Microstructure of eating behavior associated with Rorschach characteristics in obesity

Food preferences after bariatric surgery: a review update

Obesity is a serious and global health problem. The multiple complications of obesity reduce quality of life and increase mortality. Bariatric surgery is one of the best treatment options for obesity management. Bariatric surgery helps people reduce their caloric intake by treating the disease of obesity effectively, in part by increasing signaling from the gut to the brain. The most frequent surgical options are Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). There is controversy regarding changes in food preferences and selection after bariatric surgery. In this review, we aim to outline the changes in food intake and selection, clarify the behavior changes in food intake, and assess the potential mechanisms responsible for these changes in patients after bariatric surgery.

Possible Role of GnIH as a Novel Link between Hyperphagia-Induced Obesity-Related Metabolic Derangements and Hypogonadism in Male Mice

Gonadotropin-inhibitory hormone (GnIH) is a reproductive inhibitor and an endogenous orexigenic neuropeptide that may be involved in energy homeostasis and reproduction. However, whether GnIH is a molecular signal link of metabolism and the reproductive system, and thus, regulates reproductive activity as a function of the energy state, is still unknown. In the present study, we investigated the involvement of GnIH in glycolipid metabolism and reproduction in vivo, and in the coupling between these two processes in the testis level. Our results showed that chronic intraperitoneal injection of GnIH into male mice not only increased food intake and altered meal microstructure but also significantly elevated body mass due to the increased mass of liver and epididymal white adipose tissue (eWAT), despite the loss of testicular weight. Furthermore, chronic intraperitoneal administration of GnIH to male mice resulted in obesity-related glycolipid metabolic derangements, showing hyperlipidemia, hyperglycemia, glucose intolerance, and insulin resistance through changes in the expression of glucose and lipid metabolism-related genes in the pancreas and eWAT, respectively. Interestingly, the expression of GnIH and GPR147 was markedly increased in the testis of mice under conditions of energy imbalance, such as fasting, acute hypoglycemia, and hyperglycemia. In addition, chronic GnIH injection markedly inhibited glucose and lipid metabolism of mice testis while significantly decreasing testosterone synthesis and sperm quality, inducing hypogonadism. These observations indicated that orexigenic GnIH triggers hyperphagia-induced obesity-related metabolic derangements and hypogonadism in male mice, suggesting that GnIH is an emerging candidate for coupling metabolism and fertility by involvement in obesity and metabolic disorder-induced reproductive dysfunction of the testes.

Meal Microstructure Characterization from Sensor-Based Food Intake Detection

To avoid the pitfalls of self-reported dietary intake, wearable sensors can be used. Many food ingestion sensors offer the ability to automatically detect food intake using time resolutions that range from 23 ms to 8 min. There is no defined standard time resolution to accurately measure ingestive behavior or a meal microstructure. This paper aims to estimate the time resolution needed to accurately represent the microstructure of meals such as duration of eating episode, the duration of actual ingestion, and number of eating events. Twelve participants wore the automatic ingestion monitor (AIM) and kept a standard diet diary to report their food intake in free-living conditions for 24 h. As a reference, participants were also asked to mark food intake with a push button sampled every 0.1 s. The duration of eating episodes, duration of ingestion, and number of eating events were computed from the food diary, AIM, and the push button resampled at different time resolutions (0.1–30s). ANOVA and multiple comparison tests showed that the duration of eating episodes estimated from the diary differed significantly from that estimated by the AIM and the push button (p-value <0.001). There were no significant differences in the number of eating events for push button resolutions of 0.1, 1, and 5 s, but there were significant differences in resolutions of 10–30s (p-value <0.05). The results suggest that the desired time resolution of sensor-based food intake detection should be ≤5 s to accurately detect meal microstructure. Furthermore, the AIM provides more accurate measurement of the eating episode duration than the diet diary.

The Rorschach Comprehensive System (CS) Psychometric Validity of Individual Variables

Since the publication of the Rorschach Inkblot Method (Rorschach, 1921/1942 ), theorists, researchers, and practitioners have been debating the nature of the task, its conceptual foundation, and most important its psychometric properties. The validity of the Rorschach Comprehensive System (CS; Exner, 1974 , 2003; Exner & Weiner, 1995 ) has been supported by several meta-analyses that used different types of nontest external criterion for validating individual variables. In a recent meta-analysis, Mihura, Meyer, Dumitrascu, and Bombel ( 2013 ) found coefficients ranging from modest to excellent for most of the selected CS variables, with 13 of them reported as showing "little to no support." This article focuses on these variables. Although endorsing Mihura et al.'s mainly validating findings, we also suggest that the evidence presented for the little or no validity of these 13 variables is not quite compelling enough to warrant changing their definition or coding, or removing them from the system. We point to some issues concerning the description and interpretation of these variables and the appropriateness of the external criteria used for exploring their validity, and suggest considering these issues in further CS research. Implications of Mihura et al.'s meta-analysis for clinical and forensic practice are discussed.

Food selection and taste changes in humans after Roux-en-Y gastric bypass surgery: a direct-measures approach

It has been suggested that the weight loss seen in individuals who receive Roux-en-Y gastric bypass surgery may be due, at least in part, to changes in patient food selection, and that this change may stem from effects of the operation on the sense of taste. In this review, we evaluate the literature examining postoperative changes in food intake and food choice. While some evidence suggests that gastric bypass leads to altered food selection and taste perceptions, a clear picture regarding these changes remains to be elucidated and is blurred by inconsistencies, which may be rooted in the diverse subject pools within and between studies as well as in the indirect measures used to assess ingestive behavior. We argue that complementing current assessment tools with more direct measures of intake, food selection, and taste-related behavior might help provide some clarity and also facilitate translation between findings from animal models, in which similar measures are available, and clinical research.

Problem eating behaviors related to social factors and body weight in preschool children: A longitudinal study

Background

Despite the increasing prevalence of overweight/obesity and its association to eating patterns in adolescents and adults, little is known about the relationship between problematic eating behaviours and body weight in the preschool years within the context of various social factors. This research aims to analyze the relationship between social factors, mothers' perceptions of their child's eating behaviour (picky eating and overeating), and body weight in preschool years, in a population-based cohort of preschoolers from Québec (Canada).

Methods

Analyses were performed on 1498 children from the Longitudinal Study of Child Development in Québec, a representative sample of children born in 1998 in the Canadian province of Québec. Eating behaviours (picky eating and overeating) were derived from questionnaires at 2.5, 3.5, and 4.5 years of age. BMI was calculated from children's measured height and weight at 4.5 years. Children's sex and birth weight, mothers' age, immigrant status, smoking status during pregnancy, and education level, family type, annual household income and income sufficiency, the number of overweight/obese parents, children's day-care attendance, and food insufficiency were part of the analysis. Multivariate logistic regressions were used to determine odds ratios for different body weight profiles (underweight, normal weight, at risk of overweight, overweight), and one-way analysis-of-variances (ANOVA) allowed for group comparisons of means.

Results

The proportion of children reported for each eating behaviour category remained quite stable across the years studied. Picky eating and overeating related to body weight among 4.5-year-old children, even when social and parental factors were accounted for in multivariate analysis. Picky eaters were twice as likely to be underweight at 4.5 years as children who were never picky eaters. Adjusted odds ratios revealed overeaters were 6 times more likely to be overweight at 4.5 years than were children who were never overeaters.

Conclusion

Given the association between eating behaviours and bodyweight among 4.5-year-old children, particularly among those from less educated, lower income families and younger mothers, health professionals should target parents of children at risk of overweight/obesity and underweight with focussed messages and strategies for the management of emerging problematic eating behaviours.

Rorschach Personality Predictors of Weight Loss With Behavior Modification in Obesity Treatment

Weight loss outcome for 49 obese patients after 6 months treatment in a behavior modification program was related to Rorschach personality characteristics according to the Comprehensive System (Exner, 2003), also including the Rorschach Oral Dependency Scale (Bornstein, 1996; Masling & Rabie, 1967). Less weight loss was predicted by signs of perceptual and cognitive distortions indicated by the Schizophrenia Index. More weight loss was predicted by Food Contents, suggesting a food preoccupation and possibly a benign dependency orientation. Patients with a focus on food and dependent needs could benefit above all from the treatment program implying learning how to handle food and eating in a supportive setting, as evidenced by more weight loss. Distortions in perception and cognition could constitute more profound difficulties in weight reduction important to recognize in obesity treatment.

Food Intake With an Antiobesity Drug (Sibutramine) Versus Placebo and Rorschach Data: A Crossover Within-Subjects Study

We related the effect of the satiety enhancing drug sibutramine (Meridia, Reductil) on food intake to Rorschach Comprehensive System (Exner, 1991, 1993) personality factors. A placebo-controlled crossover, within-subjects design (n = 36) was used. Food intake after 2 weeks in the sibutramine and placebo conditions was assessed with a test meal using the VIKTOR (Cabmek, Stockholm, Sweden) setup, a computerized eating monitor. Building on baseline VIKTOR measurements, we had earlier studied the microstructure of eating (Elfhag, Barkeling, Carlsson, & Rossner, 2003). In this study, a model including Afr, MOR, and Populars could explain the variance in the effect of sibutramine. Sibutramine may reduce food intake in single test meals for participants whose appetite is prompted by external stimuli including food cues, suggested by the Affective ratio. Distress related to the body in obesity seen in damaged self-imagery (MOR) and adjustment to social expectations (Populars) could also have a moderating effect on the participants' consumption of test meals in an experimental design. Bodily concern (An + Xy) was also related to sibutramine response in univariate analyses.

Sibutramine treatment in obesity: predictors of weight loss including rorschach personality data

OBJECTIVE

To study personality and clinical factors in weight loss by sibutramine (Meridia and Reductil), an anti-obesity drug enhancing satiety.

RESEARCH METHODS AND PROCEDURES

The subjects were 30 obese patients [43 +/- 12 years (mean +/- SD), BMI 40 +/- 4 kg/m(2)]. The treatment comprised 15 mg of sibutramine administered daily and monthly dietary advice. Weight loss after 6 months of treatment was evaluated. For psychological assessment, the Rorschach method (Comprehensive System) and the Beck Depression Inventory were used.

RESULTS

A multiple linear regression model including the Rorschach predictors' physical demand states (animal movement, designated as FM) being intrusive or difficult to hold and a dependency orientation (food contents) could explain 47% of 6 months of weight loss. A model including initial weight loss in addition to the Rorschach predictors explained 58% of the 6-month weight loss.

DISCUSSION

The personality factors predicted greater weight loss. In particular, patients with difficulties concerning physical demand states, which would include hunger, could have reduced their eating behavior with enhanced satiety, resulting in greater weight loss. Enhanced satiety could also have helped patients with a dependent need for food to limit food intake. Being enrolled in a treatment program could also have provided essential support for patients with dependency needs. Furthermore, initial weight loss was a predictor of greater weight loss in sibutramine treatment, in accordance with prior research.