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Byrne ME, Shank LM, Lavender JM, Higgins-Neyland MK, Rice A, Sweeney RS, Norton C, Haigney M, Yanovski JA, Tanofsky-Kraff M. A systematic review and meta-analysis of loss-of-control eating in relation to cardiometabolic health components and inflammatory markers. Obes Rev 2024; 25:e13805. [PMID: 39103303 DOI: 10.1111/obr.13805] [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: 09/25/2023] [Revised: 04/10/2024] [Accepted: 06/27/2024] [Indexed: 08/07/2024]
Abstract
INTRODUCTION Loss-of-control (LOC) eating, or the subjective experience of being unable to stop eating, is a hallmark feature of binge-eating episodes, which are also characterized by consuming an unusually large amount of food. However, regardless of the size of eating episode, LOC-eating may be a risk factor for adverse health outcomes. This systematic review and meta-analysis comprehensively examine the relationship of LOC-eating with cardiometabolic health components and inflammatory markers. METHODS Search procedures were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines in six electronic databases. Studies of adult or youth samples published in English from the year 2000 onward were included. Given heterogeneity in age groups and adjustment for body mass index across studies, these factors were included as meta-regression moderators. RESULTS Fifty-eight studies were identified through the literature search. Among individuals with (versus without) LOC-eating, relative risk ratios provided evidence of a greater relative risk for metabolic syndrome, hypertension, and dyslipidemia; standardized mean differences also provided evidence of higher waist circumference and impaired levels of fasting plasma glucose, high-density lipoprotein (HDL)-cholesterol, and triglycerides, but not blood pressure. Age group did not impact cardiometabolic health components. Body mass index differences moderated the effect on waist circumference. A narrative review of inflammatory markers revealed mixed findings linking inflammatory markers to LOC-eating. DISCUSSION Overall, evidence for the relationship between LOC-eating and impaired cardiometabolic health underscores LOC-eating as an important early intervention target for prevention of serious adverse health outcomes.
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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), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Lisa M Shank
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
- Department of Medical and Clinical Psychology, USUHS, Bethesda, MD, USA
| | - Jason M Lavender
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
- Metis Foundation, San Antonio, TX, USA
| | - Mary Katy Higgins-Neyland
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
- Metis Foundation, San Antonio, TX, USA
| | - Alexander Rice
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
- Metis Foundation, San Antonio, TX, USA
| | - Regan S Sweeney
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
- Metis Foundation, San Antonio, TX, USA
| | | | - Mark Haigney
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Marian Tanofsky-Kraff
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
- Department of Medical and Clinical Psychology, USUHS, Bethesda, MD, USA
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
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Monserrat Hernández M, Jiménez-Rodríguez D. Relationship of Genetic Polymorphisms and Microbial Composition with Binge Eating Disorder: A Systematic Review. Healthcare (Basel) 2024; 12:1441. [PMID: 39057584 PMCID: PMC11276772 DOI: 10.3390/healthcare12141441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/12/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
Humans are the result of an evolutionary process, and because of this, many biological processes are interconnected with each other. The intestine-brain axis consists of an intricately connected neuronal-neuroendocrine circuit that regulates the sensation of hunger and satiety. Genetic variations and the consumption of unnatural diets (ultra-processed foods, high contents of sugars, etc.) can override this circuit and cause addiction to certain foods and/or the inability to feel satiety in certain situations. The patients who come to consultations (mainly psychology or nutrition) in an attempt to resolve this problem sometimes fail, which leads to them looking for new strategies based on biological predisposition. This investigation aims to evaluate the genetic studies regarding the microbiota carried out in the last 12 years in humans to try to determine which genes and microbes that have been recently studied are related to patients diagnosed with binge eating disorder or compulsive eating (presenting obesity or not). The protocol followed the PRISMA statement, and the following databases were searched from 2012 until the present day: PubMed, PsycINFO, SCOPUS, and Web of Science. Twenty-four international articles were analyzed, including cross-sectional or exploratory studies; five of them referred to the microbial composition, and in nineteen, the existence of genetic polymorphisms present in binge eating disorder or in compulsive eating could be observed: DRD2, OPRM1, COMT, MC4R, BNDF, FTO, SLC6A3, GHRL, CARTPT, MCHR2, and LRP11. Even though there is still much to investigate on the subject, it must be highlighted that, in the last 4 years, a two-fold increase has been observed in potential markers and in studies related to the matter, also highlighting the importance of different analyses in relation to psychosocial factors and their interaction with the genetic and microbial factors, for which research on the matter must be continued.
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Affiliation(s)
| | - Diana Jiménez-Rodríguez
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain;
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Campanile AA, Eckel LA, Keel PK. Elevated interleukin-6 in women with binge-eating spectrum disorders. Int J Eat Disord 2024; 57:1510-1517. [PMID: 38445571 PMCID: PMC11262979 DOI: 10.1002/eat.24183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/22/2024] [Accepted: 02/21/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Binge-eating spectrum disorders (BESD) involve large eating episodes accompanied by a sense of loss of control that occur in individuals with body weights spanning the full body mass index (BMI) spectrum. While research links BESD with peripheral inflammation, this literature is limited by underpowered studies and a failure to control for confounding variables that could promote inflammation independent of dysregulated eating, specifically elevated body adiposity and depression. Our study examined plasma interleukin-6 (IL-6), a marker of peripheral inflammation, in a sample of women with BESD and non-eating disorder controls, controlling for BMI, body adiposity, and depression. METHOD Participants (N = 94) included women with BESD (n = 73) or no eating disorder (n = 21) who completed structured clinical interviews in a larger study, selected to represent BMI categories ranging from underweight to obese in both groups. Fasting blood samples were processed for plasma IL-6 concentration via enzyme-linked immunosorbent assays. In addition to assessing group differences in plasma IL-6, exploratory analyses examined associations between IL-6 and biological and clinical markers of BESD. RESULTS Significantly elevated plasma IL-6 was found in women with BESD, relative to controls, that was not accounted for by BMI, adiposity, or depression. Plasma IL-6 was positively correlated with plasma leptin concentration, clinical assessments of eating disorder severity, and participants' largest self-reported eating episode. DISCUSSION Peripheral inflammation is specifically linked to presence of dysregulated eating independently from weight, adiposity, and depression in BESD. Future research should probe the potential role of neuroinflammation in altered eating behavior. PUBLIC SIGNIFICANCE This study provides the first demonstration that inflammation, characterized by elevated plasma IL-6 concentration, is uniquely associated with dysregulated eating in a transdiagnostic group of individuals with BESD. A better understanding of whether immune factors contribute to dysregulated eating could help identify novel biological targets for intervention.
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Affiliation(s)
- Alexis A. Campanile
- Division of Pharmacology and Toxicology, College of Pharmacy, University of Texas at Austin, Austin, Texas, USA
| | - Lisa A. Eckel
- Program in Neuroscience, Florida State University, Tallahassee, Florida, USA
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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Mohammedsaeed W, El Shikieri AB. Cardiometabolic Risk Factors among Women with Eating Disorders in Saudi Arabia. J Nutr Metab 2024; 2024:5953893. [PMID: 38867850 PMCID: PMC11168801 DOI: 10.1155/2024/5953893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 06/14/2024] Open
Abstract
Objective To assess selected cardiometabolic risk factors among Saudi women with eating disorders. Methods An epidemiological, cross-sectional study included women aged between 18 and 50 years with eating disorders (EDs). Women with chronic diseases, pregnant, or lactating were excluded. The weight and height were measured for the calculation of the body mass index (BMI). Fasting blood samples were drawn for the analysis of blood sugar, glycated haemoglobin, lipid profile, albumin, haemoglobin, and C-reactive levels. The atherogenic dyslipidemia index (AIP) was also calculated. Results Patients (n = 100) were enrolled. Fasting blood glucose levels were critically low among women with anorexia nervosa (AN) and bulimia nervosa (BN) but normal among those with binge eating disorders (BEDs). All women with ED suffered from anaemia based on their haemoglobin levels as well as dyslipidemia, hypoalbuminaemia, and high C-reactive protein levels. Women with AN had low cardiovascular (CV) risks based on their normal AIP values. However, women with BN and BED had intermediate CV risks. On average, women with AN suffered from severe thinness and those with BN had normal BMIs, whereas those with BED were overweight. Women (90%) with BN and BED were overweight and/or obese. Conclusion Women with ED had a high risk of cardiovascular diseases defined by their hypoalbuminaemia, dyslipidemia, anaemia, and high AIP levels. Dietitians and psychiatrists are advised to collaborate in assessing the potential risk of having eating disorders to provide counselling sessions to women on healthy balanced diets and their effect on health.
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Affiliation(s)
- Walaa Mohammedsaeed
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Science at Taibah University, Madinah, Saudi Arabia
| | - Ahlam B. El Shikieri
- Department of Clinical Nutrition, College of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia
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Camacho-Barcia L, Giel KE, Jiménez-Murcia S, Álvarez Pitti J, Micali N, Lucas I, Miranda-Olivos R, Munguia L, Tena-Sempere M, Zipfel S, Fernández-Aranda F. Eating disorders and obesity: bridging clinical, neurobiological, and therapeutic perspectives. Trends Mol Med 2024; 30:361-379. [PMID: 38485648 DOI: 10.1016/j.molmed.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 04/13/2024]
Abstract
Eating disorders (EDs) and obesity are complex health conditions sharing various risk and maintenance factors, intensified in cases of comorbidity. This review explores the similarities and connections between these conditions, examining different facets from a multidisciplinary perspective, among them comorbidities, metabolic and psychological factors, neurobiological aspects, and management and therapy implications. We aim to investigate the common characteristics and complexities of weight and EDs and explore their interrelationships in individuals who experience both. The rising prevalence of EDs in people with obesity necessitates integrated approaches to study this comorbidity and to identify and analyze both common and distinct features of these conditions. This review may offer new opportunities for simultaneous prevention and management approaches, as well as future lines of research.
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Affiliation(s)
- Lucia Camacho-Barcia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany; Centre of Excellence for Eating Disorders (KOMET), University of Tübingen, Tübingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Julio Álvarez Pitti
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain; Innovation in Paediatrics and Technologies-iPEDITEC- research group, Research Foundation, Consorcio Hospital General, University of Valencia, Valencia, Spain
| | - Nadia Micali
- Eating Disorders Research Unit, Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark; Great Ormond Street Institute of Child Health, University College London, London, UK; Institute of Biological Psychiatry, Psychiatric Center Sct. Hans, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Ignacio Lucas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Romina Miranda-Olivos
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucero Munguia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Tena-Sempere
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain
| | - Stephan Zipfel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany; Centre of Excellence for Eating Disorders (KOMET), University of Tübingen, Tübingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Downey AE, Odette M, Sanders AE, Kuykendall M, Saunders E, Nagata JM, Forsberg S, Buckelew SM, Garber AK. What medical providers need to elevate outpatient care for adolescents and young adults with binge-eating disorder: A novel protocol. Int J Eat Disord 2024; 57:294-302. [PMID: 38130097 DOI: 10.1002/eat.24110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE Binge-eating disorder (BED) in adolescents and young adults is underrecognized and understudied and no standardized guidelines exist for medical providers caring for this population. To highlight the lack of extant evidence, we examine the demographic characteristics of youth with BED in an academic eating disorders (EDs) program and primary care clinic and describe the needs of their medical care providers. METHOD A retrospective chart review was conducted for patients who met criteria for BED from July 2021 to June 2022. We surveyed their medical providers to understand their needs in caring for this population. A multidisciplinary team with expertise in the care of youth with EDs amalgamated current evidence in caring for youth with BED into a protocolized care schema designed for implementation in the outpatient medical setting. RESULTS Eighteen youth with BED were reviewed, 14 identified as female, 3 as male, and 1 as "Other." Average age was 15.4 (2.7) years old, and mean body mass index was 35.90 (8.25). 33.3% (6) patients identified as White/Caucasian, followed by 22.2% (4) Hispanic/Latinx. Eleven of 18 were privately insured. The most common medical recommendations were for regular meals and snacks and for individual psychotherapy. Medical providers desired more education about identification and management of youth with BED. CONCLUSIONS To address the lack of medical care guidelines for youth with BED, recommendations in this Forum include: increased education for medical providers, standardized medical monitoring, an emphasis on psychotherapy, and a weight-inclusive orientation. PUBLIC SIGNIFICANCE Adolescents and young adults with BED are underrecognized and undertreated. Little is known about the characteristics of these patients and the medical care these patients receive within academic EDs program. For the first time, preliminary recommendations for medical care are provided.
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Affiliation(s)
- Amanda E Downey
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Michelle Odette
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Austin E Sanders
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Mikayla Kuykendall
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Elizabeth Saunders
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Sarah Forsberg
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Sara M Buckelew
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Andrea K Garber
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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Chen JY, Oh Y, Kounios J, Lowe MR. An examination of frontal asymmetry in relation to eating in the absence of hunger and loss-of-control eating. Appetite 2023; 191:107090. [PMID: 37871365 DOI: 10.1016/j.appet.2023.107090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 10/06/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023]
Abstract
Loss-of-control (LOC) eating involves a subjective feeling that one cannot stop eating or control one's eating. Individuals with LOC eating may exhibit strong appetitive drives and weak inhibitory control, and these two opposing motivations have been related to EEG measurements of frontal asymmetry or lateralized frontal activation. The present study investigated whether frontal asymmetry is related to hedonic hunger, LOC eating severity and frequency, and eating in the absence of hunger (EAH) in the laboratory. Fifty-nine individuals participated in an ostensible taste study after resting-state electroencephalogram (EEG) recordings. After the EEGs, they were provided a meal to eat until fullness, followed by an array of snacks and instructions to eat as much as they would like. The results indicated that several measures of right-frontal asymmetry were related to greater EAH and greater self-reported LOC eating severity. Although right-frontal asymmetry has been theorized to reflect avoidance motivation, recent evidence suggests it may indicate effortful control during approach-avoidance conflicts. Because individuals with LOC eating presumably experience heightened conflict between drives to eat beyond energy needs and to minimize such eating, those experiencing greater LOC may exert greater effort to manage these conflicting motivations. An integration of these neurobiological correlates of LOC eating may help provide a more comprehensive understanding of LOC eating and inform treatments.
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Affiliation(s)
- Joanna Y Chen
- Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA, 19104, USA.
| | - Yongtaek Oh
- Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA, 19104, USA
| | - John Kounios
- Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA, 19104, USA
| | - Michael R Lowe
- Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA, 19104, USA
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Binsaeed B, Aljohani FG, Alsobiai FF, Alraddadi M, Alrehaili AA, Alnahdi BS, Almotairi FS, Jumah MA, Alrehaili AT. Barriers and Motivators to Weight Loss in People With Obesity. Cureus 2023; 15:e49040. [PMID: 38116343 PMCID: PMC10729542 DOI: 10.7759/cureus.49040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION Obesity has become a global public health challenge with associated health risks. Effective weight-loss interventions are crucial to mitigating these risks and improving overall well-being. However, individuals with obesity often encounter various barriers that hinder their weight loss efforts, while specific motivators can drive them towards successful outcomes. This systematic review aimed to explore the barriers and motivators to weight loss in people with obesity. METHODS A literature search was conducted using relevant keywords in electronic databases such as PubMed, Medline, PsycINFO, and Google Scholar. Studies published in peer-reviewed journals during the last 10 years were considered for inclusion. We included studies investigating both barriers and/or motivators to weight loss published in English. RESULTS The findings showed that motivators for weight loss include health concerns, body satisfaction, family support, normalcy restoration, emotional encouragement, self-determination, and mindful food choices. Motivators involve exercise facilities, balanced diets, and assistance from healthcare providers, peers, friends, or family. Gender influences healthcare providers' influence on weight loss, with women trusting providers more while men lean towards medication options. Healthcare providers play a role in impacting weight loss through discussions and educating patients. Age also influences motivators; adolescents emphasize health, self-esteem, and bullying avoidance, while young women focus on lifestyle influence, resources, and joy. Barriers include insufficient self-control, physical pain, time constraints, dietary restrictions, and a lack of support. Logistical issues, patient readiness, healthcare providers' views, resource scarcity, and social dynamics are also barriers. Dietary barriers involve triggers, emotional states, and limited healthy options. School-aged children with obesity face curriculum challenges and resource scarcity. CONCLUSION These findings show the intricate interplay between motivators and barriers, underscoring the multifaceted nature of weight loss in people with obesity. Targeted interventions that address these factors holistically are essential for successful weight management.
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Affiliation(s)
| | | | | | | | - Alya A Alrehaili
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Bushra S Alnahdi
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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Burstein D, Griffen TC, Therrien K, Bendl J, Venkatesh S, Dong P, Modabbernia A, Zeng B, Mathur D, Hoffman G, Sysko R, Hildebrandt T, Voloudakis G, Roussos P. Genome-wide analysis of a model-derived binge eating disorder phenotype identifies risk loci and implicates iron metabolism. Nat Genet 2023; 55:1462-1470. [PMID: 37550530 PMCID: PMC10947608 DOI: 10.1038/s41588-023-01464-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/29/2023] [Indexed: 08/09/2023]
Abstract
Binge eating disorder (BED) is the most common eating disorder, yet its genetic architecture remains largely unknown. Studying BED is challenging because it is often comorbid with obesity, a common and highly polygenic trait, and it is underdiagnosed in biobank data sets. To address this limitation, we apply a supervised machine-learning approach (using 822 cases of individuals diagnosed with BED) to estimate the probability of each individual having BED based on electronic medical records from the Million Veteran Program. We perform a genome-wide association study of individuals of African (n = 77,574) and European (n = 285,138) ancestry while controlling for body mass index to identify three independent loci near the HFE, MCHR2 and LRP11 genes and suggest APOE as a risk gene for BED. We identify shared heritability between BED and several neuropsychiatric traits, and implicate iron metabolism in the pathophysiology of BED. Overall, our findings provide insights into the genetics underlying BED and suggest directions for future translational research.
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Affiliation(s)
- David Burstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2 South), James J. Peters VA Medical Center, New York, NY, USA
| | - Trevor C Griffen
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Karen Therrien
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2 South), James J. Peters VA Medical Center, New York, NY, USA
| | - Jaroslav Bendl
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sanan Venkatesh
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2 South), James J. Peters VA Medical Center, New York, NY, USA
| | - Pengfei Dong
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Biao Zeng
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deepika Mathur
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gabriel Hoffman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robyn Sysko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tom Hildebrandt
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Georgios Voloudakis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Mental Illness Research, Education, and Clinical Center (VISN 2 South), James J. Peters VA Medical Center, New York, NY, USA.
| | - Panos Roussos
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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10
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Bauman V, Sanchez N, Repke HE, Spinner H, Thorstad I, Gulley LD, Mains AM, Lavender JM, Thompson KA, Emerick JE, Thomas V, Arnold TB, Heroy A, Gutierrez-Colina AM, Haigney MC, Shomaker LB, Tanofsky-Kraff M. Loss of control eating in relation to blood pressure among adolescent girls with elevated anxiety at-risk for excess weight gain. Eat Behav 2023; 50:101773. [PMID: 37343482 DOI: 10.1016/j.eatbeh.2023.101773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
Loss of control (LOC)-eating, excess weight, and anxiety are robustly linked, and are independently associated with markers of poorer cardiometabolic health, including hypertension. However, no study has examined whether frequency of LOC-eating episodes among youth with anxiety symptoms and elevated weight status may confer increased risk for hypertension. We examined the relationship between LOC-eating frequency and blood pressure among 39 adolescent girls (14.9 ± 1.8 years; body mass index [BMI] = 29.9 ± 5.6; 61.5 % White; 20.5 % African American/Black; 5 % Multiple Races; 2.5 % Asian; 12.8 % Hispanic/Latino; 30.8 % with reported LOC-eating) with elevated anxiety and above average BMI who enrolled in a clinical trial aimed at preventing excess weight gain. LOC-eating over the past three months was assessed via clinical interview, and blood pressure (systolic and diastolic) was measured with an automatic blood pressure monitor. Adjusting for age, fat mass, and height, LOC-eating episode frequency was significantly, positively associated with diastolic blood pressure (β = 0.38, p = 0.02), but not with systolic blood pressure (β = 0.13, p = 0.41). Replication studies, with larger sample sizes, participants of varying weight-strata, and prospective data are required to elucidate the relationship between LOC-eating and cardiovascular functioning in youth with elevated anxiety.
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Affiliation(s)
- Viviana Bauman
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Natalia Sanchez
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523, USA
| | - Hannah E Repke
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Holly Spinner
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Isabel Thorstad
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Lauren D Gulley
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523, USA; Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, CO 80045, USA
| | - Autumn M Mains
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Katherine A Thompson
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Jill E Emerick
- Department of Pediatrics, Uniformed Services University, Bethesda, MD 20814, USA
| | - Victoria Thomas
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Thomas B Arnold
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Andrew Heroy
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Ana M Gutierrez-Colina
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523, USA; Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, CO 80045, USA
| | - Mark C Haigney
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523, USA; Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, CO 80045, USA; Colorado School of Public Health, Aurora, CO 80045, USA
| | - Marian Tanofsky-Kraff
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD 20814, USA.
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11
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Behnoush AH, Bahiraie P, Shokri Varniab Z, Foroutani L, Khalaji A. Composite lipid indices in patients with obstructive sleep apnea: a systematic review and meta-analysis. Lipids Health Dis 2023; 22:84. [PMID: 37386562 DOI: 10.1186/s12944-023-01859-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/23/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND One of the most prevalent sleep disorders affecting the individual's daily life is obstructive sleep apnea (OSA), for which obesity is a major risk factor. Several novel lipid indices have been suggested to have associations with OSA, among which visceral adiposity index (VAI), atherogenic index of plasma (AIP), and lipid accumulation product (LAP) are the most important ones. Herein, the current study aimed to systematically investigate the association between these indices and OSA. METHODS Four international databases, including PubMed, Scopus, the Web of Science, and Embase were searched in order to find relevant studies that investigated LAP, VAI, or AIP in OSA and compared them with non-OSA cases or within different severities of OSA. Random-effect meta-analysis was used to generate the standardized mean difference (SMD) and 95% confidence interval (CI) of the difference in lipid indices between OSA and non-OSA cases. Moreover, the pooled area under the receiver operating characteristic curves (AUCs) observed in individual studies for diagnosis of OSA based on these lipid indices were calculated by random-effect meta-analysis. RESULTS Totally 14 original studies were included, comprised of 14,943 cases. AIP, LAP, and VAI were assessed in eight, five, and five studies, respectively. Overall, these lipid indices had acceptable diagnostic ability (AUC 0.70, 95% CI 0.67 to 073). Meta-analysis revealed that AIP was significantly higher in patients with OSA (SMD 0.71, 95% CI 0.45 to 0.97, P < 0.01). Moreover, AIP also increased in higher severities of OSA. Regarding LAP, a higher LAP was observed in OSA/patients with high risk for OSA rather than in controls/low risk for OSA (SMD 0.53, 95% CI 0.25 to 0.81, P < 0.01). VAI was also increased in OSA based on results from two studies. CONCLUSION These findings suggest that composite lipid indices are increased in OSA. Also, these indices can have the potential beneficiary diagnostic and prognostic ability in OSA. Future studies can confirm these findings and enlighten the role of lipid indices in OSA.
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Affiliation(s)
- Amir Hossein Behnoush
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Bahiraie
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Shokri Varniab
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Pediatric Urology and Regenerative Medicine Research Center, Gene, Cell and Tissue Research Institute, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Laleh Foroutani
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirmohammad Khalaji
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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12
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Hooper SC, Espinoza SE, Marshall VB, Kilpela LS. The Clinical Phenotype of Binge Eating Disorder among Postmenopausal Women: A Pilot Study. Nutrients 2023; 15:2087. [PMID: 37432212 PMCID: PMC10180572 DOI: 10.3390/nu15092087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/19/2023] [Accepted: 04/22/2023] [Indexed: 07/12/2023] Open
Abstract
Binge eating disorder (BED), a form of overnutrition, may impact healthy aging for postmenopausal women. In community samples, 12-26% of older women (ages 60+) engage in binge eating. In younger adults, BED is comorbid with physical and psychological morbidities. However, little is known regarding the clinical phenotype, including medical and psychiatric comorbidities, of BED in postmenopausal women. This pilot study sought to identify psychosomatic, cardiometabolic, body composition, and physical function characteristics of postmenopausal, older adult (age ≥60 years) women with BED. Participants (N = 21, ages 60-75) completed a battery of physical assessments and surveys assessing psychosomatic health. Overall, 62% of women reported BE onset during peri- or post-menopause. Rates of comorbid depression, anxiety, sleep problems, and a history of severe menopausal symptoms were high. Cardiometabolic health was poor, and 42.9% met the criteria for metabolic syndrome. Additionally, 71.4% met the BMI criteria for obesity, and 40% of this sample met the criteria for sarcopenic obesity. Almost half of the sample presented with at least one mobility limitation; 85.7% had poor endurance. Evidence suggests that BED is highly comorbid with other chronic health conditions and may complicate treatment of these conditions, warranting further investigation and increased attention from healthcare providers serving postmenopausal women.
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Affiliation(s)
- Savannah C. Hooper
- ReACH Center, UT Health San Antonio, San Antonio, TX 78229, USA
- Barshop Institute for Longevity and Aging Studies, UT Health San Antonio, San Antonio, TX 78229, USA
| | - Sara E. Espinoza
- Barshop Institute for Longevity and Aging Studies, UT Health San Antonio, San Antonio, TX 78229, USA
- Division of Geriatrics, Gerontology and Palliative Medicine, Department of Medicine, UT Health San Antonio, San Antonio, TX 78229, USA
- Geriatrics Research, Education, and Clinical Center, South Texas VA Healthcare System, San Antonio, TX 78229, USA
| | - Victoria B. Marshall
- ReACH Center, UT Health San Antonio, San Antonio, TX 78229, USA
- Barshop Institute for Longevity and Aging Studies, UT Health San Antonio, San Antonio, TX 78229, USA
| | - Lisa S. Kilpela
- ReACH Center, UT Health San Antonio, San Antonio, TX 78229, USA
- Barshop Institute for Longevity and Aging Studies, UT Health San Antonio, San Antonio, TX 78229, USA
- Division of Geriatrics, Gerontology and Palliative Medicine, Department of Medicine, UT Health San Antonio, San Antonio, TX 78229, USA
- Geriatrics Research, Education, and Clinical Center, South Texas VA Healthcare System, San Antonio, TX 78229, USA
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13
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Baenas I, Miranda-Olivos R, Solé-Morata N, Jiménez-Murcia S, Fernández-Aranda F. Neuroendocrinological factors in binge eating disorder: A narrative review. Psychoneuroendocrinology 2023; 150:106030. [PMID: 36709632 DOI: 10.1016/j.psyneuen.2023.106030] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/30/2023]
Abstract
Neuroendocrine mechanisms play a key role in the regulation of eating behavior. In individuals with binge eating disorder (BED), alterations in these mechanisms signaling hunger and satiety have been observed. It has been investigated that these alterations may underlie the development and maintenance of compulsive overeating in BED. The present narrative review examined the current literature related to the neurobiological processes involved in feeding dysregulation in BED with the aim of updating the most relevant aspects with special attention to neuroendocrine signaling. Studies have shown both central and peripheral endocrine dysfunctions in hormones participating in homeostatic and hedonic pathways in BED. Most studies have been especially focused on orexigenic signals, pointing out the existence of a hyperactivated mechanism promoting hunger. Fewer studies have explored anorexigenic pathways, but the findings so far seem to suggest an abnormal satiety threshold. Despite this, to date, it is unable to identify whether these alterations are typical of the BED pathophysiology or are related to an obesogenic pattern due to most studies included patients with BED and obesity. The identification of endophenotypes in BED may provide a new approach to aberrant eating behavior, favoring the implementation of biological therapeutic targets.
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Affiliation(s)
- Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Romina Miranda-Olivos
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Neus Solé-Morata
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain.
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain.
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain.
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14
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Presseller EK, Patarinski AGG, Zhang F, Page KA, Srivastava P, Manasse SM, Juarascio AS. Glucose variability: A physiological correlate of eating disorder behaviors among individuals with binge-spectrum eating disorders. Int J Eat Disord 2022; 55:1788-1798. [PMID: 36305323 PMCID: PMC11256202 DOI: 10.1002/eat.23838] [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: 06/07/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Elevated glucose variability may be one mechanism that increases risk for significant psychological and physiological health conditions among individuals with binge-spectrum eating disorders (B-EDs), given the impact of eating disorder (ED) behaviors on blood glucose levels. This study aimed to characterize glucose variability among individuals with B-EDs compared with age-matched, sex-matched, and body mass index-matched controls, and investigate the association between frequency of ED behaviors and glucose variability. METHODS Participants were 52 individuals with B-EDs and 22 controls who wore continuous glucose monitors to measure blood glucose levels and completed ecological momentary assessment surveys to measure ED behaviors for 1 week. Independent samples t-tests compared individuals with B-EDs and controls and multiple linear regression models examined the association between ED behaviors and glucose variability. RESULTS Individuals with B-EDs demonstrated numerically higher glucose variability than controls (t = 1.42, p = .08, d = 0.43), although this difference was not statistically significant. When controlling for covariates, frequency of ED behaviors was significantly, positively associated with glucose variability (t = 3.17, p = .003) with medium effect size (f2 = 0.25). Post hoc analyses indicated that binge eating frequency was significantly associated with glucose variability, while episodes of 5+ hours without eating were not. DISCUSSION Glucose variability among individuals with B-EDs appears to be positively associated with engagement in ED behaviors, particularly binge eating. Glucose variability may be an important mechanism by which adverse health outcomes occur at elevated rates in B-EDs and warrants future study. PUBLIC SIGNIFICANCE This study suggests that some individuals with binge ED and bulimia nervosa may experience elevated glucose variability, a physiological symptom that is linked to a number of adverse health consequences. The degree of elevation in glucose variability is positive associated with frequency of eating disorder behaviors, especially binge eating.
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Affiliation(s)
- Emily K. Presseller
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Fengqing Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kathleen A. Page
- Department of Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Paakhi Srivastava
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie M. Manasse
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne S. Juarascio
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
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15
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Cecchini AL, Biscetti F, Rando MM, Nardella E, Pecorini G, Eraso LH, Dimuzio PJ, Gasbarrini A, Massetti M, Flex A. Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD). Int J Mol Sci 2022; 23:10814. [PMID: 36142725 PMCID: PMC9504787 DOI: 10.3390/ijms231810814] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.
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Affiliation(s)
- Andrea Leonardo Cecchini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Federico Biscetti
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Maria Margherita Rando
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Elisabetta Nardella
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Giovanni Pecorini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Luis H. Eraso
- Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Paul J. Dimuzio
- Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Antonio Gasbarrini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Massimo Massetti
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Andrea Flex
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
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16
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Zhou JC, Rifas-Shiman SL, Haines J, Jones K, Oken E. Adolescent overeating and binge eating behavior in relation to subsequent cardiometabolic risk outcomes: a prospective cohort study. J Eat Disord 2022; 10:140. [PMID: 36100924 PMCID: PMC9472357 DOI: 10.1186/s40337-022-00660-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Binge eating disorder is bidirectionally associated with obesity and with metabolic syndrome. It is less clear whether overeating and binge eating, or overeating with loss of control, also predicts metabolic risk, and if so, whether these associations are solely attributable to greater weight. The goal of this study was to examine longitudinal associations of overeating and binge eating behavior with cardiometabolic risk markers in adolescence. METHODS Adolescents (n = 619) in the Project Viva research study self-reported overeating and binge eating behavior in early adolescence (median 12.9 years, "baseline"). In late adolescence (median 17.4 years, "follow-up"), we assessed outcomes of adiposity and blood pressure, and in a subset of participants (n = 270-424), biomarkers of dyslipidemia, insulin resistance, liver dysfunction, inflammation, and adipokine homeostasis. We conducted multivariable linear regression analyses adjusted for socio-demographics and prenatal obesogenic exposures, and additionally for baseline body mass index (BMI) z-score. RESULTS At baseline, 58 (9%) participants reported overeating behavior, and of those, 24 (41%) had binge eating behavior (e.g., overeating accompanied by loss of control). In adjusted models, adolescents with overeating had higher adiposity at follow-up ~ 5 years later (e.g., % body fat 4.03; 95% confidence interval (CI) 1.76, 6.31) than those not reporting overeating behavior; additional adjustment for baseline BMI z-score attenuated associations generally except for % body fat (2.95; 95% CI 1.03, 4.87). Overeating behavior was also associated with higher inflammation and greater adipokine dysfunction, remaining positively associated with interleukin-6 (IL-6) (log-transformed β = 0.42 pg/mL; 95% CI 0.12, 0.73) and negatively with adiponectin (log-transformed β = -0.28 ug/mL; 95% CI - 0.47, - 0.08) even after adjusting for baseline BMI z-score. Overeating behavior was not consistently associated with other outcomes. Adolescents reporting binge eating behavior generally had the greatest adiposity, (e.g., % body fat 5.00; 95% CI 1.74, 8.25) as compared to those without overeating. CONCLUSIONS Adolescents reporting overeating and binge eating behavior had higher adiposity and poorer inflammatory and adipokine profiles, but no difference in other outcomes, than adolescents who did not endorse these behaviors. These associations were only partially accounted for by higher baseline BMI z-score. These differences may signal increased risk for future cardiovascular disease.
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Affiliation(s)
- Joyce C Zhou
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.,Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA, 02215, USA
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Kathryn Jones
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA, 02215, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA, 02215, USA. .,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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17
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Guerrero-Hreins E, Foldi CJ, Oldfield BJ, Stefanidis A, Sumithran P, Brown RM. Gut-brain mechanisms underlying changes in disordered eating behaviour after bariatric surgery: a review. Rev Endocr Metab Disord 2022; 23:733-751. [PMID: 34851508 DOI: 10.1007/s11154-021-09696-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 02/07/2023]
Abstract
Bariatric surgery results in long-term weight loss and an improved metabolic phenotype due to changes in the gut-brain axis regulating appetite and glycaemia. Neuroendocrine alterations associated with bariatric surgery may also influence hedonic aspects of eating by inducing changes in taste preferences and central reward reactivity towards palatable food. However, the impact of bariatric surgery on disordered eating behaviours (e.g.: binge eating, loss-of-control eating, emotional eating and 'addictive eating'), which are commonly present in people with obesity are not well understood. Increasing evidence suggests gut-derived signals, such as appetitive hormones, bile acid profiles, microbiota concentrations and associated neuromodulatory metabolites, can influence pathways in the brain implicated in food intake, including brain areas involved in sensorimotor, reward-motivational, emotional-arousal and executive control components of food intake. As disordered eating prevalence is a key mediator of weight-loss success and patient well-being after bariatric surgery, understanding how changes in the gut-brain axis contribute to disordered eating incidence and severity after bariatric surgery is crucial to better improve treatment outcomes in people with obesity.
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Affiliation(s)
- Eva Guerrero-Hreins
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Melbourne, Australia
| | - Claire J Foldi
- Department of Physiology, Monash University, Clayton, Melbourne, Australia
- Biomedicine Discovery Institute, Monash University, Clayton, Melbourne, Australia
| | - Brian J Oldfield
- Department of Physiology, Monash University, Clayton, Melbourne, Australia
- Biomedicine Discovery Institute, Monash University, Clayton, Melbourne, Australia
| | - Aneta Stefanidis
- Department of Physiology, Monash University, Clayton, Melbourne, Australia
- Biomedicine Discovery Institute, Monash University, Clayton, Melbourne, Australia
| | - Priya Sumithran
- Department of Medicine (St Vincent's), University of Melbourne, Melbourne, Australia
- Department of Endocrinology, Austin Health, Melbourne, Australia
| | - Robyn M Brown
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, Melbourne, Australia.
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Melbourne, Australia.
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18
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Development, validation and clinical use of the Eating Behaviors Assessment for Obesity (EBA-O). Eat Weight Disord 2022; 27:2143-2154. [PMID: 35092002 PMCID: PMC8799412 DOI: 10.1007/s40519-022-01363-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/08/2022] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Obesity is a major health problem with an increasing risk of mortality, associated with comorbidities and high rates of dropout. Research demonstrated that pathological eating behaviors could help to phenotype obese patients thus tailoring clinical interventions. Therefore, our aim was to develop (study 1), validate (study 2), and test in a clinical setting (study 3) the Eating Behaviors Assessment for Obesity (EBA-O). METHOD Study 1 included the exploratory factor analysis (EFA) and McDonald's ω in a general population sample (N = 471). Study 2 foresaw the confirmatory factor analysis (CFA) and convergent validity in 169 participants with obesity. Study 3 tested the capability of the EBA-O to characterize eating behaviors in a clinical sample of 74 patients with obesity. RESULTS Study 1. EFA identified five factors (i.e., food addiction, night eating, binge eating, sweet eating, and prandial hyperphagia), explaining 68.3% of the variance. The final EBA-O consisted of 18 items. McDonald's ω ranged between 0.80 (hyperphagia) and 0.92 (binge eating), indicating very good reliability. STUDY 2 A second-order five-factor model, through CFA, showed adequate fit: relative chi-square (χ2/df) = 1.95, CFI = 0.93, TLI = 0.92, RMSEA = 0.075, and SRMR = 0.06, thus suggesting the appropriateness of the EBA-O model. Significant correlations with psychopathological questionnaires demonstrated the convergent validity. Study 3. Significant associations between EBA-O factors and emotional-related eating behaviors emerged. CONCLUSION The EBA-O demonstrated to be a reliable and easy-to-use clinical tool to identify pathological eating behaviors in obesity, particularly useful for non-experts in eating disorders. LEVEL OF EVIDENCE Level V, descriptive research.
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19
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Meng Y, Kautz A. An evidence review of the association of immune and inflammatory markers with obesity-related eating behaviors. Front Immunol 2022; 13:902114. [PMID: 35911732 PMCID: PMC9336186 DOI: 10.3389/fimmu.2022.902114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Eating behaviors contribute to disproportionate energy intake and are linked to the development of obesity. Animal studies support the role of inflammatory cytokines and chemokines in the regulation of obesity-related eating behaviors and offer a potential target to combat obesity through the modulation of inflammation. However, more complex eating behaviors are present in humans, and their relationships with immune/inflammation markers are unclear. The present study reviewed current literature to synthesize the evidence on the association of immune/inflammation markers with obesity-related eating behaviors in humans. Methods A systematic search of three electronic databases yielded 811 articles, of which 11 met the inclusion criteria. Results The majority of the included studies (91%) were either case-control or cross-sectional studies. A variety of immune/inflammation markers and obesity-related eating behaviors have been assessed in the chosen studies. Three out of four studies identified a positive relationship between C-reactive protein (CRP)/high-sensitivity CRP and loss of control eating. Other inflammatory markers that potentially have a positive relationship with obesity-related eating behaviors include fractalkine and fibrinogen. Additionally, immune molecules, including interferon gamma (INF-γ), interleukin (IL)-7, IL-10, and α-melanocyte-stimulating hormone-reactive immunoglobulin G (α-MSH/IgG) immune complex, may have negative associations with obesity-related eating behaviors. However, most findings were identified by single studies. Conclusion Limited studies have been conducted in humans. Current evidence indicates a potential bi-directional relationship between inflammatory/immune markers and obesity-related eating behaviors. Additional studies with sophisticated research design and comprehensive theoretical models are warranted to further delineate the relationship between immune/inflammation markers and obesity-related eating behaviors.
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Affiliation(s)
- Ying Meng
- School of Nursing, University of Rochester, Rochester, NY, United States
| | - Amber Kautz
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
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20
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do Rosário Caldas N, Braulio VB, Brasil MAA, Furtado VCS, de Carvalho DP, Cotrik EM, Dantas JR, Zajdenverg L. Binge eating disorder, frequency of depression, and systemic inflammatory state in individuals with obesity - A cross sectional study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:489-497. [PMID: 35758834 PMCID: PMC10697643 DOI: 10.20945/2359-3997000000489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 03/07/2022] [Indexed: 06/15/2023]
Abstract
Introduction Binge eating disorder (BED) is the most prevalent eating disorder in individuals with obesity. Its association with factors that control hunger and satiety has not yet been elucidated. We evaluated whether levels of inflammatory markers, frequency of psychiatric comorbidities, and appetite-related hormones levels differ between individuals with obesity with and without BED. Subjects and methods The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-5 - Clinician Version (SCID-5-CV), Binge Eating Scale, and Hospital Anxiety and Depression Scale were evaluated in 39 individuals with obesity. Plasma levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), leptin, ghrelin, and glucagon-like peptide-1 (GLP-1) were measured. Results Individuals of the BED group exhibited significantly higher percentages of altered eating patterns (hyperphagia, bingeing, post-dinner eating, feeling "stuffed", and emotional eating), higher depressive symptom scores and levels of leptin, CRP, and TNF-α, compared to those from the non-BED group. Logistic regression showed that BED was independently associated with depressive symptoms and CRP levels. Conclusion Individuals with obesity and BED showed greater psychiatric comorbidity, worse eating patterns and worse inflammatory profile than those without BED. BED should be assessed as an indicator of clinical severity in patients with obesity.
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Affiliation(s)
- Nelson do Rosário Caldas
- Universidade Federal do Rio de Janeiro, Serviço de Psiquiatria e Psicologia Médica, Rio de Janeiro, RJ, Brasil,
| | - Valeria Bender Braulio
- Universidade Federal do Rio de Janeiro, Serviço de Nutrologia, Rio de Janeiro, RJ, Brasil
| | - Marco Antônio Alves Brasil
- Universidade Federal do Rio de Janeiro, Serviço de Psiquiatria e Psicologia Médica, Rio de Janeiro, RJ, Brasil
| | | | - Denise Pires de Carvalho
- Universidade Federal do Rio de Janeiro, Instituto de Biofísica Carlos Chagas Filho, Rio de Janeiro, RJ, Brasil
| | - Ervin Michelstaedter Cotrik
- Universidade Federal do Rio de Janeiro, Serviço de Psiquiatria e Psicologia Médica, Rio de Janeiro, RJ, Brasil
| | - Joana Rodrigues Dantas
- Universidade Federal do Rio de Janeiro, Serviço de Nutrologia, Rio de Janeiro, RJ, Brasil
| | - Lenita Zajdenverg
- Universidade Federal do Rio de Janeiro, Serviço de Nutrologia, Rio de Janeiro, RJ, Brasil
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21
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Spirou D, Raman J, Leith M, Collison J, Bishay RH, Ahlenstiel G, Hay P, Smith E. The psychometric properties of the grazing questionnaire in an obesity sample with and without binge eating disorder. J Eat Disord 2022; 10:82. [PMID: 35710487 PMCID: PMC9202494 DOI: 10.1186/s40337-022-00604-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite being the first validated measure of grazing, the Grazing Questionnaire (GQ) has not been investigated among individuals with obesity. Therefore, the current study aimed to examine the psychometric properties of the GQ in an obesity sample. METHODS Participants (N = 259) were recruited from community and clinical settings in Australia. The sample comprised adults with normal weight (n = 77) and obesity (n = 182). A portion of individuals with obesity (n = 102) had binge eating disorder (BED). Data from the obesity group was examined to establish the factor structure, validity, and reliability of the GQ. A one-way ANOVA with planned contrasts was conducted to compare scores on the GQ across groups. RESULTS Confirmatory factor analysis revealed that the 2-factor model of the GQ was the best model fit for individuals with obesity. The GQ demonstrated high internal consistency, test-retest reliability over 3 months, and convergent and divergent validity. As hypothesised, the obesity group had significantly higher scores on the GQ than the normal weight group, while the obesity with BED group had significantly higher scores than the obesity without BED group. CONCLUSION This was the first study to investigate the psychometric properties of the GQ in an obesity sample. Overall, findings indicated that the GQ is a psychometrically sound measure of grazing among individuals with obesity. These findings provide further support for two distinct subtypes of grazing and highlight the importance of increased assessment and management of grazing behaviours for individuals with obesity and eating disorders. Maintaining a healthy weight is one of the greatest challenges for individuals with obesity. Certain eating patterns such as grazing may contribute to difficulties in weight management. Grazing is the repetitive and unplanned eating of small amounts of food that is not related to feeling hungry. Researchers and clinicians often use self-report questionnaires to measure grazing. However, the first validated questionnaire of grazing has not been investigated among individuals with obesity. Therefore, the goal of this study was to examine and validate the Grazing Questionnaire in individuals with obesity. Overall, our results showed that the Grazing Questionnaire is a valid and reliable self-report measure of grazing in individuals with obesity. Similar to previous research, we found that there are two subtypes of grazing. The first subtype involves continuous, unplanned eating. The second subtype is associated with a sense of loss of control over eating. We also found that people with obesity and binge eating disorder graze more than people with obesity that do not have binge eating disorder, while both groups graze more than individuals with normal weight. We recommend that clinicians routinely assess and treat unhelpful grazing patterns when working with individuals with obesity and eating disorders.
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Affiliation(s)
- Dean Spirou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia. .,Blacktown Metabolic and Weight Loss Program, Department of Endocrinology and Diabetes, Blacktown Hospital, Blacktown, Sydney, NSW, Australia. .,School of Medicine, Western Sydney University, Sydney, NSW, Australia.
| | - Jayanthi Raman
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Mimi Leith
- School of Psychology, Western Sydney University, Sydney, NSW, Australia
| | - James Collison
- Australian College of Applied Professions, Sydney, NSW, Australia
| | - Ramy H Bishay
- Blacktown Metabolic and Weight Loss Program, Department of Endocrinology and Diabetes, Blacktown Hospital, Blacktown, Sydney, NSW, Australia.,School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Golo Ahlenstiel
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Storr Liver Centre, Westmead Millennium Institute, Westmead Hospital, University of Sydney, Sydney, NSW, Australia.,Department of Gastroenterology and Hepatology, Blacktown and Mount Druitt Hospitals, WSLHD, Sydney, NSW, Australia
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Evelyn Smith
- School of Psychology, Western Sydney University, Sydney, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
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22
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Shank LM, Moursi NA, Tanofsky-Kraff M. Loss-of-Control Eating and Cardiometabolic Health in Relation to Overweight and Obesity. Curr Diab Rep 2022; 22:257-266. [PMID: 35403985 DOI: 10.1007/s11892-022-01466-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Loss-of-control (LOC) eating, the subjective feeling of being unable to control what or how much is being consumed, is common. The purpose of this review was to examine the relationships among LOC eating, cardiometabolic health, and weight management intervention outcomes. RECENT FINDINGS In youth and adults, LOC eating is associated with and predictive of psychological symptoms, high weight, and worsened cardiometabolic health. While LOC eating pre-intervention does not appear to impact outcomes, LOC eating during or following is associated with worsened outcomes from behavioral and surgical weight management interventions. When individuals are undergoing weight management interventions, it may be important to regularly assess for LOC eating. There is limited research on the examined relationships in diverse populations (e.g., males, individuals of a lower socio-economic status, racial/ethnic minority groups). Future research should examine these relationships across the lifespan in diverse populations, with a focus on how these relationships can be impacted through targeted interventions.
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Affiliation(s)
- Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 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), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Nasreen A Moursi
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 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), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA.
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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Hay P, Palavras MA, da Luz FQ, dos Anjos Garnes S, Sainsbury A, Touyz S, Appolinario JC, Claudino AM. Physical and mental health outcomes of an integrated cognitive behavioural and weight management therapy for people with an eating disorder characterized by binge eating and a high body mass index: a randomized controlled trial. BMC Psychiatry 2022; 22:355. [PMID: 35610603 PMCID: PMC9131673 DOI: 10.1186/s12888-022-04005-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/17/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Bulimia nervosa (BN) and binge eating disorder (BED) are eating disorders (EDs) characterized by recurrent binge eating. They are associated with medical complications, impaired adaptive function and often a high BMI, for which a multidisciplinary treatment approach may be needed. This study explored the efficacy of a novel intervention integrating Cognitive Behavioural Therapy- Enhanced (CBT-E) and weight management for people with recurrent binge eating episodes and high BMI with respect to physical, psychopathological and quality of life outcomes. METHODS Ninety-eight adults diagnosed with BN, BED, or Other Specified/Unspecified Feeding or Eating Disorder (OSFED/UFED) and BMI ≥ 27 to <40 kg/m2 were randomized to a multidisciplinary approach, the Healthy APproach to weIght management and Food in Eating Disorders (HAPIFED) or to CBT-E. Metabolic parameters, health-related quality of life, general psychological and ED symptoms and ED diagnostic status outcomes are reported. Data were analyzed with mixed effects models adopting multiple imputed datasets where data were missing. RESULTS Both HAPIFED and CBT-E showed statistical significance for the time effect, with reduction in stress (p < 0.001), improvement in mental health-related quality of life (p = 0.032), reduction in binge eating severity (p < 0.001), and also in global ED symptoms scores (p < 0.001), with the significant changes found at end of treatment and sustained at 12-month follow-up. However, no statistical significance was found for differences between the interventions in any of the outcomes measured. Despite a high BMI, most participants (> 75%) had blood test results for glucose, insulin, triglycerides and cholesterol within the normal range, and 52% were within the normal range for the physical component of quality of life at baseline with no change during the trial period. CONCLUSION Integrating weight and ED management resulted in comparable outcomes to ED therapy alone. Although adding weight management to an ED intervention had no adverse effects on psychological outcomes, it also had no beneficial effect on metabolic outcomes. Therefore, more intense weight management strategies may be required where indicated to improve metabolic outcomes. Safety will need to be concurrently investigated. TRIAL REGISTRATION US National Institutes of Health clinical trial registration number NCT02464345 , date of registration 08/06/2015. Changes to the present paper from the published protocol paper (Trials 18:578, 2015) and as reported in the Trial registration (clinicaltrials.gov) are reported in Supplementary File 1.
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Affiliation(s)
- Phillipa Hay
- School of Medicine, Translational Health Research Institute, Western Sydney University, 1797 Locked Bag Avenue, Sydney, 2751, Australia.
| | - Marly Amorim Palavras
- grid.1029.a0000 0000 9939 5719School of Medicine, Translational Health Research Institute, Western Sydney University, 1797 Locked Bag Avenue, Sydney, 2751 Australia ,grid.411249.b0000 0001 0514 7202Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Major Maragliano 241, São Paulo, SP 04017-030 Brazil
| | - Felipe Quinto da Luz
- grid.11899.380000 0004 1937 0722Eating Disorders Program (AMBULIM), Faculty of Medicine, Universidade de São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, São Paulo, SP 05403-010 Brazil ,grid.1013.30000 0004 1936 834XBoden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, 2006 Australia
| | - Sérgio dos Anjos Garnes
- grid.411249.b0000 0001 0514 7202Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Major Maragliano 241, São Paulo, SP 04017-030 Brazil
| | - Amanda Sainsbury
- grid.1012.20000 0004 1936 7910School of Human Sciences, The University of Western Australia, Perth, 6009 Australia
| | - Stephen Touyz
- grid.1013.30000 0004 1936 834XInside Out Institute and School of Psychology, Charles Perkins Centre, SLHD and The University of Sydney, Sydney, 2006 Australia
| | - José Carlos Appolinario
- grid.8536.80000 0001 2294 473XObesity and Eating Disorders Group – Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Avenida Pedro Calmon 550, Rio de Janeiro, RJ 21941-901 Brazil
| | - Angélica Medeiros Claudino
- grid.411249.b0000 0001 0514 7202Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Major Maragliano 241, São Paulo, SP 04017-030 Brazil
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Kaur J, Dang AB, Gan J, An Z, Krug I. Night Eating Syndrome in Patients With Obesity and Binge Eating Disorder: A Systematic Review. Front Psychol 2022; 12:766827. [PMID: 35069340 PMCID: PMC8766715 DOI: 10.3389/fpsyg.2021.766827] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/06/2021] [Indexed: 12/22/2022] Open
Abstract
Night eating syndrome (NES) is currently classified as an Other Specified Feeding or Eating Disorder (OSFED) under the Diagnostic Statistical Manual-5 (DSM-5). This systematic review aims to consolidate the studies that describe the sociodemographic, clinical and psychological features of NES in a population of patients with eating disorders (ED), obesity, or those undergoing bariatric surgery, and were published after the publication of the DSM-5. A further aim was to compare, where possible, NES with BED on the aforementioned variables. Lastly, we aimed to appraise the quality of the studies being included in the review. We conducted a systematic search on three databases (MEDLINE, PubMed and Embase) which resulted in the selection of 22 studies for the review. We included the articles that studied patients with NES and their sociodemographic, clinical and psychological features in a clinical (i.e., ED, obese or bariatric surgery) population, through a quantitative study design. Articles were excluded if the NES patients included in the study had a comorbid psychological disorder, and/or the sample was collected from a university/non-clinical population, and/or the study design was qualitative, and/or NES features were compared with any other disorder, except BED. Our study found that no conclusions about the link between any sociodemographic feature (such as, age, gender, income, etc.) and an NES diagnosis could be made. Further, NES patients presented with elevated ED pathology (including emotional eating and loss of control eating) and higher occurrence of depressive symptoms than controls. Contrary to the literature suggesting that NES and Binge Eating Disorder (BED; an ED subtype which is also comorbid with obesity) patients often report overlapping features, questioning the validity of NES as an ED diagnosis, we found that BED can be differentiated from NES by the higher occurrence of emotional eating, body related concerns and abnormal eating episodes. The review also suggested an overlap between NES and Sleep-Related Eating Disorder. We recommend that it is essential to study NES as an independent disorder to further develop its diagnostic criteria and treatment options, thereby, increasing the quality of life of the patients suffering from this syndrome.
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Affiliation(s)
| | | | | | | | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
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25
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Watters A, Johnson RJ, Bauschka M, Oakes J, Kelley M, Mehler PS. Uric acid levels in adult patients with severe eating disorders. Int J Eat Disord 2022; 55:141-144. [PMID: 34850969 DOI: 10.1002/eat.23649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate serum uric acid (UA) levels in patients with extreme forms of eating disorders, at admission and discharge, following weeks of nutritional rehabilitation and weight restoration. METHOD This observational study enrolled 160 patients diagnosed with anorexia nervosa restricting subtype (AN-R), AN binge-purge subtype (AN-BP), or avoidant restrictive food intake disorder (ARFID). Serum UA levels were drawn on admission and discharge. RESULTS Most of the cohorts were admitted with serum UA levels on the lower end of normal. Mean serum uric level for women was 4.3 mg/dl (SD: 2.3). Patients diagnosed with AN-BP had significantly higher UA levels on admission compared to patients with AN-R and ARFID; p < .0001, η2 = 0.13. High UA levels positively correlated with purging and admission serum blood urea nitrogen (r = .5, p = .009). DISCUSSION Serum UA levels tended to be in the low-normal range in most patients with severe AN-R, but not in AN-BP. However, levels did increase with nutritional intake and weight gain. There may be clinical value in checking UA levels on admission for patients with eating disorders.
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Affiliation(s)
- Ashlie Watters
- ACUTE Center for Eating Disorders at Denver Health, Denver, Colorado, USA
- Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Richard J Johnson
- Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Maryrose Bauschka
- ACUTE Center for Eating Disorders at Denver Health, Denver, Colorado, USA
- Eating Recovery Center, Denver, Colorado, USA
| | - Judy Oakes
- ACUTE Center for Eating Disorders at Denver Health, Denver, Colorado, USA
- Department of Medicine, Denver Health Hospital Authority, Denver, Colorado, USA
| | - Marina Kelley
- ACUTE Center for Eating Disorders at Denver Health, Denver, Colorado, USA
| | - Philip S Mehler
- ACUTE Center for Eating Disorders at Denver Health, Denver, Colorado, USA
- Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- Eating Recovery Center, Denver, Colorado, USA
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Yu Y, Fernandez ID, Meng Y, Zhao W, Groth SW. Gut hormones, adipokines, and pro- and anti-inflammatory cytokines/markers in loss of control eating: A scoping review. Appetite 2021; 166:105442. [PMID: 34111480 PMCID: PMC10683926 DOI: 10.1016/j.appet.2021.105442] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/31/2022]
Abstract
Loss of control (LOC) eating is the defining feature of binge-eating disorder, and it has particular relevance for bariatric patients. The biomarkers of LOC eating are unclear; however, gut hormones (i.e., ghrelin, cholecystokinin [CCK], peptide YY [PYY], glucagon-like peptide 1 [GLP-1], and pancreatic polypeptide [PP]), adipokines (i.e., leptin, adiponectin), and pro- and anti-inflammatory cytokines/markers (e.g., high-sensitivity C-reactive protein [hsCRP]) are candidates due to their involvement in the psychophysiological mechanisms of LOC eating. This review aimed to synthesize research that has investigated these biomarkers with LOC eating. Because LOC eating is commonly examined within the context of binge-eating disorder, is sometimes used interchangeably with subclinical binge-eating, and is the latent construct underlying disinhibition, uncontrolled eating, and food addiction, these eating behaviors were included in the search. Only studies among individuals with overweight or obesity were included. Among the identified 31 studies, 2 studies directly examined LOC eating and 4 studies were conducted among bariatric patients. Most studies were case-control in design (n = 16) and comprised female-dominant (n = 13) or female-only (n = 13) samples. Studies generally excluded fasting total ghrelin, fasting CCK, fasting PYY, and fasting PP as correlates of the examined eating behaviors. However, there was evidence that the examined eating behaviors were associated with lower levels of fasting acyl ghrelin (the active form of ghrelin) and adiponectin, higher levels of leptin and hsCRP, and altered responses of postprandial ghrelin, CCK, and PYY. The use of GLP-1 analog was able to decrease binge-eating. In conclusion, this review identified potential biomarkers of LOC eating. Future studies would benefit from a direct focus on LOC eating (especially in the bariatric population), using longitudinal designs, exploring potential mediators and moderators, and increased inclusion of the male population.
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Affiliation(s)
- Yang Yu
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
| | - I Diana Fernandez
- School of Public Health, University of Rochester, 265 Crittenden Blvd, Rochester, NY, 14642, USA.
| | - Ying Meng
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
| | - Wenjuan Zhao
- Department of Oncology, Shanghai Medical College, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, 200032, China.
| | - Susan W Groth
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
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Mason TB, Smith KE. Delineating the role of binge eating in cancer research. Eat Weight Disord 2021; 26:2109-2116. [PMID: 33201393 DOI: 10.1007/s40519-020-01066-4] [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: 06/30/2020] [Accepted: 10/26/2020] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Binge eating is defined as consumption of a large amount of food accompanied by a sense of loss of control over eating. While binge eating is associated with poor physical, behavioral, and psychosocial health, it has not been studied in cancer research. Therefore, the overarching goal of this review is to delineate the role of binge eating in cancer research and to spur new research in this area. Specifically, in this review, we outlined (1) binge eating as a possible risk factor that contributes to cancer risk, (2) how binge eating may develop after cancer diagnosis, and (3) how binge eating may be associated with health and relapse during survivorship. CONCLUSIONS It is critical to elucidate the role of binge eating in the prevention of cancer and long-term cancer survivorship. This review suggested a number of ways that binge eating may increase risk for cancer as well as several pathways that may lead to the development of binge eating after cancer diagnosis. LEVEL OF EVIDENCE Level V: narrative review.
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Affiliation(s)
- Tyler B Mason
- Department of Preventive Medicine, University of Southern California, 2001 Soto St., Los Angeles, CA, 90032, USA.
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
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Iceta S, Dadar M, Daoust J, Scovronec A, Leblanc V, Pelletier M, Biertho L, Tchernof A, Bégin C, Michaud A. Association between Visceral Adiposity Index, Binge Eating Behavior, and Grey Matter Density in Caudal Anterior Cingulate Cortex in Severe Obesity. Brain Sci 2021; 11:brainsci11091158. [PMID: 34573180 PMCID: PMC8468041 DOI: 10.3390/brainsci11091158] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 01/01/2023] Open
Abstract
Visceral adipose tissue accumulation is an important determinant of metabolic risk and can be estimated by the visceral adiposity index (VAI). Visceral adiposity may impact brain regions involved in eating behavior. We aimed to examine the association between adiposity measurements, binge eating behavior, and grey matter density. In 20 men and 59 women with severe obesity, Grey matter density was measured by voxel-based morphometry for six regions of interest associated with reward, emotion, or self-regulation: insula, orbitofrontal cortex, caudal and rostral anterior cingulate cortex (ACC), ventromedial prefrontal cortex (vmPFC), and dorsolateral prefrontal cortex (DLPFC). Binge eating behavior, depression and impulsivity was assessed by the Binge Eating Scale, Beck Depression Inventory and UPPS Impulsive Behavior Scale, respectively. Men and women were distinctively divided into two subgroups (low-VAI and high-VAI) based on the mean VAI score. Women with high-VAI were characterized by metabolic alterations, higher binge eating score and lower grey matter density in the caudal ACC compared to women with low-VAI. Men with high-VAI were characterized by a higher score for the sensation-seeking subscale of the UPPS–Impulsive Behavior Scale compared to men with low-VAI. Using a moderation–mediation analysis, we found that grey matter density in the caudal ACC mediates the association between VAI and binge eating score. In conclusion, visceral adiposity is associated with higher binge eating severity in women. Decreased grey matter density in the caudal ACC, a region involved in cognition and emotion regulation, may influence this relationship.
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Affiliation(s)
- Sylvain Iceta
- Research Center of the Quebec Heart and Lung Institute, Université Laval, Quebec City, QC G1V 4G5, Canada; (J.D.); (A.S.); (M.P.); (A.T.); (C.B.)
- School of Nutrition, Université Laval, Quebec City, QC G1V 0A6, Canada
- Correspondence: (S.I.); (A.M.)
| | - Mahsa Dadar
- CERVO Brain Research Center, Centre Intégré Universitaire Santé et Services Sociaux de la Capitale Nationale, Université Laval, Quebec City, QC G1E 1T2, Canada;
| | - Justine Daoust
- Research Center of the Quebec Heart and Lung Institute, Université Laval, Quebec City, QC G1V 4G5, Canada; (J.D.); (A.S.); (M.P.); (A.T.); (C.B.)
- School of Nutrition, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Anais Scovronec
- Research Center of the Quebec Heart and Lung Institute, Université Laval, Quebec City, QC G1V 4G5, Canada; (J.D.); (A.S.); (M.P.); (A.T.); (C.B.)
- School of Nutrition, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Vicky Leblanc
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, QC G1V 0A6, Canada;
| | - Melissa Pelletier
- Research Center of the Quebec Heart and Lung Institute, Université Laval, Quebec City, QC G1V 4G5, Canada; (J.D.); (A.S.); (M.P.); (A.T.); (C.B.)
| | - Laurent Biertho
- Département de Chirurgie Générale, Quebec Heart and Lung Institute, Université Laval, Quebec City, QC G1V 4G5, Canada;
| | - André Tchernof
- Research Center of the Quebec Heart and Lung Institute, Université Laval, Quebec City, QC G1V 4G5, Canada; (J.D.); (A.S.); (M.P.); (A.T.); (C.B.)
- School of Nutrition, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Catherine Bégin
- Research Center of the Quebec Heart and Lung Institute, Université Laval, Quebec City, QC G1V 4G5, Canada; (J.D.); (A.S.); (M.P.); (A.T.); (C.B.)
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, QC G1V 0A6, Canada;
- School of Psychology, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Andreanne Michaud
- Research Center of the Quebec Heart and Lung Institute, Université Laval, Quebec City, QC G1V 4G5, Canada; (J.D.); (A.S.); (M.P.); (A.T.); (C.B.)
- School of Nutrition, Université Laval, Quebec City, QC G1V 0A6, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, QC G1V 0A6, Canada;
- Correspondence: (S.I.); (A.M.)
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Goldschmidt AB, Khoury JC, Mitchell JE, Jenkins TM, Bond DS, Zeller MH, Michalsky MP, Inge TH. Loss of Control Eating and Health Indicators Over 6 Years in Adolescents Undergoing Metabolic and Bariatric Surgery. Obesity (Silver Spring) 2021; 29:740-747. [PMID: 33759383 PMCID: PMC8474017 DOI: 10.1002/oby.23126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/22/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of this study was to assess associations between loss of control (LOC) eating and health outcomes among adolescents undergoing metabolic and bariatric surgery. METHODS A total of 234 adolescents were studied before and up to 6 years after surgery in a prospective, observational cohort design. Adolescents provided self-reports of LOC eating, pain severity, sleep quality, polycystic ovary syndrome, gastroesophageal reflux disease, and medication usage and objective measures of fasting glucose, serum insulin, glycohemoglobin A1c , cholesterol, triglycerides, and blood pressure. χ2 tests, Wilcoxon rank sums, and generalized linear mixed models were used to assess concurrent and prospective associations between LOC eating and health indicators. RESULTS LOC eating presented in 32.5% of adolescents before surgery and was positively associated with sleep disturbances and psychiatric medication usage. After surgery, LOC eating presented in 7.9% to 14.6% of participants and was correlated with improved low- and high-density lipoprotein cholesterol levels and greater back pain. LOC eating was inversely associated with low-density lipoprotein cholesterol at the next consecutive time point. CONCLUSIONS LOC eating was unexpectedly associated with improved low- and high-density lipoprotein cholesterol in adolescents undergoing metabolic and bariatric surgery. Deleterious effects of LOC eating on obesity-related health conditions, aside from back pain, were not detected. Metabolic and other weight-independent health benefits of surgery may persist postoperatively despite LOC eating and associated weight regain.
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Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Jane C. Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - James E. Mitchell
- Department of Psychiatry and Behavioral Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Todd M. Jenkins
- Department of Surgery, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Dale S. Bond
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Meg H. Zeller
- Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Marc P. Michalsky
- Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA
| | - Thomas H. Inge
- Department of Surgery, University of Colorado, Denver and Children’s Hospital Colorado, Aurora, CO, USA
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An open-label trial on the efficacy and tolerability of naltrexone/bupropion SR for treating altered eating behaviours and weight loss in binge eating disorder. Eat Weight Disord 2021; 26:779-788. [PMID: 32356145 DOI: 10.1007/s40519-020-00910-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/17/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Binge eating disorder (BED) has a considerable clinical relevance by virtue of its high numerous psychiatric and medical comorbidities; among the latter, the most frequent is obesity. Available treatments for BED have shown frequent relapse of binges or weight regain in the long term. The new combination of naltrexone and bupropion sustained release (NB) has proved to be effective for weight loss among obese patients. As NB acts on hypothalamic and reward circuits, that seem involved in the pathogenesis and maintenance of BED symptoms, this study aims to evaluate the efficacy of NB in improving pathological eating behavior and losing weight in BED patients. METHODS In this preliminary study, 23 obese-BED patients and a control group of 20 obese non-BED patients (respectively, Groups 1 and 2) who had previously undergone at least 5 unsuccessful weight-loss programs were treated with NB in addition to modified life style. Evaluation at t0 and after 16 weeks of treatment (t1) included anthropometric measurement, eating behavior assessment and psychopathological questionnaires (EDE-Q, BES, YFAS, BDI and STAI). RESULTS A significant and similar weight loss (ΔBMI% ≈ 8%) was evident for both groups. Pathological eating behavior (i.e., binge, grazing, emotional eating, craving for carbohydrates, and post-dinner eating), BES score and YFAS severity significantly improved, especially among BED. NB was well tolerated and drop-out rate was low. CONCLUSION Treatment with NB, in addition to a reduced-calorie diet and increased physical activity, seems an effective and well-tolerated option for improving pathological eating behavior and losing weight in obese-BED patients. LEVEL OF EVIDENCE Level III case-control study.
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Chen JY, Berner LA, Brown TA, Wierenga CE, Kaye WH. Associations of elevated weight status with symptom severity and treatment outcomes in binge/purge eating disorders. Int J Eat Disord 2021; 54:621-626. [PMID: 33340380 PMCID: PMC8207454 DOI: 10.1002/eat.23446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Binge-eating and purging behaviors commonly co-occur with overweight. However, little is known about the potential associations of elevated weight status with eating disorder severity or treatment outcomes. Thus, the present study compared binge-eating and purging patients with low, normal, and high weight statuses on eating disorder and mood symptoms at treatment admission, and tested whether weight status was associated with symptom change over treatment. METHOD The sample included 135 adult female patients in an intensive outpatient program, who completed self-assessments at admission and discharge. MANOVAs compared the groups at treatment admission, and multilevel models examined changes over time. RESULTS At admission, the high-weight group reported greater fasting frequency than the normal-weight group, and higher shape and weight concerns than the low-weight group. Over time, the high-weight group additionally showed higher eating disorder psychological symptom severity than the normal-weight group. The groups did not differ on mood symptoms at admission. Longitudinal results indicated that the groups showed comparable symptom improvements over treatment. DISCUSSION These findings highlight the severity of higher-weight patients with bulimia nervosa. Additionally, although these patients may present with more severe symptoms, their response to an intensive treatment may be comparable to that of normal- or lower-weight groups.
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Affiliation(s)
- Joanna Y. Chen
- Department of Psychology, Drexel University,Department of Psychiatry, University of California, San Diego
| | - Laura A. Berner
- Department of Psychiatry, University of California, San Diego,Department of Psychiatry, Icahn School of Medicine at Mount Sinai
| | - Tiffany A. Brown
- Department of Psychiatry, University of California, San Diego,San Diego State University Research Foundation
| | | | - Walter H. Kaye
- Department of Psychiatry, University of California, San Diego
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Segura-Garcia C, Rania M, Carbone EA, de Filippis R, Aloi M, Caroleo M, Grasso G, Calabrò G, Fazia G, Staltari FA, Falvo A, Pugliese V, Gaetano R, Steardo L, De Fazio P. Naturalistic and Uncontrolled Pilot Study on the Efficacy of Vortioxetine in Binge Eating Disorder With Comorbid Depression. Front Psychiatry 2021; 12:635502. [PMID: 33815170 PMCID: PMC8010002 DOI: 10.3389/fpsyt.2021.635502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/18/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Binge eating disorder (BED) is clinically relevant by virtue of the global impairment, poor quality of life, and increased overall medical morbidity. The high comorbidity with psychiatric disorders, particularly depression, has received attention as a possible mediator of the poor outcome. Further, BED and depression share cognitive dysfunctions. This naturalistic and uncontrolled pilot study aimed at evaluating the efficacy of vortioxetine (VTX) on depressive symptoms in patients with BED, secondly the efficacy in improving a broad array of executive functions, and third to explore the effect on eating behavior and body weight. Methods: This pilot study involved 30 patients with BED and comorbid MDD, treated with VTX for 24 weeks. Assessments were run at baseline (t 0), 4 (t 1), 8 (t 2), 12 (t 3), and 24 (t 4) weeks. Changes in depressive symptoms (HDRS and BDI), executive functions, eating behaviors (binge frequency and severity, night eating, food addiction), and body weight were estimated after treatment with VTX through GLM. Results: Significant improvements emerged after treatment with VTX in: depression (HDRS p < 0.001; BDI p = 0.002) regardless the dose of VTX and first diagnosis (BED/MDD), working memory (RAVLT acquisition p = 0.01, delay recall p < 0.001, RCFT percentage of recall p = 0.01, and Attentional Matrices p = 0.05), binge days frequency (p < 0.001), binge eating severity (BES p < 0.001), night eating (p = 0.001), food addiction (YFAS 2.0 p = 0.039), and body weight (p = 0.039). The improvement in depressive symptoms was associated with the concurrent improvement in night eating as assessed by the I-NEQ. Conclusions: VTX can be a valid therapeutic choice for patients with BED with comorbid depression in controlling the depressive symptoms, working memory, and eating behavior. Indeed, by acting on affective symptoms, neurocognitive functioning, and eating behaviors, it confirms the results already obtained with VTX in other disorders, expanding them to BED.
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Affiliation(s)
- Cristina Segura-Garcia
- Psychiatric Unit, Department of Medical and Surgical Sciences, University “Magna Graecia”, Catanzaro, Italy
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Marianna Rania
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Elvira Anna Carbone
- Psychiatric Unit, Department of Medical and Surgical Sciences, University “Magna Graecia”, Catanzaro, Italy
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Renato de Filippis
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Matteo Aloi
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Mariarita Caroleo
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Gloria Grasso
- Psychiatric Unit, Department of Medical and Surgical Sciences, University “Magna Graecia”, Catanzaro, Italy
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Giuseppina Calabrò
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Gilda Fazia
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Filippo Antonio Staltari
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Antonella Falvo
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Valentina Pugliese
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Raffaele Gaetano
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Luca Steardo
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Pasquale De Fazio
- Outpatient Service for Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatric Unit, Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
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Oliveira TPD, Gonçalves BDC, Oliveira BS, de Oliveira ACP, Reis HJ, Ferreira CN, Aguiar DC, de Miranda AS, Ribeiro FM, Vieira EML, Palotás A, Vieira LB. Negative Modulation of the Metabotropic Glutamate Receptor Type 5 as a Potential Therapeutic Strategy in Obesity and Binge-Like Eating Behavior. Front Neurosci 2021; 15:631311. [PMID: 33642987 PMCID: PMC7902877 DOI: 10.3389/fnins.2021.631311] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/06/2021] [Indexed: 01/22/2023] Open
Abstract
Obesity is a multifactorial disease, which in turn contributes to the onset of comorbidities, such as diabetes and atherosclerosis. Moreover, there are only few options available for treating obesity, and most current pharmacotherapy causes severe adverse effects, while offering minimal weight loss. Literature shows that metabotropic glutamate receptor 5 (mGluR5) modulates central reward pathways. Herein, we evaluated the effect of VU0409106, a negative allosteric modulator (NAM) of mGluR5 in regulating feeding and obesity parameters. Diet-induced obese C57BL/6 mice were treated for 14 days with VU0409106, and food intake, body weight, inflammatory/hormonal levels, and behavioral tests were performed. Our data suggest reduction of feeding, body weight, and adipose tissue inflammation in mice treated with high-fat diet (HFD) after chronic treatment with VU0409106. Furthermore, a negative modulation of mGluR5 also reduces binge-like eating, the most common type of eating disorder. Altogether, our results pointed out mGluR5 as a potential target for treating obesity, as well as related disorders.
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Affiliation(s)
- Tadeu P. D. Oliveira
- Departamento de Farmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Bruno D. C. Gonçalves
- Departamento de Farmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Bruna S. Oliveira
- Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Antonio Carlos P. de Oliveira
- Departamento de Farmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Helton J. Reis
- Departamento de Farmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Claudia N. Ferreira
- Colégio Técnico, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Daniele C. Aguiar
- Departamento de Farmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline S. de Miranda
- Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fabiola M. Ribeiro
- Departamento de Bioquimica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Erica M. L. Vieira
- Departamento de Farmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - András Palotás
- Asklepios-Med (Private Medical Practice and Research Center), Szeged, Hungary
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Luciene B. Vieira
- Departamento de Farmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Harris SR, Carrillo M, Fujioka K. Binge-Eating Disorder and Type 2 Diabetes: A Review. Endocr Pract 2021; 27:158-164. [PMID: 33554873 DOI: 10.1016/j.eprac.2020.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/01/2020] [Accepted: 10/27/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To familiarize health care providers with diagnosis and treatment of binge-eating disorder (BED), a common comorbidity of type 2 diabetes (T2DM). METHODS Literature review of binge eating and T2DM. Key words used in search include BED, T2DM, obesity, and treatment. RESULTS The prevalence of BED in patients with T2DM appears to be much higher than the 2% to 3.5% prevalence seen in the general population. Studies suggest that up to 20% of patients with T2DM have an underlying eating disorder, the most common of which is binge eating. BED is probably underdiagnosed, even though there are multiple simple tools that providers can use to improve screening for the disorder. Though the relationship between BED and hemoglobin A1c control can vary, it appears that binge-eating behaviors can worsen metabolic markers, including glycemic control. Various medications used by patients with diabetes have been associated with new-onset BED, and treatment may be as simple as removing or replacing such agents. Several medications have been found to significantly reduce binge-eating frequency, and potentially, weight. Patients with BED generally benefit from psychotherapy, including cognitive behavioral therapy. CONCLUSION BED, only recently added to the International Classification of Disease-10 diagnostic list, is very common in patients with obesity and T2DM. The diagnosis is important to establish, as treatment or referral for treatment, could potentially improve many of the comorbidities and metrics of T2DM.
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Affiliation(s)
- Samantha R Harris
- Scripps Clinic Medical Group, Division of Diabetes and Endocrinology, La Jolla, California
| | - Maritza Carrillo
- Scripps Clinic Medical Group, Division of Diabetes and Endocrinology, La Jolla, California.
| | - Ken Fujioka
- Scripps Clinic Medical Group, Division of Diabetes and Endocrinology, La Jolla, California
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Butler MJ, Perrini AA, Eckel LA. The Role of the Gut Microbiome, Immunity, and Neuroinflammation in the Pathophysiology of Eating Disorders. Nutrients 2021; 13:nu13020500. [PMID: 33546416 PMCID: PMC7913528 DOI: 10.3390/nu13020500] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/19/2021] [Accepted: 01/29/2021] [Indexed: 12/23/2022] Open
Abstract
There is a growing recognition that both the gut microbiome and the immune system are involved in a number of psychiatric illnesses, including eating disorders. This should come as no surprise, given the important roles of diet composition, eating patterns, and daily caloric intake in modulating both biological systems. Here, we review the evidence that alterations in the gut microbiome and immune system may serve not only to maintain and exacerbate dysregulated eating behavior, characterized by caloric restriction in anorexia nervosa and binge eating in bulimia nervosa and binge eating disorder, but may also serve as biomarkers of increased risk for developing an eating disorder. We focus on studies examining gut dysbiosis, peripheral inflammation, and neuroinflammation in each of these eating disorders, and explore the available data from preclinical rodent models of anorexia and binge-like eating that may be useful in providing a better understanding of the biological mechanisms underlying eating disorders. Such knowledge is critical to developing novel, highly effective treatments for these often intractable and unremitting eating disorders.
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Affiliation(s)
- Michael J. Butler
- Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA;
| | - Alexis A. Perrini
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA;
| | - Lisa A. Eckel
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA;
- Correspondence: ; Tel.: +1-850-644-3480
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Carbone EA, D'Amato P, Vicchio G, De Fazio P, Segura-Garcia C. A systematic review on the role of microbiota in the pathogenesis and treatment of eating disorders. Eur Psychiatry 2020; 64:e2. [PMID: 33416044 PMCID: PMC8057489 DOI: 10.1192/j.eurpsy.2020.109] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background There is growing interest in new factors contributing to the genesis of eating disorders (EDs). Research recently focused on the study of microbiota. Dysbiosis, associated with a specific genetic susceptibility, may contribute to the development of anorexia nervosa (AN), bulimia nervosa, or binge eating disorder, and several putative mechanisms have already been identified. Diet seems to have an impact not only on modification of the gut microbiota, facilitating dysbiosis, but also on its recovery in patients with EDs. Methods This systematic review based on the PICO strategy searching into PubMed, EMBASE, PsychINFO, and Cochrane Library examined the literature on the role of altered microbiota in the pathogenesis and treatment of EDs. Results Sixteen studies were included, mostly regarding AN. Alpha diversity and short-chain fatty acid (SCFA) levels were lower in patients with AN, and affective symptoms and ED psychopathology seem related to changes in gut microbiota. Microbiota-derived proteins stimulated the autoimmune system, altering neuroendocrine control of mood and satiety in EDs. Microbial richness increased in AN after weight regain on fecal microbiota transplantation. Conclusions Microbiota homeostasis seems essential for a healthy communication network between gut and brain. Dysbiosis may promote intestinal inflammation, alter gut permeability, and trigger immune reactions in the hunger/satiety regulation center contributing to the pathophysiological development of EDs. A restored microbial balance may be a possible treatment target for EDs. A better and more in-depth characterization of gut microbiota and gut–brain crosstalk is required. Future studies may deepen the therapeutic and preventive role of microbiota in EDs.
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Affiliation(s)
- Elvira Anna Carbone
- Department of Health Sciences, University "Magna Graecia", Catanzaro88100, Italy.,Outpatient Service for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro88100, Italy
| | - Pasquale D'Amato
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro88100, Italy
| | - Giuseppe Vicchio
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende87036, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, University "Magna Graecia", Catanzaro88100, Italy
| | - Cristina Segura-Garcia
- Outpatient Service for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro88100, Italy.,Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro88100, Italy
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Yagin NL, Aliasgari F, Alizadeh M, Aliasgharzadeh S, Mahdavi R. Comparison of endocannabinoids levels, FAAH gene polymorphisms, and appetite regulatory substances in women with and without binge eating disorder: a cross- sectional study. Nutr Res 2020; 83:86-93. [DOI: 10.1016/j.nutres.2020.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/04/2020] [Accepted: 09/02/2020] [Indexed: 01/23/2023]
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Rania M, Aloi M, Caroleo M, Carbone EA, Fazia G, Calabrò G, de Filippis R, Staltari F, Segura-Garcia C. 'Impaired Autonomy and Performance' predicts binge eating disorder among obese patients. Eat Weight Disord 2020; 25:1183-1189. [PMID: 31302882 DOI: 10.1007/s40519-019-00747-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/03/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The present study examined the predictive value of early maladaptive schema (EMS) domains on the diagnosis of binge eating disorder (BED). METHODS Seventy obese patients seeking treatment for weight loss were recruited and allocated to either group 1 (obese) or group 2 (BED-obese) according to clinical diagnosis. Both groups underwent psychometric assessment for EMS (according to the latest four-factor model), eating and general psychopathologies. Logistic regression analysis was performed on significant variables and BED diagnosis. RESULTS In addition to showing higher values on all clinical variables, BED-obese patients exhibited significantly higher scores for all four schema domains. Regression analysis revealed a 12-fold increase in risk of BED with 'Impaired Autonomy and Performance'. Depression did not account for a higher risk. CONCLUSIONS Impaired Autonomy and Performance is associated with BED in a sample of obese patients. Schema therapy should be considered a potential psychotherapy strategy in the treatment of BED. LEVEL OF EVIDENCE Level III, case-control study.
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Affiliation(s)
- Marianna Rania
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Matteo Aloi
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Mariarita Caroleo
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Elvira Anna Carbone
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Gilda Fazia
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Giuseppina Calabrò
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Renato de Filippis
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Filippo Staltari
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy.
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy.
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Solmi F, Bulik CM, De Stavola BL, Dalman C, Khandaker GM, Lewis G. Longitudinal associations between circulating interleukin-6 and C-reactive protein in childhood, and eating disorders and disordered eating in adolescence. Brain Behav Immun 2020; 89:491-500. [PMID: 32755646 PMCID: PMC7902903 DOI: 10.1016/j.bbi.2020.07.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/13/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Few studies have explored the association between inflammation and eating disorders and none used a longitudinal design. We investigated the association between serum-levels of interleukin 6 (IL-6) and C-reactive protein (CRP) measured in childhood and eating disorders and related behaviours and cognitions in adolescence in a large general population sample. METHODS We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Our exposures were thirds of IL6 and CRP derived from serum measurements taken at age nine years, and outcomes were eating disorder diagnoses and self-reported disordered eating behaviours at ages 14, 16, and 18 years. We used univariable and multivariable multilevel logistic regression models adjusting for a number of potential confounders, including sex, fat mass, and pre-existing mental health difficulties. RESULTS Our sample included 3480 children. Those in the top third of CRP had lower odds of binge eating (odds ratio(OR):0.62, 95% confidence interval (CI):0.39,1.00,p "equals" 0.05) and fasting (OR:0.63, 95% CI:0.38,1.07,p "equals" 0.09) after adjustment for confounders. We also observed weak associations of comparable magnitude for purging, anorexia nervosa, and bulimia nervosa. We did not find any associations between levels of IL6 and any of the outcomes under study. CONCLUSIONS There was little evidence of an association between CRP and IL-6 and adolescent eating disorder outcomes. The inverse association observed between CRP and binge eating was unexpected, so caution is needed when interpreting it. One possible explanation is that higher CRP levels could have a protective role for disordered eating by affecting appetitive traits.
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Affiliation(s)
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Christina Dalman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Golam M Khandaker
- University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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Ayton A, Ibrahim A. The Western diet: a blind spot of eating disorder research?-a narrative review and recommendations for treatment and research. Nutr Rev 2020; 78:579-596. [PMID: 31846028 PMCID: PMC7682725 DOI: 10.1093/nutrit/nuz089] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Over the last 50 years, in parallel with the obesity epidemic, the prevalence of eating disorders has increased and presentations have changed. In this narrative review, we consider recent research exploring the implications of changing patterns of food consumption on metabolic and neurobiological pathways, a hitherto neglected area in eating disorder research. One of the major changes over this time has been the introduction of ultra-processed (NOVA-4) foods, which are gradually replacing unprocessed and minimally processed foods. This has resulted in the increased intake of various sugars and food additives worldwide, which has important metabolic consequences: triggering insulin and glucose response, stimulating appetite, and affecting multiple endocrine and neurobiological pathways, as well as the microbiome. A paradigm shift is needed in the conceptual framework by which the vulnerability to, and maintenance of, different eating disorders may be understood, by integrating recent knowledge of the individual metabolic responses to modern highly processed foods into existing psychological models. This could stimulate research and improve treatment outcomes.
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Affiliation(s)
- Agnes Ayton
- University of Oxford, Oxford, United Kingdom
| | - Ali Ibrahim
- South London and Maudsley NHS Foundation Trust, Snowsfields Adolescent Unit, Mapother House, Maudsley Hospital, London
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Psychiatric Aspects of Obesity: A Narrative Review of Pathophysiology and Psychopathology. J Clin Med 2020; 9:jcm9082344. [PMID: 32717793 PMCID: PMC7463475 DOI: 10.3390/jcm9082344] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/14/2020] [Accepted: 07/22/2020] [Indexed: 12/16/2022] Open
Abstract
In the last decades, obesity has become a major concern for clinical and public health. Despite the variety of available treatments, the outcomes remain—by and large—still unsatisfactory, owing to high rates of nonresponse and relapse. Interestingly, obesity is being associated with a growing surge of neuropsychiatric problems, certainly related to the pathogenesis of this condition, and likely to be of great consequence as for its treatment and prognosis. In a neurobiologic direction, a sturdy body of evidence has recently shown that the immune–metabolic–endocrine dyscrasias, notoriously attached to excess body weight/adiposity, affect and impair the morpho-functional integrity of the brain, thus possibly contributing to neuroprogressive/degenerative processes and behavioral deviances. Likewise, in a neuropsychiatric perspective, obesity displays complex associations with mood disorders and affective temperamental dimensions (namely cyclothymia), eating disorders characterized by overeating/binge-eating behaviors, ADHD-related executive dysfunctions, emotional dysregulation and motivational–addictive disturbances. With this review, we attempt to provide the clinician a synoptic, yet exhaustive, tool for a more conscious approach to that subset of this condition, which could be reasonably termed “psychiatric” obesity.
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Al-Sari N, Suvitaival T, Mattila I, Ali A, Ahonen L, Trost K, Henriksen TF, Pociot F, Dragsted LO, Legido-Quigley C. Lipidomics of human adipose tissue reveals diversity between body areas. PLoS One 2020; 15:e0228521. [PMID: 32544198 PMCID: PMC7297320 DOI: 10.1371/journal.pone.0228521] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/15/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND AIMS Adipose tissue plays a pivotal role in storing excess fat and its composition reflects the history of person's lifestyle and metabolic health. Broad profiling of lipids with mass spectrometry has potential for uncovering new knowledge on the pathology of obesity, metabolic syndrome, diabetes and other related conditions. Here, we developed a lipidomic method for analyzing human subcutaneous adipose biopsies. We applied the method to four body areas to understand the differences in lipid composition between these areas. MATERIALS AND METHODS Adipose tissue biopsies from 10 participants were analyzed using ultra-high-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry. The sample preparation optimization included the optimization of the lipid extraction, the sample amount and the sample dilution factor to detect lipids in an appropriate concentration range. Lipidomic analyses were performed for adipose tissue collected from the abdomen, breast, thigh and lower back. Differences in lipid levels between tissues were visualized with heatmaps. RESULTS Lipidomic analysis on human adipose biopsies lead to the identification of 186lipids in 2 mg of sample. Technical variation of the lipid-class specific internal standards were below 5%, thus indicating acceptable repeatability. Triacylglycerols were highly represented in the adipose tissue samples, and lipids from 13 lipid classes were identified. Long polyunsaturated triacylglycerols in higher levels in thigh (q<0.05), when compared with the abdomen, breast and lower back, indicating that the lipidome was area-specific. CONCLUSION The method presented here is suitable for the analysis of lipid profiles in 2 mg of adipose tissue. The amount of fat across the body is important for health but we argue that also the distribution and the particular profile of the lipidome may be relevant for metabolic outcomes. We suggest that the method presented in this paper could be useful for detecting such aberrations.
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Affiliation(s)
- Naba Al-Sari
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Dept. of Clinical Medicine, University of Copenhagen, Gentofte, Denmark
| | | | - Ismo Mattila
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Ashfaq Ali
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Linda Ahonen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | | | | | - Flemming Pociot
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Dept. of Clinical Medicine, University of Copenhagen, Gentofte, Denmark
| | - Lars Ove Dragsted
- Dept. Nutrition, Exercise and Sports, University of Copenhagen, Gentofte, Denmark
| | - Cristina Legido-Quigley
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
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Giusti EM, Spatola CA, Brunani A, Kumbhare D, Oral A, Ilieva E, Kiekens C, Pietrabissa G, Manzoni GM, Imamura M, Castelnuovo G, Capodaglio P. ISPRM/ESPRM guidelines on Physical and Rehabilitation Medicine professional practice for adults with obesity and related comorbidities. Eur J Phys Rehabil Med 2020; 56:496-507. [PMID: 32293813 DOI: 10.23736/s1973-9087.20.06232-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The World Health Organization (WHO) has declared obesity as the largest global chronic health problem in adults. In the last years, attention has been drawn to rehabilitative interventions for patients with obesity. AIM The aim of this manuscript is to provide Physical and Rehabilitation Medicine (PRM) physicians with evidence-based recommendations for the rehabilitation of patients with overweight or obesity and related comorbidities. DESIGN Evidence-based guidelines. POPULATION Adults with overweight or obesity. METHODS Guidelines were based on GRADE and WHO recommendations. A comprehensive search of the available evidence about rehabilitation treatments for obesity was performed, and 17 separate systematic literature reviews were conducted. For each outcome, estimates of the effects of rehabilitation treatments were computed and employed along with an assessment of quality of evidence, desirable and undesirable effects, values and preferences to formulate the recommendations. Recommendations were reviewed by a consensus expert panel using a modified Delphi process. RESULTS We strongly recommend providing comprehensive multiprofessional and multidisciplinary interventions including exercise, diet and behavioral or cognitive-behavioral therapy. The nutritional component of these treatments should include diets with either a high-protein or a low-fat content. It is strongly recommended to prescribe frequent moderate aerobic exercise. We strongly recommend providing cognitive-behavioral interventions as the behavioral component of rehabilitation programs. CONCLUSIONS PRM physicians should lead multidisciplinary teams providing comprehensive and individualized rehabilitation programs for patients with overweight or obesity. These guidelines were endorsed by the International Society of Physical and Rehabilitation Medicine (ISPRM) and by the European Society of Physical and Rehabilitation Medicine (ESPRM).
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Affiliation(s)
- Emanuele M Giusti
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy - .,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy -
| | - Chiara A Spatola
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Amelia Brunani
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Dinesh Kumbhare
- Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
| | - Aydan Oral
- Department of Physical and Rehabilitation Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Elena Ilieva
- Department of Physical and Rehabilitation Medicine, Sv. Georgi University Hospital, Plovdiv, Bulgaria
| | - Carlotte Kiekens
- Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven Belgium.,Spinal Unit, Montecatone Rehabilitation Institute, Imola, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy.,Faculty of Psychology, eCampus University, Novedrate, Como, Italy
| | - Marta Imamura
- Institute of Physical and Rehabilitation Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Paolo Capodaglio
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
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Abstract
Binge-eating disorder (BED) is a prevalent and serious public health issue. BED is characterized by recurrent out-of-control binge eating episodes in the absence of extreme weight control behavior and is associated with significant psychosocial and physiological impairment. Dialectical Behavior Therapy (DBT), based on the affect regulation model of binge eating, is an evidence-based treatment (EBT) approach for BED. Unfortunately, access to EBTs is often limited due to geographical barriers (i.e., lack of local providers with specialized training in EBTs), lack of financial resources, and/or time constraints. Self-help approaches (via guided and unguided versions) to delivering DBT for BED offer a potentially effective means of more widely disseminating this treatment. Compared to traditional, higher intensity approaches, self-help DBT for BED is less time-consuming, less financially costly, and requires less need for specialized therapist-training. This paper will present how DBT for BED has been adapted for self-help delivery, review the limited but promising research on DBT self-help available to date, and provide directions for future research.
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Affiliation(s)
- Therese E Kenny
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Jacqueline C Carter
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Debra L Safer
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA
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Giusti E, Spatola CM, Brunani A, Kumbhare D, Oral A, Ilieva E, Kiekens C, Pietrabissa G, Manzoni G, Imamura M, Castelnuovo G, Capodaglio P. International society of physical and rehabilitation medicine/European society of physical and rehabilitation medicine guidelines on physical and rehabilitation medicine professional practice for adults with obesity and related comorbidities. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2020. [DOI: 10.4103/jisprm.jisprm_6_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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A real world study on the genetic, cognitive and psychopathological differences of obese patients clustered according to eating behaviours. Eur Psychiatry 2020; 48:58-64. [DOI: 10.1016/j.eurpsy.2017.11.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 10/30/2017] [Accepted: 11/21/2017] [Indexed: 12/11/2022] Open
Abstract
AbstractBackgroundConsidering that specific genetic profiles, psychopathological conditions and neurobiological systems underlie human behaviours, the phenotypic differentiation of obese patients according to eating behaviours should be investigated. The aim of this study was to classify obese patients according to their eating behaviours and to compare these clusters in regard to psychopathology, personality traits, neurocognitive patterns and genetic profiles.MethodsA total of 201 obese outpatients seeking weight reduction treatment underwent a dietetic visit, psychological and psychiatric assessment and genotyping for SCL6A2 polymorphisms. Eating behaviours were clustered through two-step cluster analysis, and these clusters were subsequently compared.ResultsTwo groups emerged: cluster 1 contained patients with predominantly prandial hyperphagia, social eating, an increased frequency of the long allele of the 5-HTTLPR and low scores in all tests; and cluster 2 included patients with more emotionally related eating behaviours (emotional eating, grazing, binge eating, night eating, post-dinner eating, craving for carbohydrates), dysfunctional personality traits, neurocognitive impairment, affective disorders and increased frequencies of the short (S) allele and the S/S genotype.ConclusionsAside from binge eating, dysfunctional eating behaviours were useful symptoms to identify two different phenotypes of obese patients from a comprehensive set of parameters (genetic, clinical, personality and neuropsychology) in this sample. Grazing and emotional eating were the most important predictors for classifying obese patients, followed by binge eating. This clustering overcomes the idea that ‘binging’ is the predominant altered eating behaviour, and could help physicians other than psychiatrists to identify whether an obese patient has an eating disorder. Finally, recognising different types of obesity may not only allow a more comprehensive understanding of this illness, but also make it possible to tailor patient-specific treatment pathways.
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Aloi M, Rania M, Caroleo M, Carbone EA, Fazia G, Calabrò G, Segura-Garcia C. How are early maladaptive schemas and DSM-5 personality traits associated with the severity of binge eating? J Clin Psychol 2019; 76:539-548. [PMID: 31733127 DOI: 10.1002/jclp.22900] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The present study aimed to (a) assess and compare personological traits and early maladaptive schemas (EMSs) of obese women with and without binge eating disorder (BED) and (b) identify the variables associated with the binge severity. METHOD One hundred women (55 BED-obese and 45 non-BED-obese) completed psychopathological and personological self-report questionnaires. A forward stepwise linear regression analysis was performed to assess variables associated with binge eating severity. RESULTS Not only psychopathological but also personological differences were evident between BED and non-BED-obese women. BED severity was significantly associated with depressivity, emotional deprivation, and defectiveness. CONCLUSIONS Our preliminary findings suggest that BED patients exhibit some EMSs that could be linked to the construct of emotional neglect and specific personological traits closely related to depressive dimensions, emotional lability, and impulsivity. In particular, binge severity is associated with the pervasiveness of depressogenic cognitive schemas, as well as those of emotional deprivation and defectiveness.
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Affiliation(s)
- Matteo Aloi
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Marianna Rania
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Mariarita Caroleo
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Elvira A Carbone
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Gilda Fazia
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Giusy Calabrò
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.,Outpatient Unit for Clinical Research and Treatment of Eating Disorders, Psychiatric Unit, University Hospital Mater Domini, Catanzaro, Italy
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Rantala MJ, Luoto S, Krama T, Krams I. Eating Disorders: An Evolutionary Psychoneuroimmunological Approach. Front Psychol 2019; 10:2200. [PMID: 31749720 PMCID: PMC6842941 DOI: 10.3389/fpsyg.2019.02200] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 09/12/2019] [Indexed: 12/18/2022] Open
Abstract
Eating disorders are evolutionarily novel conditions. They lead to some of the highest mortality rates of all psychiatric disorders. Several evolutionary hypotheses have been proposed for eating disorders, but only the intrasexual competition hypothesis is extensively supported by evidence. We present the mismatch hypothesis as a necessary extension to the current theoretical framework of eating disorders. This hypothesis explains the evolutionarily novel adaptive metaproblem that has arisen when mating motives conflict with the large-scale and easy availability of hyper-rewarding but obesogenic foods. This situation is exacerbated particularly in those contemporary environments that are characterized by sedentary lifestyles, ever-present junk foods, caloric surplus and the ubiquity of social comparisons that take place via social media. Our psychoneuroimmunological model connects ultimate-level causation with proximate mechanisms by showing how the adaptive metaproblem between mating motives and food rewards leads to chronic stress and, further, to disordered eating. Chronic stress causes neuroinflammation, which increases susceptibility to OCD-like behaviors that typically co-occur with eating disorders. Chronic stress upregulates the serotonergic system and causes dysphoric mood in anorexia nervosa patients. Dieting, however, reduces serotonin levels and dysphoric mood, leading to a vicious serotonergic-homeostatic stress/starvation cycle whereby cortisol and neuroinflammation increase through stringent dieting. Our psychoneuroimmunological model indicates that between-individual and within-individual variation in eating disorders partially arises from (co)variation in gut microbiota and stress responsivity, which influence neuroinflammation and the serotonergic system. We review the advances that have been made in recent years in understanding how to best treat eating disorders, outlining directions for future clinical research. Current evidence indicates that eating disorder treatments should aim to reduce the chronic stress, neuroinflammation, stress responsivity and gut dysbiosis that fuel the disorders. Connecting ultimate causes with proximate mechanisms and treating biopsychosocial causes rather than manifest symptoms is expected to bring more effective and sophisticated long-term interventions for the millions of people who suffer from eating disorders.
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Affiliation(s)
| | - Severi Luoto
- English, Drama and Writing Studies, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Tatjana Krama
- Department of Biotechnology, Daugavpils University, Daugavpils, Latvia
| | - Indrikis Krams
- Department of Biotechnology, Daugavpils University, Daugavpils, Latvia
- Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
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Caroleo M, Carbone EA, Greco M, Corigliano DM, Arcidiacono B, Fazia G, Rania M, Aloi M, Gallelli L, Segura-Garcia C, Foti DP, Brunetti A. Brain-Behavior-Immune Interaction: Serum Cytokines and Growth Factors in Patients with Eating Disorders at Extremes of the Body Mass Index (BMI) Spectrum. Nutrients 2019; 11:E1995. [PMID: 31450770 PMCID: PMC6770139 DOI: 10.3390/nu11091995] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 12/14/2022] Open
Abstract
Alterations of the immune system are known in eating disorders (EDs), however the importance of cytokine balance in this context has not been clarified. We compared cytokines and growth factors at opposite ends of BMI ranges, in 90 patients classified in relation to BMI, depressive and EDs comorbidities. Serum concentrations of interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) were determined by a biochip analyzer (Randox Labs). Differences were calculated through ANOVA. Possible predictors of higher cytokine levels were evaluated through regression analysis. IL-1α, IL-10, EGF, and IFN-γ were altered individuals with anorexia nervosa (AN) and binge eating disorder (BED). Night-eating was associated with IL-8 and EGF levels, IL-10 concentrations with post-dinner eating and negatively with sweet-eating, long fasting with higher IFN-γ levels. IL-2 increase was not linked to EDs, but to the interaction of depression and BMI. Altogether, for the first time, IL-1α, IL-10, EGF, and IFN-γ were shown to differ between AN and HCs, and between AN and individuals with obesity with or without BED. Only IL-2 was influenced by depression. Dysfunctional eating behaviors predicted abnormal concentrations of IL-10, EGF, IL-8 and IFN-γ.
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Affiliation(s)
- Mariarita Caroleo
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Elvira Anna Carbone
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Marta Greco
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | | | - Biagio Arcidiacono
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Gilda Fazia
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Marianna Rania
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Matteo Aloi
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Luca Gallelli
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy.
| | - Daniela Patrizia Foti
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Antonio Brunetti
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
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Heriseanu AI, Hay P, Touyz S. Grazing behaviour and associations with obesity, eating disorders, and health-related quality of life in the Australian population. Appetite 2019; 143:104396. [PMID: 31386867 DOI: 10.1016/j.appet.2019.104396] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/23/2019] [Accepted: 08/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Grazing, including a compulsive subtype, represents an eating behaviour of recent interest in obesity and eating disorders (ED), however, there is little information regarding its prevalence and correlates in the general population. The current study aimed to report on the distribution of compulsive grazing (CG) and non-compulsive grazing (NCG) in the Australian population, and to assess associations with obesity, ED, and health-related functioning. METHODS A representative sample of 3047 individuals aged ≥15 years (50.8% female) completed a cross-sectional survey in 2016 assessing grazing, quality of life, BMI, and ED symptoms. Prevalence data were obtained, and logistic regressions and multivariate analyses were conducted to examine relationships between grazing and obesity, ED, and health-related quality of life. RESULTS The point prevalence of regular NCG was 38.04% (95% CI [36.33, 39.78]; n = 1159) and CG was 10.24% (95% CI [9.21, 11.37]; n = 312). Persons with regular CG had almost twice the odds of a BMI ≥ 30 than of a BMI in the "healthy" range compared to those with no grazing. CG presented stronger associations with ED features and binge-type ED diagnostic groups than NCG, with high rates found in BED-Broad and BN, although some associations with ED features were also present for NCG. Those with both ED and obesity had an 11-fold increase in the odds of engaging in CG than in no grazing, compared to those without. Mental health-related quality of life was lower in those who engaged in CG in the population, as well as in those with obesity. CONCLUSIONS Grazing, especially when associated with a more severe sense of loss of control, is a problematic eating behaviour in the general population, as well as in persons with high BMI, a binge-type ED, or both.
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Affiliation(s)
- Andreea I Heriseanu
- School of Psychology, University of Sydney, Australia, Clinical Psychology Unit, University of Sydney, Level 3 M02F, 94 Mallett Street, Camperdown, NSW, 2050, Australia.
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Australia, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia; Campbelltown Hospital, South West Sydney Local Health District (SWSLHD), Australia, PO Box 149, Campbelltown, NSW, 2560, Australia.
| | - Stephen Touyz
- School of Psychology, University of Sydney, Australia, Clinical Psychology Unit, University of Sydney, Level 3 M02F, 94 Mallett Street, Camperdown, NSW, 2050, Australia; InsideOut Institute, Level 2, The Charles Perkins Centre, The University of Sydney, Johns Hopkins Drive, Camperdown, NSW, 2006, Australia.
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