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Spinner H, Thompson KA, Bauman V, Lavender JM, Thorstad I, Schrag R, Sbrocco T, Schvey NA, Ford B, Ford C, Wilfley DE, Jorgensen S, Klein DA, Quinlan J, Yanovski JA, Haigney M, Tanofsky-Kraff M. Emotional dysregulation moderates the relation between perceived stress and emotional eating in adolescent military dependents. Int J Eat Disord 2024; 57:1609-1615. [PMID: 38600832 PMCID: PMC11262967 DOI: 10.1002/eat.24217] [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: 12/22/2023] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE Adolescent children of US service members (i.e., military-dependent youth) face unique stressors that increase risk for various forms of disinhibited eating, including emotional eating. Difficulties with adaptively responding to stress and aversive emotions may play an important role in emotional eating. This study examined emotion dysregulation as a potential moderator of the association between perceived stress and emotional eating in adolescent military dependents. METHOD Participants were military-dependent youth (N = 163, 57.7% female, Mage = 14.5 ± 1.6, MBMI-z = 1.9 ± 0.4) at risk for adult binge-eating disorder and high weight enrolled in a randomized controlled prevention trial. Prior to intervention, participants completed questionnaires assessing perceived stress and emotional eating. Parents completed a questionnaire assessing their adolescent's emotion dysregulation. Moderation analyses were conducted using the PROCESS macro in SPSS and adjusted for theoretically relevant sociodemographic covariates. RESULTS The interaction between adolescent perceived stress and emotion dysregulation (parent-reported about the adolescent) in relation to adolescent emotional eating was found to be significant, such that higher emotion dysregulation magnified the association between perceived stress and emotional eating (p = .010). Examination of simple slopes indicated that associations between perceived stress and emotional eating were strongest for youth with above-average emotion dysregulation, and non-significant for youth with average or below-average emotion dysregulation. DISCUSSION Findings suggest that greater emotion dysregulation may increase risk for emotional eating in response to stress among military-dependent youth at risk for binge-eating disorder or high weight. Improving emotion regulation skills may be a useful target for eating disorder prevention among youth who are at risk for emotional eating. PUBLIC SIGNIFICANCE Prior research has shown that adolescent military dependents are at increased risk for eating disorders and high weight. The current study found that emotion dysregulation moderated the relationship between perceived stress and emotional eating among military-dependent youth. There may be clinical utility in intervening on emotion regulation for adolescent dependents at particular risk for emotional eating and subsequent eating disorders.
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Affiliation(s)
- Holly Spinner
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Katherine A. Thompson
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Viviana Bauman
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Jason M. Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
- Department of Medicine, Uniformed Services University of the Health Sciences (USU), USA
| | - Isabel Thorstad
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Ruby Schrag
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, USU, USA
| | - Natasha A. Schvey
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, USA
- Department of Medical and Clinical Psychology, USU, USA
| | | | - Caitlin Ford
- Department of Family Medicine, Fort Belvoir Community Hospital, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, USA
| | - Sarah Jorgensen
- Department of Family Medicine, University of Iowa Hospitals & Clinics, USA
| | - David A. Klein
- Department of Family Medicine, USU, USA
- Department of Pediatrics, USU, USA
| | - Jeffrey Quinlan
- Department of Family Medicine, University of Iowa Hospitals & Clinics, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, USA
| | - Mark Haigney
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- Department of Medicine, Uniformed Services University of the Health Sciences (USU), USA
| | - Marian Tanofsky-Kraff
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, USA
- Department of Medical and Clinical Psychology, USU, USA
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Ruzicka EB, Shomaker LB, Pyle L, Bakalar JL, Shank LM, Crosby RD, Wilfley DE, Young JF, Sbrocco T, Brady SM, Gulley LD, Yanovski JA, Tanofsky-Kraff M. Effects of Therapeutic Alliance in Interpersonal Psychotherapy Among Adolescent Girls With Loss-of-Control Eating. Am J Psychother 2024; 77:7-14. [PMID: 38196343 DOI: 10.1176/appi.psychotherapy.20230011] [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: 01/11/2024]
Abstract
OBJECTIVE Interpersonal psychotherapy (IPT) has been proposed for prevention of excess weight gain among adolescents with loss-of-control (LOC) eating. Mixed findings from a trial testing this conjecture warrant elucidation of potential outcome predictors. The therapeutic alliance (adolescent-facilitator emotional bond and task collaboration) may be important for IPT but has received little attention in weight-related interventions. This study evaluated associations of adolescent-reported therapeutic alliance during IPT with weight- and eating-related outcomes. METHODS Secondary analyses of a randomized controlled trial were conducted to compare group IPT to health education (HE) for preventing excess weight gain among 113 girls (ages 12-17) with body mass index (BMI) at the 75th to 97th percentile and LOC eating. BMI and LOC eating were measured at baseline, 12 weeks (postintervention), and 1 year. Multilevel modeling was used to test associations between change in therapeutic alliance (from session 1 to session 12) and changes in weight- and eating-related outcomes (from postintervention to 1 year). Analyses were controlled for therapeutic alliance after session 1 and for baseline and postintervention outcome values; group assignment (IPT vs. HE) was a moderator. RESULTS Increases in emotional bond were associated with decreased weight and with greater decreases in number of LOC eating episodes at 1 year in the IPT group (p<0.05) and with weight gain in the HE group (p<0.05). Greater task collaboration was related to greater weight gain at 1-year follow-up, regardless of group assignment (p<0.05). CONCLUSIONS The association of therapeutic alliance during IPT with weight and LOC eating outcomes among adolescent girls merits further investigation.
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Affiliation(s)
- Elizabeth B Ruzicka
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Laura Pyle
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Jennifer L Bakalar
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Lisa M Shank
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Ross D Crosby
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Denise E Wilfley
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Jami F Young
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Tracy Sbrocco
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Sheila M Brady
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Lauren D Gulley
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Jack A Yanovski
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
| | - Marian Tanofsky-Kraff
- Department of Human Development and Family Studies, Colorado State University, Fort Collins (Ruzicka, Shomaker, Gulley); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora (Ruzicka, Shomaker, Pyle, Gulley); Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda (Bakalar, Shank, Sbrocco, Tanofsky-Kraff); Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda (Shank, Brady, Yanovski, Tanofsky-Kraff); Department of Biomedical Statistics and Methodology, Neuropsychiatric Research Institute, Fargo, North Dakota (Crosby); Department of Psychology, Washington University in St. Louis, St. Louis (Wilfley); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Young); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Young)
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St Fleur RG, Tanofsky-Kraff M, Yanovski JA, Horton NJ, Hirschhorn JN, Field AE. Phenotyping children and adolescents with obesity using behavioral, psychological, and familial data. Obesity (Silver Spring) 2023; 31:3016-3024. [PMID: 37987184 PMCID: PMC10715712 DOI: 10.1002/oby.23893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE This prospective cohort study aimed to empirically derive phenotypes of children and adolescents with overweight and obesity. METHODS Latent class analyses using Mplus were carried out in the Growing Up Today Study. Information on participants' weight status, disordered eating behaviors, body image and weight concerns, depressive symptoms, and pubertal timing, as well as and maternal weight status, were included in the latent class analyses, which were stratified by sex. Mixed-effects regression was used to examine associations of the obesity phenotypes with adult weight gain, between age 20 and 35 years, independent of weight at beginning of follow-up and duration of follow-up. RESULTS Among the girls, four obesity phenotypes were identified: 1) "early puberty"; 2) "mothers with obesity"; 3) "high weight concerns"; and 4) "mixed." Only three phenotypes were identified among the boys: 1) "high weight concerns"; 2) "mothers with obesity"; and 3) "mixed." Participants who had overweight or obesity in childhood or adolescence gained more weight in young adulthood than their leaner peers, but the patterns of weight gain in young adulthood varied by phenotype of obesity in childhood and adolescence. CONCLUSIONS These results support examining risk factors for and treatment outcomes by obesity phenotypes.
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Affiliation(s)
- Ruth G St Fleur
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of The Health Sciences, Bethesda, Maryland, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Nicholas J Horton
- Department of Mathematics and Statistics, Amherst College, Amherst, Massachusetts, USA
| | - Joel N Hirschhorn
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, USA
| | - Alison E Field
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
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Byrne ME, Tanofsky-Kraff M, Liuzzi L, Holroyd T, Parker MN, Bloomer BF, Nugent A, Brady SM, Yang SB, Turner SA, Pine DS, Yanovski JA. Neural underpinnings of threat bias in relation to loss-of-control eating behaviors among adolescent girls with high weight. Front Psychiatry 2023; 14:1276300. [PMID: 37965354 PMCID: PMC10642175 DOI: 10.3389/fpsyt.2023.1276300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/22/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction Loss-of-control (LOC) eating, a key feature of binge-eating disorder, may relate attentional bias (AB) to highly salient interpersonal stimuli. The current pilot study used magnetoencephalography (MEG) to explore neural features of AB to socially threatening cues in adolescent girls with and without LOC-eating. Methods Girls (12-17 years old) with overweight or obesity (BMI >85th percentile) completed an AB measure on an affective dot-probe AB task during MEG and evoked neural responses to angry or happy (vs. neutral) face cues were captured. A laboratory test meal paradigm measured energy intake and macronutrient consumption patterns. Results Girls (N = 34; Mage = 15.5 ± 1.5 years; BMI-z = 1.7 ± 0.4) showed a blunted evoked response to the presentation of angry face compared with neutral face cues in the left dorsolateral prefrontal cortex, a neural region implicated in executive control and regulation processes, during attention deployment (p < 0.01). Compared with those without LOC-eating (N = 21), girls with LOC-eating (N = 13) demonstrated a stronger evoked response to angry faces in the visual cortex during attention deployment (p < 0.001). Visual and cognitive control ROIs had trends suggesting interaction with test meal intake patterns among girls with LOC-eating (ps = 0.01). Discussion These findings suggest that girls with overweight or obesity may fail to adaptively engage neural regions implicated in higher-order executive processes. This difficulty may relate to disinhibited eating patterns that could lead to excess weight gain.
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Affiliation(s)
- Meghan E. Byrne
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health (NIMH), Bethesda, MD, United States
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
| | - Marian Tanofsky-Kraff
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
- Department of Medical and Clinical Psychology, USUHS, Bethesda, MD, United States
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, United States
| | - Lucrezia Liuzzi
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Tom Holroyd
- MEG Core Facility, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Megan N. Parker
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
- Department of Medical and Clinical Psychology, USUHS, Bethesda, MD, United States
| | - Bess F. Bloomer
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
| | - Allison Nugent
- MEG Core Facility, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Sheila M. Brady
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
| | - Shanna B. Yang
- Nutrition Department, Clinical Center, NIH, Bethesda, MD, United States
| | - Sara A. Turner
- Nutrition Department, Clinical Center, NIH, Bethesda, MD, United States
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Jack A. Yanovski
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
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Byrne ME, Burke NL, Neyland MKH, Bloomer BF, Hayes HE, Loch LK, Te-Vazquez J, Nwosu EE, Lazareva J, Moursi NA, Schvey NA, Shomaker LB, Brady SM, Sbrocco T, Tanofsky-Kraff M. Negative affect and loss-of-control eating in relation to adiposity among non-Hispanic youth identifying as black or white. Eat Behav 2023; 49:101721. [PMID: 36989932 PMCID: PMC10239321 DOI: 10.1016/j.eatbeh.2023.101721] [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: 11/30/2022] [Revised: 02/17/2023] [Accepted: 03/17/2023] [Indexed: 03/31/2023]
Abstract
Negative affect and loss-of-control (LOC)-eating are consistently linked and prevalent among youth identifying as non-Hispanic Black (NHB) and non-Hispanic White (NHW), particularly those with high weight. Given health disparities in high weight and associated cardiometabolic health concerns among NHB youth, elucidating how the association of negative affect with adiposity may vary by racial/ethnic group, and whether that relationship is impacted by LOC-eating, is warranted. Social inequities and related stressors are associated with negative affect among NHB youth, which may place this group at increased risk for excess weight gain. Across multiple aggregated protocols, 651 youth (13.0 ± 2.7 y; 65.9 % girls, 40.7 % NHB; 1.0 ± 1.1 BMIz; 37.6 % LOC-eating) self-reported trait anxiety and depressive symptoms as facets of negative affect. LOC-eating was assessed by interview and adiposity was measured objectively. Cross-sectional moderated mediation models predicted adiposity from ethno-racial identification (NHB, NHW) through the pathway of anxiety or depressive symptoms and examined whether LOC-eating influenced the strength of the pathway, adjusting for SES, age, height, and sex. The association between ethno-racial identity and adiposity was partially mediated by both anxiety (95 % CI = [0.01, 0.05]) and depressive symptoms (95 % CI = [0.02, 0.08]), but the mediation was not moderated by LOC-eating for either anxiety (95 % CI = [-0.04, 0.003]) or depressive symptoms (95 % CI = [-0.07, 0.03]). Mechanisms underlying the link between negative affect and adiposity among NHB youth, such as stress from discrimination and stress-related inflammation, should be explored. These data highlight the need to study impacts of social inequities on psychosocial and health outcomes.
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Affiliation(s)
- Meghan E Byrne
- National Institute of Mental Health, Emotion and Development Branch, 1 Center Drive, Bethesda, MD 20892, USA; Eunice Kennedy Shriver National Institute of Child Health and Human Development, 1 Center Drive, Bethesda, MD 20892, USA.
| | - Natasha L Burke
- Fordham University, Dept of Psychology, 441 East Fordham Road, Dealy Hall, Bronx, NY 10458, USA
| | - M K Higgins Neyland
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA
| | - Bess F Bloomer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, 1 Center Drive, Bethesda, MD 20892, USA
| | - Hannah E Hayes
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, 1 Center Drive, Bethesda, MD 20892, USA; Military Outcomes Cardiovascular Research, USU, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Lucy K Loch
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, 1 Center Drive, Bethesda, MD 20892, USA
| | - Jennifer Te-Vazquez
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, 1 Center Drive, Bethesda, MD 20892, USA
| | - Ejike E Nwosu
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, 1 Center Drive, Bethesda, MD 20892, USA
| | - Julia Lazareva
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, 1 Center Drive, Bethesda, MD 20892, USA
| | - Nasreen A Moursi
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, 1 Center Drive, Bethesda, MD 20892, USA; Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA
| | - Natasha A Schvey
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA
| | - Lauren B Shomaker
- Colorado State University, 1062 Campus Delivery, Fort Collins, CO 80523, USA
| | - Sheila M Brady
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, 1 Center Drive, Bethesda, MD 20892, USA
| | - Tracy Sbrocco
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA
| | - Marian Tanofsky-Kraff
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, 1 Center Drive, Bethesda, MD 20892, USA; Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA; Military Outcomes Cardiovascular Research, USU, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
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6
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Toledo PR, Lotufo-Neto F, Verdeli H, Goulart AC, Horvath Marques A, Solis ACDO, Wang YP. Interpersonal psychotherapy for treatment of obesity: A systematic review and meta-analysis. J Affect Disord 2023; 320:319-329. [PMID: 36183818 DOI: 10.1016/j.jad.2022.09.070] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 08/31/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Social and interpersonal context are associated with the onset and persistence of psychiatric disorders. We compared the effects of short-term interpersonal psychotherapy (IPT) on weight loss, binge eating behaviors, and depressive symptoms against cognitive-behavioral therapy (CBT), health education (HE), and behavioral weight loss (BWL). METHODS We searched until May 28th, 2022 following databases: PubMed, CINAHL, Science Direct, Web of Science, EMBASE, and Scopus. Articles on parallel randomized clinical trials were included. Outcomes were body mass index (BMI), binge days (bulimic episode), and depressive symptoms. These outcomes were self-reported or measured with specific scales (BMI) or instrument (depressive symptoms). RESULTS The initial search retrieved 820 articles, a total of 10 studies met the eligibility criteria, and seven were included in the meta-analysis. Participants with overweight/obesity were women (62-100 %), aged between 11 and 50 years. There was a trivial to small effect on BMI favoring IPT over other interventions (standardized mean difference [SMD] = -0.10; 95%CI: -0.27 to 0.07, I2 = 0 %), especially when compared to health education (SMD = -0.21; 95%CI: -0.54 to 0.12, I2 = 0 %); no effect on number of binge days (SMD = -0.09; 95%CI: -0.30 to 0.11, I2 = 0 %); and a small effect on depressive symptoms (SMD = -0.25, 95%CI = -0.50 to 0.00, I2 = 0 %). LIMITATIONS Small number of studies, the discrepancy in age cohorts, and racial diversity. Psychotherapeutic protocols and assessment tools had to be adapted across studies. CONCLUSIONS Patients with overweight/obesity and depression had some benefit from IPT when compared with other interventions. In view of existing evidence, an IPT program adapted to obesity could help to achieve reliable and long-term effects.
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Affiliation(s)
- Priscila R Toledo
- Institute of Psychiatry (LIM-23), Clinical Hospital, School of Medicine, University of Sao Paulo (HC-FMUSP), Sao Paulo, SP, Brazil
| | - Francisco Lotufo-Neto
- Department and Institute of Psychiatry, Clinical Hospital, School of Medicine, University of São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - Helen Verdeli
- Teachers College, Columbia University, New York, NY, USA
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo (HU-USP), São Paulo, SP, Brazil
| | - Andrea Horvath Marques
- Center for Global Mental Health Research, National Institute of Mental Health (NIMH), National Institute of Health, Bethesda, MD, USA
| | - Ana Cristina de Oliveira Solis
- Department and Institute of Psychiatry, Clinical Hospital, School of Medicine, University of São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - Yuan-Pang Wang
- Institute of Psychiatry (LIM-23), Clinical Hospital, School of Medicine, University of Sao Paulo (HC-FMUSP), Sao Paulo, SP, Brazil.
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7
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Le LKD, Tan EJ, Perez JK, Chiotelis O, Hay P, Ananthapavan J, Lee YY, Mihalopoulos C. Prevention of high body mass index and eating disorders: a systematic review and meta-analysis. Eat Weight Disord 2022; 27:2989-3003. [PMID: 36029370 PMCID: PMC9803760 DOI: 10.1007/s40519-022-01458-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/22/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Eating disorders (EDs) and high body mass index (BMI) are two important public health issues with significant health and cost impacts. The aim of this systematic review and meta-analysis was to establish whether interventions are effective in preventing both issues. METHODS Electronic databases were searched up to 10 May 2021. Studies were included if they were randomised or quasi-randomised controlled trials that evaluated a preventive intervention (regardless of its aim to prevent ED, high BMI or both) and reported both EDs and BMI-related outcomes. Both narrative synthesis and meta-analysis were used to synthesise the results. Publication bias was also investigated. RESULTS Fifty-four studies were included for analysis. The primary aim of the studies was ED prevention (n = 23), high BMI prevention (n = 21) and both ED and high BMI prevention (n = 10). Meta-analysis results indicated that preventive interventions had a significant effect on several ED outcomes including dieting, shape and weight concerns, body dissatisfaction, negative affect, eating disorder symptoms and internalization, with effect sizes ranging from - 0.16 (95% CI - 0.27, - 0.06) to - 0.61 (95% CI - 0.29, - 0.04). Despite several studies that demonstrated positive impacts on BMI, there was no significant effect on BMI-related measures in the meta-analysis. The risk of publication bias was low for the majority of the pooled effect results. CONCLUSION Preventive interventions were effective for either high BMI or EDs. However, there is limited evidence to show that current preventive interventions were effective in reducing both outcomes. Further research is necessary to explore the risk factors that are shared by these weight-related disorders as well as effective prevention interventions. LEVEL OF EVIDENCE Level I: systematic review.
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Affiliation(s)
- Long Khanh-Dao Le
- Health Economics Division, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Eng Joo Tan
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Burwood, VIC, 3125, Australia
| | - Joahna Kevin Perez
- Health Economics Division, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Oxana Chiotelis
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Burwood, VIC, 3125, Australia
| | - Phillipa Hay
- School of Medicine, Translational Health Research Institute (THRI), Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Camden and Campbelltown Hospital, SWSLHD, Campbelltown, NSW, 2560, Australia
| | - Jaithri Ananthapavan
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Burwood, VIC, 3125, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Burwood, VIC, 3125, Australia
| | - Yong Yi Lee
- Health Economics Division, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD, 4076, Australia
| | - Cathrine Mihalopoulos
- Health Economics Division, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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8
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Rice A, Lavender JM, Shank LM, Higgins Neyland MK, Markos B, Repke H, Haynes H, Gallagher-Teske J, Schvey NA, Sbrocco T, Wilfley DE, Ford B, Ford CB, Jorgensen S, Yanovski JA, Haigney M, Klein DA, Quinlan J, Tanofsky-Kraff M. Associations among alexithymia, disordered eating, and depressive symptoms in treatment-seeking adolescent military dependents at risk for adult binge-eating disorder and obesity. Eat Weight Disord 2022; 27:3083-3093. [PMID: 35852767 PMCID: PMC9805474 DOI: 10.1007/s40519-022-01429-z] [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: 01/12/2022] [Accepted: 05/31/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Evidence suggests that difficulties identifying and describing one's feelings, core components of alexithymia, are associated with attitudinal and behavioral symptoms of disordered eating; depressive symptoms also may underlie these associations. Specifically, research indicates that alexithymia is positively related to depressive symptoms, which in turn may promote both disordered-eating attitudes and certain disinhibited-eating behaviors (e.g., emotional eating). Findings also suggest that military-dependent youth with high weight may exhibit elevated depressive symptoms and disordered eating. As such, understanding associations among alexithymia, depressive symptoms, and disordered eating is particularly relevant for this vulnerable population. METHODS We examined 149 adolescent military dependents (14.4 ± 1.6y; 55.0% female; 20.0% non-Hispanic Black; BMIz: 1.9 ± 0.4) at high risk for binge-eating disorder and obesity in adulthood. Participants completed questionnaires assessing two components of alexithymia (difficulty identifying feelings [DIF] and difficulty describing feelings [DDF]), depressive symptoms, emotional eating, and trait anxiety; disordered-eating attitudes were assessed via semi-structured interview. RESULTS A series of regression-based models examined indirect relationships of DIF and DDF with disordered-eating attitudes and emotional eating through depressive symptoms. Bootstrapped 95% confidence intervals revealed a significant indirect path from each of the alexithymia components to disordered-eating attitudes via depressive symptoms; indirect paths to emotional eating were non-significant. CONCLUSION Results support the salience of depressive symptoms in the relationship between alexithymia and disordered-eating attitudes. Future research should utilize prospective designs and explore direct and indirect associations of alexithymia with other disordered-eating behaviors. LEVEL OF EVIDENCE Level III, evidence obtained from a well-designed cohort study.
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Affiliation(s)
- Alexander Rice
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA.
- The Metis Foundation, San Antonio, TX, USA.
- Department of Medicine, USU, Bethesda, MD, USA.
| | - Lisa M Shank
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
- Department of Medicine, USU, Bethesda, MD, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Bethesda, MD, USA
- Department of Medical and Clinical Psychology, USU, Bethesda, MD, USA
| | - M K Higgins Neyland
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
- Department of Medicine, USU, Bethesda, MD, USA
| | - Bethelhem Markos
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
| | - Hannah Repke
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
| | - Hannah Haynes
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Bethesda, MD, USA
| | - Julia Gallagher-Teske
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
| | - Natasha A Schvey
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Bethesda, MD, USA
- Department of Medical and Clinical Psychology, USU, Bethesda, MD, USA
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, USU, Bethesda, MD, USA
| | | | - Brian Ford
- Department of Family Medicine, USU, Bethesda, MD, USA
| | - Caitlin B Ford
- Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Sarah Jorgensen
- Department of Family Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Bethesda, MD, USA
| | - Mark Haigney
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA
- Department of Medicine, USU, Bethesda, MD, USA
| | - David A Klein
- Department of Family Medicine, USU, Bethesda, MD, USA
| | - Jeffrey Quinlan
- Department of Family Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Marian Tanofsky-Kraff
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA
- Department of Medicine, USU, Bethesda, MD, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Bethesda, MD, USA
- Department of Medical and Clinical Psychology, USU, Bethesda, MD, USA
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9
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Campos MLD, Castro MBD, Campos AD, Fernandes MF, Conegundes JLM, Rodrigues MN, Mügge FLB, Silva AMD, Sabarense CM, Castañon MCMN, Andreazzi AE, Scio E. Antiobesity, hepatoprotective and anti-hyperglycemic effects of a pharmaceutical formulation containing Cecropia pachystachya Trécul in mice fed with a hypercaloric diet. JOURNAL OF ETHNOPHARMACOLOGY 2021; 280:114418. [PMID: 34271111 DOI: 10.1016/j.jep.2021.114418] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/29/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The leaves of Cecropia pachystachya Trécul (Urticaceae), known as embaúba, are used as hypoglycemic and for weight reduction in Brazilian traditional medicine. AIM OF THE STUDY This study investigated the effects of a pharmaceutical formulation (ECP20) containing C. pachystachya extract on some metabolic alterations caused by a hypercaloric diet in mice. MATERIAL AND METHODS Mice were randomly fed with a standard or hypercaloric diet and orally treated with ECP20 or vehicle for 13 weeks. Subsequently, adiposity, glucose intolerance, and the presence of nonalcoholic fatty liver disease were assessed. Adipose tissue and liver were collected after euthanasia and frozen at -80 °C for histological and antioxidant analyzes. The effect of ECP20 on the differentiation of 3T3-L1 pre-adipocytes was also investigated. RESULTS Animals treated with ECP20 showed less weight gain, reduced glycemia, glucose tolerance restored, and hepatoprotective effect. Also, ECP20 presented significant in vivo antioxidant activity. Treatment of 3T3-L1 preadipocytes with ECP20 did not inhibit cellular differencing. CONCLUSIONS Therefore, ECP20 presented promising effects in the control of obesity and related disorders. Considering that glucose intolerance and hyperglycemia are strong evidence for the development of type 2 diabetes, the findings corroborated the traditional use of C. pachystachya to treat this disease. The chlorogenic acid and the flavonoids orientin and iso-orientin, present in the extract, might be involved in the activities found.
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Affiliation(s)
- Mara Lúcia de Campos
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, 36036 900, MG, Brazil.
| | - Marina Bento de Castro
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, 36036 900, MG, Brazil.
| | - Artur Domingos Campos
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, 36036 900, MG, Brazil.
| | - Maria Fernanda Fernandes
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, 36036 900, MG, Brazil.
| | - Jéssica Leiras Mota Conegundes
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, 36036 900, MG, Brazil.
| | - Matheus Nehrer Rodrigues
- Department of Morphology, Institute of Biological Sciences, Federal University of Juiz de Fora, 36036 900, Juiz de Fora, MG, Brazil.
| | - Fernanda Lins Brandão Mügge
- Laboratory of Inflammatory Genes, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, 31270-901, MG, Brazil.
| | - Aristóbolo Mendes da Silva
- Laboratory of Inflammatory Genes, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, 31270-901, MG, Brazil.
| | - Céphora Maria Sabarense
- Department of Nutrition, Institute of Biological Sciences, Federal University of Juiz de Fora, 36036 900, Juiz de Fora, MG, Brazil.
| | | | - Ana Eliza Andreazzi
- Department of Physiology, Institute of Biological Sciences, Federal University of Juiz de Fora, 36036 900, Juiz de Fora, MG, Brazil.
| | - Elita Scio
- Laboratory of Bioactive Natural Products, Department of Biochemistry, Institute of Biological Science, Federal University of Juiz de Fora, Juiz de Fora, 36036 900, MG, Brazil.
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10
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Moustafa AF, Quigley KM, Wadden TA, Berkowitz RI, Chao AM. A systematic review of binge eating, loss of control eating, and weight loss in children and adolescents. Obesity (Silver Spring) 2021; 29:1259-1271. [PMID: 34227229 PMCID: PMC8319063 DOI: 10.1002/oby.23185] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This review synthesizes literature on changes in binge eating (BE) and loss of control eating (LOC) following weight loss and the association between BE/LOC and weight loss in children and adolescents. METHODS A systematic literature search was conducted in PubMed, Scopus, and PsycInfo. Eligible studies included all peer-reviewed journal articles of primary research that assessed BE/LOC and weight change following a weight-loss intervention in individuals under 18 years of age. RESULTS The 29 articles included studies on behavioral therapy, pharmacotherapy, and surgical interventions. Of the 14 studies that assessed the relationship between weight loss and BE/LOC at baseline, 4 showed that higher baseline BE/LOC was associated with less weight loss, whereas 10 showed no significant association. BE/LOC behaviors significantly decreased following weight-loss interventions in 20 of 21 studies. A greater decrease in BE/LOC was associated with improved weight loss in 4 of 9 studies that assessed this change. CONCLUSIONS Weight-loss interventions are associated with improved BE/LOC in youth with obesity. The persistence of BE/LOC symptoms may be associated with less weight loss. These results can aid in guiding future treatment for youth with BE/LOC seeking weight-loss treatment.
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Affiliation(s)
| | - Kerry M. Quigley
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
| | - Thomas A. Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
| | - Robert I. Berkowitz
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
- The Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Philadelphia, PA, USA
| | - Ariana M. Chao
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
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11
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Rice AJ, Schvey NA, Shank LM, Neyland MH, Lavender JM, Solomon S, Hennigan K, Schindler R, Sbrocco T, Jorgensen S, Stephens M, Haigney M, Klein DA, Quinlan J, Yanovski JA, Tanofsky-Kraff M. Weight-Based Teasing and Metabolic Syndrome Components among Adolescent Military Dependents at Risk for Adult Obesity. Child Obes 2021; 17:116-124. [PMID: 33434443 PMCID: PMC7984651 DOI: 10.1089/chi.2020.0256] [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] [Indexed: 11/12/2022]
Abstract
Background: Among adults, weight stigma is associated with markers of poor cardiometabolic health. Although weight-based teasing (WBT) is common among youth with high body weight, few studies have examined its associations with cardiometabolic markers. Owing to unique stressors (e.g., parental deployment and frequent moves), military-dependent youth may be at particularly high risk for obesity, WBT, and poor cardiometabolic health. We, therefore, assessed associations between WBT and cardiometabolic health markers among adolescent military dependents presenting for a weight gain prevention trial. Methods: Participants underwent fasting phlebotomy; had fasting weight, height, and waist circumference measured; and completed assessments of WBT, anxiety, and loss-of-control eating. Multivariate analysis of covariance, adjusting for relevant covariates including demographics and body composition, was used to examine differences in metabolic syndrome (MetS) components (waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol, triglycerides, and glucose) between youth reporting WBT and youth reporting no WBT. Bootstrapped models examined whether WBT mediated the relationship between BMIz and MetS components. Results: Data from 142 youth (57.7% female; 14.4 ± 1.6 years; 51.2% non-Hispanic White, 20.9% non-Hispanic Black; BMIz: 1.9 ± 0.4) were analyzed. WBT was not significantly associated with any MetS component. Relationships were observed between BMIz and all MetS components (except systolic blood pressure and glucose), although WBT did not significantly mediate these relationships (p's > 0.05). Conclusions: This study did not find support for a relationship between WBT and MetS components in adolescent military dependents at risk for adult obesity. Prospective research is needed to determine whether associations between WBT and adverse cardiometabolic outcomes emerge primarily in adulthood.
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Affiliation(s)
- Alexander J. Rice
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA
| | - Natasha A. Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA.,Address correspondence to: Natasha A. Schvey, PhD, Department of Medical and Clinical Psychology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Lisa M. Shank
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA.,Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA
| | - M.K. Higgins Neyland
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA
| | - Jason M. Lavender
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA
| | - Senait Solomon
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
| | - Kathrin Hennigan
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA
| | - Rachel Schindler
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA
| | | | - Mark Stephens
- Pennsylvania State University, Old Main, State College, PA, USA
| | - Mark Haigney
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA
| | - David A. Klein
- Department of Family Medicine, Uniformed Services University, Bethesda, MD, USA.,Department of Pediatrics, Uniformed Services University, Bethesda, MD, USA
| | - Jeffrey Quinlan
- Department of Family Medicine, Uniformed Services University, Bethesda, MD, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA
| | - Marian Tanofsky-Kraff
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA
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12
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Pine AE, Schvey NA, Shank LM, Burke NL, Neyland MKH, Hennigan K, Young JF, Wilfley DE, Klein DA, Jorgensen S, Seehusen D, Hutchinson J, Quinlan J, Yanovski JA, Stephens M, Sbrocco T, Tanofsky-Kraff M. A Pilot Feasibility Study of Interpersonal Psychotherapy for the Prevention of Excess Weight Gain Among Adolescent Military-dependent Girls. Mil Med 2021; 186:344-350. [PMID: 33241297 PMCID: PMC7909453 DOI: 10.1093/milmed/usaa514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Adolescent military-dependents face unique psychosocial stressors due to their parents' careers, suggesting they may be particularly vulnerable to excess weight gain and symptoms of depression and anxiety. Despite these risk factors, there is a lack of tested preventative interventions for these youths. Given the transient nature of military family deployments, research may be hindered due to difficulty in collecting long-term prospective outcome data, particularly measured height and weight. The primary aim of this study was to examine the feasibility and acceptability of collecting body mass index (BMI, kg/m2) outcome data up to 2 years following a randomized controlled pilot trial of an adapted interpersonal psychotherapy (IPT) program aimed at preventing excess weight gain and improving psychological functioning for adolescent military-dependents. In exploratory analyses, patterns in body composition over time were examined. MATERIALS AND METHODS Twenty-seven adolescent military-dependent girls (baseline: Mage: 14.4 ± 1.6 years; MBMI: 30.7 ± 4.9 kg/m2; MBMI-z: 1.9 ± 0.4) participated in this study. After a baseline assessment, utilizing a computerized program to create a randomization string, girls were assigned to either an IPT or a health education (HE) program. Participants completed three follow-up visits (posttreatment, 1-year follow-up, and 2-year follow-up). Girls completed a Treatment Acceptability Questionnaire at posttreatment; at all time points, height and fasting weight were collected. For the primary aim, Fisher's exact tests examined the rate of obtained follow-up data and lost to follow-up status between the two groups, Mann-Whitney U tests examined the session attendance between groups, and treatment acceptability ratings were compared between the two groups at posttreatment using an independent samples t-test. For the exploratory aim, one-way analyses of covariance (ANCOVAs) examined the group differences in BMI at each time point, adjusting for baseline values, and paired samples t-tests examined the within-group differences at each time point relative to baseline. Using imputed data in the full intent-to-treat sample, mixed model ANCOVAs were conducted to examine the group differences over time. RESULTS Across both groups, girls attended an average of 72.0% of sessions. At least partial data were collected at posttreatment, 1-year follow-up, and 2-year follow-up for 96.3%, 85.2%, and 74.1% of the participants, respectively. There were no significant group differences in follow-up data collection rates, follow-up status, number of sessions attended, or treatment acceptability. BMI-z stabilized across groups, and there were no group differences in BMI-z. In adjusted ANCOVA models with imputed data, no significant group-by-time effects emerged. CONCLUSIONS For this randomized controlled prevention trial, long-term outcome data collection of measured BMI was possible in adolescent military-dependents and IPT was an acceptable and feasible intervention. An adequately powered trial is required to assess the efficacy of this intervention among military-dependents for obesity prevention and improvements in BMI.
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Affiliation(s)
- Abigail E Pine
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892, USA
| | - Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD 20814, USA
| | - Natasha L Burke
- Department of Psychology, Fordham University, Bronx, NY 10458, USA
| | - M K Higgins Neyland
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD 20814, USA
- Metis Foundation, San Antonio, TX 78205, USA
| | - Kathrin Hennigan
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD 20814, USA
- Metis Foundation, San Antonio, TX 78205, USA
| | - Jami F Young
- Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Denise E Wilfley
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - David A Klein
- Departments of Family Medicine and Pediatrics, USU, Bethesda, MD 20814, USA
- Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, MD 20762, USA
| | - Sarah Jorgensen
- Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060, USA
| | - Dean Seehusen
- Department of Family Medicine, Medical College of Georgia, Augusta, GA 30912, USA
| | | | - Jeffrey Quinlan
- Departments of Family Medicine and Pediatrics, USU, Bethesda, MD 20814, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892, USA
| | - Mark Stephens
- Departments of Family and Community Medicine and Humanities, Pennsylvania State University, Old Main, State College, PA 16801, USA
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD 20814, USA
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13
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Hilbert A, Petroff D, Neuhaus P, Schmidt R. Cognitive-Behavioral Therapy for Adolescents with an Age-Adapted Diagnosis of Binge-Eating Disorder: A Randomized Clinical Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2020; 89:51-53. [PMID: 31533113 DOI: 10.1159/000503116] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/02/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany, .,Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany,
| | - David Petroff
- Integrated Research and Treatment Center Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Clinical Trial Centre Leipzig, University of Leipzig, Leipzig, Germany
| | - Petra Neuhaus
- Integrated Research and Treatment Center Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Clinical Trial Centre Leipzig, University of Leipzig, Leipzig, Germany
| | - Ricarda Schmidt
- Integrated Research and Treatment Center Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
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14
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Leme ACB, Haines J, Tang L, Dunker KLL, Philippi ST, Fisberg M, Ferrari GL, Fisberg RM. Impact of Strategies for Preventing Obesity and Risk Factors for Eating Disorders among Adolescents: A Systematic Review. Nutrients 2020; 12:nu12103134. [PMID: 33066501 PMCID: PMC7602154 DOI: 10.3390/nu12103134] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 02/07/2023] Open
Abstract
An effective behavior change program is the first line of prevention for youth obesity. However, effectiveness in prevention of adolescent obesity requires several approaches, with special attention paid to disordered eating behaviors and psychological support, among other environmental factors. The aim of this systematic review is to compare the impact of two types of obesity prevention programs, inclusive of behavior change components, on weight outcomes. "Energy-balance" studies are aimed at reducing calories from high-energy sources and increasing physical activity (PA) levels, while "shared risk factors for obesity and eating disorders" focus on reducing disordered eating behaviors to promote a positive food and eating relationship. A systematic search of ProQuest, PubMed, PsycInfo, SciELO, and Web of Science identified 8825 articles. Thirty-five studies were included in the review, of which 20 regarded "energy-balance" and 15 "shared risk factors for obesity and eating disorders". "Energy-balance" studies were unable to support maintenance weight status, diet, and PA. "Shared risk factors for obesity and eating disorders" programs also did not result in significant differences in weight status over time. However, the majority of "shared risk factors for obesity and eating disorders" studies demonstrated reduced body dissatisfaction, dieting, and weight-control behaviors. Research is needed to examine how a shared risk factor approach can address both obesity and eating disorders.
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Affiliation(s)
- Ana Carolina B. Leme
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (S.T.P.); (R.M.F.)
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (J.H.); (L.T.)
- Correspondence:
| | - Jess Haines
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (J.H.); (L.T.)
| | - Lisa Tang
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (J.H.); (L.T.)
| | - Karin L. L. Dunker
- Department of Psychiatric, Federal University of São Paulo, São Paulo 04038-000, Brazil;
| | - Sonia T. Philippi
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (S.T.P.); (R.M.F.)
| | - Mauro Fisberg
- Nutrition and Feeding Difficulties Excellence Center, PENSI Institute, Sabará Children’s Hospital, São Paulo 01228-200, Brazil;
- Department of Pediatrics, Escola Paulista, Federal University of São Paulo, São Paulo 04023-062, Brazil
| | - Gerson L. Ferrari
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago 8320000, Chile;
| | - Regina M. Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (S.T.P.); (R.M.F.)
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15
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Burke NL, Neyland MKH, Young JF, Wilfley DE, Tanofsky-Kraff M. Interpersonal psychotherapy for the prevention of binge-eating disorder and adult obesity in an African American adolescent military dependent boy. Eat Behav 2020; 38:101408. [PMID: 32585564 PMCID: PMC7483707 DOI: 10.1016/j.eatbeh.2020.101408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 06/05/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Military adolescent boys report similar levels of disordered-eating as their female counterparts. Yet, interventions for the prevention of full-threshold eating disorders in adolescent boys are lacking. Interpersonal psychotherapy (IPT), an evidenced-based therapy adapted for the prevention of BED and adult obesity, has been studied in adolescent girls, but it is unclear whether IPT might resonate with adolescent boys. METHOD The current case study elucidates the use of a 12-week IPT group intervention for the prevention of BED and adult obesity in adulthood for an African American adolescent military dependent boy with reported loss-of-control (LOC)-eating, obesity, and elevated mood symptoms. RESULTS LOC-eating and body mass index metrics decreased immediately post-intervention and further decreased by one-year follow-up. Social functioning scores improved and anxiety and depression scores decreased from baseline to one-year follow-up. In contrast to previous observations among girls, these improvements were evidenced without the teen's explicit acknowledgement of the link between mood and eating behaviors. DISCUSSION Although the mechanism of change may manifest differently than for girls, adapted IPT may be an effective intervention strategy for adolescent boys with LOC-eating and obesity who endorse elevated mood symptoms.
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Affiliation(s)
- Natasha L. Burke
- Department of Psychology, Fordham University, 411 East Fordham Road, Dealy Hall, Bronx, NY 10458, USA
| | - M. K. Higgins Neyland
- Military Outcomes Cardiovascular Research (MiCOR), USUHS, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Jami F. Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104-4399,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, Campus Box 8134, St Louis, MO 63110, USA
| | - Marian Tanofsky-Kraff
- Military Outcomes Cardiovascular Research (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Department of Medical and Clinical Psychology, USUHS, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
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16
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Shank LM, Higgins Neyland MK, Lavender JM, Schindler R, Solomon S, Hennigan K, Leu W, Schvey NA, Sbrocco T, Jorgensen S, Stephens M, Olsen CH, Haigney M, Klein DA, Quinlan J, Yanovski JA, Tanofsky-Kraff M. Sex differences in metabolic syndrome components in adolescent military dependents at high-risk for adult obesity. Pediatr Obes 2020; 15:e12638. [PMID: 32286006 PMCID: PMC8183113 DOI: 10.1111/ijpo.12638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/13/2020] [Accepted: 03/19/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Metabolic syndrome in adolescence has been associated with adverse cardiometabolic outcomes in adulthood. Preliminary data suggest that boys may have worsened metabolic syndrome components compared to girls. Yet, little is known about the physical health of military dependents, a potentially at-risk population. OBJECTIVE Examine sex differences in metabolic syndrome components in a sample of adolescent military dependents. METHODS Participants were adolescents (N = 139; 14.4 ± 1.6 years; 45.3% male; 41.0% non-Hispanic White, 19.4% non-Hispanic Black; BMI-z: 1.9 ± 0.4) at-risk for adult obesity and binge-eating disorder due to an age- and sex-adjusted BMI ≥85th percentile and loss-of-control eating and/or elevated anxiety. A multivariate analysis of covariance was conducted to compare objectively measured metabolic syndrome components across boys and girls. Covariates were age, race, loss-of-control eating status, anxiety symptoms, and BMI-z. RESULTS Metabolic syndrome components differed by sex (P = .01). Boys had higher systolic blood pressure (P = .049), lower high-density lipoprotein cholesterol (P = .01), and higher glucose (P = .001) than girls. Waist circumference, diastolic blood pressure, and triglycerides did not differ between boys and girls (P > .05). CONCLUSIONS Future research should prospectively examine these relationships into adulthood. If the current findings are supported, prevention programs should consider targeting cardiometabolic health particularly among male adolescent military dependents.
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Affiliation(s)
- Lisa M. Shank
- Department of Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Metis Foundation, San Antonio, Texas,Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland
| | - M. Katy Higgins Neyland
- Department of Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Metis Foundation, San Antonio, Texas
| | - Jason M. Lavender
- Department of Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Metis Foundation, San Antonio, Texas
| | - Rachel Schindler
- Department of Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Metis Foundation, San Antonio, Texas
| | - Senait Solomon
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Department of Medical and Clinical Psychology, USU, Bethesda, Maryland,The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, Maryland
| | - Kathrin Hennigan
- Department of Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Metis Foundation, San Antonio, Texas
| | - William Leu
- Department of Medical and Clinical Psychology, USU, Bethesda, Maryland
| | - Natasha A. Schvey
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland,Department of Medical and Clinical Psychology, USU, Bethesda, Maryland
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, USU, Bethesda, Maryland
| | | | - Mark Stephens
- Pennsylvania State University, State College, Pennsylvania
| | - Cara H. Olsen
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
| | - Mark Haigney
- Department of Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
| | - David A. Klein
- Department of Family Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, Maryland
| | - Jeffrey Quinlan
- Department of Family Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland
| | - Marian Tanofsky-Kraff
- Department of Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland,Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland,Department of Medical and Clinical Psychology, USU, Bethesda, Maryland
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17
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Pine AE, Shank LM, Burke NL, Higgins Neyland MK, Schvey NA, Quattlebaum M, Leu W, Wilfley DE, Stephens M, Jorgensen S, Olsen CH, Sbrocco T, Yanovski JA, Klein DA, Quinlan J, Tanofsky-Kraff M. Examination of the Interpersonal Model With Adolescent Military Dependents at High Risk for Adult Obesity. Am J Psychother 2020; 73:43-49. [PMID: 32050783 PMCID: PMC7286799 DOI: 10.1176/appi.psychotherapy.20190034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Adolescent military dependents may be at higher risk for psychosocial stressors and disordered eating compared with civilian youths, but the mechanisms underlying these risks are unclear. Interpersonal theory proposes that difficult relationships lead to negative affect, thereby promoting emotional eating, which has been linked to and predictive of disordered eating. The interpersonal model may have particular relevance for understanding disordered eating among adolescent military dependents, given the unique stressors related to their parents' careers. This study aimed to examine the premise of the interpersonal model (that negative emotions mediate the association between multiple aspects of social functioning and emotional eating) among a cohort of adolescent military dependents. METHODS Military dependents (N=136; 56% female, mean±SD age=14±2 years, body mass index adjusted for age and sex [BMIz]=2.0±0.4) at risk for adult obesity and binge eating disorder, as indicated by reported loss-of-control eating and/or anxiety symptoms, were assessed prior to participation in a study of excess weight-gain prevention. Bootstrapped mediation analyses were conducted to examine depressive symptoms as a potential mediator of the relationship between social functioning and emotional eating. Analyses were adjusted for age, sex, race-ethnicity, BMIz, and presence of reported loss-of-control eating and anxiety. RESULTS Depressive symptoms were a significant mediator of the relationship between multiple domains of social functioning, including loneliness, social adjustment related to family and friends, attachment to father and peers, and emotional eating (p<0.05). CONCLUSIONS The interpersonal model may contribute to our understanding of excess weight gain and binge eating disorder among adolescent military dependents. Prospective data are needed to determine the utility of interpersonal theory in predicting treatment response and outcomes among this population.
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Affiliation(s)
- Abigail E Pine
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Natasha L Burke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - M K Higgins Neyland
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Mary Quattlebaum
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - William Leu
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Denise E Wilfley
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Mark Stephens
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Sarah Jorgensen
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Cara H Olsen
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Jack A Yanovski
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - David A Klein
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Jeffrey Quinlan
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
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18
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Byrne ME, Tanofsky-Kraff M, Kelly NM, Grammer AC, Jaramillo M, Mi SJ, Stojek MM, Shank LM, Burke NL, Cassidy O, Schvey NA, Brady SM, Demidowich AP, Broadney MM, Yanovski SZ, Yanovski JA. Pediatric Loss-of-Control Eating and Anxiety in Relation to Components of Metabolic Syndrome. J Pediatr Psychol 2020; 44:220-228. [PMID: 30339233 DOI: 10.1093/jpepsy/jsy077] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 09/01/2018] [Indexed: 01/17/2023] Open
Abstract
Objective Pediatric loss-of-control (LOC) eating is associated with, and predictive of, gains in adiposity and adverse metabolic outcomes. In addition, some preliminary data suggest that anxiety may exacerbate the relationship of LOC eating with weight and metabolic syndrome (MetS)-related measures. We therefore examined whether anxiety moderated the relationship between LOC eating and body mass index z (BMIz), adiposity, and MetS-related measures in youth. Methods A convenience sample of non-treatment-seeking boys and girls of varying weight strata were interviewed to determine the presence of LOC eating and completed a questionnaire assessing trait anxiety. BMIz and MetS-related measures (blood pressure, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, glucose, and insulin) were measured after an overnight fast. Adiposity was assessed by air displacement plethysmography or dual-energy x-ray absorptiometry. Analyses adjusted for age, sex, race, height, fat mass, and depressive symptoms, as appropriate. Results In all, 379 youths (13.0 ± 2.8 years; 53% female; BMIz = 0.8 ± 1.1; 22% with LOC eating) were studied. Anxiety was not significantly related to BMIz, adiposity, or MetS-related measures. However, anxiety and LOC eating interacted such that only among youth with LOC eating, anxiety was positively associated with fasting insulin (p = .02) and insulin resistance (p = .01). The interaction of anxiety and LOC eating was not significantly related to BMIz, adiposity, or any other MetS-related measure (ps = ns). Conclusions Only among non-treatment-seeking youth with LOC eating, anxiety may be associated with increased insulin secretion and insulin resistance. Longitudinal studies are required to confirm these findings and explore mechanisms for these relationships.
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Affiliation(s)
- Meghan E Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Nichole M Kelly
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Anne Claire Grammer
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Manuela Jaramillo
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Sarah J Mi
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Monika M Stojek
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS.,Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF)
| | - Natasha L Burke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Omni Cassidy
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Sheila M Brady
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Andrew P Demidowich
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Miranda M Broadney
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Susan Z Yanovski
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, DHHS
| | - Jack A Yanovski
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
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19
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Tanofsky-Kraff M, Schvey NA, Grilo CM. A developmental framework of binge-eating disorder based on pediatric loss of control eating. AMERICAN PSYCHOLOGIST 2020; 75:189-203. [PMID: 32052994 PMCID: PMC7027731 DOI: 10.1037/amp0000592] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although binge-eating disorder may manifest in childhood, a significantly larger proportion of youth report episodes involving a loss of control while eating, the hallmark feature of binge eating that predicts excess weight gain and obesity. Adults with binge-eating disorder often report that symptoms emerged during childhood or adolescence, suggesting that a developmental perspective of binge eating may be warranted. Thus, loss of control eating may be a marker of prodromal binge-eating disorder among certain susceptible youth. The present article offers a broad developmental framework of binge-eating disorder and proposes areas of future research to determine which youths with loss of control eating are at risk for persistent and exacerbated behavior that may develop into binge-eating disorder and adult obesity. To this end, this article provides an overview of loss of control eating in childhood and adolescence, including its characterization, etiology, and clinical significance, with a particular focus on associations with metabolic risk, weight gain, and obesity. A conceptual model is proposed to further elucidate the mechanisms that may play a role in determining which youths with loss of control are at greatest risk for binge-eating disorder and obesity. Ways in which treatments for adult binge-eating disorder may inform approaches to reduce loss of control eating and prevent excess weight gain in youth are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine
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20
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Shomaker LB, Berman Z, Burke M, Annameier SK, Pivarunas B, Sanchez N, Smith AD, Hendrich S, Riggs NR, Legget KT, Cornier MA, Melby C, Johnson SA, Lucas-Thompson R. Mindfulness-based group intervention in adolescents at-risk for excess weight gain: A randomized controlled pilot study. Appetite 2019; 140:213-222. [PMID: 31112737 PMCID: PMC6585452 DOI: 10.1016/j.appet.2019.05.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 05/15/2019] [Accepted: 05/17/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To assess feasibility/acceptability of a mindfulness-based approach to excess weight prevention in adolescents at-risk for excess weight gain. To pilot test efficacy of a mindfulness-based intervention for improving food reward sensitivity, stress-eating, executive function (EF), and BMI/adiposity. METHODS A pilot randomized controlled trial was conducted with 12-17y adolescents at-risk for excess weight gain based on above-average weight (body mass index [BMI]≥70%ile) or parental history of obesity (BMI≥30 kg/m2). Adolescents were randomized to a mindfulness-based (n = 29) or health education control group (n = 25) that met for six weekly one-hour sessions. Feasibility/acceptability were determined from attendance and acceptability survey ratings. At baseline, six-week and six-month follow-up, adolescents' perceived stress was measured with the Perceived Stress Scale, food reward sensitivity with a behavioral task, stress-eating during a laboratory test meal, and EF with the parent-reported Behavior Rating Inventory of Executive Function and NIH Toolbox. At the same intervals, BMI indices and body fat by air displacement plethysmography were assessed in a fasted state. RESULTS Median session attendance was 6:6 sessions in both conditions; program acceptability ratings were above-average. Compared to health education, adolescents in mindfulness had lower food reward sensitivity at six-months (Cohen's d = 0.64, p = .01). There were no between-condition differences in BMI (mindfulness vs. health educationΔsix-months 95%CI 0.20, 1.52 kg/m2 vs. 0.21, 1.62 kg/m2) or adiposity (-3.64, -0.61% vs. -4.31, -1.04%) changes. CONCLUSIONS A mindfulness-based group intervention is feasible/acceptable among adolescents at-risk for excess weight. In this pilot sample, mindfulness and health education were equivocal for BMI/adiposity outcomes. Future trials with a larger, adequately-powered sample and longer-term follow-up are necessary to test efficacy of a mindfulness-based intervention for food reward sensitivity, stress-eating, EF, and stabilizing growth trajectories in youth at-risk for adult obesity.
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Affiliation(s)
- Lauren B Shomaker
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States; Community & Behavioral Health, Colorado School of Public Health, 13001 E. 17th Pl, Aurora, CO, 80045, United States.
| | - Zoe Berman
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Morgan Burke
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Shelly K Annameier
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Bernadette Pivarunas
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Natalia Sanchez
- Community & Behavioral Health, Colorado School of Public Health, 13001 E. 17th Pl, Aurora, CO, 80045, United States
| | - Amy D Smith
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Silas Hendrich
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Nathaniel R Riggs
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Kristina T Legget
- Psychiatry, School of Medicine, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl, Aurora, CO, 80045, United States
| | - Marc-Andre Cornier
- Division of Endocrinology, Metabolism & Diabetes, Department of Medicine, School of Medicine, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl, Aurora, CO, 80045, Aurora, CO, United States
| | - Christopher Melby
- Food Science & Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Sarah A Johnson
- Food Science & Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Rachel Lucas-Thompson
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
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21
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Karam AM, Fitzsimmons-Craft EE, Tanofsky-Kraff M, Wilfley DE. Interpersonal Psychotherapy and the Treatment of Eating Disorders. Psychiatr Clin North Am 2019; 42:205-218. [PMID: 31046923 DOI: 10.1016/j.psc.2019.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Interpersonal psychotherapy (IPT) for the treatment of eating disorders is a brief treatment that addresses the social and interpersonal context in which the disorder begins and is maintained. IPT is classified as a strongly supported evidence-based treatment of bulimia nervosa and binge-eating disorder, and more research is needed to understand the effectiveness of IPT for anorexia nervosa and IPT for preventing excess weight gain. This article describes the core components and elements of IPT, the empirical evidence that supports its effectiveness, efforts to increase the dissemination and implementation of IPT, and future directions.
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Affiliation(s)
- Anna M Karam
- Department of Psychology, Washington University in St. Louis, 660 South Euclid Avenue, Mailstop 8134-29-2100, St. Louis, MO 63110, USA
| | - Ellen E Fitzsimmons-Craft
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Mailstop 8134-29-2100, St. Louis, MO 63110, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814-4712, USA
| | - Denise E Wilfley
- Scott Rudolph University, Washington University School of Medicine, 660 South Euclid Avenue, Mailstop 8134-29-2100, St. Louis, MO 63110, USA.
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22
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Quattlebaum M, Burke NL, Neyland MKH, Leu W, Schvey NA, Pine A, Morettini A, LeMay-Russell S, Wilfley DE, Stephens M, Sbrocco T, Yanovski JA, Jorgensen S, Olsen C, Klein D, Quinlan J, Tanofsky-Kraff M. Sex differences in eating related behaviors and psychopathology among adolescent military dependents at risk for adult obesity and eating disorders. Eat Behav 2019; 33:73-77. [PMID: 31005683 PMCID: PMC6535360 DOI: 10.1016/j.eatbeh.2019.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 01/14/2023]
Abstract
Stressors unique to military families may place dependents of military service members of both sexes at high-risk for disordered-eating. Yet, there are no data examining sex-related differences in eating pathology and distress among this population. Therefore, we examined disordered-eating attitudes and associated psychosocial characteristics in adolescent military dependents at high-risk for both eating disorders and adult obesity (i.e., BMI ≥ 85th percentile and elevated anxiety symptoms and/or loss-of-control eating). One-hundred-twenty-five (55.2% female) adolescent (12-17 y) military dependents were studied prior to entry in an eating disorder and obesity prevention trial. Youth were administered the Eating Disorder Examination interview to determine disordered-eating attitudes, and completed questionnaires to assess self-esteem, social functioning, and depression. Girls and boys did not differ in BMIz (p = .66) or race/ethnicity (p = .997/p = .55). Adjusting for relevant covariates, girls and boys did not differ significantly with regard to disordered-eating global scores (p = .38), self-esteem (p = .23), or social functioning (p = .19). By contrast, girls reported significantly more symptoms of depression (p = .001). Adolescent male and female dependents at high-risk for eating disorders and adult obesity reported comparable levels of eating-related and psychosocial stress. Data are needed to elucidate how adolescent military dependents respond to intervention and whether sex moderates outcome.
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Affiliation(s)
- Mary Quattlebaum
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Natasha L. Burke
- Psychology Department, Fordham University, 441 E. Fordham Road, Bronx, NY 10458, USA
| | - M. K. Higgins Neyland
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - William Leu
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Natasha A. Schvey
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, USA
| | - Abigail Pine
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Alexandria Morettini
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Sarah LeMay-Russell
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, USA
| | - Denise E. Wilfley
- Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130, USA
| | - Mark Stephens
- Pennsylvania State University, Old Main, State College, PA 16801, USA
| | - Tracy Sbrocco
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, USA
| | - Sarah Jorgensen
- Fort Belvoir Community Hospital (FBCH), 9300 DeWitt Loop, Fort Belvoir, VA 22060, USA
| | - Cara Olsen
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - David Klein
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA,Fort Belvoir Community Hospital (FBCH), 9300 DeWitt Loop, Fort Belvoir, VA 22060, USA
| | - Jeffrey Quinlan
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Marian Tanofsky-Kraff
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, USA.
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23
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Abstract
PURPOSE OF REVIEW This review summarizes findings on pediatric loss-of-control (LOC) eating and obesity published since 2013 in relation to physiological, socioenvironmental, and psychological factors. RECENT FINDINGS LOC eating and obesity are highly comorbid in youth. Genetic and physiological risk factors are associated with the development of LOC eating. Adverse physiological outcomes of LOC eating include increased risk for overweight and obesity and greater dysfunction in components of metabolic syndrome. Socioenvironmental, psychological, and behavioral factors, such as weight-based teasing, dieting, negative affect, emotion dysregulation, and aspects of cognitive functioning, are consistently related to LOC eating in youth, independent of weight. Prospectively, LOC eating may predict the onset of anxiety disorders, depression, and more severe eating psychopathology later in life. Updates on interventions and future directions are discussed. LOC eating may be a key symptom to target adverse physiological and psychological outcomes; however, treatments are limited and require further examination.
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Affiliation(s)
- Meghan E Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814-4799, USA
| | - Sarah LeMay-Russell
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814-4799, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814-4799, USA.
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Leme ACB, Philippi ST, Thompson D, Nicklas T, Baranowski T. "Healthy Habits, Healthy Girls-Brazil": an obesity prevention program with added focus on eating disorders. Eat Weight Disord 2019; 24:107-119. [PMID: 29730727 DOI: 10.1007/s40519-018-0510-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 04/24/2018] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To evaluate the immediate post-intervention and 6-month post-intervention effects of a Brazilian school-based randomized controlled trial for girls targeting shared risk factors for obesity and disordered eating. METHODS Total of 253 girls, mean of 15.6 (0.05) years from 1st to 3rd grades of high school participated in this 6-month school-based cluster randomized controlled trial. "Healthy Habits, Healthy Girls-Brazil (H3G-Brazil)", originally developed in Australia, emphasized 10 key nutrition and physical activity (PA) messages delivered over 6 months. Disordered eating prevention procedures, i.e., prevention of weight-teasing, body satisfaction, and unhealthy weight control behavior, were added to the intervention. Body dissatisfaction, unhealthy weight control behaviors and social cognitive-related diet, and physical activity variables were assessed at baseline, immediate post-intervention, and 6-month post-intervention. Intervention effects were determined by one-way analysis of covariance or logistic regression, after checking for the clustering effects of school. The control group did not receive intervention prior to follow-up assessment. A conservative significance level was set at p < 0.01. RESULTS Beneficial effects were detected for PA social support (F = 6.005, p = 0.01), and healthy eating strategies (F = 6.08, p = 0.01) immediate post-intervention; and healthy eating social support (F = 14.731, p = 0.00) and healthy eating strategies (F = 5.812, p = 0.01) at 6-month post-intervention. Intervention group was more likely to report unhealthy weight control behaviors (OR = 1.92, 95% CI 1.15-3.21, p = 0.01) at 6-month post-intervention. No other significant immediate or 6-month post effects were detected. CONCLUSION H3G-Brazil demonstrated positive 6-month effects on some social cognitive variables but an adverse effect on unhealthy weight control behaviors. Thus, this study was not able to achieve synergy by combining obesity and disordered eating prevention procedures in an intervention among low-income girls in Brazil. TRIAL REGISTRATION Level I: cluster randomized controlled trial.
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Affiliation(s)
- Ana Carolina Barco Leme
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, USA. .,Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
| | | | - Debbe Thompson
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, USA
| | - Theresa Nicklas
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Tom Baranowski
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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25
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Perceived Family Functioning in Relation to Energy Intake in Adolescent Girls with Loss of Control Eating. Nutrients 2018; 10:nu10121869. [PMID: 30513811 PMCID: PMC6315637 DOI: 10.3390/nu10121869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 11/19/2022] Open
Abstract
Family functioning is hypothesized to influence the development, maintenance, and treatment of obesity and eating disorders. However, there are limited data examining family functioning in relation to energy intake in the laboratory among youth at high-risk for eating disorders and excess weight gain. Therefore, we examined the relationship between perceived family functioning and energy intake during a laboratory test meal designed to model a binge episode. We performed hierarchical multiple regression analyses among 108 adolescent girls in an excess weight gain prevention trial. Participants were at high-risk for eating disorders and excess weight gain due to reports of loss of control eating (LOC) and high body mass index (BMI). Participants completed the Family Adaptability and Cohesion Scale III to assess family adaptability and cohesion. Following an overnight fast, girls consumed lunch from a laboratory test meal. Poorer family adaptability, but not cohesion, was associated with lower percentage of total energy intake from protein and greater percentage of total energy intake from carbohydrates. Neither adaptability nor cohesion were significantly associated with total intake. We conclude that among girls with LOC eating and high BMI, poor reported family adaptability is associated with greater consumption of obesity-promoting macronutrients during binge episodes. Directionality and temporality of this association between unhealthy consumption and family rigidity requires further study.
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26
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Puls HC, Schmidt R, Hilbert A. Therapist adherence and therapeutic alliance in individual cognitive-behavioural therapy for adolescent binge-eating disorder. EUROPEAN EATING DISORDERS REVIEW 2018; 27:182-194. [PMID: 30334340 DOI: 10.1002/erv.2650] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 08/20/2018] [Accepted: 09/21/2018] [Indexed: 11/05/2022]
Abstract
To evaluate psychological treatments for adolescent binge-eating disorder (BED), reliable information on therapeutic process factors is needed. This study examines therapist adherence and therapeutic alliance and their associations in cognitive-behavioural therapy (CBT) for adolescents with BED. In a randomised-controlled efficacy trial, adherence and alliance were objectively determined based on 247 audio-taped CBT sessions from a sample of N = 64 adolescents with BED. Variability of adherence and alliance, explained by treatment module, patient, and therapist were examined using multilevel modeling. Although adherence and alliance were excellent and unaffected by treatment module and therapist, there was significant between-patient variability for both concepts. Adherence was negatively associated with patient's treatment expectation. Alliance was negatively associated with the number of loss of control eating episodes and positively associated with adherence. Excellent adherence supported the internal validity of CBT for adolescent BED. Associations between process factors and patient characteristics demand adequate supervision in CBT.
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Affiliation(s)
- Hans-Christian Puls
- Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, Leipzig, Germany
| | - Ricarda Schmidt
- Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, Leipzig, Germany
| | - Anja Hilbert
- Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, Leipzig, Germany
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27
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Miniati M, Callari A, Maglio A, Calugi S. Interpersonal psychotherapy for eating disorders: current perspectives. Psychol Res Behav Manag 2018; 11:353-369. [PMID: 30233263 PMCID: PMC6130260 DOI: 10.2147/prbm.s120584] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Interpersonal psychotherapy (IPT) is a time-limited and affect-, life-event-, and present-focused psychotherapy originally conceptualized for unipolar depression, and then adapted to the treatment of other disorders, including eating disorders (EDs). The purpose of this paper is to conduct a systematic review of studies on IPT for EDs. Methods The authors performed literature searches, study selection, method, and quality evaluation independently. Data were summarized using a narrative approach. Results Of the 534 papers retrieved, 37 studies met the inclusion criteria, and 15 were considered for the systematic review (randomized controlled trials and long-term follow-up studies derived from the randomized controlled trials). Their analysis revealed six main findings: 1) no significant differences between IPT and cognitive-behavioral therapy (CBT) were found when administered as monotherapy to patients with anorexia nervosa; 2) when administered as monotherapy to patients with bulimia nervosa (BN), IPT had lower outcomes than CBT and its enhanced version; 3) patients with BN who remitted with IPT showed a prolonged time spent in clinical remission, when followed up on the long term; 4) IPT and CBT, with different timings and methods, have both shown efficacy in the mid-term/long-term period in patients with BN; 5) CBT and its enhanced version produced rapid changes in the acute phase. IPT led to improvements occurring later, with slower changes that tended to maintain efficacy in the long term; 6) abstinence from binge eating with group IPT for binge eating disorder is stable and maintained (or further improved) in the long term. Conclusion IPT is a reasonable, cost-effective alternative to CBT for the overall ED spectrum.
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Affiliation(s)
- Mario Miniati
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy,
| | - Antonio Callari
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy,
| | - Alessandra Maglio
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy,
| | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Verona, Italy
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28
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Hayes JF, Fitzsimmons-Craft EE, Karam AM, Jakubiak J, Brown ML, Wilfley DE. Disordered Eating Attitudes and Behaviors in Youth with Overweight and Obesity: Implications for Treatment. Curr Obes Rep 2018; 7:235-246. [PMID: 30069717 PMCID: PMC6098715 DOI: 10.1007/s13679-018-0316-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF THE REVIEW Children with obesity experience disordered eating attitudes and behaviors at high rates, which increases their risk for adult obesity and eating disorder development. As such, it is imperative to screen for disordered eating symptoms and identify appropriate treatments. RECENT FINDINGS Family-based multicomponent behavioral weight loss treatment (FBT) is effective at treating childhood obesity and demonstrates positive outcomes on psychosocial outcomes, including disordered eating. FBT utilizes a socio-ecological treatment approach that focuses on the development of individual and family healthy energy-balance behaviors as well as positive self- and body esteem, supportive family relationships, richer social networks, and the creation of a broader environment and community that facilitates overall physical and mental health. Existing literature suggests FBT is an effective treatment option for disordered eating and obesity in children. Future work is needed to confirm this conclusion and to examine the progression and interaction of obesity and disordered eating across development to identify the optimal time for intervention.
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Affiliation(s)
- Jacqueline F Hayes
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Ellen E Fitzsimmons-Craft
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Anna M Karam
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Jessica Jakubiak
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Mackenzie L Brown
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
| | - Denise E Wilfley
- Psychiatry Department, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA.
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29
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Grammer AC, Tanofsky-Kraff M, Burke NL, Byrne ME, Mi SJ, Jaramillo M, Shank LM, Kelly NR, Stojek MM, Schvey NA, Broadney MM, Brady SM, Yanovski SZ, Yanovski JA. An examination of the associations between pediatric loss of control eating, anxiety, and body composition in children and adolescents. Eat Behav 2018; 30:109-114. [PMID: 29990651 PMCID: PMC6075709 DOI: 10.1016/j.eatbeh.2018.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 06/25/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Data on the link between anxiety and body composition in youth are mixed. Yet, anxiety and disordered eating are highly correlated. One pathway between anxiety and excess body weight and fat mass may be through loss of control (LOC) eating. We examined whether LOC eating mediated the relationship between anxiety and body composition in youth with and without overweight. METHOD Non-treatment-seeking youth (8-17 years) participated in studies examining weight and eating behaviors. Anxiety (child- and parent-report of child) and LOC eating were assessed by self-report questionnaires and interviews, respectively. Fat mass was assessed by dual-energy x-ray absorptiometry or air displacement plethysmography. Cross-sectional mediation models with bias-corrected bootstrap confidence intervals (CI) were conducted. RESULTS 257 youth (12.91 ± 2.76 years; 52.5% female; BMI-z 0.93 ± 1.07) were studied. There was a significant indirect path between child-reported anxiety and both BMI-z (ab = .005, SE = 0.003, 95% CI = 0.001-0.01) and body fat mass (ab = 0.001, SE = 0.001, 95% CI ≤0.001-0.003) through the number of LOC episodes in the past month. No significant indirect paths through the number of LOC episodes was observed for parent-report of child anxiety on BMI-z (ab = 0.004, SE = 0.01, 95% CI = -0.01-0.03) or body fat mass (ab = 0.001, SE = 0.002, 95% CI = -0.002-0.01). No direct paths were observed between anxiety and body composition regardless of the informant. DISCUSSION LOC eating appears to mediate the relationship of child-reported anxiety with body composition in non-treatment seeking boys and girls. Prospective data are needed to determine if anxiety promotes LOC eating that results in increased risk for excess body weight and fat gain.
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Affiliation(s)
- Anne Claire Grammer
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - Natasha L. Burke
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Meghan E. Byrne
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Sarah J. Mi
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Manuela Jaramillo
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Lisa M. Shank
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA
| | - Nichole R. Kelly
- Counseling Psychology and Human Services, University of Oregon, 5207 University of Oregon, Eugene, OR 97403-5207
| | - Monika M. Stojek
- Department of Psychiatry and Behavioral Sciences, Emory University, 12 Executive Park Drive NE #300, Atlanta, GA 30329, USA
| | - Natasha A. Schvey
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Miranda M. Broadney
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Susan Z. Yanovski
- Office of Obesity Research, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
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30
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Vittengl JR. Mediation of the bidirectional relations between obesity and depression among women. Psychiatry Res 2018; 264:254-259. [PMID: 29655968 DOI: 10.1016/j.psychres.2018.03.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 01/05/2018] [Accepted: 03/08/2018] [Indexed: 11/27/2022]
Abstract
Past research established that obesity increases risk for development of depression, and depression increases risk for development of obesity. The current study tested physical impairment (difficulty with instrumental activities of daily living), social dysfunction (low social support and high social strain), and emotional eating (using food to cope with stress) as mediators of the bidirectional, longitudinal relations between depression and obesity. A national sample of mid-life adults in the United States (N = 7108) was assessed at three time points over 18 years. Depression predicted increases in obesity, and obesity predicted increases in depression, for women but not for men. Among women, path analyses revealed that physical impairment, social dysfunction, and emotional eating mediated development of obesity from depression, and that physical impairment and emotional eating mediated development of depression from obesity. These results suggest that prevention or treatment of obesity-linked depression and depression-linked obesity in women may need to address multiple connections between these disorders.
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31
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de Villiers B, Lionetti F, Pluess M. Vantage sensitivity: a framework for individual differences in response to psychological intervention. Soc Psychiatry Psychiatr Epidemiol 2018; 53:545-554. [PMID: 29302707 PMCID: PMC5959990 DOI: 10.1007/s00127-017-1471-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 12/11/2017] [Indexed: 11/15/2022]
Abstract
PURPOSE People differ significantly in their response to psychological intervention, with some benefitting more from treatment than others. According to the recently proposed theoretical framework of vantage sensitivity, some of this variability may be due to individual differences in environmental sensitivity, the inherent ability to register, and process external stimuli. In this paper, we apply the vantage sensitivity framework to the field of psychiatry and clinical psychology, proposing that some people are more responsive to the positive effects of psychological intervention due to heightened sensitivity. METHODS After presenting theoretical frameworks related to environmental sensitivity, we review a selection of recent studies reporting individual differences in the positive response to psychological intervention. RESULTS A growing number of studies report that some people benefit more from psychological intervention than others as a function of genetic, physiological, and psychological characteristics. These studies support the vantage sensitivity proposition that treatment response is influenced by factors associated with heightened sensitivity to environmental influences. More recently, studies have also shown that sensitivity can be measured with a short questionnaire which appears to predict the response to psychological intervention. CONCLUSIONS Vantage sensitivity is a framework with significant relevance for our understanding of widely observed heterogeneity in treatment response. It suggests that variability in response to treatment is partly influenced by people's differing capacity for environmental sensitivity, which can be measured with a short questionnaire. Application of the vantage sensitivity framework to psychiatry and clinical psychology may improve our knowledge regarding when, how, and for whom interventions work.
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Affiliation(s)
- Bernadette de Villiers
- Department of Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, G.E. Fogg Building, Office 2.01, Mile End Road, London, E1 4NS, UK
| | - Francesca Lionetti
- Department of Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, G.E. Fogg Building, Office 2.01, Mile End Road, London, E1 4NS, UK
| | - Michael Pluess
- Department of Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, G.E. Fogg Building, Office 2.01, Mile End Road, London, E1 4NS, UK.
- Centre for Economic Performance, London School of Economics, London, UK.
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32
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Shomaker LB, Kelly NR, Radin RM, Cassidy OL, Shank LM, Brady SM, Demidowich AP, Olsen CH, Chen KY, Stice E, Tanofsky-Kraff M, Yanovski JA. Prevention of insulin resistance in adolescents at risk for type 2 diabetes with depressive symptoms: 1-year follow-up of a randomized trial. Depress Anxiety 2017; 34:866-876. [PMID: 28370947 PMCID: PMC5623599 DOI: 10.1002/da.22617] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/24/2017] [Accepted: 02/07/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Depression is associated with poor insulin sensitivity. We evaluated the long-term effects of a cognitive behavioral therapy (CBT) program for prevention of depression on insulin sensitivity in adolescents at risk for type 2 diabetes (T2D) with depressive symptoms. METHODS One-hundred nineteen adolescent females with overweight/obesity, T2D family history, and mild-to-moderate depressive symptoms were randomized to a 6-week CBT group (n = 61) or 6-week health education (HE) control group (n = 58). At baseline, posttreatment, and 1 year, depressive symptoms were assessed, and whole body insulin sensitivity (WBISI) was estimated from oral glucose tolerance tests. Dual energy X-ray absorptiometry assessed fat mass at baseline and 1 year. Primary outcomes were 1-year changes in depression and insulin sensitivity, adjusting for adiposity and other relevant covariates. Secondary outcomes were fasting and 2-hr insulin and glucose. We also evaluated the moderating effect of baseline depressive symptom severity. RESULTS Depressive symptoms decreased in both groups (P < .001). Insulin sensitivity was stable in CBT and HE (ΔWBISI: .1 vs. .3) and did not differ between groups (P = .63). However, among girls with greater (moderate) baseline depressive symptoms (N = 78), those in CBT developed lower 2-hr insulin than those in HE (Δ-16 vs. 16 μIU/mL, P < .05). Additional metabolic benefits of CBT were seen for this subgroup in post hoc analyses of posttreatment to 1-year change. CONCLUSIONS Adolescent females at risk for T2D decreased depressive symptoms and stabilized insulin sensitivity 1 year following brief CBT or HE. Further studies are required to determine if adolescents with moderate depression show metabolic benefits after CBT.
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Affiliation(s)
- Lauren B. Shomaker
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS),Department of Human Development and Family Studies and Colorado School of Public Health, Colorado State University
| | - Nichole R. Kelly
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Counseling Psychology and Human Services and the Prevention Science Institute, College of Education, University of Oregon
| | - Rachel M. Radin
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Omni L. Cassidy
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Lisa M. Shank
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Sheila M. Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)
| | - Cara H. Olsen
- Biostatistics, Department of Preventive Medicine, Uniformed Services University of the Health Sciences
| | - Kong Y. Chen
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, NIH
| | | | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Jack A. Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)
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33
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Shomaker LB, Tanofsky-Kraff M, Matherne CE, Mehari RD, Olsen CH, Marwitz SE, Bakalar JL, Ranzenhofer LM, Kelly NR, Schvey NA, Burke NL, Cassidy O, Brady SM, Dietz LJ, Wilfley DE, Yanovski SZ, Yanovski JA. A randomized, comparative pilot trial of family-based interpersonal psychotherapy for reducing psychosocial symptoms, disordered-eating, and excess weight gain in at-risk preadolescents with loss-of-control-eating. Int J Eat Disord 2017; 50:1084-1094. [PMID: 28714097 PMCID: PMC5759342 DOI: 10.1002/eat.22741] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 06/21/2017] [Accepted: 06/21/2017] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Preadolescent loss-of-control-eating (LOC-eating) is a risk factor for excess weight gain and binge-eating-disorder. We evaluated feasibility and acceptability of a preventive family-based interpersonal psychotherapy (FB-IPT) program. FB-IPT was compared to family-based health education (FB-HE) to evaluate changes in children's psychosocial functioning, LOC-eating, and body mass. METHOD A randomized, controlled pilot trial was conducted with 29 children, 8 to 13 years who had overweight/obesity and LOC-eating. Youth-parent dyads were randomized to 12-week FB-IPT (n = 15) or FB-HE (n = 14) and evaluated at post-treatment, six-months, and one-year. Changes in child psychosocial functioning, LOC-eating, BMI, and adiposity by dual-energy-X-ray-absorptiometry were assessed. Missing follow-up data were multiply imputed. RESULTS FB-IPT feasibility and acceptability were indicated by good attendance (83%) and perceived benefits to social interactions and eating. Follow-up assessments were completed by 73% FB-IPT and 86% FB-HE at post-treatment, 60% and 64% at six-months, and 47% and 57% at one-year. At post-treatment, children in FB-IPT reported greater decreases in depression (95% CI -7.23, -2.01, Cohen's d = 1.23) and anxiety (95% CI -6.08, -0.70, Cohen's d = .79) and less odds of LOC-eating (95% CI -3.93, -0.03, Cohen's d = .38) than FB-HE. At six-months, children in FB-IPT had greater reductions in disordered-eating attitudes (95% CI -0.72, -0.05, Cohen's d = .66) and at one-year, tended to have greater decreases in depressive symptoms (95% CI -8.82, 0.44, Cohen's d = .69) than FB-HE. There was no difference in BMI gain between the groups. DISCUSSION Family-based approaches that address interpersonal and emotional underpinnings of LOC-eating in preadolescents with overweight/obesity show preliminary promise, particularly for reducing internalizing symptoms. Whether observed psychological benefits translate into sustained prevention of disordered-eating or excess weight gain requires further study.
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Affiliation(s)
- Lauren B. Shomaker
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Human Development and Family Studies/Colorado School of Public Health, Colorado State University, Campus Delivery 1570, Fort Collins, Colorado 80523, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Camden E. Matherne
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA,Department of Psychiatry, University of North Carolina School of Medicine, 101 Manning Dr., Chapel Hill, NC 27599, USA
| | - Rim D. Mehari
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Cara H. Olsen
- Department of Preventive Medicine and Biostatistics, USUHS, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Shannon E. Marwitz
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Jennifer L. Bakalar
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Lisa M. Ranzenhofer
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA,Eating Disorder Research Unit, New York State Psychiatric Institute Columbia University Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Nichole R. Kelly
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Counseling Psychology and Human Services and the Prevention Science Institute, College of Education, University of Oregon, College of Education, University of Oregon, Eugene, OR 97403, USA
| | - Natasha A. Schvey
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Natasha L. Burke
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Omni Cassidy
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Laura J. Dietz
- Department of Psychology, University of Pittsburgh at Johnstown, 450 Schoolhouse Road, Johnstown, PA 15904, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, Campus Box 8134, St. Louis, MO 63110, USA
| | - Susan Z. Yanovski
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK), NIH, 6707 Democracy Blvd, Rm 6025, Bethesda, MD 20892-5450, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
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Burke NL, Shomaker LB, Brady S, Reynolds JC, Young JF, Wilfley DE, Sbrocco T, Stephens M, Olsen CH, Yanovski JA, Tanofsky-Kraff M. Impact of Age and Race on Outcomes of a Program to Prevent Excess Weight Gain and Disordered Eating in Adolescent Girls. Nutrients 2017; 9:nu9090947. [PMID: 28846646 PMCID: PMC5622707 DOI: 10.3390/nu9090947] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 08/23/2017] [Accepted: 08/23/2017] [Indexed: 01/23/2023] Open
Abstract
Interpersonal psychotherapy (IPT) prevents weight gain and reduces loss-of-control (LOC)-eating in adults. However, IPT was not superior to health-education (HE) for preventing excess weight gain and reducing LOC-eating over 1-year in adolescent girls at risk for excess weight gain and eating disorders. Limited data suggest that older and non-White youth may be especially responsive to IPT. In secondary analyses, we examined if age or race moderated weight and LOC-eating outcomes. The 113 participants (12–17 years; 56.6% White) from the original trial were re-contacted 3 years later for assessment. At baseline and follow-up visits through 3 years, we assessed BMI, adiposity by dual energy X-ray absorptiometry, and LOC-eating presence. In linear mixed models, baseline age moderated 3-year BMI outcome; older girls in IPT had the lowest 3-year BMI gain compared to younger girls in IPT and all girls in HE, p = 0.04. A similar pattern was observed for adiposity. Race moderated 3-year LOC-eating; non-White girls in IPT were most likely to abstain from LOC-eating at 3 years compared to all other girls, p = 0.04. This hypothesis-generating analysis suggests future studies should determine if IPT is especially efficacious at reducing LOC-eating in older, non-White adolescents.
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Affiliation(s)
- Natasha L Burke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), US Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA.
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, 303 Behavioral Sciences Building, 1570 Campus Delivery, Fort Collins, CO 80523, USA.
| | - Sheila Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), US Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA.
| | - James C Reynolds
- Radiology and Imaging Sciences Department, Warren Grant Magnuson Clinical Center, National Institutes of Health (NIH), US Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA.
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA.
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, Campus Box 8134, St. Louis, MO 63110, USA.
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
| | - Mark Stephens
- Department of Family and Community Medicine, Pennsylvania State University, 1850 E. Park Avenue, Suite 207, State College, PA 16803, USA.
| | - Cara H Olsen
- Department of Preventative Medicine & Biometrics, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
| | - Jack A Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), US Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA.
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), US Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA.
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Shank LM, Crosby RD, Grammer AC, Shomaker LB, Vannucci A, Burke NL, Stojek M, Brady SM, Kozlosky M, Reynolds JC, Yanovski JA, Tanofsky-Kraff M. Examination of the interpersonal model of loss of control eating in the laboratory. Compr Psychiatry 2017; 76:36-44. [PMID: 28410467 PMCID: PMC5478390 DOI: 10.1016/j.comppsych.2017.03.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/04/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The interpersonal model of loss of control (LOC) eating proposes that interpersonal problems lead to negative affect, which in turn contributes to the onset and/or persistence of LOC eating. Despite preliminary support, there are no data examining the construct validity of the interpersonal model of LOC eating using temporally sensitive reports of social stress, distinct negative affective states, and laboratory energy intake. METHOD 117 healthy adolescent girls (BMI: 75th-97th %ile) were recruited for a prevention trial targeting excess weight gain in adolescent girls who reported LOC eating. Prior to the intervention, participants completed questionnaires of recent social stress and consumed lunch from a multi-item laboratory test meal. Immediately before the test meal, participants completed a questionnaire of five negative affective states (anger, confusion, depression, fatigue, anxiety). Bootstrapping mediation models were conducted to evaluate pre-meal negative affect states as explanatory mediators of the association between recent social stress and palatable (desserts and snack-type) food intake. All analyses adjusted for age, race, pubertal stage, height, fat mass percentage, and lean mass. RESULTS Pre-meal state anxiety was a significant mediator for recent social stress and palatable food intake (ps<.05). By contrast, pre-meal state anger, confusion, depression, and fatigue did not mediate the relationship between social stress and palatable food intake (ps>.05). DISCUSSION Pre-meal anxiety appears to be the salient mood state for the interpersonal model among adolescent girls with LOC eating. Interventions that focus on improving both social functioning and anxiety may prove most effective at preventing and/or ameliorating disordered eating and obesity in these adolescents.
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Affiliation(s)
- Lisa M. Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA
| | - Ross D. Crosby
- Department of Biomedical Statistics & Methodology, Neuropsychiatric Research Institute, 120 Eighth Street South, Fargo, ND, 58107, USA
| | - Anne Claire Grammer
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Lauren B. Shomaker
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Department of Human Development and Family Studies and Colorado School of Public Health, Colorado State University, Fort Collins, CO 80523-1570, USA
| | - Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Natasha L. Burke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Monika Stojek
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Merel Kozlosky
- Nutrition Department, Clinical Center, NIH, DHHS, 10 Center Drive, Bethesda. MD 20892, USA
| | - James C. Reynolds
- Radiology and Imaging Sciences Department, Warren Grant Magnuson Clinical Center, NIH, DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA.
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