1
|
Griffiths KR, Breukelaar IA, Harvie G, Yang J, Foster SL, Harris AW, Clarke S, Hay PJ, Touyz S, Korgaonkar MS, Kohn MR. Functional Connectivity Mechanisms Underlying Symptom Reduction Following Lisdexamfetamine Treatment in Binge-Eating Disorder: A Clinical Trial. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:317-325. [PMID: 38298797 PMCID: PMC10829641 DOI: 10.1016/j.bpsgos.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/03/2023] [Accepted: 08/21/2023] [Indexed: 02/02/2024] Open
Abstract
Background Speculation exists as to whether lisdexamfetamine dimesylate (LDX) acts on the functional connectivity (FC) of brain networks that modulate appetite, reward, or inhibitory control in binge-eating disorder (BED). Better insights into its action may help guide the development of more targeted therapeutics and identify who will benefit most from this medication. Here, we use a comprehensive data-driven approach to investigate the brain FC changes that underlie the therapeutic action of LDX in patients with BED. Methods Forty-six participants with moderate to severe BED received LDX titrated to 50 or 70 mg for an 8-week period. Twenty age-matched healthy control participants were also recruited. Resting-state functional magnetic resonance imaging was used to probe changes in brain FC pre- and post treatment and correlated with change in clinical measures. Results Ninety-seven percent of trial completers (n = 31) experienced remission or a reduction to mild BED during the 8-week LDX trial. Widespread neural FC changes occurred, with changes in default mode to limbic, executive control to subcortical, and default mode to executive control networks associated with improvements in clinical outcomes. These connections were not distinct from control participants at pretreatment but were different from control participants following LDX treatment. Pretreatment connectivity did not predict treatment response. Conclusions FC between networks associated with self-referential processing, executive function, and reward seem to underlie the therapeutic effect of LDX in BED. This suggests that LDX activates change via multiple systems, with most changes in compensatory networks rather than in those characterizing the BED diagnosis.
Collapse
Affiliation(s)
- Kristi R. Griffiths
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
- InsideOut Institute, University of Sydney, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Isabella A. Breukelaar
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Grace Harvie
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - Jenny Yang
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - Sheryl L. Foster
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
- Department of Radiology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Anthony W. Harris
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
- Specialty of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Simon Clarke
- Centre for Research into Adolescents’ Health, University of Sydney, Sydney, New South Wales, Australia
- Adolescent and Young Adult Medicine, Westmead Hospital, Sydney, New South Wales, Australia
| | - Phillipa J. Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Mental Health Services, Camden and Campbelltown Hospitals, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Stephen Touyz
- InsideOut Institute, University of Sydney, Sydney Local Health District, Sydney, New South Wales, Australia
- Clinical Psychology Unit, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - Mayuresh S. Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - Michael R. Kohn
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
- Centre for Research into Adolescents’ Health, University of Sydney, Sydney, New South Wales, Australia
- Adolescent and Young Adult Medicine, Westmead Hospital, Sydney, New South Wales, Australia
- Clinical Psychology Unit, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
2
|
Carbone EA, Aloi M, Rania M, de Filippis R, Quirino D, Fiorentino TV, Segura-Garcia C. The relationship of food addiction with binge eating disorder and obesity: A network analysis study. Appetite 2023; 190:107037. [PMID: 37714336 DOI: 10.1016/j.appet.2023.107037] [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: 04/12/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/17/2023]
Abstract
Food addiction (FA) has been associated with binge eating disorder (BED) and obesity at varying levels of severity and treatment outcomes. Despite much debate and scientific interest in FA, the mechanisms that underlie its co-occurrence with both conditions are not yet well understood. In order to understand this relationship, this study explores FA in a clinical sample of individuals with BED and obesity using network analysis (NA). A total of 303 patients (151 with BED and 152 with obesity) completed a battery of tests that investigated eating psychopathology, eating behaviours, emotional dysregulation, depression and FA. Two different NAs were conducted to investigate the interaction between these variables and FA. The BED and obesity groups were comparable in age (38 ± 14 vs. 42 ± 13 years), body mass index (38.8 ± 8.5 vs 42.4 ± 7.8), sex and demographics. According to the expected influence values, binge eating severity and depression were identified as the central nodes in both networks. In the BED group, binge eating severity was the central node and showed strong connections to both FA and grazing. In contrast, in the obesity group, depression was the central node, but its connections were weak, with only marginal associations to FA. These results suggest that FA represents an important and distinct construct of the two populations. In patients with BED, FA is intimately connected to other loss-of-control-related eating behaviours, such as binge eating and grazing. Conversely, in those with obesity, depression explains the relationship of FA with pathological eating behaviours. The presence of FA seems to be a distinguishing characteristic in the psychopathology of patients suffering from obesity with and without BED, and this could have implications for the prevention, treatment and management of these disorders.
Collapse
Affiliation(s)
- Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Matteo Aloi
- Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy; Department of Health Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Marianna Rania
- Center for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, 88100, Catanzaro, Italy
| | - Renato de Filippis
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Daria Quirino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Teresa Vanessa Fiorentino
- Department of Medical and Surgical 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; Center for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, 88100, Catanzaro, Italy.
| |
Collapse
|
3
|
Presseller EK, Karbassi N, Gian C, Juarascio AS. Unequivocally large, but not enormous: An examination of the nutritional content of objective and subjective binge-eating episodes using ecological momentary assessment data. Int J Eat Disord 2023; 56:1991-1997. [PMID: 37345531 PMCID: PMC10592441 DOI: 10.1002/eat.24016] [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: 09/29/2022] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE This study compared the macronutrient profiles of subjective binge-eating episodes (SBEs), objective binge-eating episodes (OBEs), and typical eating episodes. METHOD Twenty-one adults with binge eating completed ecological momentary assessment of all eating episodes for 2 weeks, including detailed monitoring of food types and portions. Binge-eating episodes (N = 237) were coded as OBEs (n = 76) or SBEs (n = 161). Calories and macronutrients were computed using manufacturer information and USDA Food and Nutrient Database for Dietary Studies. Multilevel regression models compared the eating episode types on caloric and macronutrient content. RESULTS OBEs contained an average of 121.5 (95.1) g fat, 363.7 (289.1) g carbohydrates, 65.2 (38.2) g protein, 20.9 (16.4) g fiber, and 2856.2 (1869.2) calories. SBEs contained 31.6 (30.5) g fat, 76.5 (54.0) g carbohydrates, 20.5 (21.6) g protein, 5.3 (5.9) g fiber, and 695.1 (505.9) calories. Although OBEs contained significantly more calories and grams of all macronutrients than SBEs (p < .001), the macronutrient proportions of OBEs and SBEs did not differ. The proportions of carbohydrates (p = .005) and protein (p < .001) in SBEs significantly differed from typical eating episodes. DISCUSSION Our findings offer preliminary evidence that OBEs and SBEs are more comparable in macronutrient profile than typical eating episodes. PUBLIC SIGNIFICANCE STATEMENT The present study compared the calories and grams of macronutrients in objectively large binge-eating episodes, subjectively large binge-eating episodes, and typical meals and snacks. Results suggest that objectively and subjectively large binge-eating episodes demonstrate similar profiles of macronutrients, which are different from the macronutrient profile of meals and snacks. These results may help the eating disorder field better study the impact of subjectively large binge-eating episodes.
Collapse
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
| | - Nikoo Karbassi
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Christina Gian
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Nutrition Sciences Department, 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
| |
Collapse
|
4
|
Maynard M, Burr EK, Allen Q, Dvorak RD, Paulson D. Loss-of-Control-Eating Mediates the Relationship between Cannabis-Related Problems and Eating Pathology. Psychol Rep 2023:332941231161999. [PMID: 36921084 DOI: 10.1177/00332941231161999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
The prevalence of eating pathology among college students has increased significantly in recent years. This coincides with increases in the use of cannabis, both nationally, but also among college students. Problematic cannabis use has been linked to eating pathology in prior research. Research also shows that cannabis may affect appetitive drives linked to food consumption. The current study tested the hypothesis that the association between problem cannabis use and eating pathology was mediated by greater loss of control eating. Cross-sectional data were collected from a sample of 805 college student cannabis users at a large Southeastern university in the U.S. The sample were primarily Caucasian (76%) and female (65.22%) with an average age of 20.15 (SD = 3.91). Participants completed surveys assessing eating outcomes (loss of control eating and eating pathology), cannabis use, and cannabis-related problems. The analysis used an observed variable path model. After controlling for cannabis use, cannabis-related problems were indirectly linked to eating pathology via loss of control eating (B = 0.109, SE = 0.025, p < .001), supporting the primary hypothesis. The direct relationship between cannabis-related problems and eating pathology was fully accounted for (B = 0.010, SE = 0.028, p = .724) by the indirect effect of loss of control eating. These data suggest that the association between problematic forms of cannabis use and eating pathology may be due to the association between cannabis problems and loss of control eating. While this may be due to changes in appetite and food evaluation as a function of more problematic use patterns, it may also be that individuals with problematic cannabis use have more problematic eating patterns due to deficits in adaptive coping strategies. Future research should seek to parse out these different potential explanations.
Collapse
Affiliation(s)
| | - Emily K Burr
- 6243The University of Central Florida, Orlando, FL, USA
| | - Quinn Allen
- 6243The University of Central Florida, Orlando, FL, USA
| | | | | |
Collapse
|
5
|
Burr EK, Dvorak RD, De Leon AN, Leary AV, Peterson R, Schaefer LM, Wonderlich SA. The role of eating expectancies and eating motives in the association between mood and loss-of-control eating: A national sample daily diary study. Appetite 2023; 180:106322. [PMID: 36208692 PMCID: PMC9794028 DOI: 10.1016/j.appet.2022.106322] [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: 01/18/2022] [Revised: 07/12/2022] [Accepted: 09/26/2022] [Indexed: 12/12/2022]
Abstract
Loss-of-control eating (LOCE, the subjective inability to refrain from eating or cease eating), is highly mood-driven. Mood-related eating motives and eating expectancies have been identified as contributors to binge eating. However, little is known about how these factors relate to LOCE, much less their relationship with daily-level LOCE. This study assessed the impact of trait eating expectancies and daily eating motives on the relationship between daily affective states and LOCE. United States adults (n = 109) reporting recent LOCE participated in a ten-day diary study, completing two surveys per day regarding eating behaviors, mood, and motives. Data were analyzed at the within- and between-subject levels utilizing a Bayesian approach to examine pathways from mood to LOCE, mediated by eating motives and accounting for a moderating impact of baseline eating expectancies on the path leg between mood and motives. Negative mood was associated with LOCE at both the within- and between-subjects level by way of coping motives, and directly at the within-subjects level. Negative affect (NA) reduction expectancies did not moderate the indirect pathway. Positive mood was only associated with LOCE at the within-subjects level, via pleasure motives. This relationship was potentiated via reward expectancies. Therefore, although negative mood appears be a robust predictor of LOCE regardless of trait NA reduction expectancies, positive mood appears to have a specific set of conditions under which individuals are at increased likelihood of LOCE at the within-subjects level. These findings suggest that eating expectancies and motives for eating may be meaningful targets in LOCE interventions.
Collapse
Affiliation(s)
- Emily K Burr
- University of Central Florida, Department of Psychology, United States.
| | - Robert D Dvorak
- University of Central Florida, Department of Psychology, United States
| | - Ardhys N De Leon
- University of Central Florida, Department of Psychology, United States
| | - Angelina V Leary
- University of Central Florida, Department of Psychology, United States
| | - Roselyn Peterson
- University of Central Florida, Department of Psychology, United States
| | | | | |
Collapse
|
6
|
Appolinario JC, Kaplan A, Hay PJ. Editorial: Neurocognitive and Translational Science of Binge Eating: Understanding Mechanisms of Change. Front Psychol 2022; 13:904103. [PMID: 35548552 PMCID: PMC9083402 DOI: 10.3389/fpsyg.2022.904103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jose Carlos Appolinario
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Allan Kaplan
- Center for Addiction and Mental Health, Faculty of Medicine at the University of Toronto, Toronto, ON, Canada
| | - Phillipa Jane Hay
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| |
Collapse
|
7
|
Bruzas MB, Tronieri JS, Chao AM, Jones E, McAllister C, Gruber K, McCuen-Wurst C, Berkowitz RI, Wadden TA, Allison KC. Binge size and loss of control as correlates of eating behavior and psychopathology among individuals with binge eating disorder and higher weight. J Behav Med 2022; 45:603-612. [PMID: 35449358 PMCID: PMC9578031 DOI: 10.1007/s10865-022-00312-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
Studies comparing individuals with loss of control (LOC) eating who do and do not have objectively large binge episodes have found that degree of LOC is more important than binge size to psychological and behavioral outcomes. However, the relative importance of these characteristics has not been investigated in a population with binge eating disorder (BED), who by definition all have objectively large binge episodes. Persons with BED and higher weight (N = 34) were enrolled in a BED treatment trial and completed the Loss of Control Over Eating Scale, the Eating Disorder Examination, and measures of eating behavior, mood, and quality of life. Body mass index (BMI) was calculated from measured height and weight. The size of the largest binge episode (measured in kilocalories) and degree of LOC were entered into multiple regression equations to determine their relationships with disordered eating symptoms, depression, quality of life, and BMI in this pilot study. Greater LOC had a stronger independent association than binge size with higher total eating psychopathology, shape dissatisfaction, hunger, food cravings and food addiction symptoms. Larger binge size had a stronger independent association than LOC with higher weight concern and lower general and social quality of life. Both characteristics were associated with higher eating concern and neither were associated with depression or BMI. Both binge size and degree of LOC are associated with important psychosocial treatment targets in patients with BED. Future research should validate the largest binge episode measurement method and replicate the present findings in a larger sample.
Collapse
Affiliation(s)
- Maija B Bruzas
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104, USA
| | - Jena S Tronieri
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104, USA
| | - Ariana M Chao
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104, USA.,Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Elizabeth Jones
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104, USA
| | - Cooper McAllister
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104, USA
| | - Kathryn Gruber
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104, USA
| | - Courtney McCuen-Wurst
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104, USA
| | - Robert I Berkowitz
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104, USA.,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Thomas A Wadden
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104, USA
| | - Kelly C Allison
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104, USA.
| |
Collapse
|
8
|
Burr EK, Dvorak RD, Stevenson BL, Schaefer LM, Wonderlich SA. Ability to tolerate distress moderates the indirect relationship between emotion regulation difficulties and loss-of-control over eating via affective lability. Eat Behav 2021; 43:101561. [PMID: 34517279 PMCID: PMC8629940 DOI: 10.1016/j.eatbeh.2021.101561] [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: 12/28/2020] [Revised: 07/27/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Loss-of-control eating (LOCE), inability to refrain from or cease eating, may contribute to significant distress and dysfunction, yet research is lacking specificity on vulnerabilities contributing to LOCE as an independent construct. Preliminary evidence indicates potential roles of distress tolerance, emotion regulation, and affective lability, but the relationship between these variables and LOCE has been under-assessed. MATERIAL AND METHODS A sample (N = 3968) consisting of university students completed an assessment of pathological eating and affiliated affective vulnerabilities. A latent variable structural equation model (SEM) was generated to predict LOCE by way of affective lability and indirectly, emotion regulation difficulties and low distress tolerance, controlling for general eating pathology. RESULTS Findings indicated a significant direct effect of affective lability on LOCE, as well as significant indirect effects of emotion regulation difficulties and distress tolerance on LOCE, via affect lability. Additionally, distress tolerance moderated the relationship between emotion regulation difficulties and affective lability, such that lower ability to tolerate distress strengthened the relationship and higher distress tolerance capability attenuated it. DISCUSSION Findings suggest an influence of distress tolerance on the relationship between poor emotion regulation and affective lability, which in turn may affect LOCE. Clinical implications and suggestions for future research are discussed.
Collapse
Affiliation(s)
- Emily K Burr
- Department of Psychology, University of Central Florida, United States of America.
| | - Robert D Dvorak
- Department of Psychology, University of Central Florida, United States of America.
| | | | - Lauren M Schaefer
- Sanford Center for Bio-behavioral Research, Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, United States of America
| | - Stephen A Wonderlich
- Sanford Center for Bio-behavioral Research, Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, United States of America.
| |
Collapse
|
9
|
Associations among weight-based teasing distress, impulsive emotion regulation, and loss of control eating in racially and ethnically diverse young men. Eat Behav 2021; 43:101543. [PMID: 34399304 DOI: 10.1016/j.eatbeh.2021.101543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 07/14/2021] [Accepted: 07/21/2021] [Indexed: 11/22/2022]
Abstract
According to affect regulation models, distress associated with weight-based teasing may be related to loss of control (LOC) eating. Maladaptive coping strategies may further exacerbate this association, but such hypotheses have not been evaluated in men. The purpose of the current study was to examine the association between distress from weight-based teasing and LOC eating in racially and ethnically diverse young men. The degree to which men engage in impulsive behavior when distressed was investigated as a moderating variable. Exploratory analyses examined the proposed associations within racial/ethnic identity groups. The current study included 1011 young men (18-30 years, Mage = 23.9 ± 3.6 y, 28.3% non-Hispanic White; 23.4% African American; 24.3% Hispanic/Latino; 23.8% Asian/Asian American). Participants completed an online survey with measures of weight-based teasing, LOC eating frequency, engagement in impulsive behavior when distressed, and demographics. After adjusting for age, race/ethnicity, and body mass index, there was a positive association between distress from weight-based teasing and LOC eating frequency (p < .001). In the full sample, the tendency to engage in impulsive behavior when distressed exacerbated this link (p < .01). Exploratory analyses revealed the moderating effect of impulsive coping on distress from teasing was significant in non-Hispanic White men, but was not significant for all others. These findings suggest that men are not immune to the negative correlates of weight-based teasing. LOC eating may function as a maladaptive coping mechanism, or may be an artifact of the disordered eating symptoms that can emerge during extreme efforts to obtain a thinner physique.
Collapse
|
10
|
Subjective binge eating: a marker of disordered eating and broader psychological distress. Eat Weight Disord 2021; 26:2201-2209. [PMID: 33200355 DOI: 10.1007/s40519-020-01053-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/13/2020] [Indexed: 01/20/2023] Open
Abstract
PURPOSE There is building, but limited evidence to suggest that subjective binge eating (SBE) is clinically concerning. The current study examined associated features of SBEs including disordered eating, body shame, negative affect, and interpersonal problems, as well as how SBE occurrence relates to other daily eating experiences. METHODS Participants were 400 individuals recruited via internet snowball or Amazon Mechanical Turk, including 132 with at least one SBE [with or without objective binge eating episodes (OBEs)] in the prior 3 months, 135 with at least one OBE (and no SBEs) in the prior 3 months, and 133 with no loss of control eating in the prior 3 months nor a likely lifetime history of anorexia nervosa. Participants responded to questionnaires assessing eating disorder behaviors (i.e., frequency of compensatory behaviors, dietary restriction), body shame, negative affect (depressive/anxiety symptoms), interpersonal difficulties, and perception of daily eating experiences. RESULTS Individuals with SBEs had higher numbers of vomiting, laxative misuse and hard exercise episodes, dietary restriction, body shame, depressive and anxiety symptoms, and negative perceptions of daily eating experiences as compared to those with only OBEs and no loss of control eating. CONCLUSION These results suggest that SBEs (whether on their own or combined with OBEs) are more related to disordered eating symptoms, body image concerns, depressive/anxiety symptoms, and general eating distress than OBEs on their own, suggesting that clinicians may view SBEs as markers of concern across domains. LEVEL OF EVIDENCE III, well-designed group-comparison regression analysis.
Collapse
|
11
|
Mourilhe C, Moraes CED, Veiga GD, Q da Luz F, Pompeu A, Nazar BP, Coutinho ESF, Hay P, Appolinario JC. An evaluation of binge eating characteristics in individuals with eating disorders: A systematic review and meta-analysis. Appetite 2021; 162:105176. [PMID: 33639247 DOI: 10.1016/j.appet.2021.105176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 12/16/2020] [Accepted: 02/19/2021] [Indexed: 01/29/2023]
Abstract
The objective of this review is to provide an updated synthesis of studies in individuals with eating disorders that examined the following components of binge eating episodes (BEEs): caloric intake, episode duration, and also the association of BEE size with psychopathology. A systematic review and meta-analysis were performed following the PRISMA guidelines. Searches were conducted on PubMed, PsycINFO, Scopus, SciELO, ScienceDirect and ProQuest databases. Meta-analysis was performed using random effects models and meta-regression. Forty-three studies were included. There was a paucity of information regarding BEE in individuals with anorexia nervosa. The pooled caloric intake of participants with bulimia nervosa (BN) during BEE in laboratory studies was significantly greater in comparison to the caloric intake during BEE in clinical studies [(3070 (95%CI 2596, 3544) vs. 1789 (95%CI 1498, 2081)], respectively. In participants with binge eating disorder (BED), the pooled means were 2088 (95%CI 1819, 2358) kcal in laboratory studies and 1903 (95%CI 1622, 2184) kcal in clinical studies, with no statistically significant difference between groups. Overall, BEE had a mean duration of 37.3 min in participants with BN and 41.7 min in those with BED. We found a positive correlation between the average caloric intake and level of depression (β = 55.5; p = 0.019). BEE in individuals with BN or BED were characterized by the consumption of extremely large quantities of calories. This was mainly found in laboratory studies of individuals with BN. BEE had a mean duration of less than 1 h in individuals with BN or BED. BEE size was positively associated with depression severity. Future research should explore the relevance of binge size as a core component of binge eating in clinical samples, in males, and in pediatric populations.
Collapse
Affiliation(s)
- Carla Mourilhe
- Federal University of Rio de Janeiro, Institute of Psychiatry, Obesity and Eating Disorders Group - Av. Venceslau Brás, 71, Botafogo, CEP:22290-140, Rio de Janeiro, Brazil; Federal University of Rio de Janeiro, Institute of Nutrition Josue de Castro, Department of Social and Applied Nutrition - Av. Carlos Chagas Filho, 373 - bloco J, 2° andar - Cidade Universitária, CEP:21941-902, Rio de Janeiro, Brazil.
| | - Carlos EduardoFerreira de Moraes
- Federal University of Rio de Janeiro, Institute of Psychiatry, Obesity and Eating Disorders Group - Av. Venceslau Brás, 71, Botafogo, CEP:22290-140, Rio de Janeiro, Brazil.
| | - GloriaValeria da Veiga
- Federal University of Rio de Janeiro, Institute of Nutrition Josue de Castro, Department of Social and Applied Nutrition - Av. Carlos Chagas Filho, 373 - bloco J, 2° andar - Cidade Universitária, CEP:21941-902, Rio de Janeiro, Brazil.
| | - Felipe Q da Luz
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), São Paulo, SP 05403-010, Brazil.
| | - Amanda Pompeu
- Federal University of Rio de Janeiro, Institute of Psychiatry, Obesity and Eating Disorders Group - Av. Venceslau Brás, 71, Botafogo, CEP:22290-140, Rio de Janeiro, Brazil.
| | - Bruno Palazzo Nazar
- Federal University of Rio de Janeiro, Institute of Psychiatry, Obesity and Eating Disorders Group - Av. Venceslau Brás, 71, Botafogo, CEP:22290-140, Rio de Janeiro, Brazil.
| | - Evandro Silva Freire Coutinho
- The State University of Rio de Janeiro, Institute of Social Medicine - R. São Francisco Xavier, 524 - Maracanã, CEP:20550-900, Rio de Janeiro, Brazil.
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, School of Medicine - David Pilgrim Avenue, Campbelltown, NSW 2560, Australia.
| | - Jose Carlos Appolinario
- Federal University of Rio de Janeiro, Institute of Psychiatry, Obesity and Eating Disorders Group - Av. Venceslau Brás, 71, Botafogo, CEP:22290-140, Rio de Janeiro, Brazil.
| |
Collapse
|
12
|
Berner LA, Sysko R, Rebello TJ, Roberto CA, Pike KM. Patient descriptions of loss of control and eating episode size interact to influence expert diagnosis of ICD-11 binge-eating disorder. J Eat Disord 2020; 8:71. [PMID: 33292557 PMCID: PMC7682053 DOI: 10.1186/s40337-020-00342-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/21/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Although data suggest that the sense of "loss of control" (LOC) is the most salient aspect of binge eating, the definition of LOC varies widely across eating disorder assessments. The WHO ICD-11 diagnostic guidelines for binge eating do not require an objectively large amount of food, which makes accurate LOC diagnosis even more critical. However, it can be especially challenging to assess LOC in the context of elevated weight status and in the absence of compensatory behaviors. This ICD-11 field sub-study examined how descriptions of subjective experience during distressing eating episodes, in combination with different eating episode sizes, influence diagnoses of binge-eating disorder (BED). METHOD Mental health professionals with eating disorder expertise from WHO's Global Clinical Practice Network (N = 192) participated in English, Japanese, and Spanish. Participants were asked to select the correct diagnosis for two randomly assigned case vignettes and to rate the clinical importance and ease of use of each BED diagnostic guideline. RESULTS The presence of LOC interacted with episode size to predict whether a correct diagnostic conclusion was reached. If the amount consumed during a typical distressing eating episode was only subjectively large compared to objectively large, clinicians were 23.1 times more likely to miss BED than to correctly diagnose it, and they were 9.7 times more likely to incorrectly diagnose something else than to correctly diagnose BED. In addition, clinicians were 10.8 times more likely to make a false positive diagnosis of BED when no LOC was described if the episode was objectively large. Descriptions of LOC that were reliably associated with correct diagnoses across episodes sizes included two that are similar to those already included in proposed ICD-11 guidelines and a third that is not. This third description of LOC focuses on giving up attempts to control eating because perceived overeating feels inevitable. CONCLUSIONS Results highlight the importance of detailed clarification of the LOC construct in future guidelines. Explicitly distinguishing LOC from distressing and mindless overeating could help promote consistent and accurate diagnosis of BED versus another or no eating disorder.
Collapse
Affiliation(s)
- Laura A Berner
- Department of Psychiatry, 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
| | - Tahilia J Rebello
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kathleen M Pike
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
13
|
Schulte EM, Wadden TA, Allison KC. An evaluation of food addiction as a distinct psychiatric disorder. Int J Eat Disord 2020; 53:1610-1622. [PMID: 32725769 DOI: 10.1002/eat.23350] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/25/2020] [Accepted: 06/25/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate the state of the literature for whether food addiction may warrant consideration as a distinct psychiatric disorder in the Diagnostic and Statistical Manual (DSM) using Blashfield et al.'s (1990; Comprehensive Psychiatry, 31(1), 15-19) five criteria. This framework was utilized because it has recently been applied to examine the diagnostic utility of several eating disorder phenotypes. The criteria are: (a) at least 50 journal articles published on the proposed syndrome in the past 10 years; (b) proposal of diagnostic criteria and assessment measures; (c) clinician reliability in diagnosis; (d) cohesiveness of the proposed diagnostic criteria; and (e) differentiation from similar, existing diagnostic categories. METHOD For each criterion, a literature review was conducted to examine if the minimum qualification had been met, and key findings were discussed. RESULTS Two of the criteria (literature and differentiation) have been empirically supported to extent specified. Two criteria (diagnostic criteria and syndrome) have been partially fulfilled, due to only having self-report assessment measures and no examination of the odds ratios for meeting more than one symptom, respectively. Clinician reliability has not yet been evaluated. DISCUSSION The existing literature suggests that food addiction may warrant consideration as a proposed diagnostic category in the DSM, though future research is needed to fulfill Blashfield et al.'s (1990; Comprehensive Psychiatry, 31(1), 15-19) criteria. The development of a semi-structured interview would be an impactful contribution for addressing these gaps.
Collapse
Affiliation(s)
- Erica M Schulte
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Thomas A Wadden
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Kelly C Allison
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
14
|
Pluhar EI, Abdullah S, Burton ET. Endorsement of Binge Eating Symptoms in a Sample of Predominantly Non-Hispanic Black Adolescents. Clin Pediatr (Phila) 2020; 59:766-772. [PMID: 32274933 DOI: 10.1177/0009922820915897] [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] [Indexed: 01/19/2023]
Abstract
Binge eating disorder (BED) as well as individual subthreshold binge eating symptoms are related to deleterious physical and socioemotional outcomes among adolescents. The present study examined the prevalence of specific binge eating behaviors among a sample of primarily non-Hispanic Black outpatients presenting to weight management and endocrinology clinics. Analyses are based on 103 adolescents (69.9% female, 66.9% non-Hispanic Black) who endorsed one or more binge eating symptoms on a nonstandardized clinical assessment patterned after Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. The most commonly endorsed symptom was eating in excess of what is considered normal (71.8%), while least commonly endorsed symptoms included guilt, distress, and embarrassment due to overeating (17.5% to 26.2%). More than half of the participants endorsed multiple specific binge eating symptoms. The level of subthreshold symptomatology reported underscores the importance of developmental and cultural tailoring of prevention and intervention efforts to address these behaviors as a means of curbing clinical-level onset of BED.
Collapse
Affiliation(s)
- Emily I Pluhar
- Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA USA
| | - Syidah Abdullah
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - E Thomaseo Burton
- University of Tennessee Health Science Center, Memphis, TN, USA.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| |
Collapse
|
15
|
Claudino AM, Pike KM, Hay P, Keeley JW, Evans SC, Rebello TJ, Bryant-Waugh R, Dai Y, Zhao M, Matsumoto C, Herscovici CR, Mellor-Marsá B, Stona AC, Kogan CS, Andrews HF, Monteleone P, Pilon DJ, Thiels C, Sharan P, Al-Adawi S, Reed GM. The classification of feeding and eating disorders in the ICD-11: results of a field study comparing proposed ICD-11 guidelines with existing ICD-10 guidelines. BMC Med 2019; 17:93. [PMID: 31084617 PMCID: PMC6515596 DOI: 10.1186/s12916-019-1327-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/16/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) International Classification of Diseases and Related Health Problems (ICD) is used globally by 194 WHO member nations. It is used for assigning clinical diagnoses, providing the framework for reporting public health data, and to inform the organization and reimbursement of health services. Guided by overarching principles of increasing clinical utility and global applicability, the 11th revision of the ICD proposes major changes that incorporate empirical advances since the previous revision in 1992. To test recommended changes in the Mental, Behavioral, and Neurodevelopmental Disorders chapter, multiple vignette-based case-controlled field studies have been conducted which examine clinicians' ability to accurately and consistently use the new guidelines and assess their overall clinical utility. This manuscript reports on the results from the study of the proposed ICD-11 guidelines for feeding and eating disorders (FEDs). METHOD Participants were 2288 mental health professionals registered with WHO's Global Clinical Practice Network. The study was conducted in Chinese, English, French, Japanese, and Spanish. Clinicians were randomly assigned to apply either the ICD-11 or ICD-10 diagnostic guidelines for FEDs to a pair of case vignettes designed to test specific clinical questions. Clinicians selected the diagnosis they thought was correct for each vignette, evaluated the presence of each essential feature of the selected diagnosis, and the clinical utility of the diagnostic guidelines. RESULTS The proposed ICD-11 diagnostic guidelines significantly improved accuracy for all FEDs tested relative to ICD-10 and attained higher clinical utility ratings; similar results were obtained across all five languages. The inclusion of binge eating disorder and avoidant-restrictive food intake disorder reduced the use of residual diagnoses. Areas needing further refinement were identified. CONCLUSIONS The proposed ICD-11 diagnostic guidelines consistently outperformed ICD-10 in distinguishing cases of eating disorders and showed global applicability and appropriate clinical utility. These results suggest that the proposed ICD-11 guidelines for FEDs will help increase accuracy of public health data, improve clinical diagnosis, and enhance health service organization and provision. This is the first time in the revision of the ICD that data from large-scale, empirical research examining proposed guidelines is completed in time to inform the final diagnostic guidelines.
Collapse
Affiliation(s)
- Angélica M Claudino
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Major Maragliano, 241, São Paulo, SP, 04017-030, Brazil.
| | - Kathleen M Pike
- Department of Psychiatry, Columbia University, Vagelos College of Physicians and Surgeons, Unit 9 Room 5808, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, NSW Campbelltown, Australia
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Box 842018, Richmond, VA, 23284, USA
| | - Spencer C Evans
- Department of Psychology, Harvard University, 33 Kirkland St, 1040 William James Hall, Cambridge, MA, 02138, USA
| | - Tahilia J Rebello
- Global Mental Health Program, Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, Mailman School of Public Health, 722 West 168th, Floor R2, R-233, New York, NY, 10032, USA
| | - Rachel Bryant-Waugh
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH, UK
| | - Yunfei Dai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, People's Republic of China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, People's Republic of China
| | - Chihiro Matsumoto
- National Study Coordinator for ICD-11 Field Studies, ICD-11 Committee, Japanese Society of Psychiatry and Neurology, Hongo-Yumicho Building, 2-38-4, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Cecile Rausch Herscovici
- International Life Sciences Institute (ILSI, Argentina), J. Salguero 2745, Buenos Aires, 1425, CABA, Argentina
| | - Blanca Mellor-Marsá
- Department of Psychiatry, Faculty of Medicine, Universidad Autónoma de Madrid, Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental, 2ª Planta Norte, Calle del Prof Martín Lagos, s/n, 28040, Madrid, Spain
| | - Anne-Claire Stona
- Ministry for Solidarity and Health, Avenue Duquesne, 75350, Paris, France
| | - Cary S Kogan
- School of Psychology, Faculty of Social Sciences, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON, K1N 6N5, Canada
| | - Howard F Andrews
- Departments of Biostatistics and Psychiatry and New York State Psychiatric Institute, Columbia University, Vagelos College of Physicians and Surgeons, Unit 47, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Palmiero Monteleone
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.,Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, via Allende, Baronissi, 84081, Salerno, Italy
| | - David Joseph Pilon
- Nova Scotia Health Authority, Dalhousie University, LeMarchant Place, 2nd Floor, Rm 2121, 1246 LeMarchant Street, Halifax, NS, B3H 4R2, Canada
| | - Cornelia Thiels
- Department of Social Studies, University of Applied Sciences Bielefeld, Kissinger Str. 14, D-12157, Berlin, Germany
| | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, P.C. 123, Al Khoud, Muscat, Sultanate of Oman
| | - Geoffrey M Reed
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.,Department of Psychiatry, Columbia University, Vagelos College of Physicians and Surgeons, Unit 9 Room 5816, 1051 Riverside Drive, New York, NY, 10032, USA
| |
Collapse
|
16
|
Li N, Mitchison D, Touyz S, Hay P. Cross-sectional comparison of health-related quality of life and other features in people with and without objective and subjective binge eating using a general population sample. BMJ Open 2019; 9:e024227. [PMID: 30787086 PMCID: PMC6398903 DOI: 10.1136/bmjopen-2018-024227] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Evidence suggests that while objective binge eating (OBE) and subjective binge eating (SBE) differ in the amount of food consumed, both are associated with impairment in people with eating disorders. However, only OBE is accounted for in the diagnostic criteria of eating disorders. This study compared the sociodemographic profile and burden of OBE versus SBE at a population level. DESIGN Population-based survey. PARTICIPANTS A representative sample of 3028 men and women. Participants were categorised into four groups based on their reporting of binge eating in the past 3 months: non-binge eating group (no OBE or SBE), OBE group, SBE group and OSBE group (both OBE and SBE). OUTCOME MEASURES Demographics (age, genderand body mass index, BMI), binge eating, distress, weight/shape overvaluation and health-related quality of life. Groups were compared on sociodemographic information, overvaluation and health-related quality of life. The OBE and SBE groups were also compared on the distress related to binge eating. RESULTS No differences were found between the SBE group and OBE group in age, gender, BMI, mental health-related quality of life and overvaluation (all p>0.05). However, differences were found in the OSBE participants, namely that they were younger, had a higher mean BMI, lower mental health-related quality of life and higher overvaluation of weight/shape than the non-binge-eating participants (all p<0.001). Proportions of participants who reported distress related to binge eating in the OBE and SBE groups also did not differ (p=0.678). CONCLUSION There is little difference in the demographic profile or burden of people who engage in OBE versus SBE, supporting the proposed inclusion of SBE in the diagnostic criteria for eating disorders in International Classification of Diseases-11. People who experience both OBE and SBE may experience a relatively higher eating disorder severity and impairment.
Collapse
Affiliation(s)
- Natalie Li
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Deborah Mitchison
- Psychology Department, Macquarie University, Sydney, New South Wales, Australia
| | - Stephen Touyz
- Clinical Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Phillipa Hay
- Translational Health Research Institure, School of Medicine, Western Sydney, Penrith, New South Wales, Australia
| |
Collapse
|
17
|
Kelly NR, Cotter E, Guidinger C. Men who engage in both subjective and objective binge eating have the highest psychological and medical comorbidities. Eat Behav 2018; 30:115-119. [PMID: 29990652 DOI: 10.1016/j.eatbeh.2018.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 06/18/2018] [Accepted: 07/03/2018] [Indexed: 11/24/2022]
Abstract
Data suggest that assessing for the presence of loss of control (LOC) while eating is more useful in identifying risk for excess weight gain and psychosocial comorbidities than focusing on the amount of food consumed during episodes of perceived overeating. Yet, most of this research has included children and women. The current study examined whether perceived overeating patterns with and without LOC were uniquely associated with eating- and weight-related comorbidities in a community sample of young men. Participants (N = 1114; 18-30 y) completed a brief online survey assessing body mass index (BMI); perceived overeating habits, including overeating without LOC (OEs), and subjective (SBEs) and objective binge eating episodes (OBEs); weight-related medical comorbidities; and disordered eating pathology. After adjusting for BMI and race/ethnicity, men who reported engaging in both OBE(s) and SBE(s) were the most likely to have a weight-related medical comorbidity, and reported the highest levels of dietary restraint, concerns about body fat, and excessive exercise pathology. Group differences remained even after adjusting for frequency of disordered eating episodes, a common indicator of severity of comorbid pathology. The current study's findings suggest that young men who engage in both OBE(s) and SBE(s) may be at the highest risk for chronic disease and psychological concerns, although additional studies with prospective data are necessary to confirm this hypothesis.
Collapse
Affiliation(s)
- Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America.
| | - Elizabeth Cotter
- Department of Health Studies, American University, United States of America
| | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America
| |
Collapse
|
18
|
Conceição EM, Gomes FVS, Vaz AR, Pinto-Bastos A, Machado PPP. Prevalence of eating disorders and picking/nibbling in elderly women. Int J Eat Disord 2017; 50:793-800. [PMID: 28301060 DOI: 10.1002/eat.22700] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 02/14/2017] [Accepted: 02/15/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The aim of this study was to examine the point prevalence of eating disorders and picking/nibbling in elderly women. METHODS This was a two-stage epidemiological study that assessed 342 women aged 65-94 years old. In Stage 1, the following screening measures were used to identify possible cases: the Mini-Mental State Examination, to screen and exclude patients with cognitive impairment; Weight Concerns Scale; SCOFF (Sick, Control, One, Fat, Food) Questionnaire; Eating Disorder Examination Questionnaire-dietary restraint subscale; and three questions to screen for picking/nibbling and night eating syndrome. Women selected for Stage 2 (n = 118) were interviewed using the diagnostic items of the Eating Disorder Examination. RESULTS According to the DSM-5, the prevalence of all eating disorders was 3.25% (1.83-5.7, 95% C.I.). Prevalence of binge-eating disorder was 1.68% (0.82-3.82, 95% C.I.), of other specified feeding or eating disorders was 1.48% (0.63-3.42, 95% C.I.), and of bulimia nervosa 0.3% (.05-1.7, 95% C.I.)]. Binge-eating episodes were reported by 5.62% of women. No cases of anorexia nervosa or night eating syndrome were identified. The prevalence of picking/nibbling was 18.9%. Picking/nibbling was associated with increased body mass index (t(322) = -3.28, p < .001) and binge-eating episodes (χ2 (1) = 5.65, p < .017). DISCUSSION Prevalence rates of eating disorders on elderly Portuguese women were comparable to those found on young women. Our data support the literature that suggests that binge-eating disorder is particularly prevalent in older adults. Picking/nibbling was the most prevalent eating behavior and we provide further evidence for its association with weight and disordered eating.
Collapse
Affiliation(s)
- Eva M Conceição
- School of Psychology, University of Minho, 4710-057, Braga, Portugal
| | - Fabiana V S Gomes
- School of Psychology, University of Minho, 4710-057, Braga, Portugal
| | - Ana R Vaz
- School of Psychology, University of Minho, 4710-057, Braga, Portugal
| | - Ana Pinto-Bastos
- School of Psychology, University of Minho, 4710-057, Braga, Portugal
| | - Paulo P P Machado
- School of Psychology, University of Minho, 4710-057, Braga, Portugal
| |
Collapse
|
19
|
Goldschmidt AB. Are loss of control while eating and overeating valid constructs? A critical review of the literature. Obes Rev 2017; 18:412-449. [PMID: 28165655 PMCID: PMC5502406 DOI: 10.1111/obr.12491] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/22/2016] [Accepted: 11/22/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND Binge eating is a marker of weight gain and obesity, and a hallmark feature of eating disorders. Yet its component constructs - overeating and loss of control (LOC) while eating - are poorly understood and difficult to measure. OBJECTIVE The objective of this study is to critically review the human literature concerning the validity of LOC and overeating across the age and weight spectrum. DATA SOURCES English-language articles addressing the face, convergent, discriminant and predictive validity of LOC and overeating were included. RESULTS Loss of control and overeating appear to have adequate face validity. Emerging evidence supports the convergent and predictive validity of the LOC construct, given its unique cross-sectional and prospective associations with numerous anthropometric, psychosocial and eating behaviour-related factors. Overeating may be best conceptualized as a marker of excess weight status. LIMITATIONS Binge eating constructs, particularly in the context of subjectively large episodes, are challenging to measure reliably. Few studies addressed overeating in the absence of LOC, thereby limiting conclusions about the validity of the overeating construct independent of LOC. Additional studies addressing the discriminant validity of both constructs are warranted. DISCUSSION Suggestions for future weight-related research and for appropriately defining binge eating in the eating disorders diagnostic scheme are presented.
Collapse
Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
| |
Collapse
|
20
|
Segura-Garcia C, Caroleo M, Rania M, Barbuto E, Sinopoli F, Aloi M, Arturi F, De Fazio P. Binge Eating Disorder and Bipolar Spectrum disorders in obesity: Psychopathological and eating behaviors differences according to comorbidities. J Affect Disord 2017; 208:424-430. [PMID: 27846411 DOI: 10.1016/j.jad.2016.11.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/05/2016] [Accepted: 11/06/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Obesity is not a mental disorder, yet DSM-5 recognizes a strong association between obesity and psychiatric syndromes. Disorders within the Bipolar Spectrum (BSD) and Binge Eating Disorder (BED) are the most frequent psychiatric disorders among obese patients. The aim of this research is to investigate the psychopathological differences and the distinctive eating behaviors that accompany these comorbidities in obese patients. METHODS One hundred and nineteen obese patients (40 males; 79 females) underwent psychological evaluation and psychiatric interview, and a dietitian evaluated their eating habits. Patients were divided into four groups according to comorbidities, and comparisons were run accordingly. RESULTS Forty-one percent of participants presented BED+BSD comorbidity (Group 1), 21% BED (Group 2) and 8% BSD (Group 3); only 29% obese participants had no comorbidity (Group 4). Female gender was overrepresented among Groups 1 and 2. BSD diagnosis varied according to comorbidities: Type II Bipolar Disorder and Other Specified and Related Bipolar Disorder (OSR BD) were more frequent in Group 1 and Type I Bipolar Disorder in Group 3. A trend of decreasing severity in eating behaviors and psychopathology was evident according to comorbidities (Group 1=Group2>Group3>Group 4). LIMITATIONS Limitations include the small sample size and the cross-sectional design of the study. CONCLUSIONS BED and BSD are frequent comorbidities in obesity. Type II Bipolar Disorder and OSR BD are more frequent in the group with double comorbidity. The double comorbidity seems associated to more severe eating behaviors and psychopathology. Distinctive pathological eating behaviors could be considered as warning signals, symptomatic of psychiatric comorbidities in Obesity.
Collapse
Affiliation(s)
| | - Mariarita Caroleo
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Marianna Rania
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Elvira Barbuto
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Flora Sinopoli
- Dietetic Service, University Hospital Mater Domini, Catanzaro, Italy
| | - Matteo Aloi
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| |
Collapse
|
21
|
Schmidt J, Martin A. Neurofeedback Against Binge Eating: A Randomized Controlled Trial in a Female Subclinical Threshold Sample. EUROPEAN EATING DISORDERS REVIEW 2016; 24:406-16. [DOI: 10.1002/erv.2453] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/22/2016] [Accepted: 04/01/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Jennifer Schmidt
- Department of Clinical Psychology and Psychotherapy; University of Wuppertal; Germany
| | - Alexandra Martin
- Department of Clinical Psychology and Psychotherapy; University of Wuppertal; Germany
| |
Collapse
|
22
|
Wilfley DE, Citrome L, Herman BK. Characteristics of binge eating disorder in relation to diagnostic criteria. Neuropsychiatr Dis Treat 2016; 12:2213-23. [PMID: 27621631 PMCID: PMC5010172 DOI: 10.2147/ndt.s107777] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included "binge eating disorder," DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and "shape and weight concerns." Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors' knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive-compulsive, and impulsive disorders) and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes) comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional eating). Future revisions of the BED diagnostic criteria should consider the inclusion of BED subtypes, perhaps based on the overvaluation of shape/weight, and an evidence-based reassessment of severity criteria.
Collapse
Affiliation(s)
- Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO
| | - Leslie Citrome
- Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla, NY
| | | |
Collapse
|
23
|
Abraham TM, Massaro JM, Hoffmann U, Yanovski JA, Fox CS. Metabolic characterization of adults with binge eating in the general population: the Framingham Heart Study. Obesity (Silver Spring) 2014; 22:2441-9. [PMID: 25136837 PMCID: PMC4224974 DOI: 10.1002/oby.20867] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 07/29/2014] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To describe the metabolic profile of individuals with objective binge eating (OBE) and to evaluate whether associations between OBE and metabolic risk factors are mediated by body mass index (BMI). METHODS Participants from the Framingham Heart Study, Third Generation and Omni 2 cohorts (n = 3,551, 53.1% women, mean age 46.4 years) were screened for binge eating. Multivariable-adjusted regression models to examine the associations of OBE with metabolic risk factors were used. RESULTS The prevalence of OBE was 4.8% in women and 4.9% in men. Compared to non-binge eating, OBE was associated with higher odds of hypertension (OR 1.85, 95% CI 1.32-2.60), hypertriglyceridemia (OR 1.42, 95% CI 1.01-2.01), low HDL (OR 1.70, 95% CI 1.18-2.44), insulin resistance (OR 3.18, 95% CI 2.25-4.50) and metabolic syndrome (OR 2.75, 95% CI 1.94-3.90). Fasting glucose was 7.2 mg dl(-1) higher in those with OBE (P = 0.0001). Individuals with OBE had more visceral, subcutaneous and liver fat. Most of these associations were attenuated with adjustment for BMI, with the exception of fasting glucose. CONCLUSIONS Binge eating is associated with a high burden of metabolic risk factors. Much of the associated risk appears to be mediated by BMI, with the exception of fasting glucose.
Collapse
Affiliation(s)
- Tobin M Abraham
- Department of Endocrinology, Hypertension and Diabetes, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA; National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA; National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | | | | | | | | |
Collapse
|
24
|
Latner JD, Mond JM, Kelly MC, Haynes SN, Hay PJ. The Loss of Control Over Eating Scale: development and psychometric evaluation. Int J Eat Disord 2014; 47:647-59. [PMID: 24862351 DOI: 10.1002/eat.22296] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 04/21/2014] [Accepted: 04/27/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study describes the development, content validity, and convergent validity of the Loss of Control over Eating Scale (LOCES). METHOD An initial pool of 56 items covering 13 facets of loss-of-control eating was assembled by reviewing qualitative literature, clinical descriptions, and research on binge eating. Eating disorder experts (n = 34) and eating disorder clients (n = 22) rated each proposed item's clarity and relevance to the construct of loss-of-control eating, rated 13 facets for their relevance to the construct, and provided open-ended feedback about the items and facets. Based on the experts' and clients' quantitative and qualitative feedback, scale items were clarified, 28 items were added, and 10 were deleted. University students (n = 476; 70% female, mean age = 20.4 years) completed the resulting 74-item questionnaire, rating how often they had the experience identified in the item while eating in the last 4 weeks. They also completed the measures of eating disturbance, general distress, functional impairment, and general self-control. RESULTS The resulting 24-item LOCES (Cronbach's α = .96) retained items with highest item-total correlations and coverage of the 12 construct facets that experts rated as important. The LOCES was significantly correlated with eating disturbances, general distress, functional impairment, and general self-control. Three subfactors were identified: behavioral, cognitive/dissociative, and positive/euphoric aspects of loss-of-control eating. A brief, seven-item version of the LOCES was developed and validated. DISCUSSION A thorough process of development, content validation, and psychometric evaluation in multiple samples yielded the multifaceted LOCES and its brief form. These instruments may be useful in assessing loss-of-control eating in both clinical and nonclinical settings.
Collapse
Affiliation(s)
- Janet D Latner
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | | | | | | | | |
Collapse
|