly popular diet involving short-term fasting and/or caloric restriction. While published research highlights physiological effects (e.g., weight, body fat) of IF, hardly any research has examined its associations with psychological factors. This study aimed to investigate the relationship between IF and binge eating, impulsivity, intuitive eating, and mindful eating. An undergraduate sample (N = 298) was recruited through a large southwestern university psychology subject pool. The sample was divided into three groups based on IF status: Current IF (n = 70), Past IF (n = 48), and No IF (n = 182). Current IF was negatively associated with lack of perseverance (e.g., "I generally like to see things through to the end"; p < .01) and intuitive eating (p < .05), varying by subscale, compared to the other groups. Notably, Past-IF, but not Current IF, participants were more likely to binge eat than individuals who reported never fasting (p = .03). These findings add credence to the rapidly developing area of research suggesting IF is associated with increased disordered eating behaviors. Notably, the findings from this study are limited due to the lack of diversity sample, such that generalizations can only be made toward White, middle-to-high income, college students. Future longitudinal studies are needed to test the directionality of these relationships.
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Affiliation(s)
- Jordan Schueler
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA.
| | - Samantha R Philip
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA.
| | - Darya Vitus
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA.
| | - Solangia Engler
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA.
| | - Sherecce A Fields
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA.
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Bray B, Sadowski A, Bray C, Bradley R, Zwickey H. Clinical aspects of binge eating disorder: A cross-sectional mixed-methods study of binge eating disorder experts' perspectives. Front Psychiatry 2023; 13:1087165. [PMID: 36864846 PMCID: PMC9971930 DOI: 10.3389/fpsyt.2022.1087165] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/22/2022] [Indexed: 02/16/2023] Open
Abstract
Introduction Research on binge eating disorder continues to evolve and advance our understanding of recurrent binge eating. Methods This mixed-methods, cross-sectional survey aimed to collect information from experts in the field about clinical aspects of adult binge eating disorder pathology. Fourteen experts in binge eating disorder research and clinical care were identified based on receipt of relevant federal funding, PubMed-indexed publications, active practice in the field, leadership in relevant societies, and/or clinical and popular press distinction. Anonymously recorded semi-structured interviews were analyzed by ≥2 investigators using reflexive thematic analysis and quantification. Results Identified themes included: (1) obesity (100%); (2) intentional/voluntary or unintentional/involuntary food/eating restriction (100%); (3) negative affect, emotional dysregulation, and negative urgency (100%); (4) diagnostic heterogeneity and validity (71%); (5) paradigm shifts in understanding binge eating disorder (29%); and (6) research gaps/future directives (29%). Discussion Overall, experts call for a better understanding of the relationship between binge eating disorder and obesity, including a need for clarification around the extent to which the two health issues are separate vs. related/overlapping. Experts also commonly endorse food/eating restriction and emotion dysregulation as important components of binge eating disorder pathology, which aligns with two common models of binge eating disorder conceptualization (e.g., dietary restraint theory and emotion/affect regulation theory). A few experts spontaneously identified several paradigm shifts in our understanding of who can have an eating disorder (beyond the anorexi-centric "thin, White, affluent, cis-gendered neurotypical female" stereotype), and the various factors that can drive binge eating. Experts also identified several areas where classification issues may warrant future research. Overall, these results highlight the continual advancement of the field to better understand adult binge eating disorder as an autonomous eating disorder diagnosis.
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Affiliation(s)
- Brenna Bray
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, United States
| | - Adam Sadowski
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, United States
| | - Chris Bray
- Wilder Research Division, Amherst H. Wilder Foundation, Saint Paul, MN, United States
| | - Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, United States
- Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United States
| | - Heather Zwickey
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, United States
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Abdulla ZARA, Almahmood HO, Alghasra RR, Alherz ZAS, Alsharifa HAG, Qamber SJ, Alomar NA, Almajed FE, Almahroos TR, Alnajjas ZA, Alsayyad AS. Prevalence and associated factors of binge eating disorder among Bahraini youth and young adults: a cross-sectional study in a self-selected convenience sample. J Eat Disord 2023; 11:5. [PMID: 36627719 PMCID: PMC9831363 DOI: 10.1186/s40337-022-00726-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Binge eating disorder (BED) is defined as recurrent ingestion of an unusually large amount of food in a discrete period of time. BED has the highest prevalence of all eating disorders. Studies have shown a strong relationship between BED and both physical and psychological factors such as obesity, depression and anxiety. This research aimed to report the prevalence and associated factors of BED among Bahrainis (aged 15-30 years). METHODS A total of 959 participants (aged 15-30 years) completed self-administered online questionnaires. BED was measured using the binge eating disorder Screener-7. The Patient Health Questionnaire-9 and General Anxiety Disorder-7 were used to measure depression and anxiety, respectively. RESULTS Out of all participants, 21.2% had binge eating symptoms. A higher BMI, a restricted diet, depression and anxiety were associated with more frequent binge eating symptoms. Out of all associated factors, depression had the strongest association with binge eating, (rp = 0.371, p < 0.0001). However, sociodemographic variables including age and other medical conditions were not significantly associated with BED symptoms. CONCLUSION In conclusion, the prevalence of BED symptoms was significantly high among the study participants. The results point out the crucial role of awareness of the interaction between obesity, depression and anxiety as potential risk factors for binge eating tendencies. Further research should examine their relationship with BED.
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Affiliation(s)
| | - Hend Omar Almahmood
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, 329 Bahrain
| | - Razan Raed Alghasra
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, 329 Bahrain
| | | | | | - Seham Jamal Qamber
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, 329 Bahrain
| | - Nadia Aaref Alomar
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, 329 Bahrain
| | | | | | - Zainab Ali Alnajjas
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, 329 Bahrain
| | - Adel Salman Alsayyad
- Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, 329 Bahrain
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Escrivá-Martínez T, Miragall M, Herrero R, Rodríguez-Arias M, Baños RM. Eating behaviors, eating styles and body mass index during COVID-19 confinement in a college sample: a predictive model. J Eat Disord 2022; 10:100. [PMID: 35820922 PMCID: PMC9275146 DOI: 10.1186/s40337-022-00624-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND COVID-19 confinement affected lifestyles. There is inconclusive evidence about changes in eating patterns, and there are few studies on the impact on body mass index (BMI), the occurrence of dysfunctional behaviors (binge eating, fat intake), and the predictive role of maladaptive eating styles (emotional, external, and restrained eating). OBJECTIVES (1) To analyze the differences in binge eating, fat intake, BMI, and maladaptive eating styles before and during COVID-19 confinement, and (2) to analyze whether maladaptive eating styles (before confinement) predicted binge eating, fat intake, and BMI during confinement. METHODS The sample consisted of 146 Spanish college students, divided into 104 females (71.2%; age: M = 22.20, SD = 2.97) and 42 males (28.8%; age: M = 24.74; SD = 3.53). All completed several dietary measures and BMI twice: before COVID-19 confinement (T1, November 2019) and during COVID-19 confinement (T2, April 2020). RESULTS BMI and maladaptive eating styles did not change in T2 (vs. T1). However, binge eating and fat intake decreased in T2. Emotional eating at T1 positively predicted BMI and binge eating at T2. External eating at T1 positively (and marginally) predicted fat intake at T2. Restrained eating at T1 positively predicted binge eating at T2, and negatively (and marginally) predicted BMI and fat intake at T2. The model explained 80.5% of the variance in BMI, 41.5% of the variance in binge eating, and 25.8% of the variance in fat intake during COVID-19 confinement. CONCLUSIONS The COVID-19 confinement had a positive impact on some eating behaviors. Future policies should focus part of their prevention on maladaptive eating styles to curb dysfunctional eating behaviors and BMI problems in times of stress.
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Affiliation(s)
- Tamara Escrivá-Martínez
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain. .,Instituto Polibienestar, University of Valencia, Valencia, Spain. .,CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
| | - Marta Miragall
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain.,CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Rocío Herrero
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | | | - Rosa M Baños
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain.,Instituto Polibienestar, University of Valencia, Valencia, Spain.,CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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Stewart TM, Martin CK, Williamson DA. The Complicated Relationship between Dieting, Dietary Restraint, Caloric Restriction, and Eating Disorders: Is a Shift in Public Health Messaging Warranted? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:491. [PMID: 35010751 PMCID: PMC8745028 DOI: 10.3390/ijerph19010491] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 02/01/2023]
Abstract
The origins of theories specifying dietary restraint as a cause of eating disorders can be traced to the 1970s. This paper will present an overview of the origins of dietary restraint theories and a brief historical review of evidence will be summarized. Recent research will be presented, including the results from the CALERIE Phase 1 study, as well as CALERIE Phase 2, which were NIH-sponsored randomized controlled trials. CALERIE 2 provided a test of the effect of two years of caloric restriction (CR) on the development of eating disorder syndromes and symptoms in comparison to a control group that did not alter eating behavior or body weight. The intervention was effective for inducing a chronic (two-year) reduction in total energy expenditure and increased dietary restraint but did not increase symptoms of eating disorders. The results of this recent investigation and other studies have not provided experimental support for conventional dietary restraint theories of eating disorders. These findings are discussed in terms of potential revisions of dietary restraint theory, as well as the implications for a paradigm shift in public health messaging related to dieting.
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Affiliation(s)
- Tiffany M. Stewart
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (C.K.M.); (D.A.W.)
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7
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The Association of Restrained Eating and Overeating during COVID-19: A Cross-Lagged Model. Nutrients 2021; 13:nu13124535. [PMID: 34960087 PMCID: PMC8709275 DOI: 10.3390/nu13124535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 12/18/2022] Open
Abstract
Widespread overeating has been found during the 2019 coronavirus (COVID-19) pandemic. The present study investigated whether pre-pandemic restrained eating (RE) predicted overeating during the pandemic, and further explored the behavioral (mortality threat, negative affect) mechanisms underlying this association. An eight-month longitudinal survey was conducted with a large sample of 616 undergraduates from Southwest university. From September 2019 to April 2020, three measurements were conducted. RE was tested before the pandemic (T1), and data of mortality threat, negative affect, and overeating were collected at the middle (T2) and end of (T3) the COVID-19 crisis in China. The correlation results showed that baseline RE was positively associated with mortality threat, negative affect, and overeating at T2 and T3. Moreover, negative affect and mortality threat were positively correlated with overeating. Results from longitudinal mediation showed that baseline RE would positively predict T3 overeating through T2 negative affect, but not T2 mortality threat. This study supports and extends the counterregulatory eating hypothesis that RE positively predicts future overeating, especially through negative emotions. These findings further reveal the core psychological mechanism underlying this positive RE-overeating relation in the context of COVID-19, indicating that the individuals with higher RE could not cope with negative affect adequately, contributing to more overeating.
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8
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South SC, Mann FD, Krueger RF. Marital Satisfaction as a Moderator of Molecular Genetic Influences on Mental Health. Clin Psychol Sci 2021; 9:719-731. [PMID: 36936035 PMCID: PMC10019510 DOI: 10.1177/2167702620985152] [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] [Indexed: 11/17/2022]
Abstract
The quality of one's romantic relationship is associated with mental health. Low levels of relationship quality may be a stressor that triggers a predisposition or diathesis to mental illness. Analyses were conducted to examine whether relationship quality moderated the association between polygenic risk scores (PRSs) for several mental health syndromes on phenotypic measures of those syndromes. Data were drawn from the Midlife in the United States (MIDUS) study of health and well-being. A subsample was genotyped, and PRSs were calculated. The PRS for anxiety was more strongly related to the anxiety phenotype when satisfaction was low than when satisfaction was high, providing evidence of a genetic susceptibility process between marital distress and anxiety. The expression of genetic influences on a phenotype in the presence of certain environmental stressors is complex and may depend on the specific phenotype and the methodology by which genetic influences are estimated.
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Affiliation(s)
| | - Frank D. Mann
- Department of Family, Population, and Preventative Medicine, Program in Public Health, Stony Brook University
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Kukk K, Akkermann K. Emotion regulation difficulties and dietary restraint independently predict binge eating among men. Eat Weight Disord 2020; 25:1553-1560. [PMID: 31621002 DOI: 10.1007/s40519-019-00791-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/30/2019] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Research on eating disorder symptoms among men is growing, but there still are few specific models of disordered eating. The aim of the current study is to expand the literature on male eating behavior by investigating how negative affect can lead to binge eating and overeating through possible mediators, i.e., emotion regulation difficulties and dietary restraint, both separately and together in an integrative model. METHODS Altogether 104 men (mean age 27.3, SD = 8.02; BMI 24.2, SD = 2.92) participated in the study using ecological momentary assessment to collect data on negative affect, the urge to restrict, and the occurrence of binge eating and overeating episodes. Self-report questionnaires were used to measure emotion regulation difficulties and eating disorder symptoms. RESULTS We found that both emotion regulation difficulties and the urge to restrict mediated the effect of negative affect on binge eating in separate models as well as in an integrated model. However, emotion regulation difficulties did not predict the urge to restrict in the joint model. These models did not predict overeating, indicating the pathological nature of binge eating. CONCLUSIONS Our data suggest that negative emotions themselves do not lead to binge eating, but manifest through emotion regulation difficulties and dietary restraint. The results indicate that emotion regulation and restraint play a role in precipitating binge eating among men. However, the emotion regulation and restraint pathways seem to operate independently from one another. Our study also supports the differentiation of overeating and binge eating, as these seem to have different etiologies. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Katrin Kukk
- Institute of Psychology, University of Tartu, Näituse 2, 50409, Tartu, Estonia.
| | - Kirsti Akkermann
- Institute of Psychology, University of Tartu, Näituse 2, 50409, Tartu, Estonia
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10
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Wiss DA, Avena N, Gold M. Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications. Nutrients 2020; 12:E3521. [PMID: 33207612 PMCID: PMC7698089 DOI: 10.3390/nu12113521] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022] Open
Abstract
The role of stress, trauma, and adversity particularly early in life has been identified as a contributing factor in both drug and food addictions. While links between traumatic stress and substance use disorders are well documented, the pathways to food addiction and obesity are less established. This review focuses on psychosocial and neurobiological factors that may increase risk for addiction-like behaviors and ultimately increase BMI over the lifespan. Early childhood and adolescent adversity can induce long-lasting alterations in the glucocorticoid and dopamine systems that lead to increased addiction vulnerability later in life. Allostatic load, the hypothalamic-pituitary-adrenal axis, and emerging data on epigenetics in the context of biological embedding are highlighted. A conceptual model for food addiction is proposed, which integrates data on the biological embedding of adversity as well as upstream psychological, social, and environmental factors. Dietary restraint as a feature of disordered eating is discussed as an important contextual factor related to food addiction. Discussion of various public health and policy considerations are based on the concept that improved knowledge of biopsychosocial mechanisms contributing to food addiction may decrease stigma associated with obesity and disordered eating behavior.
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Affiliation(s)
- David A. Wiss
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Nicole Avena
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Department of Psychology, Princeton University, Princeton, NJ 08540, USA
| | - Mark Gold
- School of Medicine, Washington University in St. Louis, St. Louis, MO 63130, USA
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Knight A, Castelnuovo G, Pietrabissa G, Manzoni GM, Simpson S. Drunkorexia: An Empirical Investigation among Australian Female University Students. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12212] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Alissa Knight
- School of Psychology, Social Work & Social Policy, University of South Australia,
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS,
- Department of Psychology, Catholic University of Milan,
| | - Giada Pietrabissa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS,
- Department of Psychology, Catholic University of Milan,
| | | | - Susan Simpson
- School of Psychology, Social Work & Social Policy, University of South Australia,
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12
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Wiss D, Brewerton T. Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint. Nutrients 2020; 12:E2937. [PMID: 32992768 PMCID: PMC7600542 DOI: 10.3390/nu12102937] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023] Open
Abstract
Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate regarding the value of a food addiction "diagnosis" among those with eating disorders such as anorexia nervosa binge/purge-type, bulimia nervosa, and binge eating disorder. Much of the food addiction research in eating disorder populations has failed to account for dietary restraint, which can increase addiction-like eating behaviors and may even lead to false positives. Some have argued that the concept of food addiction does more harm than good by encouraging restrictive approaches to eating. Others have shown that a better understanding of the food addiction model can reduce stigma associated with obesity. What is lacking in the literature is a description of a more comprehensive approach to the assessment of food addiction. This should include consideration of dietary restraint, and the presence of symptoms of other psychiatric disorders (substance use, posttraumatic stress, depressive, anxiety, attention deficit hyperactivity) to guide treatments including nutrition interventions. The purpose of this review is to help clinicians identify the symptoms of food addiction (true positives, or "the signal") from the more classic eating pathology (true negatives, or "restraint") that can potentially elevate food addiction scores (false positives, or "the noise"). Three clinical vignettes are presented, designed to aid with the assessment process, case conceptualization, and treatment strategies. The review summarizes logical steps that clinicians can take to contextualize elevated food addiction scores, even when the use of validated research instruments is not practical.
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Affiliation(s)
- David Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90025, USA
| | - Timothy Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA;
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Abdo N, Boyd E, Baboumian S, Pantazatos SP, Geliebter A. Relationship between binge eating and associated eating behaviors with subcortical brain volumes and cortical thickness. J Affect Disord 2020; 274:1201-1205. [PMID: 32663951 PMCID: PMC7434631 DOI: 10.1016/j.jad.2019.10.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 10/01/2019] [Accepted: 10/25/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Binge eating disorder (BED) is the most prevalent eating disorder. We examined the presence of binge eating (BE) and three associated eating behaviors in relation to subcortical regional volumes and cortical thickness from brain scans. METHODS We processed structural MRI brain scans for 466 individuals from the Nathan Kline Institute Rockland Sample using Freesurfer. We investigated subcortical volumes and cortical thicknesses among those with and without BE and in relation to the scores on dietary restraint, disinhibition, and hunger from the Three-Factor Eating Questionnaire (TFEQ). We conducted a whole-brain analysis and a region of analysis (ROI) using a priori regions associated with BE and with the three eating factors. We also compared scores on the three TFEQ factors for the BE and non-BE. RESULTS The BE group had higher scores for dietary restraint (p = .013), disinhibition (p = 1.22E-07), and hunger (p = 5.88E-07). In the whole-brain analysis, no regions survived correction for multiple comparisons (FDR corrected p<0.01) for either BE group or interaction with TFEQ. However, disinhibition scores correlated positively with left nucleus accumbens (NAc) volume (p < 0.01 FDR corrected). In the ROI analysis, those with BE also had greater left NAc volume (p = 0.008, uncorrected) compared to non-BE. LIMITATIONS Limitations include potential self-report bias on the EDE-Q and TFEQ. CONCLUSIONS The findings show that BE and disinhibition scores were each associated with greater volumes in the left NAc, a reward area, consistent with a greater drive and pleasure for food.
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Affiliation(s)
- Nadia Abdo
- Institute of Human Nutrition, Columbia University, 630 West 168th Street, New York, NY 10032, United States
| | - Emily Boyd
- Institute of Human Nutrition, Columbia University, 630 West 168th Street, New York, NY 10032, United States.
| | - Shaunte Baboumian
- Department of Psychiatry, Mount Sinai St. Luke's, and Icahn School of Medicine at Mount Sinai, 440 West 114th St New York, NY 10025, United States
| | - Spiro P. Pantazatos
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute and Department of Psychiatry at Columbia University Irvine Medical Center, 1051 Riverside Dr, New York, NY 10032, United States,Corresponding authors. (E. Boyd), (S.P. Pantazatos)
| | - Allan Geliebter
- Department of Psychiatry, Mount Sinai St. Luke's, and Icahn School of Medicine at Mount Sinai, 440 West 114th St New York, NY 10025, United States,Touro College and University System, 320 West 31st Street New York, NY 10001, United States
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Smith JM, Serier KN, Belon KE, Sebastian RM, Smith JE. Evaluation of the relationships between dietary restraint, emotional eating, and intuitive eating moderated by sex. Appetite 2020; 155:104817. [PMID: 32739329 DOI: 10.1016/j.appet.2020.104817] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022]
Abstract
Intuitive eating involves attention to feelings putatively related to hunger and satiety to guide eating choices. This adaptive eating style has been linked to a number of positive physical and psychological outcomes. Interestingly, women tend to report lower levels of intuitive eating compared to men. It has been hypothesized that sociocultural pressures or dieting could be contributing factors to this sex discrepancy. The current study aimed to explore whether sex moderates the relationship between either dietary restraint and intuitive eating, or between emotional eating and intuitive eating. Assessments were administered to a sample of college males and females (N = 478) as part of a larger study of eating behaviors. Moderation analyses indicated that higher dietary restraint was more strongly associated with lower levels of intuitive eating in women than in men. Emotional eating also had a stronger negative association with intuitive eating in women compared to men. Additionally, relationships between dietary restraint/emotional eating and a component of intuitive eating, "eating for physical rather than emotional reasons", was stronger for women compared to men. These findings suggest that dietary restraint and emotional eating may serve as barriers in the implementation of an intuitive eating style, especially for women. Prevention and intervention efforts should target those high in dietary restraint and emotional eating.
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Affiliation(s)
- Jamie M Smith
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM, 87131-0001, United States.
| | - Kelsey N Serier
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM, 87131-0001, United States.
| | - Katherine E Belon
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM, 87131-0001, United States; New Mexico Veterans Affairs Health Care System, 1501 San Pedro SE, Albuquerque, NM, 87108, United States.
| | - Riley M Sebastian
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM, 87131-0001, United States.
| | - Jane Ellen Smith
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM, 87131-0001, United States.
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15
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Polaprezinc (Zinc-L-Carnosine Complex) as an Add-on Therapy for Binge Eating Disorder and Bulimia Nervosa, and the Possible Involvement of Zinc Deficiency in These Conditions: A Pilot Study. J Clin Psychopharmacol 2020; 40:599-606. [PMID: 33044355 PMCID: PMC7643788 DOI: 10.1097/jcp.0000000000001284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Zinc plays an important role in appetite regulation. L-Carnosine, an endogenous dipeptide, may also regulate eating behavior via its histaminergic and antiglutamatergic properties. Polaprezinc (zinc-L-carnosine complex) is a medication for gastric ulcers. A small case series reported successful treatment of binge eating with add-on polaprezinc. METHODS This was an open trial of add-on polaprezinc in patients with binge eating disorder (BED; n = 22) or bulimia nervosa (BN; n = 7) receiving antidepressants. A 4-week baseline period was followed by a 16-week polaprezinc treatment at 150 mg/d (containing 34 mg zinc and 116 mg L-carnosine) in addition to ongoing psychotropic medications. We also assessed their zinc status via a laboratory index and zinc deficiency-related symptoms. RESULTS At the study end, both conditions showed a significant reduction in the 4-week frequency of combined objective and subjective binge eating episodes, the 4-week frequency of days when at least 1 such episode occurred (only in BED), several aspects of eating disorder psychopathology (rated by the Eating Disorder Examination-Questionnaire), and comorbid depressive symptoms (rated by the 16-item Quick Inventory of Depressive Symptomatology [Self-Report]). Serum copper/zinc ratio decreased from 1.4 to 1.1 on average in both conditions. All patients had multiple zinc deficiency-related symptoms at baseline that substantially improved after polaprezinc treatment. Overall, the effectiveness of polaprezinc was greater in BED patients than in BN patients, with minor adverse effects. CONCLUSIONS These findings offer preliminary evidence for the effectiveness of polaprezinc in treating BED and BN and suggest the involvement of zinc deficiency in these conditions.
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Norwood R, Cruwys T, Chachay VS, Sheffield J. The psychological characteristics of people consuming vegetarian, vegan, paleo, gluten free and weight loss dietary patterns. Obes Sci Pract 2019; 5:148-158. [PMID: 31019732 PMCID: PMC6469437 DOI: 10.1002/osp4.325] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/30/2018] [Accepted: 12/14/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Previous research has identified several psychological factors associated with dietary restriction but has focused almost exclusively on the subcategory of people following a weight loss diet. Little is known about the psychological factors associated with other kinds of restrictive dietary patterns. Furthermore, it remains unclear whether the identified psychological characteristics of dieters (e.g. elevated disordered eating behaviours, poor well-being) are a cause of dieting, follow from calorie restriction or are the result of cognitive restraint. METHODS This study conducted the first direct comparison of people (N = 393) following five different restrictive dietary patterns (vegetarian, vegan, gluten free, paleo and weight loss) as well as a comparison group who were not following a specific dietary pattern. RESULTS The weight loss group had more negative psychological characteristics than all other groups, reporting the highest levels of eating disorder symptoms (M = 1.50), food cravings (M = 69.39), emotional eating (M = 2.97) and negative affect (M = 19.72). By contrast, several of the other restrictive dietary groups showed a number of psychological strengths, relative to the comparison group. This was particularly apparent among the paleo group, who reported the lowest levels of eating disorder symptoms (M = 0.74), food cravings (M = 47.63), emotional eating (M = 2.30) and negative affect (M = 14.81). By contrast, people following vegetarian and gluten free diets were largely the same as the non-restricted comparison group in their psychological characteristics. CONCLUSIONS People adhering to different dietary patterns showed stark differences in their psychological characteristics. Indeed, some restrictive dietary patterns (paleo and vegan) were associated with more positive psychological characteristics than seen in an unrestricted comparison group. This suggests that the psychological risk factors seen in weight loss dieters are not attributable to a restrictive dietary regimen per se.
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Affiliation(s)
- R. Norwood
- School of PsychologyUniversity of QueenslandBrisbaneAustralia
| | - T. Cruwys
- School of PsychologyUniversity of QueenslandBrisbaneAustralia
- Research School of PsychologyAustralian National UniversityCanberraAustralia
| | - V. S. Chachay
- School of Human Movement and Nutrition SciencesUniversity of QueenslandBrisbaneAustralia
| | - J. Sheffield
- School of PsychologyUniversity of QueenslandBrisbaneAustralia
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17
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Racine SE, VanHuysse JL, Keel PK, Burt SA, Neale MC, Boker S, Klump KL. Eating disorder-specific risk factors moderate the relationship between negative urgency and binge eating: A behavioral genetic investigation. JOURNAL OF ABNORMAL PSYCHOLOGY 2018; 126:481-494. [PMID: 28691840 DOI: 10.1037/abn0000204] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Theoretical models of binge eating and eating disorders include both transdiagnostic and eating disorder-specific risk factors. Negative urgency (i.e., the tendency to act impulsively when distressed) is a critical transdiagnostic risk factor for binge eating, but limited research has examined interactions between negative urgency and disorder-specific variables. Investigating these interactions can help identify the circumstances under which negative urgency is most strongly associated with binge eating. We examined whether prominent risk factors (i.e., appearance pressures, thin-ideal internalization, body dissatisfaction, dietary restraint) specified in well-established etiologic models of eating disorders moderate negative urgency-binge eating associations. Further, we investigated whether phenotypic moderation effects were due to genetic and/or environmental associations between negative urgency and binge eating. Participants were 988 female twins aged 11-25 years from the Michigan State University Twin Registry. Appearance pressures, thin-ideal internalization, and body dissatisfaction, but not dietary restraint, significantly moderated negative urgency-binge eating associations, with high levels of these risk factors and high negative urgency associated with the greatest binge eating. Twin moderation models revealed that genetic, but not environmental, sharing between negative urgency and binge eating was enhanced at higher levels of these eating disorder-specific variables. Future longitudinal research should investigate whether eating disorder risk factors shape genetic influences on negative urgency into manifesting as binge eating. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | - Michael C Neale
- Departments of Psychiatry, Human Genetics, and Psychology, Virginia Commonwealth University
| | - Steven Boker
- Department of Psychology, University of Virginia
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Hunt TK, Forbush KT, Hagan KE, Chapa DA. Do emotion regulation difficulties when upset influence the association between dietary restraint and weight gain among college students? Appetite 2017; 114:101-109. [DOI: 10.1016/j.appet.2017.03.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 01/30/2017] [Accepted: 03/20/2017] [Indexed: 11/26/2022]
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Fairweather-Schmidt AK, Wade TD. Weight-related peer-teasing moderates genetic and environmental risk and disordered eating: twin study. Br J Psychiatry 2017; 210:350-355. [PMID: 27979821 DOI: 10.1192/bjp.bp.116.184648] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 07/14/2016] [Accepted: 09/02/2016] [Indexed: 11/23/2022]
Abstract
BackgroundWeight-related peer-teasing is considered a potent prospective risk factor for development of disordered eating and clinical eating disorders. Currently, the interplay between genetic and environmental influences has yet to be elucidated.AimsTo determine whether peer-teasing moderates latent genetic and/or environmental risk for disordered eating among female adolescent twins.MethodFull quantitative gene-environment interplay modelling of longitudinal trajectory of disordered eating in 685 female twins from the Australian Twin Registry.ResultsA model permitting moderation of disordered eating by peer-teasing involving genetic and non-shared environment effects fit these data best. As levels of peer-teasing increased, both genetic and environmental influences on disordered eating strengthened; however, genetic sources increased proportionally more than environmental sources.ConclusionsWeight-related peer-teasing represents a particularly powerful trigger for disordered eating. Nevertheless, it is amenable to intervention/prevention activities spanning individual to universal levels of endeavour.
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Affiliation(s)
- A Kate Fairweather-Schmidt
- A. Kate Fairweather-Schmidt, PhD, Tracey D. Wade, PhD, School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Tracey D Wade
- A. Kate Fairweather-Schmidt, PhD, Tracey D. Wade, PhD, School of Psychology, Flinders University, Adelaide, South Australia, Australia
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20
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Lewer M, Kosfelder J, Michalak J, Schroeder D, Nasrawi N, Vocks S. Effects of a cognitive-behavioral exposure-based body image therapy for overweight females with binge eating disorder: a pilot study. J Eat Disord 2017; 5:43. [PMID: 29296280 PMCID: PMC5738809 DOI: 10.1186/s40337-017-0174-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 09/15/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Although not part of the diagnostic criteria of the DSM-5, body image disturbance seems to be a relevant feature of Binge Eating Disorder (BED) as well as of other eating disorders such as Anorexia Nervosa (AN) or Bulimia Nervosa (BN). Hence, the aim of the present pilot study was to assess the changeability of body image disturbance in a sample of overweight females with BED by a cognitive-behavioral treatment, directly addressing body image disturbance. METHOD Overweight females (N = 34) with BED were randomized to a manualized body image therapy or a waiting-list control group. The final sample consisted of n = 15 participants in the intervention group and n = 19 in the control group due to two drop-outs in the control condition. Before and after the intervention or the waiting period, respectively, participants filled out a questionnaire battery assessing several body image and eating disorder related features. To quantify the perceptual component of body image disturbance, a digital photo distortion technique based on a picture of each participant taken in a standardized suit was applied. RESULTS In a two-way ANOVA, significant Time × Group interactions were found for eating and shape concerns, drive for thinness, body dissatisfaction, depressiveness and low self-esteem. Follow-up t-tests indicated a significant symptom reduction of a generally high magnitude in the intervention group. No significant changes concerning body checking and the estimations of one's own "real", "felt" and "ideal" body dimensions were found. CONCLUSION The strong symptom reduction in the cognitive-affective component of body image disturbance indicates that an exposure-based cognitive-behavioral body image intervention is a promising treatment module for overweight females with BED, but future research with a larger sample size is needed to quantify possible changes in all components of body image.
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Affiliation(s)
- Merle Lewer
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
| | - Joachim Kosfelder
- Department of Social and Cultural Sciences, University of Applied Sciences, Duesseldorf, Germany
| | - Johannes Michalak
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Dorothea Schroeder
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
| | - Nadia Nasrawi
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
| | - Silja Vocks
- Department of Clinical Psychology and Psychotherapy, Osnabrueck University, Knollstrasse 15, D-49069 Onabrück, Germany
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Patterned feeding induces neuroendocrine, behavioral and genetic changes that promote palatable food intake. Int J Obes (Lond) 2016; 41:412-419. [PMID: 28025575 DOI: 10.1038/ijo.2016.235] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 11/16/2016] [Accepted: 11/29/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Selection of a healthy diet is the cornerstone for treating obesity and metabolic disease. Unfortunately, the majority of diets fail leading to weight regain and in some cases, pathological feeding behavior. We hypothesize that alternating bouts of caloric overconsumption and caloric restriction, behavioral manifestations of dieting induce neuroendocrine, behavioral and genetic changes that promote future bouts of palatable food intake. METHODS To test this hypothesis, we subjected male Long-Evans rats to a high-fat diet (HFD) feeding paradigm that induced a pattern of caloric overconsumption and caloric restriction. Under these conditions we measured operant responding for sucrose, pre-meal ghrelin secretion, the effects of peripheral ghrelin blockade on patterned feeding, HFD intake in an aversive environment and mRNA expression of the ghrelin receptor, orexin, orexin-1 and 2 receptors, and FTO in the medial prefrontal cortex, lateral hypothalamus and ventral tegmental area. RESULTS Rats subjected to this feeding regimen displayed increased ghrelin levels prior to HFD exposure and blockade of this response attenuated patterned feeding behavior. In addition, patterned feeding promoted enhanced motivation for sucrose, diminished extinction of this response and increased HFD intake in an aversive environment. The neuroendocrine and behavioral changes correlated with increased hypothalamic expression of the ghrelin receptor and FTO. CONCLUSION Collectively, these data indicate that patterns of feeding that include caloric overconsumption and caloric restriction induce neuroendocrine and neurobiological changes that signify an enhanced drive for palatable food.
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22
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Galinski G, Lonnie M, Kowalkowska J, Wadolowska L, Czarnocinska J, Jezewska-Zychowicz M, Babicz-Zielinska E. Self-Reported Dietary Restrictions and Dietary Patterns in Polish Girls: A Short Research Report (GEBaHealth Study). Nutrients 2016; 8:E796. [PMID: 27999360 PMCID: PMC5188451 DOI: 10.3390/nu8120796] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/12/2016] [Accepted: 12/02/2016] [Indexed: 11/16/2022] Open
Abstract
Dietary restraint is a commonly reported practice observed among young females. The practice remains controversial and can be interpreted as a beneficial self-regulating behavior or the opposite, an eating disorder that may have a detrimental effect on health. The aim of this short report was to investigate if dietary restrictions are associated with dietary patterns in a representative sample of Polish girls. Analyses were carried out on data from the Girls' Eating Behavior and Health (GEBaHealth) study. The sample included 1107 girls, ranging in age from 13 to 21 years old. Restrictions regarding food quantities and selected food groups were assessed using a standardized interview. Dietary patterns were identified with Principal Component Analysis (PCA), based on dietary data collected with Food Frequency Questionnaires (FFQs). Logistic regression analysis was used to study the associations between self-reported restrictions and each dietary pattern. In the total sample, 30.5% of girls reported following some food restrictions. The most common restrictions regarded consumption of sugar and/or sweets (23.7%), high-fat foods (22.4%), and fats (21.3%). Girls who declared following any restrictions, restrictions in food quantity and restrictions in the consumption of sugar and/or sweets, high-fat foods, fats, cereals and/or bread and/or potatoes were more likely to adhere to the "fruit and vegetables" (considered pro-healthy) dietary pattern (adjusted odds ratios (ORs): 1.55, 95% CI: 1.14-2.12; 1.61, 95% CI: 1.17-2.21; 1.81, 95% CI: 1.30-2.52; 1.46, 95% CI: 1.04-2.06; 1.96, 95% CI: 1.38-2.80 and 3.25, 95% CI: 1.97-5.37, respectively), and less likely to adhere to the "fast foods and sweets" (unhealthy) and "traditional Polish" (rather unhealthy) patterns, compared to girls who declared no restrictions. Declared restrictions in the consumption of foods high in sugar, fat, and starch were observed in girls in the "fruit and vegetables" pattern and were uncommon in girls with unhealthy dietary patterns. Although cautious interpretation is needed when considering restrictions in the overall quantity of food consumed, the results indicate that dietary restrictions of sugar, high-fat foods, fats, and starch may be considered predictors of both pro-healthy and unhealthy dietary patterns in the population of Polish girls.
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Affiliation(s)
- Grzegorz Galinski
- Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, Wojska Polskiego 28, 60-637 Poznan, Poland.
| | - Marta Lonnie
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland.
| | - Joanna Kowalkowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland.
| | - Lidia Wadolowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland.
| | - Jolanta Czarnocinska
- Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, Wojska Polskiego 28, 60-637 Poznan, Poland.
| | - Marzena Jezewska-Zychowicz
- Department of Organisation and Consumption Economics, Warsaw University of Life Sciences, Nowoursynowska 159 C, 02-776 Warsaw, Poland.
| | - Ewa Babicz-Zielinska
- Department of Trade and Services, Gdynia Maritime University, Morska 81-87, 81-225 Gdynia, Poland.
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Brosof LC, Levinson CA. Social appearance anxiety and dietary restraint as mediators between perfectionism and binge eating: A six month three wave longitudinal study. Appetite 2016; 108:335-342. [PMID: 27742237 DOI: 10.1016/j.appet.2016.10.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 10/07/2016] [Accepted: 10/10/2016] [Indexed: 11/29/2022]
Abstract
Binge eating is related to perfectionism and restrained eating. However, the mechanisms underlying these relationships are not well understood. It is possible that social anxiety, specifically social appearance anxiety (i.e., the fear of overall appearance evaluation), influences the relationship between binge eating, perfectionism, and dietary restraint. In the current study (N = 300 women), we tested the relationship between dietary restraint, social appearance anxiety, concern over mistakes (a component of perfectionism), and binge eating in prospective data (three time points: at baseline, at two month, and at six month follow up). We found that social appearance anxiety, dietary restraint, and concern over mistakes each predicted binge eating at baseline. Only social appearance anxiety prospectively predicted binge eating when accounting for all variables. Further, in the tested model, social appearance anxiety mediated the relationship between concern over mistakes and binge eating across six months. On the contrary, dietary restraint did not mediate the relationship between concern over mistakes and binge eating in the tested model. The finding that social appearance anxiety served as a mediator between concern over mistakes and binge eating, but that dietary restraint did not, implies that social appearance anxiety may be a more salient prospective predictor of binge eating than dietary restraint. Intervening on social appearance anxiety may be important in the treatment and prevention of binge eating.
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Affiliation(s)
- Leigh C Brosof
- University of Louisville, Department of Psychological and Brain Sciences, United States
| | - Cheri A Levinson
- University of Louisville, Department of Psychological and Brain Sciences, United States.
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Culbert KM, Racine SE, Klump KL. Research Review: What we have learned about the causes of eating disorders - a synthesis of sociocultural, psychological, and biological research. J Child Psychol Psychiatry 2015; 56:1141-64. [PMID: 26095891 DOI: 10.1111/jcpp.12441] [Citation(s) in RCA: 286] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Eating disorders are severe psychiatric disorders with a complex etiology involving transactions among sociocultural, psychological, and biological influences. Most research and reviews, however, focus on only one level of analysis. To address this gap, we provide a qualitative review and summary using an integrative biopsychosocial approach. METHODS We selected variables for which there were available data using integrative methodologies (e.g., twin studies, gene-environment interactions) and/or data at the biological and behavioral level (e.g., neuroimaging). Factors that met these inclusion criteria were idealization of thinness, negative emotionality, perfectionism, negative urgency, inhibitory control, cognitive inflexibility, serotonin, dopamine, ovarian hormones. Literature searches were conducted using PubMed. Variables were classified as risk factors or correlates of eating disorder diagnoses and disordered eating symptoms using Kraemer et al.'s (1997) criteria. FINDINGS Sociocultural idealization of thinness variables (media exposure, pressures for thinness, thin-ideal internalization, thinness expectancies) and personality traits (negative emotionality, perfectionism, negative urgency) attained 'risk status' for eating disorders and/or disordered eating symptoms. Other factors were identified as correlates of eating pathology or were not classified given limited data. Effect sizes for risk factors and correlates were generally small-to-moderate in magnitude. CONCLUSIONS Multiple biopsychosocial influences are implicated in eating disorders and/or disordered eating symptoms and several can now be considered established risk factors. Data suggest that psychological and environmental factors interact with and influence the expression of genetic risk to cause eating pathology. Additional studies that examine risk variables across multiple levels of analysis and that consider specific transactional processes amongst variables are needed to further elucidate the intersection of sociocultural, psychological, and biological influences on eating disorders.
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Affiliation(s)
| | - Sarah E Racine
- Department of Psychology, Ohio University, Athens, OH, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
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25
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Booij L, Casey KF, Antunes JM, Szyf M, Joober R, Israël M, Steiger H. DNA methylation in individuals with anorexia nervosa and in matched normal-eater controls: A genome-wide study. Int J Eat Disord 2015; 48:874-82. [PMID: 25808061 DOI: 10.1002/eat.22374] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 11/08/2014] [Accepted: 11/19/2014] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Evidence associates anorexia nervosa (AN) with epigenetic alterations that could contribute to illness risk or entrenchment. We investigated the extent to which AN is associated with a distinct methylation profile compared to that seen in normal-eater women. METHOD Genome-wide methylation profiles, obtained using DNA from whole blood, were determined in 29 women currently ill with AN (10 with AN-restrictive type, 19 with AN-binge/purge type) and 15 normal-weight, normal-eater control women, using 450 K Illumina bead arrays. RESULTS Regardless of type, AN patients showed higher and less-variable global methylation patterns than controls. False Discovery Rate corrected comparisons identified 14 probes that were hypermethylated in women with AN relative to levels obtained in normal-eater controls, representing genes thought to be associated with histone acetylation, RNA modification, cholesterol storage and lipid transport, and dopamine and glutamate signaling. Age of onset was significantly associated with differential methylation in gene pathways involved in development of the brain and spinal cord, while chronicity of illness was significantly linked to differential methylation in pathways involved with synaptogenesis, neurocognitive deficits, anxiety, altered social functioning, and bowel, kidney, liver and immune function. DISCUSSION Although pre-existing differences cannot be ruled out, our findings are consistent with the idea of secondary alterations in methylation at genomic regions pertaining to social-emotional impairments and physical sequelae that are commonly seen in AN patients. Further investigation is needed to establish the clinical relevance of the affected genes in AN, and, importantly, reversibility of effects observed with nutritional rehabilitation and treatment.
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Affiliation(s)
- Linda Booij
- Department of Psychology, Queen's University, Kingston, ON, Canada, K7L 3N6.,Sainte-Justine Hospital Research Centre, University of Montreal, 3175, Chemin Côte Ste-Catherine, Montreal, QC, Canada, H3T 1C5.,Department of Psychiatry, McGill University, Montreal, QC, Canada, H3A1 A1
| | - Kevin F Casey
- Sainte-Justine Hospital Research Centre, University of Montreal, 3175, Chemin Côte Ste-Catherine, Montreal, QC, Canada, H3T 1C5
| | - Juliana M Antunes
- Eating Disorders Program, Douglas University Institute, 6875 LaSalle Boulevard, Montreal, Quebec, Canada, H4H 1R3
| | - Moshe Szyf
- Department of Pharmacology, McGill University, 1309-3655 Sir William Osler Promenade, Montreal, QC, Canada, H3G 1Y6
| | - Ridha Joober
- Department of Psychiatry, McGill University, Montreal, QC, Canada, H3A1 A1.,Research Centre, Douglas University Institute, 6875 LaSalle Boulevard, Montreal, Quebec, Canada, H4H 1R3
| | - Mimi Israël
- Department of Psychiatry, McGill University, Montreal, QC, Canada, H3A1 A1.,Eating Disorders Program, Douglas University Institute, 6875 LaSalle Boulevard, Montreal, Quebec, Canada, H4H 1R3.,Research Centre, Douglas University Institute, 6875 LaSalle Boulevard, Montreal, Quebec, Canada, H4H 1R3
| | - Howard Steiger
- Department of Psychiatry, McGill University, Montreal, QC, Canada, H3A1 A1.,Eating Disorders Program, Douglas University Institute, 6875 LaSalle Boulevard, Montreal, Quebec, Canada, H4H 1R3.,Research Centre, Douglas University Institute, 6875 LaSalle Boulevard, Montreal, Quebec, Canada, H4H 1R3
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Wolz I, Fagundo AB, Treasure J, Fernández-Aranda F. The processing of food stimuli in abnormal eating: a systematic review of electrophysiology. EUROPEAN EATING DISORDERS REVIEW 2015; 23:251-61. [PMID: 25982390 DOI: 10.1002/erv.2366] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 03/05/2015] [Indexed: 12/28/2022]
Abstract
To update the knowledge about attentional processing of food stimuli, a systematic review of electrophysiological studies was conducted using PubMed, PsychInfo and Web of Knowledge (2000-2014). Twenty-one studies were included into a qualitative synthesis. Presentation of food and control pictures was used to analyze event-related potentials related to sensory processing and motivated attention. Results show consistent attentional bias towards food pictures compared with neutral pictures for patient and control groups. Group comparisons between individuals with abnormal-eating and healthy-eating participants were more inconsistent. Results suggest that temporal differences in the millisecond range are essential for the understanding of visual food processing. In obesity, early attention engagement to food is followed by relatice disengagement. Loss of control eating, as well as external and emotional eating, are associated with a sustained maintenance of attention towards high-caloric food. There is a lack of studies in anorexia nervosa, bulimia nervosa and binge eating disorder.
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Affiliation(s)
- Ines Wolz
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
| | - Ana B Fagundo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
| | - Janet Treasure
- Eating Disorders Unit, Institute of Psychiatry, King's College, London, UK
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
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Cori GDC, Petty MLB, Alvarenga MDS. Atitudes de nutricionistas em relação a indivíduos obesos – um estudo exploratório. CIENCIA & SAUDE COLETIVA 2015; 20:565-76. [DOI: 10.1590/1413-81232015202.05832014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 07/31/2014] [Indexed: 12/23/2022] Open
Abstract
O objetivo foi identificar atitudes de nutricionistas em relação à obesidade; envolvendo crenças sobre características atribuídas às pessoas obesas, fatores de desenvolvimento e a obesidade em si. Os participantes (N = 344; 97,1% mulheres) foram contatados via conselho profissional e responderam a pesquisa online. As questões do estudo foram adaptadas de trabalhos internacionais com as respostas analisadas por frequência de concordância. As respostas indicaram forte estigmatização da obesidade e preconceito contra o obeso, atribuindo características como: guloso (67,4%), não atraente (52,0%), desajeitado (55,1%), sem determinação (43,6%) e preguiçoso (42,3%). E considerando entre os mais importantes fatores causais: alterações emocionais e de humor, vício ou dependência de comida e baixa autoestima. Esta temática deve ser mais pesquisada uma vez que tais atitudes podem impactar a eficácia do tratamento; também para discussão e formação ampla sobre os significados da obesidade, e tratamento mais individualizado e humanizado para pacientes obesos.
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Klump KL, Racine SE, Hildebrandt B, Burt SA, Neale M, Sisk CL, Boker S, Keel PK. Ovarian Hormone Influences on Dysregulated Eating: A Comparison of Associations in Women with versus without Binge Episodes. Clin Psychol Sci 2014; 2:545-559. [PMID: 25343062 DOI: 10.1177/2167702614521794] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Changes in ovarian hormones predict changes in emotional eating across the menstrual cycle. However, prior studies have not examined whether the nature of associations varies across dysregulated eating severity. The current study determined whether the strength and/or nature of hormone/dysregulated eating associations differ based on the presence of clinically diagnosed binge episodes (BEs). Participants included 28 women with BEs and 417 women without BEs who provided salivary hormone samples, ratings of emotional eating, and BE frequency for 45 days. Results revealed stronger associations between dysregulated eating and ovarian hormones in women with BEs as compared to women without BEs. The nature of associations also differed, as progesterone moderated the effects of lower estradiol levels on dysregulated eating in women with BEs only. Although hormone/dysregulated eating associations are present across the spectrum of pathology, the nature of associations may vary in ways that have implications for etiological models and treatment.
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Affiliation(s)
| | - Sarah E Racine
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | | | | | - Michael Neale
- Department of Psychiatry, Human Genetics, and Psychology, Virginia Commonwealth University
| | - Cheryl L Sisk
- Department of Psychology, Michigan State University ; Department of Neuroscience Program, Michigan State University
| | - Steven Boker
- Department of Psychology, University of Virginia
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Emery RL, King KM, Fischer SF, Davis KR. The moderating role of negative urgency on the prospective association between dietary restraint and binge eating. Appetite 2013; 71:113-9. [PMID: 23938953 DOI: 10.1016/j.appet.2013.08.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 06/24/2013] [Accepted: 08/01/2013] [Indexed: 11/27/2022]
Abstract
It is well documented that negative urgency, a personality trait characterized by a tendency to act impulsively in the face of negative emotions, and dietary restraint independently increase risk to binge eat; however, it is unclear how these factors interact to alter risk for such behavior. It may be that individuals high on negative urgency, who also engage in dietary restraint, are at a greater risk to binge eat than individuals low on negative urgency. Accordingly, we sought to investigate whether negative urgency moderated the prospective association between dietary restraint and binge eating frequency among a sample of college women. We hypothesized that women who engaged in dietary restraint would report higher binge eating frequencies across the first semester of college and that this effect would be strengthened among individuals higher on negative urgency. Results indicated that negative urgency moderated the prospective association between dietary restraint and binge eating frequency. This effect was found to be "protective but reactive," such that low levels of dietary restraint protected against binge eating frequency at low to moderate levels of negative urgency, but this buffering effect was lost at high levels of negative urgency where binge eating frequency was equal across all levels of dietary restraint. These findings demonstrate that negative urgency and dietary restraint interact to differentially alter risk for binge eating frequency, and individuals high on negative urgency are at the greatest risk to engage in more frequent binge eating regardless of level of dietary restraint.
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Affiliation(s)
- Rebecca L Emery
- University of Washington, 119A Guthrie Hall, Box 351525, Seattle, WA 98195, United States; University of Pittsburgh, 210 South Bouquet Street, 3129 Sennott Square, Pittsburgh, PA 15260, United States.
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Racine SE, Keel PK, Burt SA, Sisk CL, Neale M, Boker S, Klump KL. Exploring the relationship between negative urgency and dysregulated eating: etiologic associations and the role of negative affect. JOURNAL OF ABNORMAL PSYCHOLOGY 2013; 122:433-44. [PMID: 23356217 PMCID: PMC3759363 DOI: 10.1037/a0031250] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Negative urgency (i.e., the tendency to engage in rash action in response to negative affect) has emerged as a critical personality trait contributing to individual differences in binge eating. However, studies investigating the extent to which genetic and/or environmental influences underlie the effects of negative urgency on binge eating are lacking. Moreover, it remains unclear whether negative urgency-binge eating associations are simply a result of the well-established role of negative affect in the development/maintenance of binge eating. The current study addresses these gaps by examining phenotypic and etiologic associations between negative urgency, negative affect, and dysregulated eating (i.e., binge eating, emotional eating) in a sample of 222 same-sex female twin pairs from the Michigan State University Twin Registry. Negative urgency was significantly associated with both dysregulated eating symptoms, even after controlling for the effects of negative affect. Genetic factors accounted for the majority (62-77%) of this phenotypic association, although a significant proportion of this genetic covariation was due to genetic influences in common with negative affect. Nonshared environmental factors accounted for a relatively smaller (23-38%) proportion of the association, but these nonshared environmental effects were independent of negative affect. Findings suggest that the presence of emotion-based rash action, combined with high levels of negative affect, may significantly increase genetic risk for dysregulated eating.
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Affiliation(s)
| | | | | | - Cheryl L. Sisk
- Department of Psychology, Michigan State University
- Neuroscience Program, Michigan State University
| | - Michael Neale
- Departments of Psychiatry, Human Genetics, and Psychology, Virginia Commonwealth University
| | - Steven Boker
- Department of Psychology, University of Virginia
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South SC, Krueger RF. Marital satisfaction and physical health: evidence for an orchid effect. Psychol Sci 2013; 24:373-8. [PMID: 23359109 DOI: 10.1177/0956797612453116] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Marital distress and conflict are linked to poor physical health. Here, we used behavior genetic modeling to determine the etiology of this association. Biometric moderation models were used to estimate gene-by-environment interaction in the presence of gene-environment correlation between marital satisfaction and self-reported health. Using a sample of 347 married twin pairs from the Midlife in the United States study, we found that genetic influences on the variation in self-reported health were greatest at both high (h (2) = .30) and low (h (2) = .38) levels of marital satisfaction, with the lowest levels of heritability estimated for participants at the average level of marital satisfaction (h (2) = .10). These findings are evidence of the orchid effect: the idea that genetic influences on a phenotype such as physical health are enhanced in nonnormative-both unusually positive and unusually negative-environmental contexts.
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Abstract
The primary aim of the Michigan State University Twin Registry (MSUTR) is on understanding developmental changes in genetic, environmental, and neurobiological influences on internalizing and externalizing disorders, with antisocial behavior and disordered eating representing our particular areas of interest. The MSUTR has two broad components: a large-scale, population-based registry of child, adolescent, and adult twins and their families (current N ~20,000) and a series of more focused and in-depth studies drawn from the registry (current N ~4,000). Participants in the population-based registry complete a family health and demographic questionnaire via mail. Families are then recruited for one or more of the intensive, in-person studies from the population-based registry based on their answers to relevant items in the registry questionnaire. These in-person assessments target a variety of biological, genetic, and environmental phenotypes, including multi-informant measures of psychiatric and behavioral phenotypes, census and neighborhood informant reports of twin neighborhood characteristics, buccal swab and salivary DNA samples, assays of adolescent and adult steroid hormone levels, and/or videotaped interactions of child twin families. This article provides an overview of the MSUTR and describes current and future research directions.
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The effects of emotion regulation on the desire to overeat in restrained eaters. Appetite 2012; 59:256-63. [DOI: 10.1016/j.appet.2012.04.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 04/16/2012] [Accepted: 04/25/2012] [Indexed: 11/21/2022]
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DeBoer LB, Tart CD, Presnell KE, Powers MB, Baldwin AS, Smits JAJ. Physical activity as a moderator of the association between anxiety sensitivity and binge eating. Eat Behav 2012; 13:194-201. [PMID: 22664396 PMCID: PMC3614415 DOI: 10.1016/j.eatbeh.2012.01.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 12/16/2011] [Accepted: 01/17/2012] [Indexed: 10/14/2022]
Abstract
Individuals with elevated anxiety sensitivity (AS; i.e., fear of somatic arousal) may binge eat to reduce emotional distress. Because physical activity reduces stress reactivity, we predicted that: (1) the relation between AS and binge eating would be moderated by physical activity and (2) coping motives for eating would mediate the association between AS and binge eating such that the relation would be stronger for those low in physical activity. Participants (N=167) completed online self-report measures. Regression analyses revealed that moderate-intensity physical activity (MPA) moderated the relation between AS and binge eating such that AS was not related to binge eating among those who frequently engaged in MPA but was related to binge eating among those who did not report engaging in MPA. Vigorous-intensity physical activity (VPA) moderated in the opposite direction such that the relation between AS and binge eating was significant among persons reporting high levels of VPA but less strong among persons reporting low levels of VPA. The mediation model was also significant, but was not moderated by MPA or VPA. Theoretical and clinical implications are discussed.
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Affiliation(s)
| | | | | | | | | | - Jasper A. J. Smits
- Southern Methodist University, United States,Corresponding author at: Department of Psychology, Southern Methodist University, Dedman College, PO Box 750442, Dallas, TX 75275, United States. Tel.: +1 214 768 4125; fax: +1 214 768 4191.
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Brooks SJ, Rask-Andersen M, Benedict C, Schiöth HB. A debate on current eating disorder diagnoses in light of neurobiological findings: is it time for a spectrum model? BMC Psychiatry 2012; 12:76. [PMID: 22770364 PMCID: PMC3475111 DOI: 10.1186/1471-244x-12-76] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 05/14/2012] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Sixty percent of eating disorders do not meet criteria for anorexia- or bulimia nervosa, as defined by the Diagnostic and Statistical Manual version 4 (DSM-IV). Instead they are diagnosed as 'eating disorders not otherwise specified' (EDNOS). Discrepancies between criteria and clinical reality currently hampering eating disorder diagnoses in the DSM-IV will be addressed by the forthcoming DSM-V. However, future diagnoses for eating disorders will rely on current advances in the fields of neuroimaging and genetics for classification of symptoms that will ultimately improve treatment. DISCUSSION Here we debate the classification issues, and discuss how brain imaging and genetic discoveries might be interwoven into a model of eating disorders to provide better classification and treatment. The debate concerns: a) current issues in the classification of eating disorders in the DSM-IV, b) changes proposed for DSM-V, c) neuroimaging eating disorder research and d) genetic eating disorder research. SUMMARY We outline a novel evidence-based 'impulse control' spectrum model of eating disorders. A model of eating disorders is proposed that will aid future diagnosis of symptoms, coinciding with contemporary suggestions by clinicians and the proposed changes due to be published in the DSM-V.
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Affiliation(s)
| | | | - Christian Benedict
- Department of Neuroscience, University of Uppsala, Box 593, Uppsala, Sweden
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Steiger H, Gauvin L, Joober R, Israel M, Badawi G, Groleau P, Bruce KR, Yin Kin NMKN, Sycz L, Ouelette AS. Interaction of the BcII glucocorticoid receptor polymorphism and childhood abuse in Bulimia Nervosa (BN): relationship to BN and to associated trait manifestations. J Psychiatr Res 2012; 46:152-8. [PMID: 22088926 DOI: 10.1016/j.jpsychires.2011.10.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Revised: 10/13/2011] [Accepted: 10/13/2011] [Indexed: 01/09/2023]
Abstract
We recently documented a gene-environment interaction suggesting that individuals with Bulimia Nervosa (BN) differed from normal eaters as to the combined presence of the low-function allele of the glucocorticoid receptor polymorphism, BcII, and childhood abuse. The present study examined the extent to which any such interaction effect may have been attributable to behavioral impulsivity, sensation seeking, affective instability or depression. We had 174 bulimic and 130 nonbulimic women provide blood for genetic assays, and measured psychopathological traits and childhood abuse using structured interviews and self-report questionnaires. As expected, we observed a significant BcII × abuse interaction indicating genetic and environmental susceptibilities to co-occur significantly more often in bulimic than in nonbulimic individuals. The BcII × abuse interaction was attenuated when levels of depression were accounted for, but was surprisingly unaffected by controls for motoric impulsivity, sensation seeking or affective instability. Our findings suggest that stress-induced alterations in glucocorticoid sensitivity contribute to BN and depressive disturbances--without being associated with the behavioral/affective dysregulation seen in many BN sufferers. We discuss theoretical and clinical implications of these observations.
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Affiliation(s)
- Howard Steiger
- Eating Disorders Program, Douglas University Institute, Montreal, Quebec, Canada.
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