Full Text Available Suicide associated mortality rates are notable for eating disorders. Crude mortality rate associated with suicide, varies between 0% and 5.3% in patients with eating disorders. Prominent risk factors for suicidal behavior among these patients are subtype of the eating disorders, comorbid psychiatric diagnosis (e.g. depression, alcohol and substance abuse, personality disorders, ultrarapid drug metabolism, history of childhood abuse and particular family dynamics. In this article, suicidal behavior and associated factors in eating disorders are briefly reviewed.
Murphy, Rebecca; Straebler, Suzanne; Cooper, Zafra; Fairburn, Christopher G.
Cognitive behavioral therapy (CBT) is the leading evidence-based treatment for bulimia nervosa. A new ?enhanced? version of the treatment appears to be more potent and has the added advantage of being suitable for all eating disorders, including anorexia nervosa and eating disorder not otherwise specified. This article reviews the evidence supporting CBT in the treatment of eating disorders and provides an account of the ?transdiagnostic? theory that underpins the enhanced form of the treatme...
Full Text Available Laura A Berner,1 Kelly C Allison2 1Department of Psychology, Drexel University, 2Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Abstract: Night eating syndrome (NES is a form of disordered eating associated with evening hyperphagia (overeating at night and nocturnal ingestions (waking at night to eat. As with other forms of disordered eating, cognitive and behavioral treatment modalities may be effective in reducing NES symptoms. This review presents evidence for a variety of behavioral treatment approaches, including behavioral therapy, phototherapy, behavioral weight loss treatment, and cognitive-behavioral therapy. A more detailed overview of cognitive-behavioral therapy for NES is provided. All of these studies have been case studies or included small samples, and all but one have been uncontrolled, but the outcomes of many of these approaches are promising. Larger randomized controlled trials are warranted to advance NES treatment literature. With the inclusion of NES in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 as a “Feeding or Eating Disorder Not Elsewhere Classified,” more sophisticated, empirically-supported, behaviorally-based treatment approaches are much needed. Keywords: night eating syndrome, cognitive-behavioral treatment, phototherapy, behavioral weight loss, behavior therapy
Mitchell, James E; King, Wendy C; Courcoulas, Anita; Dakin, George; Elder, Katherine; Engel, Scott; Flum, David; Kalarchian, Melissa; Khandelwal, Saurabh; Pender, John; Pories, Walter; Wolfe, Bruce
To describe eating patterns, prevalence of problematic eating behaviors, and determine factors associated with binge eating disorder (BED), before bariatric surgery. Before surgery, 2,266 participants (median age 46 years; 78.6% female; 86.9% white; median body mass index 45.9 kg/m(2) ) of the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study completed eating behavior survey items in the self-administered LABS-2 Behavior form. Other measures included the Alcohol Use Disorder Identification Test, the LABS-2 Psychiatric and Emotional Test Survey, the Beck Depression Inventory, the Interpersonal Support Evaluation List-12, the Short Form-36 Health Survey, and Impact of Weight Quality of Life-Lite Survey. The majority (92.1%) of participants reported eating dinner regularly, whereas just over half (54.0%) reported eating breakfast regularly. Half of the participants reported eating at least four meals/week at restaurants; two meals/week were fast food. Loss of control eating was reported by 43.4%, night eating syndrome by 17.7%; 15.7% satisfied criteria for binge eating disorder (BED), 2% for bulimia nervosa. Factors that independently increased the odds of BED were being a college graduate, eating more times per day, taking medication for psychiatric or emotional problems, and having symptoms of alcohol use disorder, lower self-esteem and greater depressive symptoms. Before undergoing bariatric surgery a substantial proportion of patients report problematic eating behaviors. Several factors associated with BED were identified, most suggesting other mental health problems, including higher levels of depressive symptomotology. The strengths of this study include the large sample size, the multi-center design and use of standardized assessment practices. © 2014 Wiley Periodicals, Inc.
Full Text Available A sample of female undergraduates completed a packet of questionnaires consisting of the Arizona Life History Battery, a modified version of the Eating Disorders Inventory, the Behavioral Regulation scales from the Behavior Rating Inventory of Executive Function, and two measures of Female Intrasexual Competitiveness that distinguished between competition for mates and competition for status. As predicted, Executive Functions completely mediated the relation between Slow Life History Strategy and Disordered Eating Behavior. Surprisingly, however, the relation between Female Intrasexual Competitiveness (competition for mates and competition for status and Disordered Eating Behavior was completely spurious, with executive functions serving as a common cause underlying the inhibition of both Disordered Eating Behavior and Female Intrasexual Competitiveness. The protective function of Slow Life History Strategy with respect to Disordered Eating Behavior apparently resides in a higher degree of Behavioral Regulation, a type of Executive Function. The enhanced Behavioral Regulation or self-control, of individuals with a Slow Life History Strategy is also protective against hazardously escalated levels of Female Intrasexual Competitiveness.
Lydecker, Janet A.; Grilo, Carlos M.
Objective A limited literature suggests an association between maternal eating disorders and child feeding difficulties, and notes maternal concern about inadvertently transmitting eating disorders. Thus, parents may be an important target for eating-disorder research to guide the development of clinical programs. Methods The current study examined differences in child eating-disorder behaviors and parental feeding practices between a sample of parents (42 fathers, 130 mothers) exhibiting core features of anorexia nervosa, bulimia nervosa, binge-eating disorder, or purging disorder, and a matched sample of parents (n=172) reporting no eating-disorder characteristics. Results Parents with eating-disorder psychopathology were significantly more likely than parents without eating-disorder characteristics to report child binge-eating and compulsive exercise. Parents with eating-disorder psychopathology reported greater perceived feeding responsibility, greater concern about their child’s weight, and more monitoring of their child’s eating than parents without eating-disorder characteristics; however, they did not differ significantly in restriction of their child’s diet and pressure-to-eat. Child body mass index z-scores did not differ between parents with versus without eating-disorder characteristics. Conclusion Our findings suggest some important differences between parents with and without core eating-disorder psychopathology, which could augment clinical interventions for patients with eating disorders who are parents, or could guide pediatric eating-disorder prevention efforts. However, because our study was cross-sectional, findings could indicate increased awareness of or sensitivity to eating-disorder behaviors rather than a psychosocial cause of those behaviors. Longitudinal research and controlled trials examining prevention and intervention can clarify and address these clinical concerns. PMID:27302549
Smith, April R; Forrest, Lauren N; Velkoff, Elizabeth A; Ribeiro, Jessica D; Franklin, Joseph
The current study tested whether people with and without eating disorders (EDs) varied in their implicit attitudes toward ED-relevant stimuli. Additionally, the study tested whether implicit evaluations of ED-relevant stimuli predicted ED symptoms and behaviors over a 4-week interval. Participants were people without EDs (N = 85) and people seeking treatment for EDs (N = 92). All participants completed self-report questionnaires and a version of the affect misattribution procedure (AMP) at baseline. The AMP indexed implicit evaluations of average body stimuli, eating stimuli, and ED-symptom stimuli. Participants with EDs completed weekly follow-up measures of ED symptoms and behaviors for 4 weeks. Contrary to predictions, the anorexia nervosa (AN) group did not differ from the no ED group on implicit attitudes toward ED-symptom stimuli, and the bulimia nervosa (BN) group had less positive implicit attitudes toward ED-symptom stimuli relative to the no ED group. In line with predictions, people with AN and BN had more negative implicit attitudes toward average body and eating stimuli relative to the no ED group. In addition, among the ED group more negative implicit attitudes toward eating stimuli predicted ED symptoms and behaviors 4 weeks later, over and above baseline ED symptoms and behaviors. Taken together, implicit evaluations of eating stimuli differentiated people with AN and BN from people without EDs and longitudinally predicted ED symptoms and behaviors. Interventions that increase implicit liking of eating-related stimuli may reduce ED behaviors. © 2018 Wiley Periodicals, Inc.
Shelton, Virginia L.; Valkyrie, Karena T.
Eating disorders are compulsive behaviors that can consume a person's life to the point of becoming life threatening. Previous research found stress associated with eating disorders. College can be a stressful time. If stress predicted precursor behaviors to eating disorders, then counselors would have a better chance to help students sooner. This…
Castellini, Giovanni; Lo Sauro, Carolina; Rotella, Carlo M.; Faravelli, Carlo
Objective. Binge eating disorder is a serious, prevalent eating disorder that is associated with overweight. Zonisamide is an antiepileptic drug that can promote weight loss. We evaluated the efficacy and safety of zonisamide as augmentation to individual cognitive behavioral therapy in the treatment of binge eating disorder patients. Design: controlled open study. Participants: Twenty four threshold and subthreshold binge eating disorder patients were enrolled in the cognitive behavioral therapy treatment group, and 28 patients in the cognitive behavioral therapy plus zonisamide group. Measurements: At the beginning (T0), at the end (T1) of treatment, and one year after the end of treatment (T2), body mass index was measured and Eating Disorder Examination-Questionnaire, Binge Eating Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory were administered. Results. At T1 the cognitive behavioral therapy plus zonisamide group showed a higher mean reduction of body mass index, Eating Disorder Examination-Questionnaire, Beck Depression Inventory, and Binge Eating Scale scores. At T2, the cognitive behavior therapy group regained weight, while the cognitive behavioral therapy plus zonisamide group reduced their body mass and showed a higher reduction in binge eating frequency and Binge Eating Scale, Eating Disorder Examination-Questionnaire Restraint, and State and Trait Anxiety Inventory scores. Conclusion. The zonisamide augmentation to individual cognitive behavior therapy can improve the treatment of binge eating disorder patients, reducing body weight and the number of binge eating episodes. These results are maintained one year after the end of treatment. PMID:20049147
Miyake, Yoshie; Okamoto, Yuri; Jinnin, Ran; Shishida, Kazuhiro; Okamoto, Yasumasa
Eating disorders are characterized by aberrant patterns of eating behavior, including such symptoms as extreme restriction of food intake or binge eating, and severe disturbances in the perception of body shape and weight, as well as a drive for thinness and obsessive fears of becoming fat. Eating disorder is an important cause for physical and psychosocial morbidity in young women. Patients with eating disorders have a deficit in the cognitive process and functional abnormalities in the brain system. Recently, brain-imaging techniques have been used to identify specific brain areas that function abnormally in patients with eating disorders. We have discussed the clinical and cognitive aspects of eating disorders and summarized neuroimaging studies of eating disorders.
Catalina Zamora, M L; Bote Bonaechea, B; García Sánchez, F; Ríos Rial, B
New eating behavior disorders such as bigorexia (muscle dysmorphia) and orthorexia are appearing in developed countries. These disorders have not been officially recognized so that they are not classified as independent entities. The term orthorexia comes from the Greek word orthos (straight, proper) and orexia (appetite). It is characterized by the pathological obsession for biologically pure food, which leads to important dietary restrictions. Orthorexic patients exclude foods from their diets that they consider to be impure because they have herbicides, pesticides or artificial substances and they worry in excess about the techniques and materials used in the food elaboration. This obsession leads to loss of social relationships and affective dissatisfactions which, in turn, favors obsessive concern about food. In orthorexia, that patient initially wants to improve his/her health, treat a disease or lose weight. Finally, the diet becomes the most important part of their lives. We present a clinical case that responds to the characteristics of orthorexia. The differential diagnosis with chronic delusional disorder, anorexia nervosa and obsessive-compulsive disorder is carried out.
Södersten, P; Bergh, C; Leon, M; Brodin, U; Zandian, M
We examine the science and evidence supporting cognitive behavior therapy (CBT) for the treatment of bulimia nervosa and other eating disorders. Recent trials focusing on the abnormal cognitive and emotional aspects of bulimia have reported a remission rate of about 45%, and a relapse rate of about 30% within one year. However, an early CBT trial that emphasized the normalization of eating behavior had a better outcome than treatment that focused on cognitive intervention. In support of this finding, another treatment, that restores a normal eating behavior using mealtime feedback, has an estimated remission rate of about 75% and a relapse rate of about 10% over five years. Moreover, when eating behavior was normalized, cognitive and emotional abnormalities were resolved at remission without cognitive therapy. The critical aspect of the CBT treatment of bulimia nervosa therefore may actually have been the normalization of eating behavior. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
Zubatsky, Max; Berge, Jerica; Neumark-Sztainer, Dianne
The main purpose of this study was to identify the longitudinal association between specific parenting styles (authoritarian, authoritative, permissive, and neglectful) and adolescent disordered eating behaviors. The current study uses longitudinal data from a 5-year study to examine the associations between parenting style and disordered eating behaviors among adolescents. Data from adolescents (n = 2516) participating in Project EAT (Eating Among Teens), a population-based study from 31 Minnesota schools, were used in the analysis. Time 1 data were collected using in-class assessments of adolescents from Minneapolis/St. Paul schools, and Time 2 data were collected using mailed surveys 5 years later. General Linear Models were used to predict adolescent-reported disordered eating behaviors at Time 2 from adolescent-reported parenting style at Time 1. Adolescent boys and girls who had authoritarian mothers at Time 1 had a higher probability of extreme weight control behaviors 5 years later compared to adolescents with authoritative, permissive, or neglectful mothers. Adolescent girls with authoritarian mothers at Time 1 had a higher probability of engaging in binge-eating behaviors at Time 2 compared to adolescent girls with authoritative or permissive mothers. There were no significant associations between paternal parenting style and adolescent disordered eating behaviors. Although authoritarian parenting style served as a possible risk factor for disordered eating behaviors in adolescents, the findings were not conclusive. Future studies should investigate further the association between parenting style and weight control behaviors in adolescents.
Meyer, Tiffany A.; Gast, Julie
Peer influence has been found to be correlated with a host of harmful health behaviors. However, little research has been conducted investigating the relationship between peer influence and disordered eating. The present study surveyed 6th-, 7th-, and 8th-grade girls and boys using the Eating Disorder Inventory (EDI) and Inventory of Peer…
Fernanda Reistenbach Goltz
Full Text Available Objective: To identify disordered eating behaviors and body image dissatisfaction, as well as their relationship to body fat (BF, among male athletes in high risk sports for eating disorders. Methods: One hundred and fifty-six male athletes were divided into the following categories: weight-class sports, sports where leanness improves performance, and sports with aesthetic ideals. BF was assessed and three questionnaires were used: the Eating Attitudes Test; the Bulimic Investigatory Test, Edinburgh; the Body Shape Questionnaire. Results: Disordered eating behaviors and body image dissatisfaction were found in 43 (27.6% and 23 athletes (14.7%, respectively, and an association was detected between the two variables (p < 0.001. Athletes with and without disordered eating behaviors did not differ in %BF (11.0±5.2% and 9.8±4.0%, respectively; p = 0.106. However, athletes with body image dissatisfaction had higher %BF than those who were satisfied (12.6±5.9% and 9.7±3.9%, respectively; p = 0.034. There were no differences in BF, frequency of disordered eating behaviors, and body image dissatisfaction between sports categories. Conclusion: Nearly one-quarter of athletes showed disordered eating behaviors, which was associated with body image dissatisfaction. Athletes with higher %BF were more likely to be dissatisfied with body image. There was no difference in eating behavior and body image between athletes from different sports categories.
Mateos-Agut, Manuel; García-Alonso, Isabel; De la Gándara-Martín, Jesús J; Vegas-Miguel, María I; Sebastián-Vega, Carlota; Sanz-Cid, Beatriz; Martínez-Villares, Ana; Martín-Martínez, Esther
The modern way of life, characterized by the cult of individualism, discredited authority, and a proliferation of points of view about reality, has modified family structure. This social structure imbues families and the way that its members become ill, in such a way that eating behavior disorders (EDs) have become a typically postmodern way of becoming ill. The aim is to understand the systemic structure and vulnerability of families by comparing 108 families with members who have ED to 108 families without pathology. A questionnaire administered by an interview with trained personnel was used. Families with ED have a different structure from the families in the control group. They have more psychiatric history and poor coping skills. The family hierarchy is not clearly defined and the leadership is diffuse, with strict and unpredictable rules, more intergenerational coalitions, and fewer alliances. The relationship between the parents is distant or confrontational, and their attitudes towards their children are complacent and selfish, with ambivalent and unaffectionate bonds. In the case of mothers, this is manifested by separation anxiety and dyadic dependence. Their expectations concerning their offspring are either very demanding and unrealistic, or indifferent, and there is less control of their behavior, in addition to poor organization of the family meals. The structural differences between the two groups of families seem to be important for the occurrence and maintenance of EDs, although they may not be the only cause. The results suggest strategies for clinical intervention in EDs.
Masuda, Akihiko; Price, Matthew; Latzman, Robert D
Psychological flexibility and mindfulness are two related, but distinct, regulation processes that have been shown to be at the core of psychological wellbeing. The current study investigated whether these two processes independently moderated the association between disordered eating cognitions and psychological distress as well as the relation between disordered eating cognitions and disordered eating behaviors. Non-clinical, ethnically diverse college undergraduates completed a web-based survey. Of 278 participants (nfemale=208; nmale=70) aged 18-24 years old, disordered eating cognitions, mindfulness, and psychological flexibility were related to psychological distress after controlling for gender, ethnicity, and body mass index. Disordered eating cognitions and mindfulness accounted for unique variance in disordered eating behaviors. Finally, mindfulness was found to moderate the association between disordered eating cognitions and disordered eating behaviors.
Verri, A P; Verticale, M S; Vallero, E; Bellone, S; Nespoli, L
The media, mainly TV, play a significant social and cultural role and may affect the prevalence and incidence of eating disorders such as bulimia and anorexia nervosa. Their influence acts mainly by favoring a tall and thin body as the only fashionable for female adolescents: your social success depends primarily and totally by your physical appearance and you can, (and must), shape your body as you like better. Our research aims t analyze the attitude of adolescent people toward the TV and to investigate on: 1) time spent watching TV programs; 2) the influence of TV on the personal choices of goods to buy; 3) the ideal body images; 4) choice of TV programs. Sixty-seven healthy adolescents (36 F-31 M) were included in our study as controls together with 24 female adolescents with eating disorders (DCA) diagnosed according to the DSM-IV and EAT/26 criteria. Our results show a psychological dependence of DCA adolescents from the TV (longer period of time spent watching TV programs, buying attitudes more influenced by TV advertising). The thin and tall body image is preferred by the DCA girls as well as by the controls; however the body appearance and proportions have a predominant and utmost importance only for the eating disorder females. The masculine subjects instead have a preference for a female and masculine opulent body appearance. To prevent the observed increase in prevalence and incidence of eating disorders among adolescents, it is appropriate to control the messages, myths and false hood propagated by media, TV in particular.
Gempeler Rueda, Juanita
Abstract This article reviews the available literature on binge-eating disorder, currently included in the DSM IV as an Eating Disorder NOS. Its inclusion in the DSM V is under discussion. Conceptualization of this disorder is examined, as well as implications for clinical interventions from a cognitive-behavioral perspective. Resumen El presente artículo tiene por objeto revisar la bibliografía actualizada disponible sobre el tema del trastorno por atracones de la alimentación, que hasta ...
Fortes, Leonardo de Sousa; Filgueiras, Juliana Fernandes; Oliveira, Fernanda da Costa; Almeida, Sebastião Sousa; Ferreira, Maria Elisa Caputo
The objective was to construct an etiological model of disordered eating behaviors in Brazilian adolescent girls. A total of 1,358 adolescent girls from four cities participated. The study used psychometric scales to assess disordered eating behaviors, body dissatisfaction, media pressure, self-esteem, mood, depressive symptoms, and perfectionism. Weight, height, and skinfolds were measured to calculate body mass index (BMI) and percent body fat (%F). Structural equation modeling explained 76% of variance in disordered eating behaviors (F(9, 1,351) = 74.50; p = 0.001). The findings indicate that body dissatisfaction mediated the relationship between media pressures, self-esteem, mood, BMI, %F, and disordered eating behaviors (F(9, 1,351) = 59.89; p = 0.001). Although depressive symptoms were not related to body dissatisfaction, the model indicated a direct relationship with disordered eating behaviors (F(2, 1,356) = 23.98; p = 0.001). In conclusion, only perfectionism failed to fit the etiological model of disordered eating behaviors in Brazilian adolescent girls.
Vanesa Carina Góngora
Full Text Available The interest for the systematic study of personality disorder in patients with eating disorders starts in 1980 with the edition of the DSM III multiaxial classification system. Since then, several publications have been focused on the prevalence and the effect on treatment of personality disorders in bulimic and anorexic patients. These researches showed inconsistent results due to conceptual and methodological divergences. In this paper, the more relevant findings of these studies are presented and the possible sources of discrepancy are analyzed. In general, there is a moderate comorbidity between personality disorders and eating disorders. The most frequent disorders are borderline, histrionic, obsessive-compulsive, dependent and avoidant personality disorders. Borderline and histrionic personality disorders are more frequently associated with bulimia, whereas avoidant and obsessive- compulsive personality disorders are more characteristic of anorexia nervosa. Nevertheless, the effect of the relationship between eating disorders and personality disorders in treatment remains uncertain, giving raise to several controversies and researches.
... of-control eating Women are more likely than men to have eating disorders. They usually start in the teenage years and often occur along with depression, anxiety disorders, and substance abuse. Eating disorders can ...
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Full Text Available Eating disorders are considered chronic diseases of civilization. The most studied and well known are anorexia and bulimia nervosa. Anorexia is considered one of the most common psychiatric problems of girls in puberty and adolescence. Due to high mortality and morbidity as well as the increasing expansion of these diseases, it is clear why the amount of research on these diseases is growing worldwide. Eating disorders lead to numerous medical complications, mostly due to late diagnosis. The main characteristic of these diseases is changed behavior in the nutrition, either as an intentional restriction of food, i.e. extreme dieting, or overeating, i.e. binge eating. Extreme dieting, skipping meals, self-induced vomiting, excessive exercise, and misuse of laxatives and diuretics for the purpose of maintaining or reducing body weight are characteristic forms of compensatory behavior of patients with eating disorder. The most appropriate course of treatment is determined by evaluating the patient’s health condition, associated with behavior and eating habits, the experience of one’s own body, character traits of personality, and consequently the development and functioning of the individual. The final treatment plan is individual. Eating disorders are a growing medical problem even in this part of the world. Prevention should be planned in cooperation with different sectors so as to stop the epidemic of these diseases.
Vázquez-Velázquez, Verónica; Kaufer-Horwitz, Martha; Méndez, Juan Pablo; García-García, Eduardo; Reidl-Martínez, Lucy María
Associations of eating behaviors and psychological profile between mothers and daughters with eating disorders exist, but it is important to dissect the influence of the mother in each specific disorder since all eating disorders must be seen or treated not as one entity. The aim of the present study was to evaluate the association of eating behavior and psychological profile between mothers and daughters with different eating disorders and a control group. The study group included young girls with anorexia nervosa (AN, n = 30), bulimia nervosa (BN, n = 30), binge eating disorder (BED, n = 19), and a control group of women (Non-ED, n = 54) together with their mothers. BMI was calculated for dyads and Eating Disorder Inventory, Beck Depression Inventory, Beck Anxiety Inventory, Toronto Alexithymia Scale and Three-Factor Eating Questionnaire were applied. The differences between dyads were tested by Student's t test and Pearson's correlation was used to study the association between BMI, variables of eating behavior and psychological profile in each dyad. The study found significant inverse correlations between the AN dyad; some correlations between the BN dyad, and the highest positive correlations exist in BED dyad, especially in eating behavior. Finally, between the control dyads, low but significant correlations were found in the majority of cases. The study concluded that the associations between mothers and daughters with distinct eating disorders varied depending on the specific diagnosis of the daughter, indicating it is necessary to analyze them individually, given that there may be different implications for treatment.
Masuda, Akihiko; Price, Matthew; Latzman, Robert D.
Psychological flexibility and mindfulness are two related, but distinct, regulation processes that have been shown to be at the core of psychological wellbeing. The current study investigated whether these two processes independently moderated the association between disordered eating cognitions and psychological distress as well as the relation between disordered eating cognitions and disordered eating behaviors. Non-clinical, ethnically diverse college undergraduates completed a web-based s...
Baldofski, Sabrina; Tigges, Wolfgang; Herbig, Beate; Jurowich, Christian; Kaiser, Stefan; Stroh, Christine; de Zwaan, Martina; Dietrich, Arne; Rudolph, Almut; Hilbert, Anja
Binge-eating disorder (BED) as a distinct eating disorder category and night eating syndrome (NES) as a form of Other Specified Feeding or Eating Disorders were recently included in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This study sought to investigate the prevalence of BED and NES and associations with various forms of nonnormative eating behavior and psychopathology in prebariatric patients. Within a consecutive multicenter registry study, patients in 6 bariatric surgery centers in Germany were recruited. Overall, 233 prebariatric patients were assessed using the Eating Disorder Examination and self-report questionnaires. Assessment was unrelated to clinical procedures. Diagnostic criteria for full-syndrome BED and NES were currently met by 4.3% and 8.2% of prebariatric patients, respectively. In addition, 8.6% and 6.9% of patients met subsyndromal BED and NES criteria, respectively. Co-morbid BED and NES diagnoses were present in 3.9% of patients. In comparison to patients without any eating disorder symptoms, patients with BED and NES reported greater emotional eating, eating in the absence of hunger, and more symptoms of food addiction. Moreover, differences between patients with BED and NES emerged with more objective binge-eating episodes and higher levels of eating concern, weight concern, and global eating disorder psychopathology in patients with BED. BED and NES were shown to be prevalent among prebariatric patients, with some degree of overlap between diagnoses. Associations with nonnormative eating behavior and psychopathology point to their clinical significance and discriminant validity. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Williams, Gail A; Hawkins, Misty A W; Duncan, Jennifer; Rummell, Christina M; Perkins, Shannon; Crowther, Janis H
Eating pathology among bariatric surgery candidates is common and associated with adverse outcomes. However, its assessment is complicated by the inconsistent use of standardized measures. We addressed this by examining the use of the Eating Disorder Diagnostic Scale (EDDS) in a large bariatric sample (N = 343). To evaluate the EDDS among bariatric surgery candidates via examination of: (1) Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) and fifth edition (DSM-5) rates of binge eating disorder, bulimia nervosa, and maladaptive eating behaviors, and (2) the relationship between response biases and self-reported eating disorder symptoms. Participants were bariatric surgery candidates at a large public hospital in the Midwest. As part of a larger preoperative evaluation, 343 patients seeking bariatric surgery completed the EDDS and measures of problematic response bias. Approximately 16% of the sample met full threshold criteria for binge eating disorder using DSM-5 criteria. Using the DSM-IV-TR, rates were lower but still substantial at 13%. Rates for bulimia nervosa were 8% (DSM-5) and 6% (DSM-IV-TR). The majority (66.1%) of participants reported at least one binge-eating episode per week. The most commonly used compensatory behavior was fasting (20.4%), followed by excessive exercise (11.7%), laxative use (5.6%), and vomiting (1.8%). An inverse relationship between severity of the eating symptomatology and problematic response bias emerged. The EDDS shows promise as a screening tool that uses diagnostic criteria to provide rates of binge eating and eating psychopathology among surgical candidates. Our findings suggest that subsequent validation studies of this measure are needed, should address potential response bias concerns, and should employ clear definitions of binge eating to promote standardization of eating pathology assessment in the bariatric population. Copyright © 2017 American Society for Bariatric
Jeffers, Amy J.; Vatalaro Hill, Katherine E.; Benotsch, Eric G.
Objective: The present study examined energy drink consumption and relations with weight loss attempts and behaviors, body image, and eating disorders. Participants/Methods: This is a secondary analysis using data from 856 undergraduate students who completed the American College Health Association-National College Health Assessment II…
Calzo, Jerel P.; Blashill, Aaron J.; Brown, Tiffany A.; Argenal, Russell L.
Purpose of review This review summarized trends and key findings from empirical studies conducted between 2011–2017 regarding eating disorders and disordered weight and shape control behaviors among lesbian, gay, bisexual, and other sexual minority (i.e., non-heterosexual) populations. Recent findings Recent research has examined disparities through sociocultural and minority stress approaches. Sexual minorities continue to demonstrate higher rates of disordered eating; disparities are more pronounced among males. Emerging data indicates elevated risk for disordered eating pathology among sexual minorities who are transgender or ethnic minorities. Dissonance-based eating disorder prevention programs may hold promise for sexual minority males. Summary Continued research must examine the intersections of sexual orientation, gender, and ethnic identities, given emergent data that eating disorder risk may be most prominent among specific subgroups. More research is needed within sexual minorities across the lifespan. There are still a lack of eating disorder treatment and prevention studies for sexual minorities. PMID:28660475
de Carvalho, Pedro Henrique Berbert; Alvarenga, Marle Dos Santos; Ferreira, Maria Elisa Caputo
The Tripartite Influence Model posits that parents, peers and media influences mediated by internalization and appearance social comparison are predictors of body dissatisfaction, a key risk factor for eating disorders. However, the Tripartite Influence Model has not been tested in Brazil where the people are known to have high levels of body image and appearance concerns. This study aimed to test an adapted Tripartite Influence Model of body dissatisfaction and disordered eating behaviors among Brazilian women. A sample of 741 undergraduate students (M age = 23.55 years, SD = 4.09) completed measures of sociocultural influences, internalization of body ideal, social appearance comparison, body dissatisfaction, muscularity dissatisfaction, disordered eating and body change behaviors. Structural equation modeling analyses indicated that the proposed etiological model for Brazilian women has good fit indexes (χ 2 (2064) = 6793.232; p = 0.0001; χ 2 /gl = 3.29; CFI = 0.82; PCFI = 0.79; RMSEA = 0.056 [IC90% = 0.053-0.057]). Parent and media influences were related with both internalization and social comparison, while peer influence with social comparison. A full mediation model was found, with both internalization and social comparison contributing to body dissatisfaction. Finally, body dissatisfaction was associated with disordered eating behaviors. The findings inform the importance of considering cultural aspects that influence body image and eating behaviors, and highlight the validity of the proposed etiological model for Brazilian women, that can be used for research and clinical purposes. Copyright © 2017 Elsevier Ltd. All rights reserved.
Islam, Mohammed A; Fagundo, Ana B; Arcelus, Jon; Agüera, Zaida; Jiménez-Murcia, Susana; Fernández-Real, José M; Tinahones, Francisco J; de la Torre, Rafael; Botella, Cristina; Frühbeck, Gema; Casanueva, Felipe F; Menchón, José M; Fernandez-Aranda, Fernando
The study provides a systematic review that explores the current literature on olfactory capacity in abnormal eating behavior. The objective is to present a basis for discussion on whether research in olfaction in eating disorders may offer additional insight with regard to the complex etiopathology of eating disorders (ED) and abnormal eating behaviors. Electronic databases (Medline, PsycINFO, PubMed, Science Direct, and Web of Science) were searched using the components in relation to olfaction and combining them with the components related to abnormal eating behavior. Out of 1352 articles, titles were first excluded by title (n = 64) and then by abstract and fulltext resulting in a final selection of 14 articles (820 patients and 385 control participants) for this review. The highest number of existing literature on olfaction in ED were carried out with AN patients (78.6%) followed by BN patients (35.7%) and obese individuals (14.3%). Most studies were only conducted on females. The general findings support that olfaction is altered in AN and in obesity and indicates toward there being little to no difference in olfactory capacity between BN patients and the general population. Due to the limited number of studies and heterogeneity this review stresses on the importance of more research on olfaction and abnormal eating behavior.
Deniz Tuncel; Fatma Özlem Orhan
Hunger is an awakening related biological impulse. The relationship between hunger and sleep is moderated by the control of homeostatic and circadian rhytms of the body. Abnormal eating behavior during sleep period could result from different causes. Abnormal eating during the main sleep period has been categorized as either night eating syndrome or sleep related eating disorder. Night eating syndrome (NES) is an eating disorder characterised by the clinical features of morning anorexia, even...
Gucciardi, Enza; Celasun, Nalan; Ahmad, Farah; Stewart, Donna E
Abstract Health Issue Eating disorders are an increasing public health problem among young women. Anorexia and bulimia may give rise to serious physical conditions such as hypothermia, hypotension, electrolyte imbalance, endocrine disorders, and kidney failure. Key Issues Eating disorders are primarily a problem among women. In Ontario in 1995, over 90% of reported hospitalized cases of anorexia and bulimia were women. In addition to eating disorders, preoccupation with weight, body image and...
Full Text Available Binge Eating Disorder, characterized by frequent and persistent overeating episodes that are accompanied by feeling of loss of control over eating without regular compensatory behaviors and was identified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition as a new eating disorder category. Binge Eating Disorder is the most common eating disorder among adults. Binge Eating Disorder is associated with significant morbidity, including medical complications related to obesity, eating disorder psychopathology, psychiatric comorbidity; reduced quality of life, and impaired social functioning. Current treatments of Binge Eating Disorder include pharmacotherapy, psychotherapy and bariatric surgery. In this review, the definition, epidemiology, etiology, clinical features, and also mainly treatment of Binge Eating Disorder are discussed.
Allison, Kelly C; Spaeth, Andrea; Hopkins, Christina M
Insomnia is related to an increased risk of eating disorders, while eating disorders are related to more disrupted sleep. Insomnia is also linked to poorer treatment outcomes for eating disorders. However, over the last decade, studies examining sleep and eating disorders have relied on surveys, with no objective measures of sleep for anorexia nervosa or bulimia nervosa, and only actigraphy data for binge eating disorder. Sleep disturbance is better defined for night eating syndrome, where sleep efficiency is reduced and melatonin release is delayed. Studies that include objectively measured sleep and metabolic parameters combined with psychiatric comorbidity data would help identify under what circumstances eating disorders and sleep disturbance produce an additive effect for symptom severity and for whom poor sleep would increase risk for an eating disorder. Cognitive behavior therapy for insomnia may be a helpful addition to treatment of those with both eating disorder and insomnia.
Martin, Katharine; Woo, Julia; Timmins, Vanessa; Collins, Jordan; Islam, Alvi; Newton, Dwight; Goldstein, Benjamin I
This study investigates nutritional behavior among adolescents and young adults with bipolar disorder (BP) in comparison to those without history of major psychiatric disorder. 131 participants (82 BP, 49 controls) with a mean age of 16.11 ± 1.61 years were included. The self-reported Quick Weight, Activity, Variety & Excess (WAVE) Screener was used to assess dietary habits, yielding a total nutritional score as well as Excess, Variety, and Household Food Insecurity subscale scores. Specifically, the Variety subscale was used to measure daily consumption of essential nutrients; the Excess subscale measured unhealthy eating behaviors such as binge eating and excessive intake of fat and sugar; and the Household Food Insecurity subscale was used to detect food insecurity. Within-group analysis was conducted on participants with BP to identify correlates of unhealthy diet. BP participants scored significantly lower than controls on the WAVE (t=2.62, p=0.010), specifically the Excess subscale (t=3.26, p=0.001). This was related to higher prevalence of binge eating and emotional eating behaviors among participants with BP compared to controls. Within-group analyses showed that self-reported emotional dysregulation/impulsivity was associated with maladaptive nutritional behaviors (t=3.38, p=0.035). Cross-sectional design. Within-group analyses were underpowered. Diet quality was measured using a brief self-report screener. Adolescents and young adults with BP have poorer nutritional behaviors compared to controls, and this difference is related to stress-induced eating. This demonstrates the need to screen for stress-induced eating and to intervene when needed in order to optimize nutritional behaviors among adolescents and young adults with BP. Copyright © 2016 Elsevier B.V. All rights reserved.
Stice, Eric; Shaw, Heather
Understanding factors that contribute to eating disorders, which affect 13% of females, is critical to developing effective prevention and treatment programs. In this paper, we summarize results from prospective studies that identified factors predicting onset and persistence of eating disorders and core symptom dimensions. Next, implications for intervention targets for prevention, and treatment interventions from the risk- and maintenance-factor findings are discussed. Third, given that evidence suggests eating disorders are highly heritable, implying biological risk and maintenance factors for eating disorders, we offer working hypotheses about biological factors that might contribute to eating disorders, based on extant risk factor findings, theory, and cross-sectional studies. Finally, potentially fruitful directions for future research are presented. We suggest that it would be useful for experimental therapeutics trials to evaluate the effects of reducing the risk factors on future onset of eating pathology and on reducing maintenance factors on the risk for persistence of eating pathology, and encourage researchers to utilize prospective high-risk studies so that knowledge regarding potential intervention targets for prevention and treatment interventions for eating disorders can be advanced. Using the most rigorous research designs should help improve the efficacy of prevention and treatment interventions for eating disorders.
Segura-Garcia, Cristina; Caroleo, Mariarita; Rania, Marianna; Barbuto, Elvira; Sinopoli, Flora; Aloi, Matteo; Arturi, Franco; De Fazio, Pasquale
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. 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. 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 include the small sample size and the cross-sectional design of the study. 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. Copyright © 2016 Elsevier B.V. All rights reserved.
Trautmann, Julianne; Rau, Stephanie I.; Wilson, Mardell A.; Walters, Connor
This study compared restrictive and disordered eating behaviors in vegetarian versus non-vegetarian first-year college students. The Dutch Eating Behavior Questionnaire (DEBQ) and the abbreviated Eating Attitudes Test (EAT-26) were used to assess eating behaviors (n=330). The mean restrictive DEBQ and the EAT-26 scores of vegetarians were…
Zickgraf, Hana F; Franklin, Martin E; Rozin, Paul
One presentation of Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by picky eating, i.e., selective eating based on the sensory properties of food. The present study has two aims. The first is to describe distress and impairment in individuals with ARFID secondary to picky eating. The second is to determine whether eating behaviors hypothesized to be specific to picky eating can differentiate picky eaters with and without ARFID from typical eaters (e.g., individuals not reporting picky or disordered eating) and individuals who strongly endorse attitudes associated with anorexia and bulimia (eating disordered attitudes). Participants were recruited from Amazon's Mechanical Turk ( N = 325) and an online support group for adult picky eaters ( N = 81). Participants were grouped based on endorsement of picky eating, ARFID symptoms, and elevated eating disordered attitudes on the Eating Attitudes Test (EAT-26). The resulting four eating behavior groups were compared on measures of distress and impairment (e.g., anxiety/depression and, obsessive compulsive disorder symptoms, eating-related quality of life) and on measures of eating behaviors associated with picky eating (e.g., food neophobia, inflexibility about preparation and presentation of preferred foods, sensitivity to sensory stimuli, and eating from a very narrow range of foods). The groups were compared using one way ANOVA with post-hoc Tamhane's T2 tests. On measures of distress and impairment, participants with ARFID reported higher scores than both typical eaters and picky eaters without ARFID, and comparable scores to those with disordered eating attitudes. Three of four measures of picky eating behavior, eating inflexibility, food neophobia, and eating from a range of 20 or fewer foods, distinguished picky eaters with and without ARFID form typical eaters and those with disordered eating attitudes. Picky eaters with ARFID reported greater food neophobia and eating inflexibility
Durkin, Nora E; Swanson, Sonja A; Crow, Scott J; Mitchell, James; Peterson, Carol B; Crosby, Ross
Chewing and spitting (CS) out food is a relatively understudied eating disorder behavior. The aim of this study was to examine lifetime and current frequencies of CS across eating disorder diagnostic groups and to compare the severity of eating disorder symptomatology between participants who did and did not endorse CS. A total of 972 individuals presenting for outpatient eating disorder treatment between 1985 and 1996 completed a questionnaire that included items regarding current and lifetime eating disorder behaviors, including CS. Results indicated that both lifetime and current prevalence estimates of CS varied cross-diagnostically, with CS being more common among those with anorexia nervosa and bulimia nervosa compared to those with eating disorder not otherwise specified. CS was significantly associated with several eating disorder symptoms, including compensatory behaviors, meal restriction, and lower BMI. Those who reported CS were also younger in age compared to those who did not report CS. These findings indicate that CS is associated with more severe eating and weight pathology and is not equally prevalent across eating disorder diagnoses. These results also support the relatively high occurrence of CS and the importance of targeting this behavior in eating disorder treatment. Future research should clarify the correlates, mechanisms, and function of CS in eating disorders.
Leonardo de Sousa Fortes
Full Text Available INTRODUCTION: Evidence shows that the prevalence of risk behaviors for eating disorders (RBED among young people has increased in recent years. Body dissatisfaction, excessive exercise, body composition, economic status, and ethnicity may be risk factors for RBED. OBJECTIVE: To evaluate the association of body dissatisfaction, psychological commitment to exercise, body fat, nutritional status, economic class, and ethnicity with RBED in adolescents. METHOD: This study included 562 boys and girls aged 10 to 15 years. We used the Eating Attitudes Test (EAT-26 to assess RBED. The Body Shape Questionnaire (BSQ and the Commitment to Exercise Scale (CES were used to measure body dissatisfaction and commitment to exercise, respectively. Skin fold thickness was measured to classify body fat according to sex. Weight and height were measured to calculate the body mass index (BMI and classify participants according to nutritional status. The economic class was recorded according to the Brazilian Economic Classification Criterion. A questionnaire was used to record ethnicity, age and sex. Binary logistic regression was used to determine associations between variables. RESULTS: The results showed an association of RBED with body dissatisfaction, CES scores, and economic class among girls (p < 0.05. Among boys, body dissatisfaction, body fat, and nutritional status were associated with RBED (p < 0.05. CONCLUSION: Even though body dissatisfaction had the highest odds ratio, other variables were also associated with RBED.
Greenleaf, Christy; Petrie, Trent A.; Carter, Jennifer; Reel, Justine J.
Objective: The authors assessed the prevalence of pathogenic eating and weight-control behaviors among female college athletes, using a psychometrically valid measure. Participants: Participants were 204 college athletes (M age = 20.16 years, SD = 1.31 years) from 17 sports at 3 universities. On average, they participated in their sport for 10.88…
... to control them. Avoidant/Restrictive Food Intake Disorder (ARFID) ARFID is a new term that some people think ... eating issues can also cause it. People with ARFID don't have anorexia or bulimia, but they ...
Kontić Olga; Vasiljević Nadja; Trišović Marija; Jorga Jagoda; Lakić Aneta; Jašović-Gašić Miroslava
Eating disorders are considered chronic diseases of civilization. The most studied and well known are anorexia and bulimia nervosa. Anorexia is considered one of the most common psychiatric problems of girls in puberty and adolescence. Due to high mortality and morbidity as well as the increasing expansion of these diseases, it is clear why the amount of research on these diseases is growing worldwide. Eating disorders lead to numerous medical complications, mostly due to late diagnosis...
Levinson, Cheri A; Sala, Margarita; Fewell, Laura; Brosof, Leigh C; Fournier, Lauren; Lenze, Eric J
Individuals with eating disorders experience high anxiety when eating, which may contribute to the high relapse rates seen in the eating disorders. However, it is unknown if specific cognitions associated with such anxiety (e.g., fears of gaining weight) may lead to engagement in eating disorder behaviors (e.g., weighing oneself). Participants (N = 66) recently treated at a residential eating disorder facility and diagnosed with an eating disorder (primarily anorexia nervosa; n = 40; 60.6%) utilized a mobile application to answer questions about mealtime cognitions, anxiety, and eating disorder behaviors four times a day for one week. Hierarchical linear models using cross-lag analyses identified that there were quasi-causal (and sometimes reciprocal) within-person relationships between specific eating disorder cognitions and subsequent eating disorder behaviors. These cognitions predicted higher anxiety during the next meal and eating disorder pathology at one-month follow-up. Interventions personalized to target these specific cognitions in real time might reduce eating disorder relapse. Copyright © 2018 Elsevier Ltd. All rights reserved.
Federici, Anita; Wisniewski, Lucene; Ben-Porath, Denise
The authors describe an intensive outpatient dialectical behavior therapy (DBT) program for multidiagnostic clients with eating disorders who had not responded adequately to standard, empirically supported treatments for eating disorders. The program integrates DBT with empirically supported cognitive behavior therapy approaches that are well…
Full Text Available Radek Ptacek,1,2 George B Stefano,1,3 Simon Weissenberger,1 Devang Akotia,1 Jiri Raboch,1 Hana Papezova,1 Lucie Domkarova,1 Tereza Stepankova,1 Michal Goetz4 1Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic; 2Department of Psychology, University of New York in Prague, Prague, Czech Republic; 3MitoGenetics Research Institute, MitoGenetics, LLC, Farmingdale, NY, USA; 4Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic Abstract: Attention deficit hyperactivity disorder (ADHD is a neurodevelopmental disorder that often persists in adulthood. It is defined by inattention and/or hyperactivity–impulsivity. ADHD is associated with many comorbidities, including eating disorders (EDs. In the last decade, studies have reported that ADHD is linked with binge EDs, bulimia nervosa, and anorexia nervosa. Many postulates have been proposed to explain the association: 1 impulsive behavior in ADHD patients leads to disordered eating behavior; 2 other psychologic comorbidities present in ADHD patients account for eating behavior; 3 poor eating habits and resulting nutritional deficiencies contribute to ADHD symptoms; and 4 other risk factors common to both ADHD and EDs contribute to the coincidence of both diseases. Additionally, sex differences become a significant issue in the discussion of EDs and ADHD because of the higher incidence of bulimia nervosa and anorexia nervosa in females and the ability of females to mask the symptoms of ADHD. Interestingly, both EDs and ADHD rely on a common neural substrate, namely, dopaminergic signaling. Dopaminergic signaling is critical for motor activity and emotion, the latter enabling the former into a combined motivated movement like eating. This linkage aids in explaining the many comorbidities associated with ADHD. The interconnection of ADHD and EDs is discussed from
Fatima, S.; Khan, I.; Bashir, M.S.; Fatima, M.
To find level of anxiety and disordered eating behavior among young female athletes. Methodology: A questionnaire based survey was undertaken among 71 athletes (15-25 years old) athletes from University of Lahore and Lahore College for Women University. Then the level of anxiety and disordered eating behavior calculated. Data were statistically analyzed by SPSS version 16. Results: Out of 71 athletes, 56 (78.87%) had anxiety due to eating disorder and 15 (21.12%) had no eating disorder. And 67 (94.3%) athletes had raised anxiety levels while 3 (4.2%) had no anxiety. Conclusion: Dieting behavior and binge eating that prompted eating disorder are the main cause of anxiety among young female athletes. (author)
Watson, Ryan J; Veale, Jaimie F; Saewyc, Elizabeth M
Research has documented high rates of disordered eating for lesbian, gay, and bisexual youth, but prevalence and patterns of disordered eating among transgender youth remain unexplored. This is despite unique challenges faced by this group, including gender-related body image and the use of hormones. We explore the relationship between disordered eating and risk and protective factors for transgender youth. An online survey of 923 transgender youth (aged 14-25) across Canada was conducted, primarily using measures from existing youth health surveys. Analyses were stratified by gender identity and included logistic regressions with probability profiles to illustrate combinations of risk and protective factors for eating disordered behaviors. Enacted stigma (the higher rates of harassment and discrimination sexual minority youth experience) was linked to higher odds of reported past year binge eating and fasting or vomiting to lose weight, while protective factors, including family connectedness, school connectedness, caring friends, and social support, were linked to lower odds of past year disordered eating. Youth with the highest levels of enacted stigma and no protective factors had high probabilities of past year eating disordered behaviors. Our study found high prevalence of disorders. Risk for these behaviors was linked to stigma and violence exposure, but offset by social supports. Health professionals should assess transgender youth for disordered eating behaviors and supportive resources. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:515-522). © 2016 Wiley Periodicals, Inc.
Zickgraf, Hana F.; Franklin, Martin E.; Rozin, Paul
Background One presentation of Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by picky eating, i.e., selective eating based on the sensory properties of food. The present study has two aims. The first is to describe distress and impairment in individuals with ARFID secondary to picky eating. The second is to determine whether eating behaviors hypothesized to be specific to picky eating can differentiate picky eaters with and without ARFID from typical eaters (e.g., individ...
Full Text Available Functional, molecular and genetic neuroimaging has highlighted the existence of brain anomalies and neural vulnerability factors related to obesity and eating disorders such as binge eating or anorexia nervosa. In particular, decreased basal metabolism in the prefrontal cortex and striatum as well as dopaminergic alterations have been described in obese subjects, in parallel with increased activation of reward brain areas in response to palatable food cues. Elevated reward region responsivity may trigger food craving and predict future weight gain. This opens the way to prevention studies using functional and molecular neuroimaging to perform early diagnostics and to phenotype subjects at risk by exploring different neurobehavioral dimensions of the food choices and motivation processes. In the first part of this review, advantages and limitations of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI, positron emission tomography (PET, single photon emission computed tomography (SPECT, pharmacogenetic fMRI and functional near-infrared spectroscopy (fNIRS will be discussed in the context of recent work dealing with eating behavior, with a particular focus on obesity. In the second part of the review, non-invasive strategies to modulate food-related brain processes and functions will be presented. At the leading edge of non-invasive brain-based technologies is real-time fMRI (rtfMRI neurofeedback, which is a powerful tool to better understand the complexity of human brain–behavior relationships. rtfMRI, alone or when combined with other techniques and tools such as EEG and cognitive therapy, could be used to alter neural plasticity and learned behavior to optimize and/or restore healthy cognition and eating behavior. Other promising non-invasive neuromodulation approaches being explored are repetitive transcranial magnetic stimulation (rTMS and transcranial direct-current stimulation (tDCS. Converging evidence points at
Val-Laillet, D; Aarts, E; Weber, B; Ferrari, M; Quaresima, V; Stoeckel, L E; Alonso-Alonso, M; Audette, M; Malbert, C H; Stice, E
Functional, molecular and genetic neuroimaging has highlighted the existence of brain anomalies and neural vulnerability factors related to obesity and eating disorders such as binge eating or anorexia nervosa. In particular, decreased basal metabolism in the prefrontal cortex and striatum as well as dopaminergic alterations have been described in obese subjects, in parallel with increased activation of reward brain areas in response to palatable food cues. Elevated reward region responsivity may trigger food craving and predict future weight gain. This opens the way to prevention studies using functional and molecular neuroimaging to perform early diagnostics and to phenotype subjects at risk by exploring different neurobehavioral dimensions of the food choices and motivation processes. In the first part of this review, advantages and limitations of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), pharmacogenetic fMRI and functional near-infrared spectroscopy (fNIRS) will be discussed in the context of recent work dealing with eating behavior, with a particular focus on obesity. In the second part of the review, non-invasive strategies to modulate food-related brain processes and functions will be presented. At the leading edge of non-invasive brain-based technologies is real-time fMRI (rtfMRI) neurofeedback, which is a powerful tool to better understand the complexity of human brain-behavior relationships. rtfMRI, alone or when combined with other techniques and tools such as EEG and cognitive therapy, could be used to alter neural plasticity and learned behavior to optimize and/or restore healthy cognition and eating behavior. Other promising non-invasive neuromodulation approaches being explored are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS). Converging evidence points at the value of
Val-Laillet, D.; Aarts, E.; Weber, B.; Ferrari, M.; Quaresima, V.; Stoeckel, L.E.; Alonso-Alonso, M.; Audette, M.; Malbert, C.H.; Stice, E.
Functional, molecular and genetic neuroimaging has highlighted the existence of brain anomalies and neural vulnerability factors related to obesity and eating disorders such as binge eating or anorexia nervosa. In particular, decreased basal metabolism in the prefrontal cortex and striatum as well as dopaminergic alterations have been described in obese subjects, in parallel with increased activation of reward brain areas in response to palatable food cues. Elevated reward region responsivity may trigger food craving and predict future weight gain. This opens the way to prevention studies using functional and molecular neuroimaging to perform early diagnostics and to phenotype subjects at risk by exploring different neurobehavioral dimensions of the food choices and motivation processes. In the first part of this review, advantages and limitations of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), pharmacogenetic fMRI and functional near-infrared spectroscopy (fNIRS) will be discussed in the context of recent work dealing with eating behavior, with a particular focus on obesity. In the second part of the review, non-invasive strategies to modulate food-related brain processes and functions will be presented. At the leading edge of non-invasive brain-based technologies is real-time fMRI (rtfMRI) neurofeedback, which is a powerful tool to better understand the complexity of human brain–behavior relationships. rtfMRI, alone or when combined with other techniques and tools such as EEG and cognitive therapy, could be used to alter neural plasticity and learned behavior to optimize and/or restore healthy cognition and eating behavior. Other promising non-invasive neuromodulation approaches being explored are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS). Converging evidence points at the value of
Song, Youn Joo; Lee, Jung-Hyun; Jung, Young-Chul
Recent studies suggest that chewing and spitting out food may be associated with severe eating-related pathology. The purpose of this study was to investigate the relationship between chewing and spitting, and other symptoms of eating disorders. We hypothesized that patients who chew and spit as a compensatory behavior have more severe eating-related pathology than patients who have never engaged in chewing and spitting behavior. We divided 359 patients with eating disorders into two groups according to whether they engaged in chewing and spitting as a compensatory behavior to lose weight or not. After comparing eating-related pathology between the two groups, we examined factors associated with pathologic eating behaviors using logistic regression analysis. Among our 359 participants, 24.5% reported having engaged in chewing and spitting as a compensatory behavior. The chewing and spitting (CHSP+) group showed more severe eating disorder symptoms and suicidal behaviors. This group also had significantly higher scores on subscales that measured drive for thinness, bulimia, and impulse regulation on the EDI-2, Food Craving Questionnaire, Body Shape Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, and Maudsley Obsessive Compulsive Inventory. Chewing and spitting is a common compensatory behavior among patients with eating disorders and is associated with more-pathologic eating behaviors and higher scores on psychometric tests. Copyright © 2015 Elsevier Inc. All rights reserved.
Bardone-Cone, Anna M.; Higgins, M. K.; St George, Sara M.; Rosenzweig, Ilyssa; Schaefer, Lauren M.; Fitzsimmons-Craft, Ellen E.; Henning, Taylor M.; Preston, Brittany F.
This study examined the relationship between behavioral and psychological aspects of exercise and eating disorder recovery. Participants were categorized as having an eating disorder (n = 53), partially recovered (n = 15), fully recovered (n = 20), or non-eating disorder controls (n = 67). Groups did not differ significantly in time spent exercising, but did differ in exercise intensity, guilt related exercise, obsessive exercise cognitions, and appearance/weight management and stress/mood management motivations for exercise. Results support the importance of measuring psychological aspects of exercise in particular across the course of an eating disorder. PMID:27463591
Segura-García, C; Papaianni, M C; Caglioti, F; Procopio, L; Nisticò, C G; Bombardiere, L; Ammendolia, A; Rizza, P; De Fazio, P; Capranica, L
Striving for enhancing athletic performance, many sportsmen undergo rigid dietary habits, which could lead to eating disorders (EDs) or Orthorexia Nervosa (ON), a psychopathological condition characterized by the obsession for high quality food. The aim of the study was to examine the occurrence of ON in athletes and to verify the relationship between ON and EDs. Five-hundred-seventy-seven athletes and 217 matched controls were administered the following tests: ORTO-15, Eating Attitude Test 26 (EAT-26), Body Uneasiness Test (BUT) and Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS). High positivity to ORTO-15 (28%) and EAT-26 (14%) emerged in athletes, whereas a high rate of BUT positivity was evident among controls (21%). Multivariate logistic regression analysis revealed that independent predictors of ON are previous dieting, age, positivity to YBC-EDS, positivity to EAT-26, competition level, and number of YBC-EDS preoccupations and rituals. Sharing many features with both EDs and Obsessive-Compulsive Spectrum, ON represents a crossroad between these pathologic conditions and might compromise the health state of an athlete. Therefore, coaches should consider important to detect symptoms of EDs and ON in their athletes.
Støving, René Klinkby; Andries, Alin; Brixen, Kim Torsten
Purging behavior in eating disorders is associated with medical risks. We aimed to compare remission rates in purging and non-purging females with anorexia nervosa (AN) and eating disorder not otherwise specified (EDNOS) in a large retrospective single center cohort. A total of 339 patients...
Choate, Laura H.
Eating disorder not otherwise specified (EDNOS; American Psychiatric Association, 2000) is, by far, the most common eating disorder that college counseling professionals encounter among their female clients. Empirical evidence and best practice guidelines support use of cognitive behavior therapy (CBT) with women experiencing EDNOS. This article…
Klomek, Anat Brunstein; Lev-Wiesel, Rachel; Shellac, Evia; Hadas, Arik; Berger, Uri; Horwitz, Mira; Fennig, Silvana
The aim of the current study is to examine the association between self disclosure and self-injurious behaviors among adolescent patients diagnosed with an eating disorder. Sixty three female patients who fulfilled the DSM-IV diagnostic criteria of eating disorders were included (i.e. anorexia, bulimia, binge eating disorder and eating disorders not otherwise specified). Participants' age ranged from 11.5 to 20 years (M = 15.42, SD = 1.82). Participants completed self- report questionnaires about eating disorders, self-disclosure, self-injurious behaviors (FASM) and depression (BDI-II) RESULTS: 82.5% of the sample endorsed severe self-injurious behaviors. A moderate negative relationship was found between general disclosure to parents and self-injurious behaviors indicating that patients who generally self-disclose to their parents (on different topics, apart from suicidal ideation) engage less frequently in self-injurious behaviors. In addition, the more patients self-disclose their suicidal ideation to others, the more they tend to self-injure. Self-disclosure to parents on any topic may buffer against self-injurious behaviors and therefore it is important to work with adolescents suffering from eating disorders on effective self disclosure. In addition, self-disclosure about suicidal ideation to others by adolescents suffering from eating disorders should always be taken seriously, since it may be related to self-injurious behaviors.
Alfonsson, Sven; Parling, Thomas; Ghaderi, Ata
The aim of the present study was to assess whether behavioral activation (BA) is an efficacious treatment for decreasing eating disorder symptoms in patients with obesity and binge eating disorder (BED). Ninety-six patients with severe obesity and BED were randomized to either 10 sessions of group BA or wait-list control. The study was conducted at an obesity clinic in a regular hospital setting. The treatment improved some aspects of disordered eating and had a positive effect on depressive symptoms but there was no significant difference between the groups regarding binge eating and most other symptoms. Improved mood but lack of effect on binge eating suggests that dysfunctional eating (including BED) is maintained by other mechanisms than low activation and negative mood. However, future studies need to investigate whether effects of BA on binge eating might emerge later than at post-assessment, as in interpersonal psychotherapy for bulimia nervosa. © The Author(s) 2014.
Hoffmann, Anika; Postma, Frank P; Sterkenburg, Anthe S; Gebhardt, Ursel; Müller, Hermann L
As a result of hypothalamic involvement and/or treatment-related hypothalamic damage, up to 75% of childhood craniopharyngioma patients develop hypothalamic obesity. Eating behavior was analyzed in 101 survivors of childhood craniopharyngioma, recruited from 1980 to 2001 in the HIT-Endo multicenter study, and in 85 body mass index (BMI)-matched healthy controls using the Inventory for Eating Behavior and Weight Problems (IEG) and the Inventory for Eating Disorders (ESI). Severely obese patients (BMI>8 SD; n=9) presented with pathological eating behavior, more weight problems, and eating disorders, as compared to obese (BMI 3-8 SD; n=44) and normal or overweight patients (BMICraniopharyngioma patients with different degrees of obesity showed similar or even less pathological findings as compared to BMI-matched normal controls. Severe obesity is associated with pathological eating behavior/disorders in craniopharyngioma patients. As these disorders are not disease-specific, risk factors for hypothalamic obesity should be the focus of further craniopharyngioma research.
Romito, Patrizia; Cedolin, Carlotta; Bastiani, Federica; Saurel-Cubizolles, Marie-Josèphe
The aim of this study is to describe sexual harassment among Italian university students and analyze the relationship between harassment and disordered eating behaviors. An observational survey was conducted among university students at Trieste University (Italy) in spring 2014. Students answered an anonymous self-administered questionnaire about sexual harassment, including three domains-sexual harassment, unwanted comments on physical appearance, cyber-harassment-and disordered eating behaviors. The global sexual harassment index was computed with three levels: Level 0, no harassment; Level 1, harassment in at least one of the three domains; and Level 2, harassment in two or three domains. Disordered eating behaviors were classified by at least one of the following: (a) eating without being able to stop or vomiting at least once or twice a month, (b) using laxatives or diuretics at least once or twice a week, (c) monitoring weight every day, and (d) dieting at least very often. The sample included 759 students (347 men and 412 women; 18-29 years old). Experiencing sexual harassment was related to eating disorder symptoms for both genders with a regular gradient: the higher the harassment score, the more frequent the disordered eating behavior symptoms, even after adjusting for age and previous sexual violence. The association was stronger for males than females. Sexual harassment and disordered eating behaviors have long been considered mainly a female problem. Men are not exempt from these problems and in some cases may be more affected than women. The topics should be assessed in men and women.
Yu, Zhiping; Tan, Michael
Evidence of whether nutrition students are free from food-related issues or at higher risk for eating disorders is inconsistent. This study aimed to assess disordered eating behaviors and food addiction among nutrition and non-nutrition major college students. Students ( n = 967, ages 18-25, female 72.7%, white 74.8%) enrolled at a public university completed online demographic characteristics surveys and validated questionnaires measuring specific disordered eating behaviors. Academic major category differences were compared. Additionally, high risk participants were assessed by weight status and academic year. Overall, 10% of respondents were a high level of concern for developing eating disorders. About 10.3% of respondents met criteria for food addiction. In addition, 4.5% of respondents had co-occurrence of eating disorder risk and food addiction risk out of total respondents. There were no significant differences in level of concern for developing an eating disorder, eating subscales, or food addiction among academic majors. The percentage of high risk participants was lower in the underweight/normal weight group than in the overweight/obese group in health-related non-nutrition major students but not in nutrition students. Early screening, increasing awareness, and promoting healthy eating habits could be potential strategies to help treat and prevent the development of disorders or associated health conditions in nutrition as well as non-nutrition students.
Yu, Zhiping; Tan, Michael
Evidence of whether nutrition students are free from food-related issues or at higher risk for eating disorders is inconsistent. This study aimed to assess disordered eating behaviors and food addiction among nutrition and non-nutrition major college students. Students (n = 967, ages 18–25, female 72.7%, white 74.8%) enrolled at a public university completed online demographic characteristics surveys and validated questionnaires measuring specific disordered eating behaviors. Academic major category differences were compared. Additionally, high risk participants were assessed by weight status and academic year. Overall, 10% of respondents were a high level of concern for developing eating disorders. About 10.3% of respondents met criteria for food addiction. In addition, 4.5% of respondents had co-occurrence of eating disorder risk and food addiction risk out of total respondents. There were no significant differences in level of concern for developing an eating disorder, eating subscales, or food addiction among academic majors. The percentage of high risk participants was lower in the underweight/normal weight group than in the overweight/obese group in health-related non-nutrition major students but not in nutrition students. Early screening, increasing awareness, and promoting healthy eating habits could be potential strategies to help treat and prevent the development of disorders or associated health conditions in nutrition as well as non-nutrition students. PMID:27792162
Full Text Available Evidence of whether nutrition students are free from food-related issues or at higher risk for eating disorders is inconsistent. This study aimed to assess disordered eating behaviors and food addiction among nutrition and non-nutrition major college students. Students (n = 967, ages 18–25, female 72.7%, white 74.8% enrolled at a public university completed online demographic characteristics surveys and validated questionnaires measuring specific disordered eating behaviors. Academic major category differences were compared. Additionally, high risk participants were assessed by weight status and academic year. Overall, 10% of respondents were a high level of concern for developing eating disorders. About 10.3% of respondents met criteria for food addiction. In addition, 4.5% of respondents had co-occurrence of eating disorder risk and food addiction risk out of total respondents. There were no significant differences in level of concern for developing an eating disorder, eating subscales, or food addiction among academic majors. The percentage of high risk participants was lower in the underweight/normal weight group than in the overweight/obese group in health-related non-nutrition major students but not in nutrition students. Early screening, increasing awareness, and promoting healthy eating habits could be potential strategies to help treat and prevent the development of disorders or associated health conditions in nutrition as well as non-nutrition students.
Background Binge eating disorder is a prevalent adolescent disorder, associated with increased eating disorder and general psychopathology as well as an increased risk for overweight and obesity. As opposed to binge eating disorder in adults, there is a lack of validated psychological treatments for this condition in adolescents. The goal of this research project is therefore to determine the efficacy of age-adapted cognitive-behavioral therapy in adolescents with binge eating disorder ? the ...
Full Text Available Hunger is an awakening related biological impulse. The relationship between hunger and sleep is moderated by the control of homeostatic and circadian rhytms of the body. Abnormal eating behavior during sleep period could result from different causes. Abnormal eating during the main sleep period has been categorized as either night eating syndrome or sleep related eating disorder. Night eating syndrome (NES is an eating disorder characterised by the clinical features of morning anorexia, evening hyperphagia, and insomnia with awakenings followed by nocturnal food ingestion. Recently night eating syndrome, conceptualized as a delayed circadian intake of food. Sleep-related eating disorder, thought to represent a parasomnia and as such included within the revised International Classification of Sleep Disorders (ICSD-2, and characterized by nocturnal partial arousals associated with recurrent episodes of involuntary food consumption and altered levels of consciousness. Whether, however, sleep-related eating disorder and night eating syndrome represent different diseases or are part of a continuum is still debated. This review summarizes their characteristics, treatment outcomes and differences between them.
Full Text Available Jiri Koutek, Jana Kocourkova, Iva Dudova Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic Abstract: Comorbid psychopathology, including self-harm and suicidal behavior, is often found in patients with eating disorders. To better understand the reasons for high comorbid psychopathology among eating disorders, self-harm, and suicidal behavior, we examined this comorbidity in female patients hospitalized with eating disorders. In a sample of 47 girls admitted for anorexia nervosa, atypical anorexia nervosa, and bulimia nervosa, 72% had depressive symptoms, 11% had obsessive-compulsive symptoms, 9% had anxiety disorder, 23% had substance abuse, and 57% had disharmonious personality development. Suicidal behavior was present in 60% of patients and self-harm in 49%. Association was found between self-harm and suicidality. In all, 68% of girls with eating disorders had a positive score in the Children’s Depression Inventory questionnaire and 62% of them in the Child Adolescent Suicidal Potential Index questionnaire. Clinical examination of girls with eating disorders should focus on identifying the risk of suicidal behavior and self-harm. Keywords: eating disorders, child, adolescent, self-harm, suicidal behavior
Binge eating disorder is a common eating disorder that recently has received increasing attention. Goals in treating binge eating disorder typically include controlling binge eating and diminishing excess body weight. A variety of treatment approaches have been used, including diet/lifestyle modification, psychotherapy, and pharmacologic treatment. Diet and lifestyle interventions are somewhat effective in diminishing the binge eating behavior and lead to modest weight loss, but the weight ef...
Hrabosky, Joshua I; Grilo, Carlos M
The current study examined body image concerns and eating disordered behaviors in a community sample of Black and Hispanic women. In addition, this study explored whether there are ethnic differences in the correlates or in the prediction of body image concerns. Participants were 120 (67 Black and 53 Hispanic) women who responded to advertisements to participate in a study of women and health. Participants completed a battery of established self-report measures to assess body image, eating disordered behaviors, and associated psychological domains. Black and Hispanic women did not differ significantly in their self-reports of body image, eating disordered behaviors, or associated psychological measures. Comparisons performed separately within both ethnic groups revealed significant differences by weight status, with a general graded patterning of greater concerns in obese than overweight than average weight groups. In terms of predicting body image, multiple regression analyses testing a number of variables, including BMI, performed separately for Black and Hispanic women revealed that eating concern and depressive affect were significant predictors of body image concern for both groups. Overall, Black and Hispanic women differed little in their self-reports of body image, eating-disordered features, and depressive affect. Higher weight was associated with a general pattern of increased body image concerns and features of eating disorders in both groups and with binge eating in Black women. Eating concerns and depressive affect emerged as significant independent predictors of body image for both ethnic groups.
Lundahl, Alyssa; Wahlstrom, Laura C; Christ, Christa C; Stoltenberg, Scott F
We investigated relationships among gender, impulsivity and disordered eating in healthy college students. Participants (N=1223) were healthy, undergraduate men (28.5%) and women (71.5%), who completed the Barratt Impulsiveness Scale - Version 11 (BIS-11) and a four-factor version of the Eating Attitudes Test (EAT-16). As predicted, mean scores on all four EAT-16 factors were significantly higher for women than for men. Attentional impulsivity was related to poorer self-perception of body shape, more dieting, and a greater preoccupation with food for the sample as a whole. Moreover, motor impulsivity was related to poorer self-perceptions of body shape and a greater preoccupation with food. However, no gender differences emerged in the relationship between impulsivity and disordered eating attitudes. This study elucidates the role of impulsivity in disordered eating behaviors among non-clinical college students. For both women and men, attentional and motor impulsivity were related to disordered eating attitudes and behaviors. Overall, these findings suggest that different facets of impulsivity are related to disordered eating attitudes and behaviors in a non-clinical college population. Copyright © 2015 Elsevier Ltd. All rights reserved.
Stone, Jay M
.... The EDE relies on retrospective self-report to obtain eating behavior information. However, there is growing evidence that retrospective self-reports are prone to errors arising from autobiographical memory...
Riccardo Dalle Grave
Full Text Available Enhanced cognitive behaviour therapy (CBT-E for eating disorders has been developed and evaluated only in outpatient setting. Aim of the paper is to describe a novel model of inpatient treatment, termed inpatient CBT-E, indicated for patients with an eating disorder of clinical severity not manageable in an outpatient setting or that failed outpatient treatment. Inpatient CBT-E is derived by the outpatients CBT-E with some adaptations to rend the treatments suitable for an inpatient setting. The principal adaptations include: 1 multidisciplinary and non-eclectic team composed of physicians, psychologists, dieticians and nurses all trained in CBT; 2 assisted eating; 3 group sessions; and a CBT family module for patients younger than 18 years. The treatment lasts 20 weeks (13 for inpatients followed by seven weeks of residential day treatment and, as CBT-E, is divided in four stages and can be administered in a focused form (CBT-F or in a broad form (CBT-B. A randomized control trial is evaluating the effectiveness of the treatment.
Phillipa J Hay
Full Text Available BACKGROUND: Evidence for an increase in the prevalence of eating disorders is inconsistent. Our aim was to determine change in the population point prevalence of eating disorder behaviors over a 10-year period. METHODOLOGY/PRINCIPAL FINDINGS: Eating disorder behaviors were assessed in consecutive general population surveys of men and women conducted in 1995 (n = 3001, 72% respondents and 2005 (n = 3047, 63.1% respondents. Participants were randomly sampled from households in rural and metropolitan South Australia. There was a significant (all p<0.01 and over two-fold increase in the prevalence of binge eating, purging (self-induced vomiting and/or laxative or diuretic misuse and strict dieting or fasting for weight or shape control among both genders. The most common diagnosis in 2005 was either binge eating disorder or other "eating disorders not otherwise specified" (EDNOS; n = 119, 4.2%. CONCLUSIONS/SIGNIFICANCE: In this population sample the point prevalence of eating disorder behaviors increased over the past decade. Cases of anorexia nervosa and bulimia nervosa, as currently defined, remain uncommon.
ter Huurne, Elke D; de Haan, Hein A; Postel, Marloes G; van der Palen, Job; VanDerNagel, Joanne E L; DeJong, Cornelis A J
Many patients with eating disorders do not receive help for their symptoms, even though these disorders have severe morbidity. The Internet may offer alternative low-threshold treatment interventions. This study evaluated the effects of a Web-based cognitive behavioral therapy (CBT) intervention using intensive asynchronous therapeutic support to improve eating disorder psychopathology, and to reduce body dissatisfaction and related health problems among patients with eating disorders. A two-arm open randomized controlled trial comparing a Web-based CBT intervention to a waiting list control condition (WL) was carried out among female patients with bulimia nervosa (BN), binge eating disorder (BED), and eating disorders not otherwise specified (EDNOS). The eating disorder diagnosis was in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and was established based on participants' self-report. Participants were recruited from an open-access website, and the intervention consisted of a structured two-part program within a secure Web-based application. The aim of the first part was to analyze participant's eating attitudes and behaviors, while the second part focused on behavioral change. Participants had asynchronous contact with a personal therapist twice a week, solely via the Internet. Self-report measures of eating disorder psychopathology (primary outcome), body dissatisfaction, physical health, mental health, self-esteem, quality of life, and social functioning were completed at baseline and posttest. A total of 214 participants were randomized to either the Web-based CBT group (n=108) or to the WL group (n=106) stratified by type of eating disorder (BN: n=44; BED: n=85; EDNOS: n=85). Study attrition was low with 94% of the participants completing the posttest assignment. Overall, Web-based CBT showed a significant improvement over time for eating disorder psychopathology (F97=63.07, PWeb-based CBT participants in all three
Full Text Available Eating disorders develop through a combination of genetic vulnerability and environmental stress, however the genetic basis of this risk is unknown.To understand the genetic basis of this risk, we performed whole exome sequencing on 93 unrelated individuals with eating disorders (38 restricted-eating and 55 binge-eating to identify novel damaging variants. Candidate genes with an excessive burden of predicted damaging variants were then prioritized based upon an unbiased, data-driven bioinformatic analysis. One top candidate pathway was empirically tested for therapeutic potential in a mouse model of binge-like eating.An excessive burden of novel damaging variants was identified in 186 genes in the restricted-eating group and 245 genes in the binge-eating group. This list is significantly enriched (OR = 4.6, p<0.0001 for genes involved in neuropeptide/neurotrophic pathways implicated in appetite regulation, including neurotensin-, glucagon-like peptide 1- and BDNF-signaling. Administration of the glucagon-like peptide 1 receptor agonist exendin-4 significantly reduced food intake in a mouse model of 'binge-like' eating.These findings implicate ultra-rare and novel damaging variants in neuropeptide/neurotropic factor signaling pathways in the development of eating disorder behaviors and identify glucagon-like peptide 1-receptor agonists as a potential treatment for binge eating.
Brandt, Lorenna Mendes Temóteo; Fernandes, Liege Helena Freitas; Aragão, Amanda Silva; Aguiar, Yêska Paola Costa; Auad, Sheyla Márcia; de Castro, Ricardo Dias; Cavalcanti, Sérgio D'Ávila Lins Bezerra; Cavalcanti, Alessandro Leite
The aim of this study was to evaluate whether there is an association between risk behavior for eating disorders (EDs) and dental erosion and caries. A controlled cross-sectional study was conducted in Brazil, involving 850 randomly selected female adolescents. After evaluating risk behavior for eating disorders through the Bulimic Investigatory Test of Edinburgh, 12 adolescents were identified with severe risk behavior for EDs and matched to 48 adolescents without such risk. Dental examinations, anthropometric measurements, and eating habits and oral hygiene were performed. Adolescents with high severity eating disorder condition were not more likely to show dental caries ( p = 0.329; OR = 2.2, 95% CI: 0.35-13.72) or dental erosion ( p = 0.590; OR = 2.33; 95% CI: 0.56-9.70). Adolescents with high body mass index (BMI) were five times more likely to have high severity eating disorder condition ( p = 0.031; OR = 5.1; 95% CI: 1.61-23.07). Therefore, high severity risk behavior for EDs was not significantly associated with dental caries and dental erosion. However, high BMI was a risk factor for developing eating disorders and should be an alert for individuals with this condition.
Striegel-Moore, Ruth H; Rosselli, Francine; Holtzman, Niki; Dierker, Lisa; Becker, Anne E; Swaney, Gyda
To examine prevalence and correlates (gender, Body Mass Index) of disordered eating in American Indian/Native American (AI/NA) and white young adults. We examined data from the 10,334 participants (mean age 21.93 years, SD = 1.8) of the National Longitudinal Study of Adolescent Health (ADD Health) Wave III for gender differences among AI/NA participants (236 women, 253 men) and ethnic group differences on measures of eating pathology. Among AI/NA groups, women were significantly more likely than men to report loss of control and embarrassment due to overeating. In gender-stratified analyses, a significantly higher prevalence of AI/NA women reported disordered eating behaviors compared with white women; there were no between group differences in prevalence for breakfast skipping or having been diagnosed with an eating disorder. Among men, disordered eating behaviors were uncommon and no comparison was statistically significant. Our study offers a first glimpse into the problem of eating pathology among AI/NA individuals. Gender differences among AI/NA participants are similar to results reported in white samples. That AI/NA women were as likely as white women to have been diagnosed with an eating disorder is striking in light of well documented under-utilization of mental health care among AI/NA individuals. Copyright © 2010 Wiley Periodicals, Inc.
Delaney, Charlotte B; Eddy, Kamryn T; Hartmann, Andrea S; Becker, Anne E; Murray, Helen B; Thomas, Jennifer J
Pica and rumination disorder (RD)-formerly classified within DSM-IV Feeding and Eating Disorders of Infancy or Early Childhood-are now classified within DSM-5 Feeding and Eating Disorders. Though pica and RD have been studied in select populations (e.g., pregnant women, intellectually disabled persons), their typical features and overall prevalence remain unknown. This study examined the clinical characteristics and frequency of DSM-5 pica and RD among individuals seeking treatment for eating disorders and obesity. We conducted structured interviews with adolescent and young adult females from a residential eating disorder center (N = 149), and adult males and females with overweight or obesity from an outpatient weight-loss clinic (N = 100). Several participants reported ingesting non-nutritive substances (e.g., ice) for weight-control purposes. However, only 1.3% (n = 2; 95% CI: .06% to 5.1%) at the residential eating disorder center and 0% at the weight-loss clinic met DSM-5 criteria for pica, consuming gum and plastic. Although no eating disorder participants were eligible for an RD diagnosis due to DSM-5 trumping rules, 7.4% (n = 11; 95% CI: 4.0% to 12.9%) endorsed rumination behavior under varying degrees of volitional control. At the weight-loss clinic, 2.0% (n = 2; 95% CI: 0.1% to 7.4%) had RD. DSM-5 pica and RD were rare in our sample of individuals seeking treatment for eating disorders and obesity, but related behaviors were more common. The wide range of pica and rumination presentations highlights the challenges of differential diagnosis with other forms of disordered eating. © 2014 Wiley Periodicals, Inc.
ter Huurne, E.D.; de Haan, H.A.; Postel, Marloes Gerda; van der Palen, Jacobus Adrianus Maria; VanDerNagel, Joanneke E.L.; de Jong, Cor A.J.
Background: Many patients with eating disorders do not receive help for their symptoms, even though these disorders have severe morbidity. The Internet may offer alternative low-threshold treatment interventions. Objective: This study evaluated the effects of a Web-based cognitive behavioral therapy
Conclusions: Present results suggest that self-compassionate actions hold a protective effect on eating behavior through higher levels of respect and appreciation toward body image, despite body weight, shape, and imperfections. The ability to act following self-compassionate motivations seems to contribute to higher levels of body image appreciation, which reflects in a lower susceptibility to adopt disordered eating attitudes and behaviors. The present study seems to represent an important contribution to research and clinical practice and underlines the importance of including strategies to develop self-compassionate and body appreciation competencies in programs to prevent and intervene in the area of eating psychopathology.
Fabbri,Alessandra Donzelli; Deram,Sophie; Kerr,Daniel Shikanai; Cordás,Táki Athanássios
Background Ghrelin is a potent hormone with central and peripheral action. This hormone plays an important role in the regulation of appetite, food intake, and energy balance. Studies have suggested that ghrelin is involved with eating disorders (ED), particularly bingeing and purging. Genetic variants have also been studied to explain changes in eating behavior. Methods We conducted a literature review; we searched PubMed, Scientific Electronic Library Online (SciELO), and LILACS databases u...
Elran-Barak, Roni; Sztainer, Maya; Goldschmidt, Andrea B; Crow, Scott J; Peterson, Carol B; Hill, Laura L; Crosby, Ross D; Powers, Pauline; Mitchell, James E; Le Grange, Daniel
To compare dietary restriction behaviors among adults with eating disorders involving binge eating, including anorexia nervosa-binge/purge subtype (AN-BE/P), bulimia nervosa (BN), and binge eating disorder (BED), and to examine whether dietary restriction behaviors impact binge eating frequency across diagnoses. Participants included 845 treatment seeking adults (M=30.42+10.76years) who met criteria for DSM-5 AN-BE/P (7.3%;n=62), BN (59.7%;n=504), and BED (33.0%;n=279). All participants self-reported their past and current eating disorder symptoms on the Eating Disorder Questionnaire. Adults with AN-BE/P and BN reported significantly more dietary restriction behaviors (e.g. eating fewer meals per day, higher frequency of fasting, consuming small and low calorie meals) in comparison to adults with BED. Adults with AN-BE/P and BN who reported restricting food intake via eating fewer meals per day had more frequent binge eating episodes. However, adults with BN who reported restricting food intake via eating small meals and low calorie meals had less frequent binge eating episodes. This study provides mixed support for the restraint model by suggesting that not all dietary restriction behaviors are associated with higher levels of binge eating. It may be that adults with BN who report a higher frequency of eating small and low calorie meals display more control over their eating in general, and therefore also have lower frequency of binge eating. Clinicians should assess for dietary restriction behaviors at the start of treatment prior to assuming that all forms of strict dieting and weight control behaviors similarly impact binge eating. Copyright © 2015. Published by Elsevier Ltd.
Chardon, Marie L; Janicke, David M; Carmody, Julia K; Dumont-Driscoll, Marilyn C
Internalizing symptoms increase the risk for disordered eating; however, the mechanism through which this relationship occurs remains unclear. Sleep-related problems may be a potential link as they are associated with both emotional functioning and disordered eating. The present study aims to evaluate the mediating roles of two sleep-related problems (sleep disturbance and daytime sleepiness) in the relationship between youth internalizing symptoms and disordered eating, and to explore if age moderates these relations. Participants were 225 youth (8-17years) attending a primary care appointment. Youth and legal guardians completed questionnaires about youth disordered eating attitudes and behaviors, internalizing symptoms, sleep disturbance, and daytime sleepiness. Mediation and moderated mediation analyses were utilized. The mediation model revealed both youth sleep disturbance and daytime sleepiness independently mediated the association between internalizing symptoms and disordered eating attitudes and behaviors, and explained 18% of the variance in disordered eating. The moderated mediation model including youth age accounted for 21% of the variance in disordered eating; youth age significantly interacted with sleep disturbance, but not with daytime sleepiness, to predict disordered eating. Sleep disturbance only mediated the relationship between internalizing symptoms and disordered eating in youth 12years old and younger, while daytime sleepiness was a significant mediator regardless of age. As sleep-related problems are frequently improved with the adoption of health behaviors conducive to good sleep, these results may suggest a relatively modifiable and cost-effective target to reduce youth risk for disordered eating. Copyright © 2016 Elsevier Ltd. All rights reserved.
Roehrig, Megan; Masheb, Robin M.; White, Marney A.; Grilo, Carlos M.
This study examined the frequency of the metabolic syndrome (MetSyn) and explored behavioral eating- and weight-related correlates in obese patients with binge eating disorder (BED). Ninety-three treatment-seeking obese BED patients (22 men and 71 women) with and without the MetSyn were compared on demographic features and a number of current and historical eating and weight variables. Sixty percent of the obese patients with BED met criteria for the MetSyn, with men and whites having signifi...
Racine, Sarah E; VanHuysse, Jessica L; Keel, Pamela K; Burt, S Alexandra; Neale, Michael C; Boker, Steven; Klump, Kelly L
Theoretical models of binge eating and eating disorders include both transdiagnostic and eating disorder-specific risk factors. Negative urgency (i.e., the tendency to act impulsively when distressed) is a critical transdiagnostic risk factor for binge eating, but limited research has examined interactions between negative urgency and disorder-specific variables. Investigating these interactions can help identify the circumstances under which negative urgency is most strongly associated with binge eating. We examined whether prominent risk factors (i.e., appearance pressures, thin-ideal internalization, body dissatisfaction, dietary restraint) specified in well-established etiologic models of eating disorders moderate negative urgency-binge eating associations. Further, we investigated whether phenotypic moderation effects were due to genetic and/or environmental associations between negative urgency and binge eating. Participants were 988 female twins aged 11-25 years from the Michigan State University Twin Registry. Appearance pressures, thin-ideal internalization, and body dissatisfaction, but not dietary restraint, significantly moderated negative urgency-binge eating associations, with high levels of these risk factors and high negative urgency associated with the greatest binge eating. Twin moderation models revealed that genetic, but not environmental, sharing between negative urgency and binge eating was enhanced at higher levels of these eating disorder-specific variables. Future longitudinal research should investigate whether eating disorder risk factors shape genetic influences on negative urgency into manifesting as binge eating. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Lewer, Merle; Nasrawi, Nadia; Schroeder, Dorothea; Vocks, Silja
Whereas the manifestation of body image disturbance in binge eating disorder (BED) has been intensively investigated concerning the cognitive-affective component, with regard to the behavioral and the perceptual components of body image disturbance in BED, research is limited and results are inconsistent. Therefore, the present study assessed body image disturbance in BED with respect to the different components of body image in a sample of obese females (n = 31) with BED compared to obese females without an eating disorder (n = 28). The Eating Disorder Inventory-2, the Eating Disorder Examination-Questionnaire, the Body Image Avoidance Questionnaire and the Body Checking Questionnaire as well as a Digital Photo Distortion Technique based on a picture of each participant taken under standardized conditions were employed. Using two-sample t tests, we found that the participants with BED displayed significantly greater impairments concerning the cognitive-affective component of body image than the control group. Concerning the behavioral component, participants with BED reported more body checking and avoidance behavior than the controls, but group differences failed to reach significance after the Bonferroni corrections. Regarding the perceptual component, a significant group difference was found for the perceived "ideal" figure, with the individuals suffering from BED displaying a greater wish for a slimmer ideal figure than the control group. These results support the assumption that body image disturbance is a relevant factor in BED, similar to other eating disorders.
Wade, Stephanie; Byrne, Sue; Allen, Karina
This randomized control trial is an evaluation of the effectiveness of enhanced cognitive behavioral treatment (CBT-E) for eating disorders adapted for a group setting. The study aimed to examine the effects of group CBT-E on eating disorder psychopathology and additional maintaining pathology. A transdiagnostic sample of individuals with eating disorders with a BMI ≥ 18 kg/m 2 (N = 40) were randomized to an immediate-start or delayed-start condition so as to compare therapeutic effects of group CBT-E with a waitlist control. Global Eating Disorder Examination Questionnaire (EDE-Q) scores, BMI, and measures of Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were measured across the 8-week control period, throughout the group treatment and at 3-months post-treatment. Over 70% of those who entered the trial completed treatment. The first eight weeks of group CBT-E were more effective at reducing Global EDE-Q scores than no treatment (waitlist control). By post-treatment, good outcome (a Global EDE-Q within 1 SD of Australian community norms plus BMI ≥ 18.5) was achieved by 67.9% of treatment completers and 66.7% of the total sample. Symptom abstinence within the previous month was reported by 14.3% of treatment completers and 10.3% of the total sample. Significant reductions in Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were also observed. This study demonstrated that a group version of CBT-E can be effective at reducing eating disorder psychopathology in a transdiagnostic sample of individuals with eating disorders. Group CBT-E could provide a means of increasing availability of evidence-based treatment for eating disorders. © 2017 Wiley Periodicals, Inc.
Daniella Fagundes SOUTO
Full Text Available Abstract Introduction The overvaluation of thinness as a standard of beauty has contributed to the development of eating disorders and has mainly affected adolescents and young adults. Objective To evaluate the prevalence of risk behaviors for eating disorders and their association with dental erosion in adolescents. Material and method This is a cross-sectional observational epidemiological study. The sample consisted of 278 adolescents aged 12 to 19 years, enrolled in a State School in Campinas - SP. Two questionnaires were used for the data collection on eating disorders: Bulimic Investigatory Test of Edinburgh and Eating Attitudes Test -26. The presence of erosion was evaluated by calibrated examiners. Result The mean age of the sample was 14.8 years. The prevalence of mean risk for bulimia in the sample was 43.2% (95% CI: 37.3%-49.0% and the prevalence of adolescents with a probability of developing bulimia was 53.2% (95% CI: 47.4%-59.1%. Of the total, 11.9% (95% CI: 8.1%-15.7% showed results suggestive of anorexia. Among women, 66.9% were classified as probability developing bulimia, whereas in men the prevalence was 39.0%. As for dental erosion, only 1.1% of the sample presented erosion. Conclusion The study pointed to large number of adolescents with risk behaviors for eating disorders but no association was found with dental erosion due to low prevalence.
Araia, E; Hendrieckx, Christel; Skinner, Timothy
OBJECTIVE: To examine gender differences in disordered eating behaviors (DEB) and body dissatisfaction in adolescents with type 1 diabetes. While evidence shows that female youth with type 1 diabetes are more prone to DEB compared to their peers without diabetes, little is known about male adoles...
Haines, Jess; Ziyadeh, Najat J.; Franko, Debra L.; McDonald, Julia; Mond, Jonathan M.; Austin, S. Bryn
Background: Early identification can greatly impact the trajectory of eating disorders, and school-based screening is 1 avenue for identifying those at risk. To be feasible in a school setting, a screening program must use a brief, valid screening tool. The aim of this study was to assess how well brief attitudinal and behavioral survey items…
Humphrey, Laura Lynn
Compared observations of family interactions among anorexic, bulimic-anorexic, bulimic, and normal families (N=74 families) consisting of father, mother, and teenage daughter. Benjamin's structural analysis of social behavior methodology differentiated clinical from normal families. Found unique patterns among subtypes of eating disorders which…
Grilo, Carlos M.; Crosby, Ross D.; Wilson, G. Terence; Masheb, Robin M.
Objective: The longer term efficacy of medication treatments for binge-eating disorder (BED) remains unknown. This study examined the longer term effects of fluoxetine and cognitive behavioral therapy (CBT) either with fluoxetine (CBT + fluoxetine) or with placebo (CBT + placebo) for BED through 12-month follow-up after completing treatments.…
ter Huurne, E.D.; Postel, Marloes Gerda; de Haan, H.A.; van der Palen, Jacobus Adrianus Maria; de Jong, C.A.
Treatment dropout is an important concern in eating disorder treatments as it has negative implications for patients’ outcome, clinicians’ motivation, and research studies. Our main objective was to conduct an exploratory study on treatment dropout in a two-part web-based cognitive behavioral
Full Text Available Ignacio Jáuregui-LoberaBehavioral Sciences Institute and Pablo de Olavide University, Seville, SpainAbstract: Neuroimaging techniques have been useful tools for accurate investigation of brain structure and function in eating disorders. Computed tomography, magnetic resonance imaging, positron emission tomography, single photon emission computed tomography, magnetic resonance spectroscopy, and voxel-based morphometry have been the most relevant technologies in this regard. The purpose of this review is to update the existing data on neuroimaging in eating disorders. The main brain changes seem to be reversible to some extent after adequate weight restoration. Brain changes in bulimia nervosa seem to be less pronounced than in anorexia nervosa and are mainly due to chronic dietary restrictions. Different subtypes of eating disorders might be correlated with specific brain functional changes. Moreover, anorectic patients who binge/purge may have different functional brain changes compared with those who do not binge/purge. Functional changes in the brain might have prognostic value, and different changes with respect to the binding potential of 5-HT1A, 5-HT2A, and D2/D3 receptors may be persistent after recovering from an eating disorder.Keywords: neuroimaging, brain changes, brain receptors, anorexia nervosa, bulimia nervosa, eating disorders
Full Text Available OBJECTIVE: To examine temporal trends in the burden of eating disorder (ED features, as estimated by the composite of their prevalence and impact upon quality of life (QoL over a period of 10 years. METHODOLOGY: Representative samples of 3010 participants in 1998 and 3034 participants in 2008 from the South Australian adult population were assessed for endorsement of ED features (objective binge eating, extreme dieting, and purging were assessed in both years; subjective binge eating and extreme weight/shape concerns were also assessed in 2008 and QoL using the Medical Outcomes Study Short Form (SF-36. PRINCIPAL FINDINGS: From 1998 to 2008 significant increases in the prevalence of objective binge eating (2.7% to 4.9%, p0.05. Multiple linear regressions found that in 1998 only objective binge eating significantly predicted scores on the mental health summary scale of the SF-36; however, in 2008 extreme weight/shape concerns, extreme dieting, and subjective binge eating were also significant predictors. Objective binge eating and extreme dieting were significant predictors of scores on the physical health summary scale of the SF-36 in both 1998 and 2008. CONCLUSIONS AND SIGNIFICANCE: The prevalence of ED behaviors increased between 1998 and 2008, while their impact on QoL remained stable. This suggests an overall increase in the burden of disordered eating from 1998 to 2008. Given that binge eating and extreme dieting predict impairment in QoL, the necessity of interventions to prevent both under- and over-eating is reinforced.
... himself. Understanding Binge Eating If you gorged on chocolate during Halloween or ate so much pumpkin pie ... binge eating, doctors may prescribe medications along with therapy and nutrition advice. People with binge eating disorder ...
Müller, Astrid; Loeber, Sabine; Söchtig, Johanna; Te Wildt, Bert; De Zwaan, Martina
Exercise dependence (EXD) is considered a behavioral addiction that is often associated with eating disorders. To date, only few studies examined the potential overlap between EXD and other addictive behaviors. Therefore, the present study aimed at investigating the relationship of EXD with pathological buying, pathological video gaming (offline and online), hypersexual behavior, and alcohol use disorder in a sample of clients of fitness centers. The following questionnaires were answered by 128 individuals (age M = 26.5, SD = 6.7 years; 71.7% men, 74.2% university students): Exercise Dependence Scale, Eating Disorder Examination-Questionnaire, Compulsive Buying Scale, Pathological Computer-Gaming Scale, Hypersexual Behavior Inventory, and Alcohol Use Disorders Identification Test (AUDIT). 7.8% of the sample were at-risk for EXD, 10.9% reported eating disorder pathology, 2.3% pathological buying, 3.1% hypersexual behavior, and none of the participants suffered from pathological video gaming. The criteria for severe alcohol disorder pathology (AUDIT ≥ 16) were fulfilled by 10.2%. With regard to continuous symptom scores, EXD symptoms were positively correlated with both eating disorder pathology and pathological buying but not with pathological video gaming, hypersexuality or alcohol use disorder. It is noteworthy that more symptoms of pathological buying corresponded with more symptoms of hypersexual behavior. The correlation pattern did not differ by gender. The co-occurrence of EXD, pathological buying and hypersexual behavior on a subclinical level or in the early stage of the disorders should be taken into account when assessing and treating patients. More research is warranted in order to investigate possible interactions between these conditions.
Camilla CP Estima
Full Text Available Objective: To evaluate eating disorders risk behaviors and unhealthy weight control practices among adolescents who consider themselves as vegetarians and those who are omnivorous.Material and Methods: A cross-sectional study was conducted in 12 technical schools in the city of São Paulo, Brazil. The sample included 1167 adolescents (51% female, aged 14 to 19 (mean age, 16. Adolescents stated whether they were currently vegetarian, and the sample was dichotomized as vegetarian and non-vegetarian. The two groups were compared as regards weight status, eating disorder risk behavior, unhealthy weight control methods and the perception of healthy eating.Results: About 4% of the sample was currently vegetarian, most of them female (70.8%, and females were 2.89 times more likely to be vegetarian than males. No relationship was found between the vegetarian status and unhealthy weight control behavior; however the vegetarian group considered their diet to be healthier than the non-vegetarian group (P=.04.Conclusions: The frequency of vegetarianism, as well the frequency of eating disorder risk behaviors had no association in this adolescent sample from São Paulo, Brazil.
Moulos, Ioannis; Maramis, Christos; Mourouzis, Alexandros; Maglaveras, Nicos
The recent immense diffusion of smartphones has significantly upgraded the role of mobile user interfaces in interventions that build and/or maintain healthier lifestyles. Indeed, high-quality, user-centered smartphone applications are able to serve as advanced front-ends to such interventions. These smartphone applications, coupled with portable or wearable sensors, are being employed for monitoring day to day health-related behaviors, including eating and physical activity. Some of them take one step forward by identifying unhealthy behaviors and contributing towards their modification. This work presents the design as well as the preliminary implementation of the mobile user interface of SPLENDID, a novel, sensor-oriented intervention for preventing obesity and eating disorders in young populations. This is implemented by means of an Android application, which is able to monitor the eating and physical activity behaviors of young individuals at risk for obesity and/or eating disorders, subsequently guiding them towards the modification of those behaviors that put them at risk. Behavior monitoring is based on multiple data provided by a set of communicating sensors and self-reported information, while guidance is facilitated through a feedback/encouragement provision and goal setting mechanism.
de Jong, M.; Korrelboom, C.W.; van der Meer, I.; Deen, M.; Hoek, H.W.; Spinhoven, P.
Background While eating disorder not otherwise specified (EDNOS) is the most common eating disorder (ED) diagnosis in routine clinical practice, no specific treatment methods for this diagnosis have yet been developed and studied. Enhanced cognitive behavioral therapy (CBT-E) has been described and
de Jong, Martie; Korrelboom, Kees; van der Meer, Iris; Deen, Mathijs; Hoek, Hans W.; Spinhoven, Philip
Background: While eating disorder not otherwise specified (EDNOS) is the most common eating disorder (ED) diagnosis in routine clinical practice, no specific treatment methods for this diagnosis have yet been developed and studied. Enhanced cognitive behavioral therapy (CBT-E) has been described and
Slof-Op 't Landt, Margarita Cornelia Theodora
In this thesis, a series of studies on different aspects of the genetics of eating disorders is presented. The heritability of disordered eating behavior and attitudes in relation with body mass index (BMI) was evaluated in a large adolescent twin-family sample ascertained through the Netherlands
Wilson, G. Terence; Fairburn, Christopher G.
Sees cognitive-behavioral therapy (CBT) as applicable to all eating disorders but most intensively studied in treatment of bulimia nervosa. Briefly reviews most commonly used cognitive treatments for eating disorders, provides critical evaluation of their effectiveness, and speculates about their mechanisms of action. Notes that CBT has not been…
Chen, Eunice Y; Matthews, Lauren; Allen, Charese; Kuo, Janice R; Linehan, Marsha Marie
This treatment development study provides summary data for standard Dialectical Behavior Therapy (DBT) with minimal adaptation for 8 women with binge-eating disorder (BED) (5) or bulimia nervosa (BN) (3) and Borderline Personality Disorder (BPD). DBT involved 6 months of weekly skills group, individual DBT, therapist consultation team meeting, and 24-hour telephone coaching. Assessments were conducted at pre-, post-treatment, and 6-months follow-up and utilized standardized clinical interviews including the Eating Disorders Examination (EDE), Personality Disorders Exam, and the Structured Clinical Interview for DSM-IV. From pre- to post-treatment, effect sizes for objective binge eating, total EDE scores and global adjustment were large and for number of non-eating disorder axis I disorders and for suicidal behavior and self-injury were medium. From pre- to 6-months follow-up, effect sizes were large for all these outcomes. This provides promising pilot data for larger studies utilizing DBT for BED or BN and BPD. (c) 2008 by Wiley Periodicals, Inc.
Fursland, Anthea; Byrne, Sharon; Watson, Hunna; La Puma, Michelle; Allen, Karina; Byrne, Susan
Eating disorders are serious mental illnesses affecting a significant proportion of women and a smaller number of men. Approximately half of those with an eating disorder (ED) will not meet the criteria for anorexia or bulimia nervosa, and will be diagnosed with an eating disorder not otherwise specified (EDNOS). Until recently, there were no…
Sonia Tucunduva Philippi
Full Text Available Objective: To evaluate the frequency of risk behaviors for eating disorder (ED in patients with type 1 diabetes (T1D and their association with gender, nutritional status, variables related to T1D, and body satisfaction. Method: 189 individuals with T1D (12-56 years old answered the Bulimic Investigation Test (BITE, the Eating Attitude Test (EAT, the Binge Eating Scale (BES, Stunkard's Figure Rating Scale, and questions regarding control of T1D. Association between ED risk behaviors and the selected variables was assessed with the chi-square test and Student's t-test; factors that influenced the risk of ED were identified by means of logistic regression. Results: Of the patients with T1D, 58.7% were at risk of ED (45, 40, and 16% according to the EAT, BITE and BES, respectively. There were significant differences between groups with and without risk for ED related to BMI (p = 0.009, gender (p = 0.001, insulin omission (p = 0.003, use of the carbohydrate counting method (p = 0.019, and body dissatisfaction (p = 0.001. The risk of ED was nine times higher in patients who reduced or omitted insulin (p = 0.036. Conclusions: Patients with T1D demonstrated a high frequency of body dissatisfaction and ED risk behaviors; the omission or reduction of insulin was an important risk factor.
Waller, Glenn; Stringer, Hannah; Meyer, Caroline
Objective: Clinicians commonly "drift" away from using proven therapeutic techniques. This study examined the degree to which such drift occurs among cognitive behavioral therapy (CBT) clinicians working with a specific clinical population--adults with eating disorders. Method: The study used a correlational design. The participants were…
Srinivasan, T.N.; Suresh, T.R.; Jayaram, Vasantha; Fernandez, M. Peter
Data on the nature and extent of major eating disorders, anorexia nervosa and bulimia is lacking in non-white, native populations of the developing world, leaving a gap in understanding the determinants of these disorders. In a study on 210 medical students examined by a two-stage survey method, 31 subjects were found to have distress relating to their eating habits and body size not amounting to criterion-based diagnosis of eating disorders. The characteristics of this eating distress syndro...
Alessandra Donzelli Fabbri
Full Text Available Background Ghrelin is a potent hormone with central and peripheral action. This hormone plays an important role in the regulation of appetite, food intake, and energy balance. Studies have suggested that ghrelin is involved with eating disorders (ED, particularly bingeing and purging. Genetic variants have also been studied to explain changes in eating behavior. Methods We conducted a literature review; we searched PubMed, Scientific Electronic Library Online (SciELO, and LILACS databases using the keywords “eating disorder”, “ghrelin”, “polymorphism”, “anorexia nervosa”, “bulimia nervosa”, “binge eating disorder”, and their combinations. We found 319 articles. Thirty-nine articles met the inclusion criteria. Results High levels of ghrelin were found in patients with anorexia nervosa (AN, especially in the purging subtype (AN-P. There was also a positive correlation between fasting ghrelin level and frequency of episodes of bingeing/purging in bulimia nervosa (BN and the frequency of bingeing in periodic binge eating disorder (BED. Some polymorphisms were associated with AN and BN. Conclusion Changes in ghrelin levels and its polymorphism may be involved in the pathogenesis of EDs; however, further studies should be conducted to clarify the associations.
Wold, P N
Patients with Major Affective Disorder (MAD), Secondary Depression, Panic Disorder, and bulimia with and without MAD, were given the Eating Disorder Inventory, the Beck Depression Inventory, and the General Behavior Inventory at presentation. It was found that patients with MAD have a triad of eating disorder symptoms: a disturbance in interoceptive awareness, the sense of ineffectiveness, and a tendency toward bulimia. The data supported the concept that the sense of ineffectiveness is secon...
Magtoto, Joanne; Cox, David; Saewyc, Elizabeth
Using a province-wide school-based health survey, this article investigated body satisfaction as a mediator of the association between eating disorder behaviors and immigrant status. Participants were a sample of adolescent girls (n = 15,066) and boys (n = 14,200) who completed the 2008 McCreary Centre Society Adolescent Health Survey IV.…
Brauhardt, Anne; de Zwaan, Martina; Herpertz, Stephan; Zipfel, Stephan; Svaldi, Jennifer; Friederich, Hans-Christoph; Hilbert, Anja
While cognitive-behavioral therapy (CBT) is the most well-established treatment for binge-eating disorder (BED), little is known about process factors influencing its outcome. The present study sought to explore the assessment of therapist adherence, its course over treatment, and its associations with patient and therapist characteristics, and the therapeutic alliance. In a prospective multicenter randomized-controlled trial comparing CBT to internet-based guided self-help (INTERBED-study...
Goebel-Fabbri, Ann E.
The problem of insulin restriction is an important women's health issue in type 1 diabetes. This behavior is associated with increased rates of diabetes complications and decreased quality of life. Clinical and technological research is greatly needed to improve treatment tools and strategies for this problem. In this commentary, the author describes the scope of the problem of eating disorders and diabetes, as well as offers ideas about ways technology may be applied to help solve this compl...
Murray, Marisa; Maras, Danijela; Goldfield, Gary S
Social networking sites (SNS) are a popular form of communication among undergraduate students. Body image concerns and disordered eating behaviors are also quite prevalent among this population. Maladaptive use of SNS has been associated with disordered eating behaviors; however, the mechanisms remain unclear. The present study examined if body image concerns (e.g., appearance and weight esteem) mediate the relationship between excessive time spent on SNS and disordered eating behaviors (restrained and emotional eating). The sample included 383 (70.2 percent female) undergraduate students (mean age = 23.08 years, standard deviation = 3.09) who completed self-report questionnaires related to SNS engagement, body image, disordered eating behaviors, and demographics. Parallel multiple mediation and moderated mediation analyses revealed that lower weight and appearance esteem mediated the relationship between excessive time on SNS and restrained eating for males and females, whereas appearance esteem mediated the relationship between excessive time on SNS and emotional eating for females only. The study adds to the literature by highlighting mediational pathways and gender differences. Intervention research is needed to determine if teaching undergraduate students more adaptive ways of using SNS or reducing exposure to SNS reduces body dissatisfaction and disordered eating in this high-risk population.
Sayed Shahabuddin Hoseini
Full Text Available Night eating syndrome is a common disorder in eating behaviors that occurs in close relation to the night time sleep cycle. Although eating disorders are common in society, night eating syndrome has been left neglected by health care professionals. In this report we present a case of eating disorder that exhibits some novel features of night eating syndrome. Our case was a progressed type of eating disorder which may increase awareness among physicians about sleep-related eating disorders.
Full Text Available Eating disorders (EDs are often associated with various impulsive behaviors. This study investigated the prevalence of impulsive behaviors in ED patients in Taiwan. Three hundred sixteen female outpatients with ED and 142 psychiatric controls were recruited. All participants completed self-administered questionnaires assessing lifetime presence of impulsive behaviors, including suicide, self-injury, stealing, alcohol use, illicit drug use, excessive spending, sexual promiscuity, and general psychopathology. More than 60% of the ED patients had at least one impulsive behavior. The most common impulsive behaviors among ED patients were excessive spending (34.9%, deliberate self-harm (32.7%, and stealing (26.3%. However, there were no significant differences in prevalences of any impulsive behaviors between ED patients and psychiatric controls. Clinicians should routinely assess and treat impulsive behaviors in female psychiatric patients with negative affectivity, regardless of the presence of ED, to help prevent potential adverse outcomes related to impulsive behaviors.
Full Text Available According to International Classification of Diseases by World Health Organization, eating disorders are behavioural syndromes associated with physiological disturbances . Eating disorders include anorexia nervosa, atypical anorexia nervosa, bulimia nervosa, atypical bulimia nervosa, overeating associated with other psychological disturbances and vomiting associated with other psychological disturbances . Maladaptive eating pattern and inadequate physical activity are seen in adolescents with eating disorders and obesity . Those with comorbid eating disorder and obesity have a poorer prognosis and are at higher risk for future medical problems.
Pawaskar, Manjiri; Solo, Kirk; Valant, Jason; Schmitt, Emily; Nwankwo, Millicent; Herman, Barry K
Characterize the frequency, duration, and severity of binge-eating behaviors in adults meeting DSM-5 criteria for binge-eating disorder (BED) in a large US community sample. A representative sample of US adults from the National Health and Wellness Survey was recruited from an online panel and asked to respond to an Internet survey (conducted in October 2013) that included questions designed to assess binge-eating behaviors in relation to DSM-5 BED diagnostic criteria. Of 22,397 respondents, 344 self-reported meeting DSM-5 BED criteria (BED respondents). Most BED respondents reported that binge-eating episodes had occurred for the past 7-12 months (61.0%), and 93.6% reported ≥ 2-3 binge-eating episodes/wk. All BED respondents reported that "extreme" (52.6%) or "great" (47.4%) distress levels were associated with binge-eating episodes. Among BED respondents who agreed to provide detailed binge-eating behavior data after being invited to respond to additional survey questions, 40.6% reported binge eating on average > 1 time/d, and 59.2% reported binge eating 2-3 times/d. For 44.5% of BED respondents, binge-eating duration was 31-60 minutes. BED respondents reported that they "very often" (36.6%) or "often" (34.0%) had urges to binge eat between 7-10 pm. "Feeling disgusted with oneself, depressed, or guilty afterward" was the most bothersome symptom of binge eating for BED respondents (extremely bothersome: 41.9%). Binge-eating frequency among BED respondents averaged once daily. Most BED respondents exhibited binge-eating behavior for 7-12 months, often with severe symptoms. These findings highlight the disease burden of BED and have potential implications for diagnosing and treating BED. © Copyright 2016 Physicians Postgraduate Press, Inc.
Vannucci, Anna; Nelson, Eric E.; Bongiorno, Diana M.; Pine, Daniel S.; Yanovski, Jack A.; Tanofsky-Kraff, Marian
Background Pediatric loss-of-control eating is a robust behavioral precursor to binge-type eating disorders. Elucidating precursors to loss-of-control eating and binge-type eating disorders may refine developmental risk models of eating disorders and inform interventions. Method We review evidence within constructs of the Negative Valence Systems (NVS)-domain, as specified by the Research Domain Criteria framework. Based on published studies, we propose an integrated NVS model of binge-type eating disorder risk. Results Data implicate altered corticolimbic functioning, neuroendocrine dysregulation, and self-reported negative affect as possible risk-factors. However, neuroimaging and physiological data in children and adolescents are sparse, and most prospective studies are limited to self-report measures. Conclusions We discuss a broad NVS framework for conceptualizing early risk for binge-type eating disorders. Future neural and behavioral research on the developmental trajectory of loss-of-control and binge-type eating disorders is required. PMID:26040923
The present dissertation addresses psychological influences on eating behavior.Understanding why people eat what they eat in everyday life, that is, motives for eating behavior, is crucial for the development of interventions to promote normal eating and to prevent eating disorders. Furthermore, enhancing knowledge about both, individual and situational factors facilitating (pull factors) or impeding (push factors) healthy eating is essential for the prevention and treatment of obesity and it...
Linardon, Jake; Wade, Tracey D; de la Piedad Garcia, Xochitl; Brennan, Leah
This meta-analysis examined the efficacy of cognitive-behavioral therapy (CBT) for eating disorders. Randomized controlled trials of CBT were searched. Seventy-nine trials were included. Therapist-led CBT was more efficacious than inactive (wait-lists) and active (any psychotherapy) comparisons in individuals with bulimia nervosa and binge eating disorder. Therapist-led CBT was most efficacious when manualized CBT-BN or its enhanced version was delivered. No significant differences were observed between therapist-led CBT for bulimia nervosa and binge eating disorder and antidepressants at posttreatment. CBT was also directly compared to other specific psychological interventions, and therapist-led CBT resulted in greater reductions in behavioral and cognitive symptoms than interpersonal psychotherapy at posttreatment. At follow-up, CBT outperformed interpersonal psychotherapy only on cognitive symptoms. CBT for binge eating disorder also resulted in greater reductions in behavioral symptoms than behavioral weight loss interventions. There was no evidence that CBT was more efficacious than behavior therapy or nonspecific supportive therapies. CBT is efficacious for eating disorders. Although CBT was equally efficacious to certain psychological treatments, the fact that CBT outperformed all active psychological comparisons and interpersonal psychotherapy specifically, offers some support for the specificity of psychological treatments for eating disorders. Conclusions from this study are hampered by the fact that many trials were of poor quality. Higher quality RCTs are essential. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Chia, Jia Li Pauline; Fuller-Tyszkiewicz, Matthew; Buck, Kimberly; Chamari, Karim; Richardson, Ben; Krug, Isabel
Dietary restriction contributes to disordered eating (DE) behaviors and associated cognitions. However, it is unclear how these outcomes are impacted by dietary restriction for religious purposes, such as fasting observed by Muslims during Ramadan. Using ecological momentary assessment, this study assessed the impact of Ramadan fasting on DE behaviors and correlates. Muslim participants fasting during Ramadan (n = 28) and a control group of non-fasting participants (n = 74) completed baseline measures assessing demographic characteristics and eating pathology. A mobile phone application then prompted participants six times per day for seven days to self-report on dietary restriction efforts, body satisfaction, temptation to eat unhealthily, feelings of guilt or shame following food, and DE behaviors including bingeing, vomiting, and other purging behaviors (use of laxatives, diuretics, or diet pills). After controlling for eating pathology, multilevel modeling indicated that, as expected, the Ramadan fasting group spent significantly more time restricting food intake than the non-fasting group. The Ramadan fasting group also experienced significantly greater temptation to eat unhealthily than their non-fasting counterparts. However, this difference disappeared once models were adjusted for differences in time spent restricting food intake. There were no other significant differences between the groups on any DE variables. These findings suggest that while dietary restriction for health or appearance-related reasons is a known contributor to DE, dietary restriction for religious purposes, such as that observed during the practice of Ramadan, may not confer increased risk of DE symptoms. Copyright © 2018 Elsevier Ltd. All rights reserved.
Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight. Anorexia nervosa and bulimia nervosa are the two main types of eating disorders. Eating disorders frequently co-occur with…
Ferrer-Garcia, Marta; Pla-Sanjuanelo, Joana; Dakanalis, Antonios; Vilalta-Abella, Ferran; Riva, Giuseppe; Fernandez-Aranda, Fernando; Sánchez, Isabel; Ribas-Sabaté, Joan; Andreu-Gracia, Alexis; Escandón-Nagel, Neli; Gomez-Tricio, Osane; Tena, Virginia; Gutiérrez-Maldonado, José
Eating behavior style (emotional, restrictive, or external) has been proposed as an explanation for the differences in response to food-related cues between people who overeat and those who do not, and has been also considered a target for the treatment of eating disorders (EDs) characterized by lack of control over eating and weight-related (overweight/obesity) conditions. The aim of this study was to analyze the relationship between eating behavior style and psychophysiological responses (self-reported food craving and anxiety) to food-related virtual reality (VR) environments in outpatients with bulimia nervosa (BN) and binge eating disorder (BED) and to compare them with healthy participants. Fifty-eight outpatients and 135 healthy participants were exposed to palatable foods in four experimental everyday real-life VR environments (kitchen, dining room, bedroom and café). During exposure, cue-elicited food craving and anxiety were assessed. Participants also completed standardized instruments for the study purposes. ED patients reported significantly higher levels of craving and anxiety when exposed to the virtual food than healthy controls. Eating behavior styles showed strong associations with cue-elicited food craving and anxiety. In the healthy group, external eating was the only predictor of cue-elicited craving and anxiety. In participants with BN and BED, external and emotional eating were the best predictors of cue-elicited craving and anxiety, respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.
Sonneville, Kendrin R; Thurston, Idia B; Milliren, Carly E; Gooding, Holly C; Richmond, Tracy K
The purpose of this study was to examine the cross-sectional association between weight misperception among young adults with overweight/obesity and disordered eating behaviors. In a subsample of young adults with overweight or obesity participating in Wave III (2001-2002) of The National Longitudinal Study of Adolescent to Adult Health (n = 5,184), we examined the cross-sectional association between weight under-perception (i.e., perceiving oneself to be at a healthy body weight or underweight) and disordered eating (fasting/meal skipping for weight control, purging/pills for weight control, overeating/loss of control eating, and use of performance-enhancing products/substances). About 20% of young adult females under-perceived their weight compared to 48% of males. Individuals who misperceived their weight as healthy were significantly less likely to report fasting/meal skipping (Females: OR: 0.25, 95% CI: 0.14-0.43; Males: OR: 0.31, 95% CI: 0.20-0.48) and vomiting or taking diet pills/laxatives/diuretics (Females: OR: 0.10, 95% CI: 0.04-0.25; Males: OR: 0.10, 95% CI: 0.04-0.25) for weight control. Among females, those who misperceived their weight status as healthy were also less likely to report overeating or loss of control eating (OR: 0.41, 95% CI: 0.24-0.71). Greater use of performance-enhancing products/substances was seen among males who under-perceived their weight as healthy (OR: 2.06, 95% CI: 1.57-2.72) and among both females (OR: 2.29, 95% CI: 1.40-20.0) and males (OR: 2.27, 95% CI: 1.13-4.55) who perceived themselves to be underweight. Weight under-perception among young adults with overweight/obesity may convey some benefit related to disordered eating behaviors, but could be a risk factor for the use of performance-enhancing products/substances. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord ; 49:937-946). © 2016 Wiley Periodicals, Inc.
Vossbeck-Elsebusch, Anna N; Waldorf, Manuel; Legenbauer, Tanja; Bauer, Anika; Cordes, Martin; Vocks, Silja
Body-related avoidance behavior, e.g., not looking in the mirror, is a common feature of eating disorders. It is assumed that it leads to insufficient feedback concerning one's own real body form and might thus contribute to distorted mental representation of one's own body. However, this assumption still lacks empirical foundation. Therefore, the aim of the present study was to examine the relationship between misperception of one's own body and body-related avoidance behavior in N = 78 female patients with Bulimia nervosa and eating disorder not otherwise specified. Body-size misperception was assessed using a digital photo distortion technique based on an individual picture of each participant which was taken in a standardized suit. In a regression analysis with body-related avoidance behavior, body mass index and weight and shape concerns as predictors, only body-related avoidance behavior significantly contributed to the explanation of body-size overestimation. This result supports the theoretical assumption that body-related avoidance behavior makes body-size overestimation more likely.
Eating disorders (EDs), including anorexia nervosa, bulimia nervosa, and binge-eating disorder, constitute a class of common and deadly psychiatric disorders. While numerous studies in humans highlight the important role of neurobiological alterations in the development of ED-related behaviors, the precise neural substrate that mediates this risk is unknown. Historically, pharmacological interventions have played a limited role in the treatment of eating disorders, typically providing symptomatic relief of comorbid psychiatric issues, like depression and anxiety, in support of the standard nutritional and psychological treatments. To date there are no Food and Drug Administration-approved medications or procedures for anorexia nervosa, and only one Food and Drug Administration-approved medication each for bulimia nervosa (fluoxetine) and binge-eating disorder (lisdexamfetamine). While there is little primary interest in drug development for eating disorders, postmarket monitoring of medications and procedures approved for other indications has identified several novel treatment options for patients with eating disorders. In this review, I utilize searches of the PubMed and ClinicalTrials.gov databases to highlight emerging treatments in eating disorders.
Binge eating disorder is a prevalent adolescent disorder, associated with increased eating disorder and general psychopathology as well as an increased risk for overweight and obesity. As opposed to binge eating disorder in adults, there is a lack of validated psychological treatments for this condition in adolescents. The goal of this research project is therefore to determine the efficacy of age-adapted cognitive-behavioral therapy in adolescents with binge eating disorder - the gold standard treatment for adults with binge eating disorder. In a single-center efficacy trial, 60 12- to 20-year-old adolescents meeting diagnostic criteria of binge eating disorder (full-syndrome or subthreshold) according to the Diagnostic and Statistical Manual of Mental Disorders 4th or 5th Edition, will be centrally randomized to 4 months of cognitive-behavioral therapy (n = 30) or a waiting-list control condition (n = 30). Using an observer-blind design, patients are assessed at baseline, mid-treatment, post-treatment, and at 6- and 12-month follow-ups after the end of treatment. In 20 individual outpatient sessions, cognitive-behavioral therapy for adolescents focuses on eating behavior, body image, and stress; parents receive psychoeducation on these topics. Primary endpoint is the number of episodes with binge eating over the previous 28 days at post-treatment using a state-of-the art clinical interview. Secondary outcome measures address the specific eating disorder psychopathology, general psychopathology, mental comorbidity, self-esteem, quality of life, and body weight. This trial will allow us to determine the short- and long-term efficacy of cognitive-behavioral therapy in adolescent binge eating disorder, to determine cost-effectiveness, and to identify predictors of treatment outcome. Evidence will be gathered regarding whether this treatment will help to prevent excessive weight gain. If efficacy can be demonstrated, the results from this trial will enhance
Claes, Laurence; Vandereycken, Walter; Vertommen, Hans
Understanding an individual's self-harming behaviors should be the basis for selecting person-specific therapeutic interventions. For that purpose, the assessment is aimed at identifying the self-harming behaviors and related symptoms as well as analyzing the external (situational) and internal (cognitive and emotional) conditions that contribute directly to the instigation of the self-harming behaviors. In this article, we demonstrate the use of a new assessment procedure that may guide the selection of therapeutic interventions. Data collection and processing are illustrated by an individual case study of an eating-disordered patient showing different types of self-harming behavior such as vomiting, alcohol abuse, cutting, and suicide attempts.
Basow, Susan A.; Foran, Kelly A.; Bookwala, Jamila
Social pressure to conform to the thin ideal is believed to play a decisive role in the development of eating disorders. In this field study at a college with only sophomore rush, 99 sorority women, 80 nonsorority women past their first year, and 86 first-year women completed three subscales of the Eating Disorders Inventory-2 (Garner, 1991), the…
Di Lodovico, Laura; Dubertret, Caroline; Ameller, Aurely
Excessive exercise is frequently associated with eating disorders and may degenerate into exercise addiction. We still don't know whether runners at risk for eating disorders are at risk for exercise addiction. Our aim is to assess: 1) risk for exercise addiction in runners at risk for eating disorders and 2) socio-demographic, behavioral and psychological characteristics distinguishing runners at-risk from not-at-risk for eating disorders. We assessed risk for eating disorders and exercise addiction using the SCOFF questionnaire and the Exercise Addiction Inventory personality traits with the Big-Five Inventory Test, socio-demographic data, eating and training habits in a sample of 154 healthy runners. Twenty five subjects had a score of ≥2 at the SCOFF and were included in the group "at risk for eating disorders". In this group, we found a higher percentage of subjects at risk for exercise addiction (p=0.01) and higher average scores at the Exercise Addiction Inventory (p=0.01) than runners not at risk (N=136). Runners at risk were statistically younger (p=0.03), women (p=0.001), started running to lose weight more often (p=0.03), lost more kilos since affiliation in their running club (p=0.04), and were characterized by neurotic traits using the Big-Five-Inventory Test (p=3.10 -6 ). Screening for exercise addiction and mood disorders could lead to a more accurate management of runners at risk for eating disorders. Identifying vulnerable individuals will facilitate the prevention of eating disorders and preserve the benefits of sport practice. Copyright © 2018. Published by Elsevier Inc.
Blomquist, Kerstin K.; Milsom, Vanessa A.; Barnes, Rachel D.; Boeka, Abbe G.; White, Marney A.; Masheb, Robin M.; Grilo, Carlos M.
The metabolic syndrome (MetSyn), characterized by vascular symptoms, is strongly correlated with obesity, weight-related medical diseases and mortality, and has increased commensurately with secular increases in obesity in the U.S. Little is known about the distribution of MetSynin obese patients with binge eating disorder (BED) or its associations with different developmental trajectories of dieting, binge eating, and obesity problems. Further, inconsistencies in the limited data necessitate...
Full Text Available Abstract Introduction Somnambulism or sleepwalking is a disorder of arousal from non-rapid eye movement sleep. The prevalence of sleep-related eating disorder has been found to be approximately between 1% and 5% among adults. Many cases of medication-related somnambulism and sleep-related eating disorder-like behavior have been reported in the literature. Quetiapine, an atypical antipsychotic medication, has been associated with somnambulism but has not yet been reported to be associated with sleep-related eating disorder. Case presentation Case 1 is a 51-year-old obese African American male veteran with a body mass index of 34.11kg/m2 and severe sleep apnea who has taken 150mg of quetiapine at bedtime for more than one year for depression. He developed sleepwalking three to four nights per week which resolved after stopping quetiapine while being compliant with bi-level positive pressure ventilation therapy. At one year follow-up, his body mass index was 32.57kg/m2. Case 2 is a 50-year-old African American female veteran with a body mass index of 30.5kg/m2 and mild sleep apnea who has taken 200mg of quetiapine daily for more than one year for depression. She was witnessed to sleepwalk three nights per week which resolved after discontinuing quetiapine while being treated with continuous positive airway pressure. At three months follow-up, her body mass index was 29.1kg/m2. Conclusion These cases illustrate that quetiapine may precipitate complex motor behavior including sleep-related eating disorder and somnambulism in susceptible patients. Atypical antipsychotics are commonly used in psychiatric and primary care practice, which means the population at risk of developing parasomnia may often go unrecognized. It is important to recognize this potential adverse effect of quetiapine and, to prevent injury and worsening obesity, discuss this with the patients who are prescribed these medications.
Ellis, Jordan M; Galloway, Amy T; Webb, Rose Mary; Martz, Denise M; Farrow, Claire V
Picky eating is a childhood behavior that vexes many parents and is a symptom in the newer diagnosis of Avoidant/Restrictive Food Intake Disorder (ARFID) in adults. Pressure to eat, a parental controlling feeding practice aimed at encouraging a child to eat more, is associated with picky eating and a number of other childhood eating concerns. Low intuitive eating, an insensitivity to internal hunger and satiety cues, is also associated with a number of problem eating behaviors in adulthood. Whether picky eating and pressure to eat are predictive of young adult eating behavior is relatively unstudied. Current adult intuitive eating and disordered eating behaviors were self-reported by 170 college students, along with childhood picky eating and pressure through retrospective self- and parent reports. Hierarchical regression analyses revealed that childhood parental pressure to eat, but not picky eating, predicted intuitive eating and disordered eating symptoms in college students. These findings suggest that parental pressure in childhood is associated with problematic eating patterns in young adulthood. Additional research is needed to understand the extent to which parental pressure is a reaction to or perhaps compounds the development of problematic eating behavior. Copyright © 2015 Elsevier Ltd. All rights reserved.
Berkman, Nancy D; Bulik, Cynthia M; Brownley, Kimberly A; Lohr, Kathleen N; Sedway, Jan A; Rooks, Adrienne; Gartlehner, Gerald
OBJECTIVES The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on efficacy of treatment for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), harms associated with treatments, factors associated with the treatment efficacy and with outcomes of these conditions, and whether treatment and outcomes for these conditions differ by sociodemographic characteristics. DATA SOURCES We searched MEDLINE, the Cumulative Index to Nursing and Applied Health (CINAHL), PSYCHINFO, the Educational Resources Information Center (ERIC), the National Agricultural Library (AGRICOLA), and Cochrane Collaboration libraries. REVIEW METHODS We reviewed each study against a priori inclusion/exclusion criteria. For included articles, a primary reviewer abstracted data directly into evidence tables; a second senior reviewer confirmed accuracy. We included studies published from 1980 to September 2005, in all languages. Studies had to involve populations diagnosed primarily with AN, BN, or BED and report on eating, psychiatric or psychological, or biomarker outcomes. RESULTS We report on 30 treatment studies for AN, 47 for BN, 25 for BED, and 34 outcome studies for AN, 13 for BN, 7 addressing both AN and BN, and 3 for BED. The AN literature on medications was sparse and inconclusive. Some forms of family therapy are efficacious in treating adolescents. Cognitive behavioral therapy (CBT) may reduce relapse risk for adults after weight restoration. For BN, fluoxetine (60 mg/day) reduces core bulimic symptoms (binge eating and purging) and associated psychological features in the short term. Individual or group CBT decreases core behavioral symptoms and psychological features in both the short and long term. How best to treat individuals who do not respond to CBT or fluoxetine remains unknown. In BED, individual or group CBT reduces binge eating and improves abstinence rates for up
Background Previous research with adolescents has shown associations of body weight, weight control concerns and behaviors with eating disorder symptoms, but it is unclear whether these associations are direct or whether a mediating effect exists. This study was conducted to investigate the prevalence of overweight and obesity, weight control concerns and behaviors, and eating disorder symptoms and to examine the mediating function of weight control concerns and behaviors on the relationship between body mass index (BMI) and eating disorder symptoms among non-clinical adolescents in China. Methods A cross-sectional survey among 2019 adolescent girls and 1525 adolescent boys in the 7th, 8th, 10th and 11th grades from seven cities in China was conducted. Information on weight control concerns and behaviors, and eating disorder symptoms (Eating Disorder Inventory-3) were collected from the adolescents using a self-administrated questionnaire. Results Weight control concerns and behaviors, and eating disorder symptoms were prevalent among the study population. A high proportion of adolescents scored at or above the threshold on the eating disorder inventory (EDI) subscale such as bulimia, interoceptive deficits, perfectionism, and maturity fears, which indicated eating disorder symptoms. High BMI was significantly associated with high score of drive for thinness, body dissatisfaction, bulimia, low self-esteem, interceptive deficits and maturity fears, so do perceived body weight status. Almost all weight control concerns and behaviors we investigated were significantly associated with high EDI subscale scores. When weight control concerns were added to the model, as shown in the model, the association between BMI and tendency of drive to thinness and bulimia was attenuated but still kept significant. The association between BMI and body dissatisfaction were no further significant. The association of BMI and drive for thinness, body dissatisfaction and bulimia was
Full Text Available Abstract Background Previous research with adolescents has shown associations of body weight, weight control concerns and behaviors with eating disorder symptoms, but it is unclear whether these associations are direct or whether a mediating effect exists. This study was conducted to investigate the prevalence of overweight and obesity, weight control concerns and behaviors, and eating disorder symptoms and to examine the mediating function of weight control concerns and behaviors on the relationship between body mass index (BMI and eating disorder symptoms among non-clinical adolescents in China. Methods A cross-sectional survey among 2019 adolescent girls and 1525 adolescent boys in the 7th, 8th, 10th and 11th grades from seven cities in China was conducted. Information on weight control concerns and behaviors, and eating disorder symptoms (Eating Disorder Inventory-3 were collected from the adolescents using a self-administrated questionnaire. Results Weight control concerns and behaviors, and eating disorder symptoms were prevalent among the study population. A high proportion of adolescents scored at or above the threshold on the eating disorder inventory (EDI subscale such as bulimia, interoceptive deficits, perfectionism, and maturity fears, which indicated eating disorder symptoms. High BMI was significantly associated with high score of drive for thinness, body dissatisfaction, bulimia, low self-esteem, interceptive deficits and maturity fears, so do perceived body weight status. Almost all weight control concerns and behaviors we investigated were significantly associated with high EDI subscale scores. When weight control concerns were added to the model, as shown in the model, the association between BMI and tendency of drive to thinness and bulimia was attenuated but still kept significant. The association between BMI and body dissatisfaction were no further significant. The association of BMI and drive for thinness, body
Castellini, Giovanni; Mannucci, Edoardo; Lo Sauro, Carolina; Benni, Laura; Lazzeretti, Lisa; Ravaldi, Claudia; Rotella, Carlo M; Faravelli, Carlo; Ricca, Valdo
Different studies considered the mechanisms involved in the maintenance of binge eating in bulimia nervosa (BN) and binge eating disorder (BED), suggesting different pathways. The present 3-year follow-up study evaluated the relationships between psychopathological variables, and objective and subjective binge eating episodes in the two syndromes. 85 BN and 133 BED patients were studied. Objective and subjective binge eating, and psychopathological data were collected in a face-to-face interview, and by means of different self-reported questionnaires. The same assessment was repeated at baseline (T0), at the end of an individual cognitive-behavioral treatment (T1), and 3 years after the end of treatment (T2). At baseline, BN and BED patients showed different emotions associated with binge eating: anger/frustration for BN and depression for BED patients. Objective binge eating frequency reduction across time was associated with lower impulsivity and shape concern in BN patients, and with lower emotional eating and depressive symptoms in BED patients. Lower subjective binge eating frequency at baseline predicted recovery, in both BN and BED patients. Recovery was associated with lower impulsivity and body shape concern at baseline for BN patients, and lower depression and emotional eating for BED patients. Eating psychopathology, psychiatric comorbidity, impulsivity and emotional eating have a different pattern of association with objective and subjective binge eating in BN and BED patients, and they act as different moderators of treatment. A different target of intervention for these two syndromes might be taken into account, and subjective binge eating deserves an accurate assessment. Copyright © 2011 S. Karger AG, Basel.
Schleien, Jenna L; Bardone-Cone, Anna M
The present study examined competitiveness as a moderator of the relationships between appearance-related factors (i.e., thin-ideal internalization, appearance contingent self-worth) and disordered eating behaviors (i.e., dieting, excessive exercise). Participants were 441 undergraduate females for cross-sectional analyses, with 237 also contributing data longitudinally, 1 year later. Results showed that, in a model including thin-ideal internalization and appearance contingent self-worth and their interactions with competitiveness, thin-ideal internalization (but not appearance contingent self-worth) interacted with competitiveness to identify concurrent levels of both dieting and excessive exercise. Individuals high in both thin-ideal internalization and competitiveness exhibited the highest levels of concurrent dieting and excessive exercise. After controlling for baseline levels of the dependent variables, neither appearance-related factor interacted with competitiveness to predict dieting or excessive exercise. These findings suggest that individuals who are both competitive and accept and strive to achieve the thin ideal may be at risk for disordered eating behaviors. Copyright © 2016 Elsevier Ltd. All rights reserved.
Davis, Caroline; Mackew, Laura; Levitan, Robert D; Kaplan, Allan S; Carter, Jacqueline C; Kennedy, James L
While there is good evidence that binge eating disorder (BED) is linked to higher-than-expected use of a broad range of addictive behaviors, mechanisms underlying this association are not well understood. Using a mediation-analytical approach with three age- and gender-matched groups - overweight/obese adults with ( n = 42) and without ( n = 104) BED, and normal-weight control participants ( n = 73) - we tested the hypothesis that adults with BED would engage in more addictive behaviors and have higher scores on a personality-risk index than the two control groups. We also anticipated that the relationship between BED and addictive behaviors would be mediated by a high-risk personality profile. The predicted mediation effect was strongly supported. Contrary to expectation, BED participants did not engage in more addictive behaviors or have higher personality-risk scores than their weight-matched counterparts. However, both overweight/obese groups did have significantly higher scores than the normal-weight group. The relationships among personality risk, elevated body mass index (BMI), and addictive behaviors have important clinical implications, especially for treatments that target psycho-behavioral intervention for compulsive overeating and substance-use disorders.
Full Text Available While there is good evidence that binge eating disorder (BED is linked to higher-than-expected use of a broad range of addictive behaviors, mechanisms underlying this association are not well understood. Using a mediation-analytical approach with three age- and gender-matched groups – overweight/obese adults with (n = 42 and without (n = 104 BED, and normal-weight control participants (n = 73 – we tested the hypothesis that adults with BED would engage in more addictive behaviors and have higher scores on a personality-risk index than the two control groups. We also anticipated that the relationship between BED and addictive behaviors would be mediated by a high-risk personality profile. The predicted mediation effect was strongly supported. Contrary to expectation, BED participants did not engage in more addictive behaviors or have higher personality-risk scores than their weight-matched counterparts. However, both overweight/obese groups did have significantly higher scores than the normal-weight group. The relationships among personality risk, elevated body mass index (BMI, and addictive behaviors have important clinical implications, especially for treatments that target psycho-behavioral intervention for compulsive overeating and substance-use disorders.
Sienko, Rachel M; Saules, Karen K; Carr, Meagan M
This study tested the potential mediating role of Internalized Weight Bias (IWB) in the relationship between depressive symptoms (DEP-SX) and disordered eating behavior. In particular, we hypothesized that IWB may be an intervening variable in the well documented association between depression and disordered eating. College women (N=172) who were taking undergraduate psychology courses and who endorsed thinking they were overweight completed the Patient Health Questionnaire depression screener (PHQ-9), the Weight Bias Internalization Scale (WBIS), and the Eating Disorder Examination Questionnaire (EDE-Q). Bootstrapping mediation analyses were conducted to explore the relationships between these variables. IWB was significantly correlated with eating disorder symptoms and DEP-SX, but not Body Mass Index. Mediation analyses supported a model in which IWB mediated the relationship between DEP-SX and disordered eating behavior. Results indicate that individuals with elevated DEP-SX may be likely to internalize weight bias, which may in turn lead to maladaptive approaches to eating and weight control, regardless of one's actual weight status. Copyright © 2016 Elsevier Ltd. All rights reserved.
Leonardo de Sousa Fortes
Full Text Available Abstract The present study aimed to compare the power, anaerobic capacity (AC and performance in a road bicycle race among cyclists with and without risk of disordered eating behaviors (DEB. The sample was selected in a non-probabilistic way, totaling 69 male road cyclists aged between 19 and 30 years. The Wingate test was used to evaluate peak power (PP and mean power. Time in minutes was adopted to determine performance in a 120-km road cycling race (competitive event. The Eating Attitudes Test (EAT-26 was completed to assess DEBs. The results did not indicate a difference in PP among cyclists with and without risk of DEBs (F (2, 67=3.92; p=0.13. Findings showed a difference in mean power among cyclists with and without risk of DEBs (F (2, 67=36.43; p=0.01. The results revealed a difference in performance in 120-km cycling races among cyclists with and without risk of DEBs (F (2, 67=46.03; p=0.01. It could be concluded that DEBs were associated with a lower mean power and performance in a competitive event among male road cyclists, although the same was not true for PP.
Wagner, Birgit; Nagl, Michaela; Dölemeyer, Ruth; Klinitzke, Grit; Steinig, Jana; Hilbert, Anja; Kersting, Anette
Binge-eating disorder (BED) is a prevalent health condition associated with obesity. Few people with BED receive appropriate treatment. Personal barriers include shame, fear of stigma, geographic distance to mental health services, and long wait-lists. The aims of this study were to examine the efficacy of an Internet-based cognitive-behavioral intervention for adults with threshold BED (DSM-IV) and to examine the stability of treatment effects over 12months. Participants were randomly assigned to a 16-week Internet-based cognitive-behavioral intervention (n=69) or a wait-list condition (n=70). Binge-eating frequency and eating disorder psychopathology were measured with the Eating Disorder Examination-Questionnaire and the Eating Disorder Examination administered over the telephone. Additionally, body weight and body mass index, depression, and anxiety were assessed before and immediately after treatment. Three-, 6-, and 12-month follow-up data were recorded in the treatment group. Immediately after the treatment the number of binge-eating episodes showed significant improvement (d=1.02, between group) in the treatment group relative to the wait-list condition. The treatment group had also significantly reduced symptoms of all eating psychopathology outcomes relative to the wait-list condition (0.82≤d≤1.11). In the treatment group significant improvement was still observed for all measures 1year after the intervention relative to pretreatment levels. The Internet-based intervention proved to be efficacious, significantly reducing the number of binge-eating episodes and eating disorder pathology long term. Low-threshold e-health interventions should be further evaluated to improve treatment access for patients suffering from BED. Copyright © 2016. Published by Elsevier Ltd.
Full Text Available Background: Eating disorders are associated with physical morbidity and appear to have causal factors like stressful life events and negative affect. Binge eating disorder (BED is characterized by eating in a discrete period of time a larger than normal amount of food, a sense of lack of control over eating, and marked distress. There are still unmet needs for the identification of mechanisms regulating excessive eating, which is in part due to the lack of appropriate animal models. We developed a naturalistic murine model of subordination stress induced hyperphagia associated with the development of obesity. Here we tested the hypotheses that the eating responses of subordinate mice recapitulate the BED and that limiting hyperphagia could prevent stress-associated metabolic changes. Methods: Adult male mice were exposed to a model of chronic subordination stress associated with the automated acquisition of food intake and we performed a detailed meal pattern analysis. Additionally, using a pair-feeding protocol was test the hypothesis that the manifestation of obesity and the metabolic syndrome could be prevented by limiting hyperphagia. Results: The architecture of feeding of subordinate mice was disrupted during the stress protocol due to disproportionate amount of food ingested at higher rate and with shorter satiety ratio than control mice. Subordinate mice hyperphagia was further exacerbated in response to either hunger or to the acute application of a social defeat. Notably, the obese phenotype but not the fasting hyperglycemia of subordinate mice was abrogated by preventing hyperphagia in a pair feeding paradigm. Conclusion: Overall these results support the validity of our chronic subordination stress to model binge eating disorder allowing for the determination of the underlying molecular mechanisms and the generation of testable predictions for innovative therapies, based on the understanding of the regulation and the control of food
Rodríguez Guarín, Maritza; Rodríguez Malagón, Nelcy; Gempeler Rueda, Juanita; Garzón, Daniel Felipe
Suicide attempt (SA) and non-suicidal self-injurious behaviors (NSSI) have been described in patients with eating disorders (ED), and they have been associated with increased morbidity and poor prognosis. To explore the presence of SA and NSSI in patients attending an outpatient ED program, as well as to evaluate the associated variables and the correlation between both types of behaviors. A total of 908 patients of both sexes attending the Equilibrio outpatient program in Bogotá were studied. The histories of SA and NSSI were systematically examined in the development of medical history by direct and structured questions to the patient, and then validated during interviews with the family. Sociodemographic and clinical variables, as well as history of traumatic experiences, were also studied. Simple frequencies were calculated, and a bivariate analysis was performed between SA, NSSI, and the other variables of the study. Finally, two models of association were designed for the multivariate analysis, using variables of clinical importance and statistical significance. SA sometime in their lives was reported by 13% of the patients, and 26% of them reported NSSI. The variables associated with SA were bipolar disorder (OR: 3.86, 95% CI; 2.4-6.1), borderline personality, purgative subtype of ED, and self-injury. Sexual abuse was associated with NSSI (OR: 3.48, 95%CI; 2.2-5.4), as well as bipolar disorder, trichotillomania, and suicide attempt. SA and NSSI are frequent in patients with eating disorders with multiple comorbidities, increased impulsivity and emotional dysregulation, and they should be explored and treated. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Hayaki, Jumi; Free, Sarah
Deficits in emotion regulation are known to characterize disordered eating patterns including binge eating, purging, and dietary restraint, though much of this work has been conducted exclusively on women. Eating expectancies, or expectations regarding reinforcement from food and eating, constitute one cognitive mechanism that is thought to serve as a proximal influence on eating behavior. Previous research shows that eating to manage negative affect (a negative eating expectancy) is associated with eating pathology in women, but less is known about eating as a reward or for pleasure (a positive eating expectancy). In addition, no prior work has examined eating expectancies among men. This study examines the role of emotion regulation and eating expectancies on disordered eating in women and men. Participants were 121 female and 80 male undergraduates who completed self-report measures of emotion regulation, eating expectancies, and disordered eating. In women, body mass index (BMI), emotion regulation, and eating to manage negative affect directly predicted disordered eating in the final multivariate model, whereas eating for pleasure or reward was inversely associated with disordered eating. However, in men, emotion regulation predicted disordered eating, but not when eating expectancies were added to the model. In the final model, only BMI and eating to manage negative affect contributed significantly to the variance in disordered eating. These findings suggest that some correlates of eating pathology, particularly eating expectancies, may vary by gender. Future research should continue to examine gender differences in the explanatory mechanisms underlying disordered eating. Copyright © 2016 Elsevier Ltd. All rights reserved.
Emmons, Lillian Miller
This study examines the prevalence and intensity of dieting behavior and the development of eating disorders in a sample of 1269 high school students from ten schools in the Greater Cleveland area. The sample includes four race-sex groups: black and white male and female students. Differences in dieting behavior between these groups are examined and, within each race-sex group, dieters and non-dieters are compared to see whether they differ in such factors as current weight and personal weight history, parental weights, socioeconomic class, religion, birth order, exercise and personality factors such as self-esteem and eating disorder measures. Data were collected using both self-administered questionnaires and in-depth interviews with a subsample of students. The study documents a higher prevalence of dieting and purging behavior than has been reported in other research. Forty-one percent of both black and white males, 61 percent of black females, and 77 percent of white females dieted and many purged, particularly black females who tended to use laxatives and diuretics and white females and males who tended to use vomiting. Dieters and non -dieters differed significantly in past experience with being overweight and in their current weights. At the time of the study 20 to 30 percent of the dieters were classifiable as overweight. While black and white male dieters and non-dieters were in agreement about ideal body weight, white female dieters and non-dieters wanted considerably lower weights than black female dieters and non-dieters. Ethnicity, as determined by socioeconomic class and religion, was not significantly related to dieting behavior, nor was birth order, a familial factor. It appeared that pervasive cultural pressures to attain an ideal figure affected all race-sex groups and led large percentages of the students to diet, even many who were already underweight.
Maras, Danijela; Obeid, Nicole; Flament, Martine; Buchholz, Annick; Henderson, Katherine A; Gick, Mary; Goldfield, Gary S
Obesity and overweight are associated with many negative health outcomes. Attachment style has been implicated in the development of obesity in youth. The present study examined if disordered eating behaviors mediate the relationship between attachment style and body mass index (BMI) in a large community sample of Canadian youth. A total of 3,043 participants (1,254 males and 1,789 females, Mage = 14.20 years) completed self-report questionnaires including the Relationship Questionnaire and the Dutch Eating Behavior Questionnaire, and BMI was objectively measured. Disordered eating behaviors (restrained, emotional, and external) were examined as possible mediating mechanisms in the relationship between attachment style and BMI z-score, using a multiple mediation model using bootstrapping while controlling for socio-demographic covariates. Insecure attachment was significantly associated with higher BMI, and disordered eating mediated this relationship. Restrained eating was the strongest mediator of this pathway. Results suggest that it may be important to take attachment history and restrained eating into account when designing treatment and prevention strategies for obesity in youth.
Ter Huurne, Elke D; Postel, Marloes G; de Haan, Hein A; van der Palen, Job; DeJong, Cor A J
Treatment dropout is an important concern in eating disorder treatments as it has negative implications for patients' outcome, clinicians' motivation, and research studies. Our main objective was to conduct an exploratory study on treatment dropout in a two-part web-based cognitive behavioral therapy with asynchronous therapeutic support. The analysis included 205 female patients with eating disorders. Reasons for dropout, treatment experiences, and predictors of dropout were analyzed. Overall treatment dropout was 37.6%, with 18.5% early dropout (before or during treatment part 1) and 19.0% late dropout (after part 1 or during part 2). Almost half of the participants identified personal circumstances as reason for dropout. The other participants mostly reported reasons related to the online delivery or treatment protocol. Predictors of early dropout included reporting less vigor and smoking at baseline and a longer average duration per completed treatment module of part 1. Late dropout was predicted by reporting less vigor at baseline and uncertainty about recommendation of the treatment to others after completion of treatment part 1. Generally, the web-based treatment and online therapeutic support were evaluated positively, although dropouts rated the treatment as significantly less helpful and effective than completers did. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Eating disorders are serious psychiatric conditions often demanding specialized psychiatric care. Several effective treatments have been developed and disseminated, but more needs to be done, as not all patients respond well to intervention, let alone achieve recovery. Obvious candidates such as eating disorder diagnosis, symptoms and psychiatric comorbidity have generally failed to explain variability in prognosis and outcome, warranting investigation of a wider range of relevant factors. Ac...
Hoddy, Kristin K; Kroeger, Cynthia M; Trepanowski, John F; Barnosky, Adrienne R; Bhutani, Surabhi; Varady, Krista A
Alternate day fasting (ADF; ad libitum intake "feed day" alternated with 75% restriction "fast day"), is effective for weight loss, but the safety of the diet has been questioned. Accordingly, this study examined occurrences of adverse events and eating disorder symptoms during ADF. Obese subjects (n = 59) participated in an 8-week ADF protocol where food was provided on the fast day. Body weight decreased (P Bad breath doubled from baseline (14%) to post-treatment (29%), though not significantly. Depression and binge eating decreased (P effects on eating disorder symptoms.
Rhea, Deborah J; Thatcher, W Gregory
The purpose of this study was two-fold: to determine the relationship between ethnic identity and self-esteem as dimensions of one's self-concept; and to determine if differences exist among one's ethnicity, ethnic identity, and/or self-esteem when examining at-risk eating disordered behaviors. A total of 893 urban adolescent females completed three behavioral subscales: the Eating Disorder Inventory, Rosenberg's Self-Esteem Scale, and Phinney's Multigroup Ethnic Identity Measure. As hypothesized, ethnic identity was significantly associated with self-esteem to form one's self-concept. When compared to Mexican American and White females, only Black females who were in the higher ethnic identity and self-esteem categories had significantly lower at-risk eating disordered scores. Our findings suggest eating disorder status in Mexican American and White females may not be associated as much with ethnic identity as with other acculturation and self-concept factors. Further, this study demonstrated ethnicity, self-esteem, and ethnic identity play significant roles in eating disorder risks.
Becker, Daniel F; Masheb, Robin M; White, Marney A; Grilo, Carlos M
We examined correlates of avoidant and obsessive-compulsive personality pathology--with respect to psychiatric comorbidity, eating disorder psychopathology, and associated psychologic factors--in patients with binge-eating disorder (BED). Three hundred forty-seven treatment-seeking patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), research criteria for BED were reliably assessed with semistructured interviews to evaluate DSM-IV Axis I disorders, personality disorders, and behavioral and attitudinal features of eating disorder psychopathology. Fifteen percent of subjects had avoidant personality disorder features, 12% had obsessive-compulsive personality disorder features, 8% had features of both disorders, and 66% had features of neither. These groups differed significantly in the frequencies of depressive and anxiety disorders, as well as on measures of psychologic functioning (negative/depressive affect and self-esteem) and eating disorder attitudes (shape and weight concerns). There were no group differences on measures of eating behaviors. The avoidant and obsessive-compulsive groups had more psychiatric comorbidity than the group without these personality features but less than the combined group. The group without these features scored significantly lower than all other groups on negative/depressive affect and significantly higher than the avoidant and combined groups on self-esteem. The combined group had the greatest severity on shape and weight concerns. Avoidant and obsessive-compulsive personality features are common in patients with BED. Among BED patients, these forms of personality psychopathology--separately and in combination--are associated with clinically meaningful diagnostic, psychologic, and attitudinal differences. These findings have implications for the psychopathologic relationship between BED and personality psychopathology and may also have implications for assessment and treatment. Copyright
Full Text Available Background: Adolescents pay more attention to their appearance and body.Irregular nutritional patterns, eating certain types of food, and consuming more protein-containing food are more common in this age group. Considering the importance of this issue and lack of adequate studies in Iran, especially in Fars province, we aimed to assess the relationship between weight-controlling attitudes and eating disorders with dietary intake in female adolescents. Methods: This cross-sectional study was done on 600 female students aged 14-17 years from the four educational districts of Shiraz, southern Iran, during 2011-2012 using the stratified random sampling method. Data were collected using three questionnaires as follows: demographic data questionnaire, Eating Attitudes Test (EAT-26 to assess eating attitude disorders in students, and the Food Frequency Questionnaire (FFQ. Data were analyzed using SPSS software, version 13 and the NUT 4 software. Results: Six (1% EAT-26 questionnaire were omitted from analysis for being incomplete. Also, 556, 446, and 491 questionnaires were evaluated in meat, bread, and fat groups, respectively; and the rest were omitted because of not being complete. The mean±SD age of the students was 15.8±0.9 years. According to the EAT-26, we found that 80.1% of the students were at risk of eating attitude disorders (CI=95%, 76.9-83.3. By comparing the results of the FFQ and the EAT-26 and weight controlling behaviors, we found that consumption of meat and fat was significantly higher in students with eating attitude disorder (P=0.027 and P=0.003 respectively. Bread intake was significantly higher in the groups with no disorder (P=0.08. (This P value is not significant. Moreover, the mean consumption of sandwiches was higher in students with eating attitude disorders (P=0.002. Conclusion: Considering the high prevalence of eating attitude disorders in our study, assessing the underlying reasons and implementing preventive
Hoffmann, Anika; Postma, Frank P.; Sterkenburg, Anthe S.; Gebhardt, Ursel; Mueller, Hermann L.
Background: As a result of hypothalamic involvement and/or treatment-related hypothalamic damage, up to 75% of childhood craniopharyngioma patients develop hypothalamic obesity. Methods: Eating behavior was analyzed in 101 survivors of childhood craniopharyngioma, recruited from 1980 to 2001 in the
Ramirez, Maria E.; McIntosh, David E.; Kruczek, Theresa
Eating disorders, once thought to be exclusively a disorder of the more affluent Western countries, are now spreading around the world. Despite the wealth of information on the prevalence of eating disorders in developed countries, epidemiological data for South America is scarce. The 26-item Eating Attitude Test (EAT-26) was used to explore the…
Full Text Available Beatriz Jáuregui-Garrido1, Ignacio Jáuregui-Lobera2,31Department of Cardiology, University Hospital Virgen del Rocío, 2Behavioral Sciences Institute, 3Pablo de Olavide University, Seville, SpainAbstract: Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfactory explanation of the cause can be ascertained. In many cases of sudden death, autopsies do not clarify the main cause. Cardiovascular complications are usually involved in these deaths. The purpose of this review was to report an update of the existing literature data on the main findings with respect to sudden death in eating disorders by means of a search conducted in PubMed. The most relevant conclusion of this review seems to be that the main causes of sudden death in eating disorders are those related to cardiovascular complications. The predictive value of the increased QT interval dispersion as a marker of sudden acute ventricular arrhythmia and death has been demonstrated. Eating disorder patients with severe cardiovascular symptoms should be hospitalized. In general, with respect to sudden death in eating disorders, some findings (eg, long-term eating disorders, chronic hypokalemia, chronically low plasma albumin, and QT intervals >600 milliseconds must be taken into account, and it must be highlighted that during refeeding, the adverse effects of hypophosphatemia include cardiac failure. Monitoring vital signs and performing electrocardiograms and serial measurements of plasma potassium are relevant during the treatment of eating disorder patients.Keywords: sudden death, cardiovascular complications, refeeding syndrome, QT interval, hypokalemia
Mohammad Reza Khodabakhsh
Full Text Available Abstract Background and Objectives: Emotion regulation difficulties predicts disordered eating, but how emotion regulation difficulties lead to disordered eating remains an unanswered question. In this research, the role of alexithymia and emotion regulation difficulties was investigated in the prediction of disordered eating behaviors among students. Methods: This descriptive study was performed on 264 students of Allameh Tabataba’i University, who were selected by multiple cluster sampling. Data were collected using Toronto Alexithymia Scale, Eating Attitudes Test, and Emotion Regulation Questionnaire. Analysis of data was performed using Pearson correlation coefficient and stepwise regression. The significance level was considered to be p<0.01. Results: Results showed that there was a significant correlation among emotion regulation difficulties, alexithymia, and disordered eating behaviors (p<0.01. The results of stepwise regression analysis indicated that alexithymia and emotion regulation difficulties significantly predicted disoredered eating behaviors (p<0.01 and emotion regulation difficulties has a mediator role in the relationship between alexithymia and disordered eating behaviors (p<0.01. Conclusion: The results of this study is indicative of the importance of emotion regulation difficulties and alexithymia in the prediction of disordered eating behaviors, and these factors can explain the high rate of disordered eating behaviors variance.
Full Text Available Abstract Background Being overweight is an increasing problem among young people, among whom disordered eating behavior is linked with weight problems as well as unhealthy weight control. The aim of the present study was to investigate whether health factors and motives to exercise differ in young men by the type of disordered eating behavior. Methods The population-based, cross-sectional MOPO study consisted of 2,096 young Finnish men (mean age 17.9, SD 0.7 attending compulsory call-ups for military service in the Oulu area in 2010, 2011, and 2013. They responded to a questionnaire that included two subscales of the Eating Disorder Inventory-3 indicating drive for thinness and bulimic behavior and questions on health, physical activity, and motives to exercise. The association between disordered eating behavior and related factors was analyzed by binary logistic regression. Results Altogether, 6.9 % (n = 145 of the men had symptoms of disordered eating, i.e., 5.4 % had a drive for thinness (n = 114 and 3.7 % had bulimic behavior (n = 77. Drive for thinness was associated with a perception of being overweight (OR 3.7; 95 % CI 2.2–6.1, poor self-rated health (2.3; 1.2–4.4, more leisure sitting time (1.1; 1.0–1.2, and body-related exercise motives (body acceptance: 3.0; 1.7–5.2; weight loss: 2.5; 1.4–4.4. Bulimic behavior was positively associated with poor self-rated health (2.6; 1.1–5.8 and several motives to exercise, i.e., due to another person’s suggestion (2.8; 1.6–4.8, competitive sports (2.1; 1.2–3.7, body acceptance (2.1; 1.1–3.9, and weight loss (1.9; 1.1–3.3, but inversely associated with health/fitness-related exercise motives (health promotion: 0.3; 0.1–0.5; muscular strength or physical performance: 0.5; 0.2–0.9. Conclusions In young men, disordered eating behavior was associated with being overweight, having poor self-rated health, and having a greater amount of leisure sitting time as well
Breland, Jessica Y; Donalson, Rosemary; Dinh, Julie; Nevedal, Andrea; Maguen, Shira
Disordered eating, which includes subclinical and clinical maladaptive eating behaviors, is common among women, including those served by the Veterans Health Administration (VA). We used qualitative methods to determine whether and how women veterans want to receive treatment for disordered eating. Women veterans participated in one of seven focus groups/interviews and completed in-person demographic and psychological questionnaires. We used thematic analysis of focus groups/interviews to understand preferences for disordered eating treatment. Participants (n = 20) were mostly women of color (55%); mean age was 48 (SD = 15) and 65% had significant psychological symptoms. Few participants described being assessed for disordered eating, but all thought VA should provide treatment for disordered eating. Through thematic analysis, we identified six preferences: 1) treatment for disordered eating should be provided in groups, 2) treatment for disordered eating should provide concrete skills to facilitate the transition out of structured military environments, 3) treatment for disordered eating should address the relationship between eating and mental health, 4) disordered eating can be treated with mindfulness and cognitive-behavioral therapy, 5) disordered eating treatment providers should be experienced and take an interactive approach to care, but can come from diverse disciplines, and 6) referrals to treatment for disordered eating should be open ended, occur early, and allow for ongoing, flexible access to treatment. Women veterans are interested in treatment for disordered eating. Preferred treatments align with existing treatments, could be offered in conjunction with weight loss or primary care services, and should provide social support and interactive learning. Published by Elsevier Inc.
Micali, Nadia; Solmi, Francesca; Horton, Nicholas J; Crosby, Ross D; Eddy, Kamryn T; Calzo, Jerel P; Sonneville, Kendrin R; Swanson, Sonja A; Field, Alison E
To investigate whether anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED), including purging disorder (PD), subthreshold BN, and BED at ages 14 and 16 years, are prospectively associated with later depression, anxiety disorders, alcohol and substance use, and self-harm. Eating disorders were ascertained at ages 14 and 16 years in 6,140 youth at age 14 (58% of those eligible) and 5,069 at age 16 (52% of those eligible) as part of the prospective Avon Longitudinal Study of Parents and Children (ALSPAC). Outcomes (depression, anxiety disorders, binge drinking, drug use, deliberate self-harm, weight status) were measured using interviews and questionnaires about 2 years after predictors. Generalized estimating equation models adjusting for gender, socio-demographic variables, and prior outcome were used to examine prospective associations between eating disorders and each outcome. All eating disorders were predictive of later anxiety disorders. AN, BN, BED, PD, and OSFED were prospectively associated with depression (respectively AN: odds ratio [OR] = 1.39, 95% CI = 1.00-1.94; BN: OR = 3.39, 95% CI = 1.25-9.20; BED: OR = 2.00, 95% CI = 1.06-3.75; and PD: OR = 2.56, 95% CI = 1.38-4.74). All eating disorders but AN predicted drug use and deliberate self-harm (BN: OR = 5.72, 95% CI = 2.22-14.72; PD: OR = 4.88, 95% CI = 2.78-8.57; subthreshold BN: OR = 3.97, 95% CI = 1.44-10.98; and subthreshold BED: OR = 2.32, 95% CI = 1.43-3.75). Although BED and BN predicted obesity (respectively OR = 3.58, 95% CI = 1.06-12.14 and OR = 6.42, 95% CI = 1.69-24.30), AN was prospectively associated with underweight. Adolescent eating disorders, including subthreshold presentations, predict negative outcomes, including mental health disorders, substance use, deliberate self-harm, and weight outcomes. This study highlights the high public health and clinical burden of eating disorders
Micali, Nadia; Solmi, Francesca; Horton, Nicholas J.; Crosby, Ross D.; Eddy, Kamryn T.; Calzo, Jerel P.; Sonneville, Kendrin R.; Swanson, Sonja A.; Field, Alison E.
Objective To investigate whether anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED), including purging disorder (PD), subthreshold BN, and BED at ages 14 and 16, are prospectively associated with later depression, anxiety disorders, alcohol and substance use, and self-harm. Method Eating disorders were ascertained at 14 and 16 years of age in 6,140 youth at age 14 (58% of those eligible) and 5,069 at age 16 (52% of those eligible) as part of the prospective Avon Longitudinal Study of Parents and Children (ALSPAC). Outcomes (depression, anxiety disorders, binge drinking, drug use, deliberate self-harm, weight status) were measured using interviews and questionnaires about 2 years following predictors. Generalized estimating equation models adjusting for gender, socio-demographic variables, and prior outcome were used to examine prospective associations between eating disorders and each outcome. Results All eating disorders were predictive of later anxiety disorders. AN, BN, BED, PD, and OSFED were prospectively associated with depression (respectively AN: odds ratio [OR]=1.39 [95% CIs: 1.00-1.94]; BN: OR=3.39[1.25-9.20]; BED: OR=2.00 [1.06-3.75]; PD: OR=2.56 [1.38-4.74]). All eating disorders but AN predicted drug use and deliberate self-harm (BN: OR=5.72[2.22-14.72], PD: OR=4.88[2.78-8.57], subthreshold BN: OR=3.97[1.44-10.98], subthreshold BED: OR=2.32[1.43-3.75]). Whilst BED and BN predicted obesity (respectively OR=3.58 [1.06-12.14] and OR=6.42 [1.69-24.30]), AN was prospectively associated with underweight. Conclusions Adolescent eating disorders, including subthreshold presentations, predict negative outcomes, including mental health disorders, substance use, deliberate self-harm, and weight outcomes. This study highlights the high public health and clinical burden of eating disorders among adolescents. PMID:26210334
Full Text Available Carrie J McAdams,1,2 Whitney Smith1 1University of Texas at Southwestern Medical Center, 2Department of Psychiatry, Texas Health Presbyterian Hospital of Dallas, Dallas, TX, USA Abstract: Eating disorders are complex and serious psychiatric illnesses whose etiology includes psychological, biological, and social factors. Treatment of eating disorders is challenging as there are few evidence-based treatments and limited understanding of the mechanisms that result in sustained recovery. In the last 20 years, we have begun to identify neural pathways that are altered in eating disorders. Consideration of how these pathways may contribute to an eating disorder can provide an understanding of expected responses to treatments. Eating disorder behaviors include restrictive eating, compulsive overeating, and purging behaviors after eating. Eating disorders are associated with changes in many neural systems. In this targeted review, we focus on three cognitive processes associated with neurocircuitry differences in subjects with eating disorders such as reward, decision-making, and social behavior. We briefly examine how each of these systems function in healthy people, using Neurosynth meta-analysis to identify key regions commonly implicated in these circuits. We review the evidence for disruptions of these regions and systems in eating disorders. Finally, we describe psychiatric and psychological treatments that are likely to function by impacting these regions. Keywords: anorexia nervosa, bulimia nervosa, social cognition, reward processing, decision-making
Grilo, Carlos M.; Masheb, Robin M.; Crosby, Ross D.
Objective: To examine predictors and moderators of response to cognitive behavioral therapy (CBT) and medication treatments for binge-eating disorder (BED). Method: 108 BED patients in a randomized double-blind placebo-controlled trial testing CBT and fluoxetine treatments were assessed prior, throughout, and posttreatment. Demographic factors,…
Shea, Munyi; Cachelin, Fary; Uribe, Luz; Striegel, Ruth H.; Thompson, Douglas; Wilson, G. Terence
Data on the compatibility of evidence-based treatment in ethnic minority groups are limited. This study utilized focus group interviews to elicit Mexican American women's (N = 12) feedback on a cognitive behavior therapy guided self-help program for binge eating disorders. Findings revealed 6 themes to be considered during the cultural adaptation…
Landry, Alicia S.; Moorer, Kayla D.; Madson, Michael B.; Zeigler-Hill, Virgil
The current study examined the degree to which associations that protective behavioral strategy use had with alcohol consumption and alcohol-related negative consequences were moderated by disordered eating and race. Participants were 382 female undergraduates (ages 18-25) who had consumed alcohol at least once within the previous month.…
Nagel, K. L.; Jones, Karen H.
School prevention programs for teenage eating disorders should emphasize nutrition education (knowledge, attitudes, behavior) and living skills (self-concept, coping). Secondary prevention involves identifying early warning signs and places for referral; tertiary prevention creates a supportive school environment for recoverers with teachers as…
Cristiane P. Lázaro
Full Text Available Abstract Objective To investigate the eating behavior of individuals with autism through their mothers’ narratives. Methods The study of narratives was used to report on the narrators’ experiences. Data on the eating habits of individuals with autism were collected using semi-structured interviews held individually with the mothers. The interviews were recorded, transcribed and codified using the NVivo software program. Results Eighteen mothers of boys/young men with autism participated in the study. Analysis yielded three major categories: eating patterns, the family's attitudes to the child's eating habits, and food-related behavior. Conclusion Results show that autism-related factors may affect the child's food choices. Environmental factors, particularly the parents’ behavior, may also play a decisive role, both in reinforcing the child's food choices and in encouraging a healthier and more diversified diet. Professionals should instruct parents regarding their decisive role in reinforcing or discouraging inappropriate mealtime behavior in children with autism.
Sharan, Pratap; Sundar, A. Shyam
Eating disorders, especially anorexia nervosa and bulimia nervosa have been classically described in young females in Western population. Recent research shows that they are also seen in developing countries including India. The classification of eating disorders has been expanded to include recently described conditions like binge eating disorder. Eating disorders have a multifactorial etiology. Genetic factor appear to play a major role. Recent advances in neurobiology have improved our understanding of these conditions and may possibly help us develop more effective treatments in future. Premorbid personality appears to play an important role, with differential predisposition for individual disorders. The role of cultural factors in the etiology of these conditions is debated. Culture may have a pathoplastic effect leading to non-conforming presentations like the non fat-phobic form of anorexia nervosa, which are commonly reported in developing countries. With rapid cultural transformation, the classical forms of these conditions are being described throughout the world. Diagnostic criteria have been modified to accommodate for these myriad presentations. Treatment of eating disorders can be quite challenging, given the dearth of established treatments and poor motivation/insight in these conditions. Nutritional rehabilitation and psychotherapy remains the mainstay of treatment, while pharmacotherapy may be helpful in specific situations. PMID:26330646
Kravvariti, V; Gonidakis, Fr
Women suffering from eating disorders, present considerable retardation and difficulties in their psychosexual development during adolescence. This leads to primary or secondary insufficiencies in their adult sexual life. The cause of these difficulties seems to be a series of biological, family and psychosocial factors. The majority of the research findings indicate that eating disorders have a negative impact on the patient's sexual function. The factors related to eating disorders symptomatology that influence sexuality are various and differ among each eating disorder diagnostic categories. Considering anorexia nervosa, it has been reported that women have negative attitudes to sexual issues and their body. Their sexual motivation increases when they engage in psychotherapy and their body weight is gradually restored. Starvation and its consequences on the human physiology and especially on the brain function seem to be the main factor that leads to reduced sexual desire and scarce sexual activity. Moreover, personality traits that are common in patients suffering from anorexia nervosa such as compulsivity and rigidity are also related with difficulties initiating and retaining romantic and sexual relationships. Usually patients suffering from anorexia nervosa report impaired sexual behavior and lack of interest to engage in a sexual relationship. Considering Bulimia Nervosa, impulsivity and difficulties in emotion regulation that are common features of the individuals that suffer from bulimia nervosa are also related to impulsive and sometimes self-harming sexual behaviors. Moreover women sufferers often report repulsion, anger and shame towards their body and weight, mainly due to the distorted perception that they are fat and ugly. It is interesting that a number of research findings indicate that although patients suffering from bulimia nervosa are more sexually active and have more sexual experiences than patients suffering from anorexia nervosa, both
Atalayer, Deniz; Gibson, Charlisa; Konopacka, Alexandra; Geliebter, Allan
There is growing evidence supporting a multifactorial etiology that includes genetic, neurochemical, and physiological components for eating disorders above and beyond the more conventional theories based on psychological and sociocultural factors. Ghrelin is one of the key gut signals associated with appetite, and the only known circulating hormone that triggers a positive energy balance by stimulating food intake. This review summarizes recent findings and several conflicting reports on ghrelin in eating disorders. Understanding these findings and inconsistencies may help in developing new methods to prevent and treat patients with these disorders. PMID:22960103
Moriarty, Dick; Moriarty, Mary
Since sports can sometimes lend themselves to eating disorders, coaches and sports administrators must get involved in the detection and treatment of this problem. While no reliable studies or statistics exist on the incidence of anorexia nervosa and/or bulimia among athletes, some research suggests that such disorders occur frequently among…
Wisniewski, Lucene; Hernandez Hernandez, Maria Elena; Waller, Glenn
Research has shown that clinicians underuse or omit techniques that constitute an essential part of evidence-based therapies. However, it is not known whether this is the case in DBT for eating disorders. The aims of this study were; 1) exploring the extent to which DBT techniques were used by self-identified DBT clinicians treating eating disorders; 2) determining whether therapists fell into distinct groups, based on their usage of DBT techniques; and 3) examining whether clinician characteristics were related to the use of such techniques. Seventy-three clinicians offering DBT for eating disorders completed an online survey about their use of specific DBT techniques. They also completed measures of personality and intolerance of uncertainty. In relation to the first aim, the pattern of use of DBT techniques showed a bimodal distribution - most were used either a lot or a little. Considering the second aim, clinicians fell into two groups according to the techniques that they delivered - one characterized by a higher use of DBT techniques and the other by a higher use of techniques that were specific to the treatment of eating disorders, rather than DBT methods. Finally, more experienced clinicians were more likely to be in the 'DBT technique-focused' group. DBT clinicians are encouraged to implement both sets of techniques (DBT techniques and standard techniques for the treatment of eating disorders) in an integrated way. Training, supervision and the use of manuals are recommended to decrease therapist drift in DBT. Copyright © 2017 Elsevier Ltd. All rights reserved.
Dennard, E Eliot; Richards, C Steven
The eating disorder literature has sought to understand the role of comorbid psychiatric diagnoses and coping in relation to eating disorders. The present research extends these findings by studying the relationships among depression, coping, and the entire continuum of disordered eating behaviors, with an emphasis on subthreshold eating disorders. 109 undergraduate females completed questionnaires to assess disordered eating symptoms, depressive symptoms, and the use of active and avoidant coping mechanisms. Hypotheses were tested using bivariate linear regression and multivariate linear regression. Results indicated that depression was a significant predictor of disordered eating symptoms after controlling for relationships between depression and coping. Although avoidant coping was positively associated with disordered eating, it was not a significant predictor after controlling for depression and coping. Previous research has found associations between depression and diagnosable eating disorders, and this research extends those findings to the entire continuum of disordered eating. Future research should continue to investigate the predictors and correlates of the disordered eating continuum using more diverse samples. Testing for mediation and moderation among these variables may also be a fruitful area of investigation. Published by Elsevier Ltd.
Matteo Di Segni; Enrico Patrono; Loris Patella; Stefano Puglisi-Allegra; Rossella Ventura
Eating disorders are multifactorial conditions that can involve a combination of genetic, metabolic, environmental, and behavioral factors. Studies in humans and laboratory animals show that eating can also be regulated by factors unrelated to metabolic control. Several studies suggest a link between stress, access to highly palatable food, and eating disorders. Eating “comfort foods” in response to a negative emotional state, for example, suggests that some individuals overeat to self-medica...
Linardon, Jake; Brennan, Leah
Meta-analyses have documented the efficacy of cognitive-behavioral therapy (CBT) for reducing symptoms of eating disorders. However, it is not known whether CBT for eating disorders can also improve quality of life (QoL). This meta-analysis therefore examined the effects of CBT for eating disorders on subjective QoL and health-related quality of life (QoL). Studies that assessed QoL before and after CBT for eating disorders were searched in the PsycInfo and Medline database. Thirty-four articles met inclusion criteria. Pooled within and between-groups Hedge's g were calculated at post-treatment and follow-up for treatment changes on both subjective and HRQoL using a random effects model. CBT led to significant and modest improvements in subjective QoL and HRQoL from pre to post-treatment and follow-up. CBT led to greater subjective QoL improvements than inactive (i.e., wait-list) and active (i.e., a combination of bona fide therapies, psychoeducation) comparisons. CBT also led to greater HRQoL improvements than inactive, but not active, comparisons. Prepost QoL improvements were larger in studies that delivered CBT individually and by a therapist or according to the cognitive maintenance model of eating disorders (CBT-BN or CBT-E); though this was not replicated at follow-up CONCLUSIONS: Findings provide preliminary evidence that CBT for eating disorders is associated with modest improvements in QOL, and that CBT may be associated with greater improvements in QOL relative to comparison conditions. © 2017 Wiley Periodicals, Inc.
Linardon, Jake; Hindle, Annemarie; Brennan, Leah
Cognitive-behavioral therapy (CBT) is efficacious for a range of eating disorder presentations, yet premature dropout is one factor that might limit CBTs effectiveness. Improved understanding of dropout from CBT for eating disorders is important. This meta-analysis aimed to study dropout from CBT for eating disorders in randomized controlled trials (RCTs), by (a) identifying the types of dropout definitions applied, (b) providing estimates of dropout, (c) comparing dropout rates from CBT to non-CBT interventions for eating disorders, and (d) testing moderators of dropout. RCTs of CBT for eating disorders that reported rates of dropout were searched. Ninety-nine RCTs (131 CBT conditions) were included. Dropout definitions varied widely across studies. The overall dropout estimate was 24% (95% CI = 22-27%). Diagnostic type, type of dropout definition, baseline symptom severity, study quality, and sample age did not moderate this estimate. Dropout was highest among studies that delivered internet-based CBT and was lowest in studies that delivered transdiagnostic enhanced CBT. There was some evidence that longer treatment protocols were associated with lower dropout. No significant differences in dropout rates were observed between CBT and non-CBT interventions for all eating disorder subtypes. Present study dropout estimates are hampered by the use of disparate dropout definitions applied. This meta-analysis highlights the urgency for RCTs to utilize a standardized dropout definition and to report as much information on patient dropout as possible, so that strategies designed to minimize dropout can be developed, and factors predictive of CBT dropout can be more easily identified. © 2018 Wiley Periodicals, Inc.
Grilo, Carlos M.; Masheb, Robin M.; Wilson, G. Terence; Gueorguieva, Ralitza; White, Marney A.
Objective: Cognitive-behavioral therapy (CBT) is the best established treatment for binge-eating disorder (BED) but does not produce weight loss. The efficacy of behavioral weight loss (BWL) in obese patients with BED is uncertain. This study compared CBT, BWL, and a sequential approach in which CBT is delivered first, followed by BWL (CBT + BWL).…
Haleama Al Sabbah
Results: The participants' mean age and standard deviation (Mean ± SD was 19 ± 1.3 years. 31.4% of the participants showed disordered eating attitudes. The percentage of participants engaged in at least one concerning behavior in the past six months was 43.8%. A membership in a health club was significantly related to disordered eating attitudes (p< 0.01. A high level of physical activity was correlated with laxative use, over the counter supplements, and exercising for more than 60 minutes to control weight (p < 0.05. Conclusion: There is a great need for intervention programs and policies to contain the level of abnormal eating attitudes and promote healthy level of physical activity among college students.
Thaler, Lea; Steiger, Howard
Eating disorders (EDs) are characterized by intense preoccupation with shape and weight and maladaptive eating practices. The complex of symptoms that characterize EDs often arise through the activation of latent genetic potentials by environmental exposures, and epigenetic mechanisms are believed to link environmental exposures to gene expression. This chapter provides an overview of genetic factors acting in the etiology of EDs. It then provides a background to the hypothesis that epigenetic mechanisms link stresses such as obstetric complications and childhood abuse as well as effects of malnutrition to eating disorders (EDs). The chapter then summarizes the emerging body of literature on epigenetics and EDs-mainly studies on DNA methylation in samples of anorexia and bulimia. The available evidence base suggests that an epigenetically informed perspective contributes in valuable ways to the understanding of why people develop EDs.
Legenbauer, Tanja; Martin, Franziska; Blaschke, Ariane; Schwenzfeier, Anne; Blechert, Jens; Schnicker, Katja
Body checking (BC) and avoidance behaviors (BA) are the dominant behavioral features of body image disturbances (BID) that characterize most individuals with eating disorders (EDs). Whereas BC can be reliably assessed, a valid assessment tool for BA is lacking, preventing an adequate assessment of BID differences across different EDs (anorexia nervosa, AN; bulimia nervosa, BN; binge eating disorder, BED). A total of 310 women with EDs and 112 nonclinical controls completed measures of BC-, BA- and ED-related symptoms. BA did not differentiate between EDs, whereas BC did: it was highest in AN and BN, and lowest in BED. Multivariate analyses also discriminated AN from BN based on BC. Given that results are of preliminary nature, evidence is promising that EDs can be discriminated from healthy controls and that differential BID profiles for the behavioral component among ED subgroups exist. However, replication of the factor structure remains open within ED subsamples. Copyright © 2017 Elsevier Ltd. All rights reserved.
Frederick, Christina M.; Grow, Virginia M.
Findings from a study of the relationships among autonomy deficits, low self-esteem, and eating disorders of 71 college women supported a mediational model in which lack of autonomy was related to decreased global self-esteem, which in turn was associated with bulimia and body dissatisfaction. (SLD)
Schousboe, Birgitte Hartvig; Waaddegaard, Mette
Binge eating disorder kaldes også bulimi uden opkastning eller den tredje spiseforstyrrelse. Det er en udbredt, men mindre kendt spiseforstyrrelse end anoreksi og bulimi. Patienterne er ofte overvægtige og har ikke kompenserende adfærd over for overspisningen i form af opkastning eller brug af...
Davis, Haley; Attia, Evelyn
Medications are commonly prescribed in the treatment of eating disorders. In this review, we discuss relevant medications used for the treatment of bulimia nervosa, binge eating disorder (BED), and anorexia nervosa. We focus on recent research developments, where applicable, in addition to discussing important findings from older studies to provide a complete synopsis of the current evidence base for eating disorder treatment using pharmacologic agents. Medications are generally useful for patients with bulimia nervosa and BED. For bulimia nervosa, antidepressant medications are the primary pharmacologic treatment and limited new research has been completed. For BED, lisdexamfetamine is reported to be generally well tolerated and effective, and is the first medication to be indicated by the US Food and Drug Administration for treatment of BED. For anorexia nervosa, there is limited evidence supporting benefits of medications. Second-generation antipsychotics, particularly olanzapine, appear to demonstrate some benefit for weight gain in anorexia nervosa, although are not advised as a stand-alone treatment. Transdermal administration of hormonal agents is also being explored for improving bone health in anorexia nervosa. Although pharmacotherapy has established utility in bulimia nervosa and BED, further research on medications for the treatment of eating disorders, particularly anorexia nervosa, is necessary.
Pike, Kathleen M.; Hoek, Hans W.; Dunne, Patricia E.
Purpose of review Culture has long been recognized as significant to the cause and expression of eating disorders. We reviewed the recent literature about recent trends in the occurrence of eating disorders in different cultures. Recent findings While historically, eating disorders were
Pike, Kathleen M.; Hoek, Hans W.; Dunne, Patricia E.
Purpose of review Culture has long been recognized as significant to the cause and expression of eating disorders. We reviewed the recent literature about recent trends in the occurrence of eating disorders in different cultures. Recent findings While historically, eating disorders were
Olivardia, R; Pope, H G; Mangweth, B; Hudson, J I
This study was designed to assess the characteristics of men with eating disorders in the community. The authors recruited 25 men meeting DSM-IV criteria for eating disorders and 25 comparison men through advertisements in college newspapers. A second comparison group comprised 33 women with bulimia nervosa who were recruited and interviewed with virtually identical methods. The men with eating disorders closely resembled the women with eating disorders but differed sharply from the comparison men in phenomenology of illness, rates of comorbid psychiatric disorders, and dissatisfaction with body image. Homosexuality did not appear to be a common feature of men with eating disorders in the community. Childhood physical and sexual abuse appeared slightly more common among the eating-disordered men than among the comparison men. Eating disorders, although less common in men than in women, appear to display strikingly similar features in affected individuals of the two genders.
Allison, Kelly C.; Grilo, Carlos M.; Masheb, Robin M.; Stunkard, Albert J.
The authors compared eating patterns, disordered eating, features of eating disorders, and depressive symptoms in persons with binge eating disorder (BED; n = 177), with night eating syndrome (NES; n = 68), and in an overweight comparison group without BED or NES (comparison; n = 45). Participants completed semistructured interviews and several…
Satherley, R; Howard, R; Higgs, S
To systematically review evidence concerning disordered eating practices in dietary-controlled gastrointestinal conditions. Three key questions were examined: a) are disordered eating practices a feature of GI disorders?; b) what abnormal eating practices are present in those with GI disorders?; and c) what factors are associated with the presence of disordered eating in those with GI disorders? By exploring these questions, we aim to develop a conceptual model of disordered eating development in GI disease. Five key databases, Web of Science with Conference Proceedings (1900-2014) and MEDLINE (1950-2014), PubMed, PsycINFO (1967-2014) and Google Scholar, were searched for papers relating to disordered eating practices in those with GI disorders. All papers were quality assessed before being included in the review. Nine papers were included in the review. The majority of papers reported that the prevalence of disordered eating behaviours is greater in populations with GI disorders than in populations of healthy controls. Disordered eating patterns in dietary-controlled GI disorders may be associated with both anxiety and GI symptoms. Evidence concerning the correlates of disordered eating was limited. The presence of disordered eating behaviours is greater in populations with GI disorders than in populations of healthy controls, but the direction of the relationship is not clear. Implications for further research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Yi, Chun-Xia; Heppner, Kristy; Tschöp, Matthias H.
Ghrelin is the only known circulating hormone that acts on peripheral and central targets to increase food intake and promote adiposity. The present review focuses on the possible clinical relevance of ghrelin in the regulation of human feeding behavior in individuals with obesity and other eating
Greisse Viero da Silva Leal
Full Text Available OBJETIVO: Caracterizar comportamento de risco para transtornos alimentares (TA e sua frequência entre adolescentes em uma revisão da literatura nacional e internacional. MÉTODOS: Foi realizada uma busca bibliográfica por meio de uma revisão integrativa nas bases de dados PubMed (US National Library of Medicinee Lilacs e no portal SciELO,utilizando-se os descritores relacionados à "eating disorder risk behavior". Foram selecionados artigos publicados nos últimos 10 anos, nos idiomas português, espanhol e inglês, e especificamente com adolescentes. Foram avaliados 76 artigos e analisados a nomenclatura e os instrumentos utilizados para avaliar comportamento de risco para TA e sua prevalência. RESULTADOS: Encontrou-se uma série de termos para avaliar risco para TA. A metodologia mais utilizada foi a de questionários e escalas, destacando-se o EAT-26 ou 40 e o BITE, dentre os mais frequentes; a prevalência de risco variou de 0,24% a 58,4%. CONCLUSÃO: Diferentes nomenclaturas e instrumentos são utilizados para avaliar comportamento de risco para TA entre adolescentes, com grande amplitude nos resultados de prevalência. Maior padronização de termos e metodologia de avaliação permitiriam melhor comparação entre estudos epidemiológicos em diferentes localidades.OBJECTIVE: To characterize eating disorder (ED risk behavior and its prevalence among adolescents in a review of national and international literature. METHODS: We carried out an integrative review on PubMed (U.S. National Library of Medicine, Lilacs and SciELO, using descriptors related to "eating disorder risk behavior". Articles published in the last 10 years, in Portuguese, Spanish and English, and specifically with adolescents were selected. The nomenclature and instruments used to assess eating disorder risk behaviors and its frequency were evaluated and analyzed in 76 articles. RESULTS: Several terms to assess ED risk behavior were found; questionnaires and scales
Mangweth-Matzek, Barbara; Kummer, Kai K; Pope, Harrison G
Few studies have assessed symptoms of eating disorders in older men. We administered anonymous questionnaires to 470 men, aged 40-75 years, in and around Innsbruck, Austria, to assess eating behavior, body image, and exercise activities. We defined current eating disorder symptoms (EDS) as (1) BMI men, 32 (6.8%) reported one of the four eating disorder symptoms. The 32 men with eating disorder symptoms, compared to the 438 men with normal eating, showed significantly greater pathology on scales assessing eating behavior, exercise addiction, satisfaction with body shape, and weight. However, the EDE-Q cutoff score for eating disturbance identified only three (9%) of the EDS men. Symptoms of disordered eating, sometimes involving purging via excessive exercise, do occur in older men, and may be missed by conventional instruments. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:953-957). © 2016 Wiley Periodicals, Inc.
Anderson, Lisa M; Reilly, Erin E; Schaumberg, Katherine; Dmochowski, Sasha; Anderson, Drew A
Mindful eating and intuitive eating are promoted as means to circumvent potentially maladaptive dietary restraint while maintaining a healthy weight. Although theoretically related, no studies have examined the correlations between intuitive eating, mindful eating, and restraint in the same sample. This study sought to examine these constructs and their correlations with body mass index (BMI), eating-disordered behaviors, and meal consumption in a college sample. Participants (N = 125) completed a laboratory taste-test meal and measures of each eating-related construct using the EDDS, IES, MEQ, and TFEQ-Restraint Subscale. Mindful eating, intuitive eating, and restraint were not strongly correlated. Hierarchical multiple regression analyses indicated that restraint and intuitive eating accounted for significant variance in disordered eating and BMI. Elevated restraint was associated with increased BMI and disordered eating; elevated intuitive eating was associated with decreased BMI and disordered eating. Mindful eating did not correlate with any outcome variables. Follow-up analyses suggested that specific intuitive eating subscales accounted for unique variance in the relation between intuitive eating and disordered eating. Intuitive eating was the only construct that was significantly associated with meal consumption. Intuitive eating and restraint appear to be only weakly correlated, and each is differentially associated with meal consumption. Mindful eating does not appear to relate to outcome variables.
HALMI, KATHERINE A.
The treatment of eating disorders is based on a multimodal model, recognizing that these disorders do not have a single cause or a predictable course. The treatment strategy is determined by the severity of illness and the specific eating disorder diagnosis. For the treatment of anorexia nervosa, the key elements are medical management, behavioral therapy, cognitive therapy and family therapy, while pharmacotherapy is at best an adjunct to other therapies. In bulimia nervosa...
Giel, Katrin Elisabeth; Hermann-Werner, Anne; Mayer, Jochen; Diehl, Katharina; Schneider, Sven; Thiel, Ansgar; Zipfel, Stephan
We aimed to investigate eating disorder pathology in German elite adolescent athletes. Evidence suggests that eating disorder pathology is more common in adult elite sports, especially in female athletes and in sports emphasizing leanness. There is a scarcity of studies in elite adolescent athletes who are in a vulnerable developmental stage and are affected by general as well as sport-specific risk factors. Our data was derived from the German Young Olympic Athletes' Lifestyle and Health Management Study (GOAL) which conducted a survey in 1138 elite adolescent athletes. In this sample, we assessed body weight, weight control behavior, body acceptance and screened overall for core symptoms of eating disorders, depression and anxiety. We performed a tree analysis to identify high risk groups for eating disorder pathology. High risk groups comprised (a) athletes competing in weight dependent sports, and among athletes competing in disciplines other than weight dependent sports (b) athletes who are high on negative affectivity, (c) female athletes and (d) male athletes competing in endurance, technical or power sports. Athletes competing in weight dependent disciplines reported wide spread use of compensatory behaviors to influence body weight. Athletes reporting eating disorder pathology showed higher levels of depression and anxiety than athletes without eating disorder pathology. Increased psychosocial burden in athletes with eating disorder pathology suggests that eating disorder symptoms should not be accepted as an unproblematic and functional part of elite sports. The prevention and management of eating disorder pathology is especially important in weight dependent sports. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:553-562). © 2016 Wiley Periodicals, Inc.
Smith, April R; Velkoff, Elizabeth A; Ribeiro, Jessica D; Franklin, Joseph
This meta-analysis addressed whether eating disorders (EDs) are risk factors (i.e., longitudinal predictors) for suicidal thoughts and behaviors. We identified 2,611 longitudinal studies published through August 1, 2017. Inclusion required studies include at least one longitudinal analysis predicting suicide ideation, attempt, or death using an ED diagnosis and/or symptom. Fourteen studies (42 prediction cases) met criteria. Results indicated that clinically diagnosed EDs and disordered eating symptoms were significant but weak predictors of suicide attempts but not death. Effects remained weak when moderators were considered. By reviewing the methodological limitations of previous research, these results highlight avenues for future research. © 2018 The American Association of Suicidology.
Full Text Available Stressors can trigger binge-eating but researchers have yet to consider their effects on both neural responses to food cues and food consumption among those at risk. In this experiment, we examined the impact of acute stressors on neural activation to food images and subsequent food consumption within binge-eating disorder (BED and non-eating disordered control groups. Eighteen women meeting DSM-IV BED criteria and 26 women serving as non-eating disordered controls were randomly assigned to unpleasant stressor (painful cold pressor test followed by negative performance feedback or less unpleasant stressor (non-painful sensory discrimination task followed by positive performance feedback conditions. Subsequently, they were scanned with functional magnetic resonance imaging (fMRI while viewing food and neutral images. After the scans, participants completed a self-report battery in an environment conducive to snacking. During exposure to food images, BED-symptomatic women in the unpleasant stressor condition reported more liking of high calorie food images and showed less activation in one inhibitory area, the hippocampus, compared to controls in this condition. BED-symptomatic women exposed to unpleasant stressors also consumed more chocolate than any other group during the post-scan questionnaire completion. Crucially, reduced hippocampal activation to high calorie food images predicted more chocolate consumption following fMRI scans within the entire sample. This experiment provides initial evidence suggesting unpleasant acute stressors contribute to reduced inhibitory region responsiveness in relation to external food cues and later food consumption among BED-symptomatic women.
van Hoeken, Daphne; Burns, Jonathan K.; Hoek, Hans W.
Purpose of reviewThis is the first review of studies on the epidemiology of eating disorders on the African continent.Recent findingsThe majority of articles found through our search did not assess formal diagnoses, but only screened for eating attitudes and behaviors. Only four studies - including
van Hoeken, Daphne; Burns, Jonathan K.; Hoek, Hans W.
Purpose of reviewThis is the first review of studies on the epidemiology of eating disorders on the African continent.Recent findingsThe majority of articles found through our search did not assess formal diagnoses, but only screened for eating attitudes and behaviors. Only four studies - including
Burckes-Miller, Mardie E.; Black, David R.
A review of research regarding athletes' eating habits suggests that they may practice eating disorder habits and poor weight management behaviors as well as have poor attitudes and knowledge regarding nutrition, indicating their immediate need for appropriate education about the possible detrimental effects of such practices. (CB)
Larrañaga, Alejandra; Fluiters, Enrique; Docet, María F; Fernández Sastre, José Luis; García-Mayor, Ricardo V
There are several psychological approaches to treat ED with efficacy being revealed by empirical research; however none of them are universally accepted. The objective was to compare response to Cognitive Behavioral Therapy in patients with different clinical forms of Eating Disorders. Seventy-four patients diagnosed with eating disorders, 32 with Anorexia nervosa (AN), 19 with Bulimia nervosa (BN) and 23 with Eating disorders not otherwise specified (EDNOS) were included. This is a prospective and comparative study. Patients were treated by psychotherapy, nutritional treatment and pharmacotherapy. The recovery rates in the groups of patients with AN, BN and EDNOS were 14 (43.7%), 8 (42.1%), 10 (43.4%), respectively, p>0.05. The rates of improvement were 14 (43.7%), 10 (52.6%), 12 (52.1%) for AN, BN and EDNOS, respectively, p>0.05. Finally, the rate of patients who had poor outcome were 3 (9.3%), 1 (5.2%), and 1 (4.3%), p>0.05, for AN, BN, and EDNOS, respectively. Cox regression analysis showed that the age of disease onset and no use of psychotropic drugs predicted a good response in patients with ED. The treatment response to Cognitive Behavioral Therapy, nutritional support and psychotropic drugs in the majority of patients was favorable and similar in most patients with different types of Eating Disorders. Furthermore, a young age and no use of psychotropic drugs predict a favorable outcome in patients with ED. Copyright © 2013 Elsevier España, S.L. All rights reserved.
Stein, Karen Farchaus; Corte, Colleen
There is broad consensus that the eating disorders of anorexia nervosa and bulimia nervosa stem from fundamental disturbances in identity development, but theoretically based empirical support is lacking. To extend work on the identity impairment model by investigating the relationship between organizational properties of the self-concept and change in disordered eating behaviors (DEB) in an at-risk sample of college women transitioning between freshman and sophomore years. The number, valence, and organization of self-schemas; availability of a fat body weight self-schema; and DEB were measured at baseline in the freshman year and 6 and 12 months later in a community-based sample of college women engaged in subthreshold DEB (n = 77; control: n = 41). Repeated-measures analyses of variances were used to examine group differences, and hierarchical regression analyses were used to predict disordered eating behaviors. Women in the DEB group had more negative self-schemas at baseline and showed information-processing evidence of a fat self-schema compared with the controls. The groups did not differ in the number of positive self-schemas or interrelatedness. The number of negative self-schemas predicted increases in the level of DEB at 6- and 12-month follow-up, and these effects were mediated through the fat self-schema. The number of positive self-schemas predicted the fat self-schema score but was not predictive of increases in DEB. Interrelatedness of the self-concept was not a significant predictor in this model. Impairments in overall collection of identities are predictive of the availability in memory of a fat self-schema, which in turn is predictive of increases in DEB during the transition to college in a sample of women at risk for an eating disorder. Therefore, organizational properties of the self-concept may be an important focus for effective primary and secondary prevention.
Reyes-Rodríguez, Mae Lynn; Gulisano, Monica; Silva, Yormeri; Pivarunas, Bernadette; Luna-Reyes, Kiara L; Bulik, Cynthia M
This study elucidated the experiences of eighteen Latina adults (mean age = 38.5 years) from "Promoviendo una Alimentación Saludable" Project who received nutritional intervention as part of the clinical trial. Half of the participants were first generation immigrants from Mexico (50%), followed by U.S. born with 16.7%. Remaining nationalities represented were Bolivia, Colombia, Guatemala, Honduras, Peru, and Venezuela with 33.3% combined. The average duration of living in the U.S. was 11.1 years. The mean body mass index (BMI) at baseline was 36.59 kg/m(2) (SD = 7.72). Based on the DSM-IV, 28% (n = 5) participants were diagnosed with binge-eating disorder, 33% (n = 6) with bulimia nervosa purging type and 39% (n = 7) with eating disorder not otherwise specified. Participants received up to three nutritional sessions; a bilingual dietitian conducted 97.8% of sessions in Spanish. In total, fifty nutritional sessions were included in the qualitative analysis. A three step qualitative analysis was conducted. First, a bilingual research team documented each topic discussed by patients and all interventions conducted by the dietitian. Second, all topics were classified into specific categories and the frequency was documented. Third, a consensus with the dietitian was performed to validate the categories identified by the research team. Six categories (describing eating patterns, emotional distress, Latino culture values, family conflicts associated with disturbed eating behaviors, lack of knowledge of healthy eating, and treatment progress) emerged from patients across all nutritional sessions. Considering the background of immigration and trauma (60%, n = 15) in this sample; the appropriate steps of nutritional intervention appear to be: 1) elucidating the connection between food and emotional distress, 2) providing psychoeducation of healthy eating patterns using the plate method, and 3) developing a meal plan. Copyright © 2016 Elsevier Ltd. All rights
Mason, Tyler B; Crosby, Ross D; Kolotkin, Ronette L; Grilo, Carlos M; Mitchell, James E; Wonderlich, Stephen A; Crow, Scott J; Peterson, Carol B
Individuals with obesity and binge eating disorder (BED) report poorer weight-related quality of life (WRQOL) compared to individuals with obesity alone. Cognitive behavioral therapy (CBT), the best available treatment for BED, does not consistently produce weight loss or improvements in weight QOL. The purpose of the current study was to examine baseline and longitudinal associations between eating-related and psychosocial variables and dimensions of weight QOL. We examined associations between predictor variables, including body mass index (BMI), eating disorder (ED) psychopathology, and psychosocial factors, in relation to three dimensions of WRQOL among 171 patients whom received CBT for BED. Participants completed interviews and self-report measures at baseline prior to CBT and at end of treatment. At baseline the following associations were significant: BMI, ED psychopathology, and self-esteem were associated with weight-related self-esteem; gender, BMI, and self-esteem were associated with weight-related public distress (i.e., stigma and worry in public because of one's weight); and age, BMI, and ED psychopathology were associated with weight-related physical function. At end of treatment, the following associations were significant: changes in ED psychopathology and coping predicted weight-related self-esteem; changes in coping and self-esteem predicted weight-related public distress; and changes in BMI and subjective binge eating predicted weight-related physical function. Overall, changes in a number of ED and associated symptoms were associated with improvements in WRQOL. Copyright © 2017 Elsevier Ltd. All rights reserved.
Chithambo, Taona P; Huey, Stanley J
The current study evaluated two web-based programs for eating disorder prevention in high-risk, predominantly ethnic minority women. Two hundred and seventy-one women with elevated weight concerns were randomized to Internet dissonance-based intervention (DBI-I), Internet cognitive-behavioral intervention (CBI-I), or no intervention (NI). Both interventions consisted of four weekly online sessions. Participants were assessed at pre- and post intervention. Outcome measures included eating pathology, body dissatisfaction, dieting, thin-ideal internalization, and depression. At postintervention, DBI-I and CBI-I led to greater reductions in body dissatisfaction, thin-ideal internalization, and depression than NI. In addition, CBI-I was effective at reducing dieting and composite eating pathology relative to NI. No outcome differences were found between the active conditions. Moderation analyses suggested that both active conditions were more effective for ethnic minorities than Whites relative to NI. Results suggest that both DBI-I and CBI-I are effective at reducing eating disorder risk factors in a high-risk, predominantly minority population relative to no intervention. © 2017 Wiley Periodicals, Inc.
Melin, Anna; Torstveit, Monica Klungland; Burke, Louise; Marks, Saul; Sundgot-Borgen, Jorunn
Disordered eating behavior (DE) and eating disorders (EDs) are of great concern because of their associations with physical and mental health risks and, in the case of athletes, impaired performance. The syndrome originally known as the Female Athlete Triad, which focused on the interaction of energy availability, reproductive function, and bone health in female athletes, has recently been expanded to recognize that Relative Energy Deficiency in Sport (RED-S) has a broader range of negative effects on body systems with functional impairments in both male and female athletes. Athletes in leanness-demanding sports have an increased risk for RED-S and for developing EDs/DE. Special risk factors in aquatic sports related to weight and body composition management include the wearing of skimpy and tight-fitting bathing suits, and in the case of diving and synchronized swimming, the involvement of subjective judgments of performance. The reported prevalence of DE and EDs in athletic populations, including athletes from aquatic sports, ranges from 18 to 45% in female athletes and from 0 to 28% in male athletes. To prevent EDs, aquatic athletes should practice healthy eating behavior at all periods of development pathway, and coaches and members of the athletes' health care team should be able to recognize early symptoms indicating risk for energy deficiency, DE, and EDs. Coaches and leaders must accept that DE/EDs can be a problem in aquatic disciplines and that openness regarding this challenge is important.
Full Text Available Few studies have used diffusion tensor imaging (DTI to investigate the micro-structural alterations of WM in patients with restrictive eating disorders (rED, and longitudinal data are lacking. Twelve patients with rED were scanned at diagnosis and after one year of family-based treatment, and compared to twenty-four healthy controls (HCs through DTI analysis. A tract-based spatial statistics procedure was used to investigate diffusivity parameters: fractional anisotropy (FA and mean, radial and axial diffusivities (MD, RD and AD, respectively. Reduced FA and increased RD were found in patients at baseline in the corpus callosum, corona radiata and posterior thalamic radiation compared with controls. However, no differences were found between follow-up patients and controls, suggesting a partial normalization of the diffusivity parameters. In patients, trends for a negative correlation were found between the baseline FA of the right anterior corona radiata and the Eating Disorder Examination Questionnaire total score, while a positive trend was found between the baseline FA in the splenium of corpus callosum and the weight loss occurred between maximal documented weight and time of admission. A positive trend for correlation was also found between baseline FA in the right anterior corona radiata and the decrease in the Obsessive-Compulsive Inventory Revised total score over time. Our results suggest that the integrity of the limbic-thalamo-cortical projections and the reward-related circuitry are important for cognitive control processes and reward responsiveness in regulating eating behavior.
Alvarenga, M S; Koritar, P; Pisciolaro, F; Mancini, M; Cordás, T A; Scagliusi, F B
The objective was to compare eating attitudes, conceptualized as beliefs, thoughts, feelings, behaviors and relationship with food, of anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) patients and a group of obese (OBS) without eating disorders (ED). Female patients from an Eating Disorder (ED) Unit with AN (n=42), BN (n=52) and BED (n=53) and from an obesity service (n=37) in Brazil answered the Disordered Eating Attitude Scale (DEAS) which evaluate eating attitudes with 5 subscales: relationship with food, concerns about food and weight gain, restrictive and compensatory practices, feelings toward eating, and idea of normal eating. OBS patients were recruited among those without ED symptoms according to the Binge Eating Scale and the Questionnaire on Eating and Weight Patterns. ANOVA was used to compare body mass index and age between groups. Bonferroni test was used to analyze multiple comparisons among groups. AN and BN patients presented more dysfunctional eating attitudes and OBS patients less dysfunctional (peating." BED patients were worst than OBS for "Relationship with food" and as dysfunctional as AN patients - besides their behavior could be considered the opposite. Differences and similarities support a therapeutic individualized approach for ED and obese patients, call attention for the theoretical differences between obesity and ED, and suggest more research focused on eating attitudes. Copyright © 2014 Elsevier Inc. All rights reserved.
Full Text Available Gabriela Morgado de Oliveira Coelho,1 Ainá Innocencio da Silva Gomes,2 Beatriz Gonçalves Ribeiro,2 Eliane de Abreu Soares11Nutrition Institute, Rio de Janeiro State University, Maracanã, Rio de Janeiro, Brazil; 2Federal University of Rio de Janeiro, Macaé Campus, Granja dos Cavaleiros, Macaé, BrazilAbstract: Eating disorders are serious mental diseases that frequently appear in female athletes. They are abnormal eating behaviors that can be diagnosed only by strict criteria. Disordered eating, although also characterized as abnormal eating behavior, does not include all the criteria for diagnosing eating disorders and is therefore a way to recognize the problem in its early stages. It is important to identify factors to avoid clinical progression in this high-risk population. Therefore, the purpose of this review is to discuss critical information for the prevention of eating disorders in female athletes. This review discusses the major correlates for the development of an eating disorder. We also discuss which athletes are possibly at highest risk for eating disorders, including those from lean sports and female adolescent athletes. There is an urgent need for the demystification of myths surrounding body weight and performance in sports. This review includes studies that tested different prevention programs' effectiveness, and the majority showed positive results. Educational programs are the best method for primary prevention of eating disorders. For secondary prevention, early identification is essential and should be performed by preparticipation exams, the recognition of dietary markers, and the use of validated self-report questionnaires or clinical interviews. In addition, more randomized clinical trials are needed with athletes from multiple sports in order for the most reliable recommendations to be made and for some sporting regulations to be changed.Keywords: nutrition, disordered eating, sport, anorexia nervosa, bulimia nervosa
Cartwright, Martina M
Eating disorders are maladaptive eating behaviors that typically develop in adolescence and early adulthood. Psychiatric maladies and comorbid conditions, especially insulin-dependent diabetes mellitus, frequently co-exist with eating disorders. Serious medical complications affecting all organs and tissues can develop and result in numerous emergent hospitalizations. This article reviews the pathophysiologies of anorexia nervosa, bulimia nervosa, and orthorexia nervosa and discusses the complexities associated with the treatment of medical complications seen in these patients.
Díaz-Marsá, Marina; Alberdi-Páramo, Iñigo; Niell-Galmés, Lluis
Eating disorders (EDs) are a series of differentiated nosological entities sharing the common link of a continuous alteration in food intake or in food intake-related behavior. Within this classification, the following disorders are noteworthy: anorexia nerviosa (AN) and bulimia nerviosa (BN). Anorexia nervosa is a chronic disorder characterized mainly by negative or decreased food intake accompanied by a distortion of body image and intense accompanying fear of weight gain. The estimated vital prevalence of this disorder in adolescence is approximately 0.5%-1%.1 The primary feature of BN is the presence of binge eating accompanied by compensatory behavior (in the form of intense exercise and the use of laxatives and diuretics, etc.). The prevalence of BN is estimated to be between 2% and 4% in young women, and it generally starts at somewhat later stages than AN. It is believed that biological, psychological, and environmental factors, as well as genetic vulnerability, influence the pathogenesis of EDs. A variety of therapies exist, both biological and psychological, whose effectiveness is supported by the scientific literature. Nonetheless, we find these therapies only partially effective and new targets as well as new treatments should be sought. Although the etiopathogenesis of EDs is unclear, some of the neurobiological dysfunction found suggests that diet and nutrient supplementation could be relevant in their treatment. We review in this article new treatments focusing on nutritional deficits.
Full Text Available This article reviews several most important evolutionary mechanisms that underlie eating disorders. The first part clarifies evolutionary foundations of mental disorders and various mechanisms leading to their development. In the second part selective pressures and evolved adaptations causing contemporary epidemic of obesity as well as differences in dietary regimes and life-style between modern humans and their ancestors are described. Concerning eating disorders, a number of current evolutionary explanations of anorexia nervosa are presented together with their main weaknesses. Evolutionary explanations of eating disorders based on the reproductive suppression hypothesis and its variants derived from kin selection theory and the model of parental manipulation were elaborated. The sexual competition hypothesis of eating disorder, adapted to flee famine hypothesis as well as explanation based on the concept of social attention holding power and the need to belonging were also explained. The importance of evolutionary theory in modern conceptualization and research of eating disorders is emphasized.
King, Stephanie L.
Adolescents entering college are often affected by eating disorders and during this transition to emerging adulthood, individuals begin to establish personal values and beliefs, which makes this population interesting when studying Eating Disorders, values, and faith. This research project seeks to examine the association among strength of…
Davidsen, Annika Helgadóttir; Lau, Marianne Engelbrecht
Researchers at the Stolpegaard Psychotherapy Centre are seeking to improve outcomes for patients with eating disorders by gathering their feedback on group psychotherapy sessions with the aim of optimising treatment.......Researchers at the Stolpegaard Psychotherapy Centre are seeking to improve outcomes for patients with eating disorders by gathering their feedback on group psychotherapy sessions with the aim of optimising treatment....
Wagener, Amy M.; Much, Kari
This article focuses on the complex nature of eating disorders, specifically highlighting their use as coping mechanisms for underlying emotional and psychological concerns. Case examples of college counseling center clients are discussed in order to illustrate common ways in which eating disorders are utilized by clients with varying…
... for eating patterns and beliefs that might signal unhealthy behavior, as well as peer pressure that may ... or other sources that promote anorexia as a lifestyle choice, rather than an eating disorder. Promote a ...
Tasca, Giorgio A
Prominent models of eating disorders tend to focus on cognitive and behavioral features, but tend not to consider important developmental issues related to affect regulation, interpersonal style, self concept, and mentalization-all of which are well conceptualized within attachment theory. Higher levels of attachment insecurity across diagnoses are related to greater eating disorder symptoms. Low parental care and early trauma may lead to attachment insecurity that then might lead to greater eating disorder symptoms. The association between insecure attachment and eating disorder severity is likely mediated by affect dysregulation and perfectionism. Recent research using the Adult Attachment Interview highlights the importance of reflective functioning in predicting treatment response and therapeutic processes, and on the utility of therapies that increase mentalization. Copyright © 2018 Elsevier Ltd. All rights reserved.
Koefoed, Maja Schølarth; Clausen, Loa; Rokkedal, Kristian
Objective In general eating disorder pathology in men shows more similarities than differences compared to women though with an overall lower level of pathology. In community studies men have been found to have more excessive exercise and more binge eating and in clinical populations men have been...... found to have more vomiting. Eating Disorder Examination (EDE) is “the golden standard” of diagnostic interviewing in eating disorder but analysis of gender differences in scores on the EDE have never been reported. The present study aim to explore gender differences on the EDE among adolescents...
King, M B
A total of 748 patients who attended four south London group practices were screened using the eating attitudes test; 1% of women had bulimia nervosa and a further 3% a partial syndrome eating disorder. Eating and weight control behaviour and psychiatric indicators for an eating disorder were analysed. Patients with bulimia nervosa and partial syndromes were remarkably similar. They were mainly women, from the middle to upper classes, in the normal weight range but having had considerable weight fluctuation in the past, more likely to have had a history of menstrual irregularity, often psychologically troubled, and tended to have more family psychopathology. PMID:3099893
Frank, Guido K. [Department of Child and Adolescent Psychiatry, Center for Eating Disorders Research, School of Medicine, University of California San Diego, San Diego, CA 92123 (United States); Kaye, Walter H. [Department of Psychiatry, Western Psychiatric Institute and Clinic, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213 (United States)
Modern imaging techniques that visualize disease-specific organ neurotransmitter or protein receptor sites are increasingly able to define pathological processes on a molecular level. One of those imaging modalities, positron emission tomography (PET), for the assessment of brain neuroreceptor binding has revolutionized the in vivo assessment of biologic markers that may be related to human behavior. Such studies may help identify chemical targets that may be directly related to psychiatric pathology and, thus, opportunities for pharmacological intervention. In this review, we describe results from PET studies in eating disorders (EDs). Eating disorders are frequently debilitating illnesses that are quite homogeneous in their presentation. Those studies that identified particular serotonin and dopamine receptor alterations can distinguish recovered ED subjects from controls as well as ED subgroups. Furthermore, correlations of receptor binding with behavioral constructs, such as harm avoidance or novelty seeking, could be found. These recognized receptors may now help us to move away from rather nonspecific treatment approaches in psychiatric research and clinic to the possibility of more syndrome- and symptom-specific treatment approaches.
Frank, Guido K.; Kaye, Walter H.
Modern imaging techniques that visualize disease-specific organ neurotransmitter or protein receptor sites are increasingly able to define pathological processes on a molecular level. One of those imaging modalities, positron emission tomography (PET), for the assessment of brain neuroreceptor binding has revolutionized the in vivo assessment of biologic markers that may be related to human behavior. Such studies may help identify chemical targets that may be directly related to psychiatric pathology and, thus, opportunities for pharmacological intervention. In this review, we describe results from PET studies in eating disorders (EDs). Eating disorders are frequently debilitating illnesses that are quite homogeneous in their presentation. Those studies that identified particular serotonin and dopamine receptor alterations can distinguish recovered ED subjects from controls as well as ED subgroups. Furthermore, correlations of receptor binding with behavioral constructs, such as harm avoidance or novelty seeking, could be found. These recognized receptors may now help us to move away from rather nonspecific treatment approaches in psychiatric research and clinic to the possibility of more syndrome- and symptom-specific treatment approaches
Wagner, Allison F; Stefano, Emily C; Cicero, David C; Latner, Janet D; Mond, Jonathan M
This study examined whether gender moderates the associations between eating disorder features and quality-of-life impairment and whether eating disorder features can explain gender differences in quality of life in a sample of undergraduate students. The SF-12 Physical and Mental Component Summary Scales were used to measure health-related quality of life (HRQoL), and the Eating Disorders Examination Questionnaire (EDE-Q) was used to quantify eating disorder behaviors and cognitions. These self-report forms were completed by undergraduate men and women (n = 709). Gender was a significant predictor of mental HRQoL, such that women in this sample reported poorer mental HRQoL than men. Eating disorder cognitions were the strongest predictor of undergraduate students' mental and physical HRQoL, while binge eating negatively predicted their physical HRQoL only. Gender was not found to moderate the associations between eating disorder features and HRQoL, and eating disorder cognitions were found to mediate the association between gender and mental HRQoL such that a proportion of the difference between undergraduate men and women's mental HRQoL was attributable to eating disorder cognitions. This study provided further evidence of the significant impact of eating disorder features, particularly eating disorder cognitions, on HRQoL. The finding that gender did not moderate the relationships between eating disorder features and HRQoL indicates the importance of investigating these features in both men and women in future research.
Full Text Available OBJETIVO: Explorar el control personal de la conducta en sus tres aspectos: control objetivo, control subjetivo y creencias de control en mujeres con trastornos alimentarios, en riesgo de padecer trastornos alimentarios y normales. MATERIAL Y MÉTODOS: Es un estudio transversal que se llevó a cabo en Caracas, Venezuela, en 1997. Se trabajó con una muestra de 87 mujeres, 21 con trastornos alimentarios subclínicos, 33 en riesgo y 33 normales. Se utilizaron los siguientes instrumentos: Test de actitudes hacia la alimentación, Entrevista diagnóstica internacional compuesta, Inventario de autocontrol, Inventario de autoeficacia percibida para el autocontrol de la conducta e Inventario de locus de control. Los datos fueron analizados mediante el análisis de varianza y para las comparaciones post hoc se utilizó la prueba Student-Neuman-Keuls. RESULTADOS: Se encontró que las personas con trastornos alimentarios presentan dificultad en la emisión de conductas de autocontrol, menor sentimiento de eficacia personal para autorregular la conducta y mayor creencia en el control de otros poderosos sobre sus actos y consecuencias. CONCLUSIONES: Los resultados encontrados constituyen una primera aproximación para entender el papel que juega la variable psicológica "control personal de la conducta" como factor protector o de riesgo en el desarrollo de la anorexia o bulimia nerviosa. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.htmlOBJECTIVE: To explore the three components of personal behavioral control: Objective control, subjective control and control beliefs among normal women, women at risk of anorexia or bulimia and women with sub-clinical eating disorders. MATERIAL AND METHODS: In 1997, a cross-sectional study was conducted in Caracas, Venezuela. The study population consisted of 87 women: 21 with sub-clinical eating disorders, 33 at risk of having an eating disorder, and 33 normal women
Allan, Steven; Goss, Ken
To test for differences between diagnostic groups on the severity of eating disorder beliefs and behaviours, evaluate the clinical significance of such differences, and assess the extent to which these beliefs and behaviours may be present at clinically significant levels across eating disorder diagnoses. 136 adult women outpatients (aged 18-65, with a BMI over 15) were diagnosed with an eating disorder and completed the Stirling Eating Disorder Scale. The expected pattern of statistically significant differences was found between diagnostic groups on anorexic dietary beliefs and behaviours and bulimic dietary beliefs and behaviours. A high percentage of participants in each diagnostic group scored above the clinical cut-off on the eating disorder belief and behaviour measures and a very high percentage of participants in each group reported clinically significant levels of restricting beliefs. Transdiagnostic or functional analytic approaches to treatment planning may lead to more effective interventions than current, diagnostically-based, care pathways. The high prevalence of restricting beliefs reported suggested that this may need to be a key focus for intervention for the majority of individuals presenting with an eating disorder. © 2013.
Lee, Darrin J; Elias, Gavin J B; Lozano, Andres M
Eating disorders and obesity adversely affect individuals both medically and psychologically, leading to reduced life expectancy and poor quality of life. While there exist a number of treatments for anorexia, morbid obesity and bulimia, many patients do not respond favorably to current behavioral, medical or bariatric surgical management. Neuromodulation has been postulated as a potential treatment for eating disorders and obesity. In particular, deep brain stimulation and transcranial non-invasive brain stimulation have been studied for these indications across a variety of brain targets. Here, we review the neurobiology behind eating and eating disorders as well as the current status of preclinical and clinical neuromodulation trials for eating disorders and obesity.
Álvarez Ruiz, Eva M; Gutiérrez-Rojas, Luis
The comorbidity of bipolar disorder and eating disorders has not been studied in depth. In addition, clinical implications involved in the appearance of both disorders are very important. A systematic literature review of MEDLINE published up to September 2013 was performed, analyzing all the articles that studied the comorbidity of both conditions (bipolar disorder and eating disorders) and others research that studied the efficacy of pharmacological treatment and psychotherapy to improve these illnesses. In this review we found a high comorbidity of bipolar disorder and eating disorders, especially of bulimia nervosa and binge eating disorder. Studies show that lithium and topiramate are 2 of the more effective pharmacological agents in the treatment of both disorders. There are a lot of studies that show evidence of comorbidity of bipolar disorder and eating disorders. However, further research is needed on assessment and treatment when these conditions co-exist, as well as study into the biopsychological aspects to determine the comorbid aetiology. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.
Holland, Lauren A; Brown, Tiffany A; Keel, Pamela K
The current study sought to compare different features of unhealthy exercise on associations with disordered eating and their ability to identify individuals with eating disorders. A secondary aim of the study was to compare prevalence and overlap of different aspects of unhealthy exercise and potential differences in their gender distribution. Cross-sectional epidemiological study. A community-based sample of men (n=592) and women (n=1468) completed surveys of health and eating patterns, including questions regarding exercise habits and eating disorder symptoms. Compulsive and compensatory features of exercise were the best predictors of disordered eating and eating disorder diagnoses compared to exercise that was excessive in quantity. Further, compulsive and compensatory aspects of unhealthy exercise represented overlapping, yet distinct qualities in both men and women. Including the compulsive quality among the defining features of unhealthy exercise may improve identification of eating disorders, particularly in men. Results suggest that the compensatory aspect of unhealthy exercise is not adequately captured by the compulsive aspect of unhealthy exercise. Thus, interventions that target unhealthy exercise behaviors among high-risk individuals, such as athletes, may benefit from addressing both the compulsive and compensatory aspects of unhealthy exercise. Future prospective longitudinal studies will aid in determining the direction of the association between these features of unhealthy exercise and the onset of eating pathology.
Doyle, Elizabeth A; Quinn, Sheila M; Ambrosino, Jodie M; Weyman, Kate; Tamborlane, William V; Jastreboff, Ania M
Emerging adults (EA) with disordered eating behaviors (DEBs) and Type 1 diabetes (T1D) are at increased risk for severe complications of T1D, and these behaviors have been reported in EA women with T1D. Few studies, though, have included men. This study assessed the prevalence of DEB in both EA men and women with T1D. DEB was measured with the diabetes-specific Diabetes Eating Problem Survey-Revised (DEPS-R); scores of 20 or greater indicate need for further evaluation for DEB. A total of 27 women and 33 men (age range = 21 ± 2.5 years) completed the DEPS-R; 27% of women and 18% of men had scores of 20 or greater (p = .23). Hemoglobin A1c level was significantly higher in subjects with elevated DEPS-R scores (10.4 ± 2.1% vs. 7.8 ± 1.3%; p < .001), and DEPS-R scores correlated with increased body mass index values (r = 0.27, p < .05). Clinicians should assess for DEB in both male and female emerging adults with T1D, especially overweight patients with poor glycemic control. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Full Text Available Abstract Background We sought to evaluate the hypothesis that mental health impairment in underweight women, where this occurs, is due to an association between low body weight and elevated levels of body dissatisfaction and/or eating-disordered behaviour. Methods Subgroups of underweight and normal-weight women recruited from a large, general population sample were compared on measures of body dissatisfaction, eating-disordered behaviour and mental health. Results Underweight women had significantly greater impairment in mental health than normal-weight women, even after controlling for between-group differences in demographic characteristics and physical health. However, there was no evidence that higher levels of body dissatisfaction or eating-disordered behaviour accounted for this difference. Rather, underweight women had significantly lower levels of body dissatisfaction and eating-disordered behaviour than normal-weight women. Conclusions The findings suggest that mental health impairment in underweight women, where this occurs, is unlikely to be due to higher levels of body dissatisfaction or eating-disordered behaviour. Rather, lower levels of body dissatisfaction and eating-disordered behaviour among underweight women may counterbalance, to some extent, impairment due to other factors.
DeBate, Rita D; Severson, Herbert H; Cragun, Deborah L; Gau, Jeff M; Merrell, Laura K; Bleck, Jennifer R; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; McCormack Brown, Kelli R; Tedesco, Lisa A; Hendricson, William
Oral healthcare providers have a clinical opportunity for early detection of disordered eating behaviors because they are often the first health professionals to observe overt oral and physical signs. Curricula regarding early recognition of this oral/systemic medical condition are limited in oral health educational programs. Web-based learning can supplement and reinforce traditional learning and has the potential to develop skills. The study purpose was to determine the efficacy of a theory-driven Web-based training program to increase the capacity of oral health students to perform behaviors related to the secondary prevention of disordered eating behaviors. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance evaluation framework, a longitudinal group-randomized controlled trial involving 27 oral health classes from 12 oral health education programs in the United States was implemented to assess the efficacy of the Web-based training on attitudes, knowledge, self-efficacy and skills related to the secondary prevention of disordered eating behaviors. Mixed-model analysis of covariance indicated substantial improvements among students in the intervention group (effect sizes: 0.51-0.83) on all six outcomes of interest. Results suggest that the Web-based training program may increase the capacity of oral healthcare providers to deliver secondary prevention of disordered eating behaviors. Implications and value of using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework are discussed.
Tasca, Giorgio A; Balfour, Louise; Presniak, Michelle D; Bissada, Hany
We assessed whether an attachment-based treatment, Group Psychodynamic Interpersonal Psychotherapy (GPIP) had a greater impact compared to Group Cognitive Behavioral Therapy (GCBT) on Cold/Distant and Intrusive/Needy interpersonal problems. Ninety-five individuals with Binge Eating Disorder (BED) were randomized to GPIP or GCBT and assessed at pre-, post-, and six months post-treatment. Both therapies resulted in a significant decrease in all eight interpersonal problem subscales except the Nonassertive subscale. GPIP resulted in a greater reduction in the Cold/Distant subscale compared to GCBT, but no differences were found for changes in the Intrusive/Needy subscale. GPIP may be most relevant for those with BED who have Cold/Distant interpersonal problems and attachment avoidance.
König, Hans-Helmut; Bleibler, Florian; Friederich, Hans-Christoph; Herpertz, Stephan; Lam, Tony; Mayr, Andreas; Schmidt, Frauke; Svaldi, Jennifer; Zipfel, Stephan; Brettschneider, Christian; Hilbert, Anja; de Zwaan, Martina; Egger, Nina
To determine the cost-effectiveness of individual face-to-face cognitive behavioral therapy (CBT) compared to therapist guided Internet-based self-help (GSH-I) in overweight or obese adults with binge-eating disorder (BED). Analysis was conducted alongside the multicenter randomized controlled INTERBED trial. CBT (n = 76) consisted of up to 20 individual therapy sessions over 4 months. GSH-I (n = 71) consisted of 11 modules combining behavioral interventions, exercises including a self-monitoring food diary, psychoeducation, and 2 face-to-face coaching sessions over 4 months. Assessments at baseline, after 4 months (post-treatment), as well as 6 and 18 months after the end of treatment included health care utilization and sick leave days to calculate direct and indirect costs. Binge-free days (BFD) were calculated as effect measure based on the German version of the Eating Disorder Examination. The incremental cost-effectiveness ratio (ICER) was determined, and net benefit regressions, adjusted for comorbidities and baseline differences, were used to derive cost-effectiveness acceptability curves. After controlling for baseline differences, CBT was associated with non-significantly more costs (+€2,539) and BFDs (+40.1) compared with GSH-I during the 22-month observation period, resulting in an adjusted ICER of €63 per additional BFD. CBTs probability of being cost-effective increased above 80% only if societal willingness to pay (WTP) was ≥€250 per BFD. We did not find clear evidence for one of the treatments being more cost-effective. CBT tends to be more effective but also more costly. If the societal WTP for an additional BFD is low, then our results suggest that GSH-I should rather be adopted. © 2018 Wiley Periodicals, Inc.
Vanderlinden, Johan; Adriaensen, An; Vancampfort, Davy; Pieters, Guido; Probst, Michel; Vansteelandt, Kristof
The goal of this study is to investigate the efficacy of a manualized cognitive-behavioral therapeutic (CBT) approach for patients with obesity and binge eating disorder (BED) on the short and longer term. A prospective study without a control group consisting of three measurements (a baseline measurement and two follow-up assessments up to 5…
Mond, J. M.; Marks, P.; Hay, P. J.; Rodgers, B.; Kelly, C.; Owen, C.; Paxton, S. J.
This research examined the "mental health literacy" of adolescents concerning eating-disordered behavior. A vignette describing a fictional 16-year old female meeting diagnostic criteria for bulimia nervosa was presented to 522 female high school students, followed by a series of questions concerning treatment of and treatment-seeking…
Olvera, Norma; McCarley, Kendall; Matthews-Ewald, Molly R.; Fisher, Felicia; Jones, Martinque; Flynn, Erika G.
This study investigated the direct and indirect effects of biological, psychological, and sociocultural factors in predicting disordered eating behaviors in girls with overweight/obesity. A total of 135 Hispanic and African American girls ([x-bar][subscript age] = 11.13 ± 1.54 years) completed surveys assessing the desire to be thinner, peer…
Hamilton, Kristin L.
Maladaptive eating behaviors are a growing phenomenon which has captured the interest of not only health and psychology professionals, but also the general public. This paper examines the various types of treatment and counseling approaches for treating anorexia nervosa and bulimia nervosa. Definitions for both disorders are provided, followed by…
Favazza, Armando R.; And Others
Presents evidence from literature review, patient interviews, responses to Self-Harm Behavior Survey, and case reports that patients with eating disorders are at high risk for self-mutilation. In lieu of dual diagnosis, postulates that combination of self-mutilation, anorexia, bulimia, and other symptoms may be manifestations of impulse control…
van Hoeken, Daphne; Burns, Jonathan K; Hoek, Hans W
This is the first review of studies on the epidemiology of eating disorders on the African continent. The majority of articles found through our search did not assess formal diagnoses, but only screened for eating attitudes and behaviors. Only four studies - including only one recent study - provided specific epidemiological data on anorexia nervosa, bulimia nervosa, and/or eating disorder not otherwise specified (EDNOS). No cases of anorexia nervosa according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria were found among a total of 1476 (young) females. The combined point-prevalence rate of bulimia nervosa is 0.87% (95% CI 0.22-1.51) and of EDNOS is 4.45% (95% CI 2.74-6.16) in young women in Africa. The epidemiological study of eating disorders in Africa is still in its infancy. Over time in total four studies providing epidemiological data on specific, formally assessed eating disorders were found. No cases of anorexia nervosa were reported in African epidemiological studies, which concurs with the very low prevalence rates of anorexia nervosa in Latin Americans and in African Americans in the USA. With the DSM-5 criteria for anorexia nervosa, some women in the African studies would have fulfilled the criteria for anorexia nervosa. The prevalence rate of bulimia nervosa in women in Africa is within the range reported for western populations, as well as African Americans and Latin Americans.
Amitabh Saha; Neha Sharma
This is a case of Eating Disorder, which is described in a teenage girl who presented with intractable vomiting, hydropneumothorax and pulmonary Koch′s. The patient′s initial presentation was markedpreoccupation with body shape and image, restrictive eating, which progressed to episodes of vomiting after every meal, and led to academic decline followed by amenorrhoea and deterioration of general medical condition. She was managed with nutritional restoration, ATT and Olanzapine with Fluoxetin...
Full Text Available This is a case of Eating Disorder, which is described in a teenage girl who presented with intractable vomiting, hydropneumothorax and pulmonary Koch′s. The patient′s initial presentation was markedpreoccupation with body shape and image, restrictive eating, which progressed to episodes of vomiting after every meal, and led to academic decline followed by amenorrhoea and deterioration of general medical condition. She was managed with nutritional restoration, ATT and Olanzapine with Fluoxetine, to which she responded poorly.
Gredysa, Dana M.; Altman, Myra; Wilfley, Denise E.
Binge eating disorder (BED) is the most prevalent eating disorder in adults, and individuals with BED report greater general and specific psychopathology than non-eating disordered individuals. The current paper reviews research on psychological treatments for BED, including the rationale and empirical support for cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), dialectical behavior therapy (DBT), behavioral weight loss (BWL), and other treatments warranting further study. Research supports the effectiveness of CBT and IPT for the treatment of BED, particularly for those with higher eating disorder and general psychopathology. Guided self-help CBT has shown efficacy for BED without additional pathology. DBT has shown some promise as a treatment for BED, but requires further study to determine its long-term efficacy. Predictors and moderators of treatment response, such as weight and shape concerns, are highlighted and a stepped-care model proposed. Future directions include expanding the adoption of efficacious treatments in clinical practice, testing adapted treatments in diverse samples (e.g., minorities and youth), improving treatment outcomes for nonresponders, and developing efficient and cost-effective stepped-care models. PMID:22707016
Haycraft, Emma; Blissett, Jackie
This study aimed to examine associations between symptoms of eating disorders and parenting style, in a non-clinical sample. One hundred and five mothers completed self-report measures of eating disorder symptoms and parenting style. Higher levels of eating disorder symptoms were associated with more authoritarian and permissive parenting styles. Authoritative parenting was not significantly related to eating disorder symptoms. The findings demonstrate that eating disorder symptoms in non-clinical individuals are related to less adaptive parenting styles. These findings have potential implications for clinicians working with mothers with eating disorders. 2009 Elsevier Ltd. All rights reserved.
Klump, K L; Kaye, W H; Strober, M
Data described earlier are clear in establishing a role for genes in the development of eating abnormalities. Estimates from the most rigorous studies suggest that more than 50% of the variance in eating disorders and disordered eating behaviors can be accounted for by genetic effects. These high estimates indicate a need for studies identifying the specific genes contributing to this large proportion of variance. Twin and family studies suggest that several heritable characteristics that are commonly comorbid with AN and BN may share genetic transmission with these disorders, including anxiety disorders or traits, body weight, and possibly major depression. Moreover, some developmental research suggests that the genes involved in ovarian hormones or the genes that these steroids affect also may be genetically linked to eating abnormalities. Molecular genetic research of these disorders is in its infant stages. However, promising areas for future research have already been identified (e.g., 5-HT2A receptor gene, UCP-2/UCP-3 gene, and estrogen receptor beta gene), and several large-scale linkage and association studies are underway. These studies likely will provide invaluable information regarding the appropriate phenotypes to be included in genetic studies and the genes with the most influence on the development of these disorders.
Waller, Glenn; Tatham, Madeleine; Turner, Hannah; Mountford, Victoria A; Bennetts, Alison; Bramwell, Kate; Dodd, Julie; Ingram, Lauren
Existing forms of evidence-based cognitive behavior therapy for eating disorders (CBT-ED) are relatively effective for nonunderweight cases. However, they are also expensive compared to CBT for other disorders. This study reports the first outcomes for a shorter, 10-session form of CBT-ED (CBT-T) for such cases, designed to be less demanding of resources. A case series of 106 nonunderweight eating disordered cases were considered for this effectiveness study. A protocolized 10-session version of CBT-ED was delivered by clinical assistants, under supervision. Measures assessed eating attitudes and behaviors, anxiety, depression, personality pathology, and the working alliance. Intention-to-treat analyses were used. Suitability, acceptability, working alliance ratings, and retention were all positive. Outcomes by the end of therapy and at three-month follow-up were positive for all symptoms, with levels of change, abstinence and remission that were comparable to those from effectiveness studies of longer forms of CBT. Higher levels of pretreatment anxiety predicted retention in treatment, but no factors predicted poorer response. Early change in eating attitudes and the working alliance were the strongest predictors of a positive response. This 10-session form of CBT-ED for nonunderweight eating disorders performed at a level that is comparable to versions of CBT-ED that are twice as long, despite being delivered by nonspecialist therapists. Replication and longer-term follow-ups are needed to ensure retained effects. However, CBT-T has promise as a therapy for use in a range of healthcare settings, to enhance access to treatment for such eating disorders. © 2018 Wiley Periodicals, Inc.
Daigneault, Susan Dahlgren
Describes a school-based group intervention designed to address issues of body image, self-esteem, weight, and eating disturbances. This 10-session group provides female high school students with opportunities to explore their concerns about relationships, appearance, and what it means to be female. Provides descriptions of narrative techniques…
... wanting to go to parties or out for dinner) What Is Bulimia? Instead of starving themselves, people who have bulimia nervosa (say: boo-LEE-mee-uh nur-VOH-suh) will binge and purge . That means they will binge (that is, eat a huge amount of food, like a tub ...
Conviser, Jenny H; Fisher, Sheehan D; McColley, Susanna A
Pediatric chronic illnesses (CI) can affect a child's mental health. Chronic illnesses with treatment regimens that specify a therapeutic diet may place the child at increased risk for disordered eating and specific eating disorders (ED). The aim of this review is to examine the relation between diet-treated CI and disordered eating and to determine the order of onset to infer directionality. Diet-treated CI is hypothesized to precede and to be associated with disordered eating. A comprehensive search of empirical articles that examine the relation between diet-treated CI (diabetes, cystic fibrosis, celiac disease, gastrointestinal disorders, and inflammatory bowel diseases) and disordered eating was conducted in Medline and PsycINFO using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A table of the sample's characteristics, ED measures, major pertinent findings, and the onset of CI in relation to ED were provided. Diet-treated CI was associated with disordered eating and ED. Diet-treated CI had onset prior to disordered eating in most studies, except for inflammatory bowel diseases. Disordered eating and unhealthy weight management practices put children at risk for poor medical outcomes. Interventions for diet-treated CI require a focus on diet and weight, but may increase the risk for disordered eating. Future research is needed to elucidate the mechanisms that transform standard treatment practices into pathological eating, including characteristics and behaviors of the child, parents/care providers, family, and treatment providers. © 2018 Wiley Periodicals, Inc.
Full Text Available Background: Eating Disorders (EDs are characterized by a persistent disturbance of eating or eating-related behavior that significantly impairs physical health or psychosocial functioning. EDs are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. Their epidemiology is rising for the past decades, and EDs affect all races, social levels and both genders. Due to the long and expensive treatment, chronic course, and the fact that most of the sufferers do not realize the need for therapy or do not seek treatment, the demand on developing prevention programs, early detection and assessment is essential. Despite the fact, that many new EDs screening tools were developed already, there is a great lack of validated screening instruments, adapted to the Bulgarian conditions. Objects and methods: Our study aimed at eliciting a comprehensive battery for screening of not only specific ED pathology, but also some risk factors, such as negative body image, weight and depressive symptoms. The object of our study consisted of 201 females, aged 18 to 45 (mean 24.65. SCOOF- questionnaire, Eating Disorder Diagnostic Scale (EDDS-5, Body Image Questionnaire-34 and Beck Depression Inventory (BDI were applied. Results: Our preliminary results show that approximately 45% of the tested subjects show some of the: negative body image, eating disorders’ clinical pathology, distorted eating patterns, subclinical eating disorders pathology, overweight/obesity, or depressive symptoms. Conclusion: Our ongoing efforts in area of research also are aimed at developing and refining strategies for preventing and treating ED among adolescents and adults.
Podfigurna-Stopa, Agnieszka; Czyzyk, Adam; Katulski, Krzysztof; Smolarczyk, Roman; Grymowicz, Monika; Maciejewska-Jeske, Marzena; Meczekalski, Blazej
Eating disorders (EDs) are disturbances that seriously endanger the physical health and often the lives of sufferers and affect their psychosocial functioning. EDs are usually thought of as problems afflicting teenagers. However, the incidence in older women has increased in recent decades. These cases may represent either late-onset disease or, more likely, a continuation of a lifelong disorder. The DSM-5 classification differentiates 4 categories of eating disorder: anorexia nervosa, bulimia nervosa, binge-eating disorders and other specified feeding and eating disorders. The weight loss and malnutrition resulting from EDs have widespread negative consequences for physical, mental and social health. The main risk factors for developing long-term consequences are the degree of weight loss and the chronicity of the illness. Most of the cardiac, neurological, pulmonary, gastric, haematological and dermatological complications of EDs are reversible with weight restoration. EDs are serious illnesses and they should never be neglected or treated only as a manifestation of the fashion for dieting or a woman's wish to achieve an imposed standard feminine figure. Additionally, EDs are associated with high risk of morbidity and mortality. The literature concerning EDs in older, postmenopausal women is very limited. The main aim of this paper is to ascertain the epidemiology and prognosis of EDs in older women, and to review their diagnosis and management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Borowsky, Hannah M.; Eisenberg, Marla E.; Bucchianeri, Michaela M.; Piran, Niva; Neumark-Sztainer, Dianne
Using data from a community-based sample (Project EAT-III), this study (N = 1241; mean age = 25.2) examined the relationship of feminist identity with body image and disordered eating. Feminist-identified women reported significantly higher body satisfaction than non-feminist women and women who did not identify as feminists but held feminist beliefs. However, feminist-identified women did not differ from non-feminist women in disordered eating. Women holding feminist beliefs and non-feminist women did not differ in body satisfaction. Our findings suggest that self-identification as a feminist may promote positive body image in young adult women, but may be insufficient to change behaviors. PMID:26694553
Borowsky, Hannah M; Eisenberg, Marla E; Bucchianeri, Michaela M; Piran, Niva; Neumark-Sztainer, Dianne
Using data from a community-based sample (Project EAT-III), this study (N = 1241; mean age = 25.2) examined the relationship of feminist identity with body image and disordered eating. Feminist-identified women reported significantly higher body satisfaction than non-feminist women and women who did not identify as feminists but held feminist beliefs. However, feminist-identified women did not differ from non-feminist women in disordered eating. Women holding feminist beliefs and non-feminist women did not differ in body satisfaction. Our findings suggest that self-identification as a feminist may promote positive body image in young adult women, but may be insufficient to change behaviors.
Neumark-Sztainer, Dianne; Eisenberg, Marla E; Fulkerson, Jayne A; Story, Mary; Larson, Nicole I
To examine 5-year longitudinal associations between family meal frequency and disordered eating behaviors in adolescents. Longitudinal study. Participants from 31 Minnesota schools completed in-class assessments in 1999 (time 1) and mailed surveys in 2004 (time 2). Adolescents (N=2516) who completed Project EAT (Eating Among Teens)-I (time 1) and -II (time 2) assessments. Time 1 family meal frequency and time 2 disordered eating behaviors, including extreme weight control behaviors (self-induced vomiting and use of laxatives, diet pills, or diuretics), less extreme unhealthy weight control behaviors (eating very little, fasting, using food substitutes, skipping meals, or smoking), binge eating, and chronic dieting. Among adolescent girls, time 1 regular family meals (> or = 5 meals/wk) were associated with lower prevalences of time 2 extreme weight control behaviors (odds ratio, 0.71; 95% confidence interval, 0.52-0.97), even after adjusting for sociodemographic characteristics, body mass index, family connectedness, parental encouragement to diet, and extreme weight control behaviors at time 1. Associations with other disordered eating behaviors were also suggestive of a protective effect of family meals in unadjusted analyses but were not statistically significant in adjusted analyses. Among adolescent boys, regular family meals did not predict lower levels of disordered eating behaviors. The high prevalence of disordered eating behaviors among adolescent girls and the protective role of family meals suggest a need for interventions aimed at promoting family meals. Further exploration of predictors of disordered eating behaviors in adolescent boys and the role of family meals is warranted.
de Jong, Martie; Korrelboom, Kees; van der Meer, Iris; Deen, Mathijs; Hoek, Hans W; Spinhoven, Philip
While eating disorder not otherwise specified (EDNOS) is the most common eating disorder (ED) diagnosis in routine clinical practice, no specific treatment methods for this diagnosis have yet been developed and studied. Enhanced cognitive behavioral therapy (CBT-E) has been described and put to the test as a transdiagnostic treatment protocol for all EDs, including EDNOS. Initial research in the UK suggests that CBT-E is more effective for EDs, especially bulimia nervosa (BN) and EDNOS, than the earlier version of CBT. These positive results of CBT-E have to be replicated in more detail, preferably by independent researchers in different countries. Being the first Dutch study into CBT-E, the results from this national multicenter study - on three sites specialized in EDs - will deliver important information about the effectiveness of CBT-E in several domains of ED pathology, while providing input for the upcoming update of the Dutch Multidisciplinary Guideline for the Treatment of Eating Disorders. A multicenter randomized controlled trial will be conducted. One hundred and thirty-two adult outpatients (aged 18 years and older) with an ED diagnosis and a Body Mass index (BMI) of between 17.5 and 40 will be randomly allocated to the control or the intervention group. Subjects in the control group will receive Treatment as Usual (standard outpatient treatment provided at the participating sites). Subjects in the intervention group will receive 20 sessions of CBT-E in 20 weeks. The design is a 2 (group) × 5 (time) repeated measures factorial design in which neither therapists nor patients will be blinded for treatment allocation. The primary outcome measure is recovery from the ED. Secondary outcome measures include ED psychopathology, common mental disorders, anxiety and depressive symptoms, health-related quality of life, health care use and productivity loss. Self-esteem, perfectionism and interpersonal problems will be examined as putative predictors and
Eisenberg, Miriam H; Lipsky, Leah M; Dempster, Katherine W; Liu, Aiyi; Nansel, Tonja R
Among adolescents with type 1 diabetes, disordered eating behaviors (DEBs) are more prevalent and have more serious health implications than in adolescents without diabetes, necessitating identification of modifiable correlates of DEB in this population. This study hypothesized that (1) autonomous motivation and (2) controlled motivation for healthy eating (i.e., eating healthfully because it is important to oneself vs. important to others, respectively) are associated with DEB among adolescents with type 1 diabetes. The third hypothesis was that baseline healthy eating self-efficacy moderates these associations. Adolescents with type 1 diabetes (n = 90; 13-16 years) participating in a behavioral nutrition intervention efficacy trial reported DEB, controlled and autonomous motivation, and self-efficacy at baseline, 6, 12, and 18 months. Linear-mixed models estimated associations of controlled and autonomous motivation with DEB, adjusting for treatment group, body mass index, socioeconomic status, age, and gender. Separate models investigated the interaction of self-efficacy with each motivation type. Controlled motivation was positively associated with DEB (B = 2.18 ± .33, p motivation was not associated with DEB (B = -.70 ± .43, p = .11). Findings identify controlled motivation for healthy eating as a novel correlate of DEB among adolescents with type 1 diabetes and show that self-efficacy can modify this association. Motivation and self-efficacy for healthy eating represent potential intervention targets to reduce DEB in adolescents with type 1 diabetes. Published by Elsevier Inc.
Eisenberg, Miriam H.; Lipsky, Leah M.; Dempster, Katherine; Liu, Aiyi; Nansel, Tonja R.
Purpose Among adolescents with type 1 diabetes, disordered eating behaviors (DEB) are more prevalent and have more serious health implications than in adolescents without diabetes, necessitating identification of modifiable correlates of DEB in this population. This study hypothesized that 1) autonomous motivation and 2) controlled motivation for healthy eating (i.e., eating healthfully because it’s important to oneself versus important to others respectively) are associated with DEB among adolescents with type 1 diabetes. The third hypothesis was that baseline healthy eating self-efficacy moderates these associations. Methods Adolescents with T1D (n = 90; 13–16 years) participating in a behavioral nutrition intervention efficacy trial reported DEB, controlled and autonomous motivation, and self-efficacy at baseline, 6, 12, and 18 months. Linear mixed models estimated associations of controlled and autonomous motivation with DEB, adjusting for treatment group, BMI, socio-economic status, age, and gender. Separate models investigated the interaction of self-efficacy with each motivation type. Results Controlled motivation was positively associated with DEB (B=2.18±.33, pmotivation was not associated with DEB (B=−.70± .43, p=.11). Conclusions Findings identify controlled motivation for healthy eating as a novel correlate of DEB among adolescents with type 1 diabetes and show that self-efficacy can modify this association. Motivation and self-efficacy for healthy eating represent potential intervention targets to reduce DEB in adolescents with type 1 diabetes. PMID:27567063
Steiger, Howard; Fichter, Manfred; Bruce, Kenneth R; Joober, Ridha; Badawi, Ghislaine; Richardson, Jodie; Groleau, Patricia; Ramos, Cinthia; Israel, Mimi; Bondy, Brigitta; Quadflieg, Norbert; Bachetzky, Nadine
Across populations, findings suggest that rates of self-mutilation, suicidal acts, and other self-harming behaviors (SHBs) may be influenced by polymorphisms that code for activity of the serotonin transporter (e.g., 5HTTLPR) and the enzyme, monoamine oxidase A (e.g., MAOAuVNTR). SHBs being common in patients with Eating Disorders (EDs), we evaluated (in a large sample of eating-disordered women) relationships between triallelic 5HTTLPR and MAOAuVNTR variants, on the one hand, and SHBs, on the other. We had 399 eating-disordered women report on eating symptoms and lifetime history of SHBs, and provide blood samples for genotyping. Individuals carrying high-function MAOAuVNTR alleles reported a history of SHBs about twice as often as did carriers of low-function alleles. We obtained no comparable main effect of 5HTTLPR, or MAOAuVNTR×5HTTLPR interaction effect. Genetic variations did not predict severity of eating symptoms. As in other populations, our findings link the MAOAuVNTR high-function alleles with increased risk of self-directed harm in bulimic females. We discuss theoretical and clinical ramifications of our results. Copyright © 2010 Elsevier Inc. All rights reserved.
... your chance of success. Keep healthy snacks at work. Pack healthy lunches that you make at home. Pay attention to your feelings of hunger. Learn the difference between physical hunger and habitual eating or eating as a response to stress or boredom.
Krentz, Adrienne; Chew, Judy; Arthur, Nancy
The purpose of this study was to characterize the psychological processes of recovery from binge eating disorder (BED). A model was developed by asking the research question, "What is the experience of recovery for women with BED?" Unstructured interviews were conducted with six women who met the DSM-IV criteria for BED, and who were recovered…
Muuss, Rolf E.
Examines anorexia nervosa, an eating disorder seen with increasing frequency, especially among adolescent girls. Presents five theories about causation, discusses early characteristics, typical family patterns, physical and medical characteristics, social adjustment problems, and society's contribution to anorexia. Describes course of the…
Patrick, Julie Hicks; Stahl, Sarah T.; Sundaram, Murali
The majority of our knowledge about eating disorders derives from adolescent and young adult samples; knowledge regarding disordered eating in middle and later adulthood is limited. We examined the associations among known predictors of eating disorders for younger adults in an age-diverse sample and within the context of psychological distress.…
regarding the abnormality of reproductive hormone function ... This paper reviews the existing literature on males with eating disorders in an ... through the work of Gerald Russell.7 The term “bulimia” is .... a critical time for adolescents, as an eating disorder could po- ..... Gender Related Aspects of Eating Disorders: A Guide.
Rodgers, Rachel F; Watts, Allison W; Austin, S Bryn; Haines, Jess; Neumark-Sztainer, Dianne
High rates of disordered eating exist among adolescents with overweight and among ethnic/racial minority adolescents. Given the lack of research examining how eating disorder risk is moderated by both overweight and ethnicity/race, this study aimed to explore interactions between ethnicity/race and overweight status on disordered eating behaviors in a population-based adolescent sample. Cross-sectional data from adolescents (n = 2,271; 52% females) of White (23%), Black (34%), Hispanic (20%), and Asian (23%; 82% Hmong) ethnicity/race participating in the EAT 2010 study were used to examine associations between overweight status and disordered eating behaviors across ethnic/racial groups. Disordered eating behaviors occurred more frequently among adolescents with overweight compared with those without overweight across all ethnic/racial groups. Although some differences in the prevalence of disordered eating were found by ethnicity/race, particularly in girls, no consistent patterns of interaction emerged. Overweight White and Hispanic girls reported the highest risk for dieting, while the highest risk for unhealthy weight control behaviors was among overweight Black girls, and for overeating among overweight White and Asian girls. Within a society in which thinness is highly valued and being overweight is stigmatized, across diverse cultural groups, adolescents with overweight are at risk for disordered eating. © 2016 Wiley Periodicals, Inc.
Utzinger, Linsey M; Gowey, Marissa A; Zeller, Meg; Jenkins, Todd M; Engel, Scott G; Rofey, Dana L; Inge, Thomas H; Mitchell, James E
This study assessed loss of control (LOC) eating and eating disorders (EDs) in adolescents undergoing bariatric surgery for severe obesity. Preoperative baseline data from the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) multisite observational study (n = 242; median BMI = 51 kg/m 2 ; mean age= 17; 76% female adolescents; 72% Caucasian) included anthropometric and self-report questionnaires, including the Questionnaire of Eating and Weight Patterns-Revised (QEWP-R), the Night Eating Questionnaire (NEQ), the Beck Depression Inventory (BDI-II), and the Impact of Weight on Quality of Life-Kids (IWQOL-Kids) RESULTS: LOC eating (27%) was common and ED diagnoses included binge-eating disorder (7%), night eating syndrome (5%), and bulimia nervosa (1%). Compared to those without LOC eating, those with LOC eating reported greater depressive symptomatology and greater impairment in weight-related quality of life. Before undergoing bariatric surgery, adolescents with severe obesity present with problematic disordered eating behaviors and meet diagnostic criteria for EDs. LOC eating, in particular, was associated with several negative psychosocial factors. Findings highlight targets for assessment and intervention in adolescents before bariatric surgery. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:947-952). © 2016 Wiley Periodicals, Inc.
Scaglioni, Silvia; Arrizza, Chiara; Vecchi, Fiammetta; Tedeschi, Sabrina
Parents have a high degree of control over the environments and experiences of their children. Food preferences are shaped by a combination of genetic and environmental factors. This article is a review of current data on effective determinants of children's eating habits. The development of children's food preferences involves a complex interplay of genetic, familial, and environmental factors. There is evidence of a strong genetic influence on appetite traits in children, but environment plays an important role in modeling children's eating behaviors. Parents use a variety of strategies to influence children's eating habits, some of which are counterproductive. Overcontrol, restriction, pressure to eat, and a promise of rewards have negative effects on children's food acceptance. Parents' food preferences and eating behaviors provide an opportunity to model good eating habits. Satiety is closely related to diet composition, and foods with low energy density contribute to prevent overeating. Parents should be informed about the consequences of an unhealthy diet and lifestyle and motivated to change their nutritional habits. Parents should be the target of prevention programs because children model themselves on their parents' eating behaviors, lifestyles, eating-related attitudes, and dissatisfaction regarding body image. Pediatricians can have an important role in the prevention of diet-related diseases. Informed and motivated parents can become a model for children by offering a healthy, high-satiety, low-energy-dense diet and promoting self-regulation from the first years of life.
Clausen, Loa; Lübeck, Marlene; Jones, Allan
The aim of the study was to review the eating disorder literature in order to examine the effect of pretreatment autonomous/level of motivation to change on treatment outcome as measured by change in eating disorder pathology. Relevant databases were systematically searched for studies in which motivation to change prior to treatment was examined in relation to treatment outcome. Pretreatment autonomous/level of motivation were associated with change in restrictive eating behaviors, bingeing behaviors, and cognitive/affective measures of eating disorder pathology. There was mixed support for the effect of motivation to change on global measures of eating disorder symptoms and virtually no support for the effect of motivation to change on purging behavior. The level of pretreatment motivation the person exhibits prior to commencement of treatment appears to be helpful in predicting treatment outcome. Copyright © 2013 Wiley Periodicals, Inc.
Machado, Paulo P. P.; Gonçalves, Sónia; Machado, Bárbara César; Torres, António Roma; Brandão, Isabel
The present study examines whether eating disorders patients with suicide attempts present differences in disordered eating and clinical traits compared to those without suicide attempts. Method: 144 patients with eating disorders (65 anorexia nervosa and 79 bulimia nervosa) completed the Eating Disorders Inventory (EDI; Garner, Omstead & Polivy, 1983), the Symptom Checklist - 90- Revised (SCL-90; Derrogatis, 1977), and a questionnaire to assess eating behaviors and attitudes, information reg...
Goldschmidt, Andrea B; Le Grange, Daniel; Powers, Pauline; Crow, Scott J; Hill, Laura L; Peterson, Carol B; Crosby, Ross D; Mitchell, Jim E
Although normal-weight individuals comprise a substantial minority of the binge eating disorder (BED) population, little is known about their clinical presentation. This study sought to investigate the nature and severity of eating disturbances in normal-weight adults with BED. We compared 281 normal-weight (n = 86) and obese (n = 195) treatment-seeking adults with BED (mean age = 31.0; s.d. = 10.8) on a range of current and past eating disorder symptoms using ANOVA and χ(2) analyses. After controlling for age and sex, normal-weight participants reported more frequent use of a range of healthy and unhealthy weight control behaviors compared to their obese peers, including eating fewer meals and snacks per day; exercising and skipping meals more frequently in the past month; and avoiding certain foods for weight control. They also endorsed more frequent attempts at dieting in the past year, and feeling more frequently distressed about their binge eating, at a trend level. There were no group differences in binge eating frequency in the past month, age at onset of binge eating, overvaluation of shape/weight, or likelihood of having used certain weight control behaviors (e.g., vomiting, laxative use) or having sought treatment for an eating disorder in the past. Based on our findings, normal-weight individuals appear to be a behaviorally distinct subset of the BED population with significantly greater usage of both healthy and unhealthy weight control behaviors compared to their obese peers. These results refute the notion that distress and impairment in BED are simply a result of comorbid obesity.
Wolf, L M; Houdent, C
In most cases, obesity does not stem from a specific psychologic disturbance. Some obese people overeat, as do their family or their socio-professional peers, and this cannot be considered a pathologic behaviour. Many obese patients increase their energy intake when frustrated, anxious, or tired, like many normal individuals who enjoy a better weight regulation. But when obesity increases suddenly and/or severely in these circumstances, and in gross obesity, abnormal feeding behaviour is usually responsible: prandial or, more often extraprandial overeating (nibbling, gorging, binge eating, night eating, excess alcohol, carbohydrate craving). Serotoninergic mechanisms of the latter have focused wide interest. Conflicting situations and/or anxiety are usually a factor in child obesity. Deppreciated self-image and feelings of culpability, partly secondary to obesity itself and dietary failures often contribute to feeding disturbances, sometimes surreptitious, carrying a risk of vicious circle. But weight reduction itself, while improving self image, carries a risk of unmasking depressive tendencies, especially when too quick. Hence the importance of careful and comprehensive management.
... Therapy Neutral stance Nutritional Therapy Operant conditioning or behavior modification Parent Counseling/Parent Coaching with a Clinician Parent ... Therapy Neutral stance Nutritional Therapy Operant conditioning or behavior modification Parent Counseling/Parent Coaching with a Clinician Parentectomy ...
Full Text Available Norbert Dahmen, Julia Becht, Alice Engel, Monika Thommes, Peter TonnPsychiatry Department, University of Mainz, GermanyAbstract: Narcoleptic patients suffer frequently from obesity and type II diabetes. Most patients show a deficit in the energy balance regulating orexinergic system. Nevertheless, it is not known, why narcoleptic patients tend to be obese. We examined 116 narcoleptic patients and 80 controls with the structured interview for anorectic and bulimic eating disorders (SIAB to test the hypothesis that typical or atypical eating attacks or eating disorders may be more frequent in narcoleptic patients. No difference in the current prevalence of eating disorders bulimia nervosa, binge eating disorder, or anorexia nervosa was found, nor was the frequency of eating attacks higher in the narcolepsy group. We conclude that present eating disorders and eating attacks as defined in DSM IV are not the reason for the observed differences in body composition. Additional factors, such as basal metabolic rates and lifestyle factors need to be considered.Keywords: narcolepsy, eating disorder, SIAB, bulimia, anorexia, eating attack
Ferguson, Christopher J; Muñoz, Monica E; Winegard, Ben; Winegard, Bo
The relative impact of genetic and social influences on disordered eating behaviors (DEB) including binging, purging, excessive dieting and negative self-evaluations about weight remain an issue of debate. The current study sought to examine the relative influence of genetic and social influences on DEB. A 7-year prospective analysis of 580 monozygotic (MZ) and dizygotic (DZ) twins was conducted. Estimates of heritability of DEB were obtained using the DF Analysis Model. Regression equations revealed the relative predictive value of sibling's DEB, neurotic personality, maternal warmth and television and video game exposure on DEB. Heritability estimates for DEB were 0.40 for females and 0.48 for males. Among MZ and DZ twin pairs, female sex, neurotic personality and a genetic variable component, but not maternal warmth or school related problems, predicted DEB. Contrary to the expectations of media effects theory, greater media use was associated with lower DEB among DZ twins and had no influence on MZ twins. These results indicate that DEB is highly heritable and that personality variables may play an important role in the formation of DEB. This suggests that it is important to control for genetic variables when analyzing risk factors for DEB.
Brauhardt, Anne; de Zwaan, Martina; Herpertz, Stephan; Zipfel, Stephan; Svaldi, Jennifer; Friederich, Hans-Christoph; Hilbert, Anja
While cognitive-behavioral therapy (CBT) is the most well-established treatment for binge-eating disorder (BED), little is known about process factors influencing its outcome. The present study sought to explore the assessment of therapist adherence, its course over treatment, and its associations with patient and therapist characteristics, and the therapeutic alliance. In a prospective multicenter randomized-controlled trial comparing CBT to internet-based guided self-help (INTERBED-study), therapist adherence using the newly developed Adherence Control Form (ACF) was determined by trained raters in randomly selected 418 audio-taped CBT sessions of 89 patients (25% of all sessions). Observer-rated therapeutic alliance, interview-based and self-reported patient and therapist characteristics were assessed. Three-level multilevel modeling was applied. The ACF showed adequate psychometric properties. Therapist adherence was excellent. While significant between-therapist variability in therapist adherence was found, within-therapist variability was non-significant. Patient and therapist characteristics did not predict the therapist adherence. The therapist adherence positively predicted the therapeutic alliance. The ACF demonstrated its utility to assess therapist adherence in CBT for BED. The excellent levels of therapist adherence point to the internal validity of the CBT within the INTERBED-study serving as a prerequisite for empirical comparisons between treatments. Variability between therapists should be addressed in therapist trainings and dissemination trials. Copyright © 2014 Elsevier Ltd. All rights reserved.
Calzo, J.P. (Jerel P.); Horton, N.J. (Nicholas J.); Sonneville, K.R. (Kendrin R.); S.A. Swanson (Sonja); Crosby, R.D. (Ross D.); N. Micali (Nadia); Eddy, K.T. (Kamryn T.); Field, A.E. (Alison E.)
textabstractObjective Research on the manifestations and health correlates of eating disorder symptoms among males is lacking. This study identified patterns of appearance concerns and eating disorder behaviors from adolescence through young adulthood and their health correlates. Method Participants
McElroy, Susan L
Binge-eating disorder (BED) is the most common eating disorder and is associated with poor physical and mental health outcomes. Psychological and behavioral interventions have been a mainstay of treatment for BED, but as understanding of this disorder has grown, pharmacologic agents have become promising treatment options for some patients. At this time, only one drug-the stimulant prodrug lisdexamfetamine-is approved for the treatment of BED. Numerous classes of medications including antidepressants, anticonvulsants, and antiobesity drugs have been explored as off-label treatments for BED with variable success. Although not all patients with BED may be suitable candidates for pharmacotherapy, all patients should be considered for and educated about pharmacologic treatment options. © Copyright 2017 Physicians Postgraduate Press, Inc.
Walker, Morgan; Thornton, Laura; De Choudhury, Munmun; Teevan, Jaime; Bulik, Cynthia M; Levinson, Cheri A; Zerwas, Stephanie
Disordered eating behavior-dieting, laxative use, fasting, binge eating-is common in college-aged women (11%-20%). A documented increase in the number of young women experiencing eating psychopathology has been blamed on the rise of engagement with social media sites such as Facebook. We predicted that college-aged women's Facebook intensity (e.g., the amount of time spent on Facebook, number of Facebook friends, and integration of Facebook into daily life), online physical appearance comparison (i.e., comparing one's appearance to others' on social media), and online "fat talk" (i.e., talking negatively about one's body) would be positively associated with their disordered eating behavior. In an online survey, 128 college-aged women (81.3% Caucasian, 6.7% Asian, 9.0% African-American, and 3.0% Other) completed items, which measured their disordered eating, Facebook intensity, online physical appearance comparison, online fat talk, body mass index, depression, anxiety, perfectionism, impulsivity, and self-efficacy. In regression analyses, Facebook intensity, online physical appearance comparison, and online fat talk were significantly and uniquely associated with disordered eating and explained a large percentage of the variance in disordered eating (60%) in conjunction with covariates. However, greater Facebook intensity was associated with decreased disordered eating behavior, whereas both online physical appearance comparison and online fat talk were associated with greater disordered eating. College-aged women who endorsed greater Facebook intensity were less likely to struggle with disordered eating when online physical appearance comparison was accounted for statistically. Facebook intensity may carry both risks and benefits for disordered eating. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Agras, W. Stewart; And Others
Examines the effectiveness of group interpersonal therapy (IPT) in treating overweight, binge-eating patients. Participants were randomly allocated to cognitive-behavioral therapy (CBT) or to an assessment-only group. After 12 weeks, those who did not respond to CBT were assigned 12 weeks of IPT. IPT led to no further improvement. (JPS)
Michalska, Aneta; Szejko, Natalia; Jakubczyk, Andrzej; Wojnar, Marcin
The aim of this paper was to characterise nonspecific eating disorders (other than anorexia nervosa and bulimia nervosa). The Medline database was searched for articles on nonspecific eating disorders. The following disorders were described: binge eating disorder (BED), pica, rumination disorder, avoidant/restrictive food intake disorder, night eating syndrome (NES), sleep-related eating disorder (SRED), bigorexia, orthorexia, focusing on diagnosis, symptoms, assessment, comorbidities, clinical implications and treatment. All of the included disorders may have dangerous consequences, both somatic and psychological. They are often comorbid with other psychiatric disorders. Approximately a few percent of general population can be diagnosed with each disorder, from 0.5-4.7% (SRED) to about 7% (orthorexia). With the growing literature on the subject and changes in DSM-5, clinicians recognise and treat those disorders more often. More studies have to be conducted in order to differentiate disorders and treat or prevent them appropriately.
Cesa, Gian Luca; Manzoni, Gian Mauro; Bacchetta, Monica; Castelnuovo, Gianluca; Conti, Sara; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; C?rdenas-L?pez, Georgina; Riva, Giuseppe
Background Recent research identifies unhealthful weight-control behaviors (fasting, vomiting, or laxative abuse) induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. In particular, according to the allocentric lock hypothesis, individuals with obesity may be locked to an allocentric (observer view) negative memory of the body that is no longer updated by contrasting egocentric representations driven by perception. In other words, these...
Cooper, Zafra; Fairburn, Christopher G.
In recent years there has been widespread acceptance that cognitive behavior therapy (CBT) is the treatment of choice for bulimia nervosa. The cognitive behavioral treatment of bulimia nervosa (CBT-BN) was first described in 1981. Over the past decades the theory and treatment have evolved in response to a variety of challenges. The treatment has…
Leonardo de Sousa Fortes
Full Text Available The objective of this study was to analyze the relationship between depressive symptoms and eating disorders in female adolescents. The sample included 371 girls ranging from 12 to 16 years of age in Juiz de Fora, Minas Gerais State, Brazil. The study used the Eating Attitudes Test (EAT-26 and Major Depression Inventory (MDI to evaluate eating disorders and depressive symptoms, respectively. The linear regression model showed that 18% of the EAT-26 scores were influenced by MDI (F(1, 370 = 14.18; p = 0.001. Moreover, the findings indicated a statistically significant association between depressive symptoms and eating disorders (χ2 = 14.71; Wald = 12.90; p = 0.001. The authors concluded that depressive symptoms were related to eating disorders in female adolescents. Thus, girls with some level of depression showed a greater tendency to adopt disordered eating as a daily habit.
Williams, G J; Power, K G; Miller, H R; Freeman, C P; Yellowlees, A; Dowds, T; Walker, M; Parry-Jones, W L
The development and reliability/validity check of an 80-item, 8-scale measure for use with eating disorder patients is presented. The Stirling Eating Disorder Scales (SEDS) assess anorexic dietary behavior, anorexic dietary cognitions, bulimic dietary behavior, bulimic dietary cognitions, high perceived external control, low assertiveness, low self-esteem, and self-directed hostility. The SEDS were administered to 82 eating disorder patients and 85 controls. Results indicate that the SEDS are acceptable in terms of internal consistency, reliability, group validity, and concurrent validity.
Schreiber-Gregory, Deanna N.; Lavender, Jason M.; Engel, Scott G.; Wonderlich, Steve A.; Crosby, Ross D.; Peterson, Carol B.; Simonich, Heather; Crow, Scott; Durkin, Nora; Mitchell, James E.
Objective The primary goal of this paper is to examine and clarify characteristics of binge eating in individuals with binge eating disorder (BED), particularly the duration of binge eating episodes, as well as potential differences between individuals with shorter compared to longer binge eating episodes. Method Two studies exploring binge eating characteristics in BED were conducted. Study 1 examined differences in clinical variables among individuals (N = 139) with BED who reported a short (binge duration. Study 2 utilized an ecological momentary assessment (EMA) design to examine the duration and temporal pattern of binge eating episodes in the natural environment in a separate sample of nine women with BED. Results Participants in Study 1 who were classified as having long duration binge eating episodes displayed greater symptoms of depression and lower self-esteem, but did not differ on other measures of eating disorder symptoms, compared to those with short duration binge eating episodes. In Study 2, the average binge episode duration was approximately 42 minutes, and binge eating episodes were most common during the early afternoon and evening hours, as well as more common on weekdays versus weekends. Discussion Past research on binge episode characteristics, particularly duration, has been limited to studies of binge eating episodes in BN. This study contributes to the existing literature on characteristics of binge eating in BED. PMID:23881639
Lavender, Jason M; Brown, Tiffany A; Murray, Stuart B
There is growing recognition that eating disorder (ED) symptoms, particularly those of a muscularity-oriented nature, are more common in men than previously understood. The purpose of the current review is to describe contemporary directions and implications of research on traditional and muscularity-oriented ED symptoms among males. Evidence indicates that ED symptoms occur in a substantial minority of men. Importantly, recent research has focused on muscularity-oriented body image and disordered eating in males, demonstrating the prevalence, correlates, and consequences of maladaptive muscularity-oriented attitudes and behaviors. A growing number of assessments are available to measure these constructs in males, and preliminary treatment considerations have begun to be addressed in the literature. Research on male EDs and body image is increasingly focusing on muscularity-oriented manifestations. Continued empirical work will be critical to improve our understanding of the onset, maintenance, and treatment of muscularity-oriented disordered eating in males.
María Luisa Avargues-Navarro
Full Text Available Antecedentes/Objetivo: La evidencia sobre la eficacia de intervenciones cognitivoconductuales en los Trastornos de la Conducta Alimentaria (TCA aún presenta resultados no concluyentes respecto al papel que desempe˜nan en las conductas purgativas, más aún cuando se realizan en situaciones no controladas. Se pretende conocer la evolución tras un tratamiento multicomponente en pacientes con TCA, con presencia o ausencia de conductas purgativas, después de 30 meses del inicio del tratamiento. Método: Participaron 162 mujeres (87 purgativas y 75 no purgativas, tratadas en régimen ambulatorio o hospitalario + ambulatorio, en Espa˜na. Los instrumentos de evaluación fueron: BSQ, EAT-40, EDI, STAI, BDI y BITE. Resultados: Al inicio del tratamiento, las participantes con conductas purgativas presentaban mayor sintomatología bulímica, más insatisfacción corporal, obsesión por la delgadez, perfeccionismo e ineficacia, ansiedad y sintomatología depresiva. Tras 30 meses, en ambos grupos, la intervención produjo mejoría en las características de TCA, alteraciones emocionales y variables de desarrollo personal, siendo menor en las pacientes sin conductas purgativas. El efecto de la intervención fue mayor en las participantes purgativas y las variables con mayor tamaño de efecto: insatisfacción corporal, sintomatología bulímica y ansiedad. Conclusiones: Es importante considerar las conductas purgativas en el dise˜no de estos tratamientos de cara al pronóstico.
Analysis of questionnaires returned by 395 sophomores reveals that the eating difficulties of college women may be a problem that only partially resembles clinical eating disorders. They displayed the behavioral symptoms but not the psychological traits associated with anorexia and bulimia. Diagnosis and treatment issues, and sociocultural…
Chao, Ariana M.; Grilo, Carlos M.; Sinha, Rajita
Objective To examine the moderating effects of gender and race on the relationships among food cravings, binge eating, and eating disorder psychopathology in a community sample. Methods Data were collected from a convenience sample of 320 adults (53% male; mean age 28.5±8.2 years; mean BMI 27.1±5.2 kg/m2; mean education 15.1±2.2 years; 64% white, 24% black, and 13% other race) participating in a cross-sectional study examining the interactions between stress, self-control and addiction. Participants completed a comprehensive assessment panel including a demographic questionnaire, the Food Craving Inventory, and Eating Disorder Examination Questionnaire. Data were analyzed using multiple logistic regression for binge eating behavior and multiple linear regression for eating disorder psychopathology. Results Overall, food cravings demonstrated significant main effects for binge eating behavior (adjusted OR=2.65, peating disorder psychopathology (B=.47±.09, peating disorder psychopathology than males; there were no statistically significant differences by race. Conclusion These findings, based on a diverse sample recruited from the community, suggest that food cravings are associated with binge eating and eating disorder psychopathology and may represent an important target for interventions. PMID:26741258
Friedlander, Myrna L.; Siegel, Sheri M.
Tested theoretical link between difficulties with separation-individuation and cognitive-behavioral indicators characteristic of anorexia nervosa and bulimia. Assessed 124 college women using three self-report measures. Results suggest strong relation between 2 sets of variables and support theoretical assertions about factors that contribute to…
Muuss, Rolf E.
Defines bulimia and lists associated features of bulimia, physical side effects, and cognitive disturbances related to binging and purging. Asserts that bulimics resist treatment; but that such methods as cognitive, group, family, behavior, and drug therapy, and hospitalization appear promising. (Author/ABB)
Studies from recent decades indicate that the ideal of thinness can be discerned in a growing dissatisfaction with weight and an increase of the prevalence of disordered eating at an earlier age of onset. The purpose of this study is to evaluate the prevalence of disordered eating (above the cutoff point of 30 on the EAT-40) among a normal population of school students in Israel. The study sample was composed of Israeli (Jewish) adolescents in grades 7 to 12 from four schools. Of 326 students approached (181 females and 142 males), 323 completed the self-report EAT-40 and a structured questionnaire that provided socio-demographic and other information. 41.5% of adolescents were not satisfied with their weight and 45.3% want to lose weight. A third of the sample engages in dieting behavior frequently; 6.1% of the adolescents have pathologic EAT-40 scores, with about three times as many girls as boys exhibiting disordered eating; 8.2% of the girls and 2.8% of the males show disordered eating (Ø=0.115, p times more with pathologic EAT scores than those who are satisfied with their weight (Ø=0.220; p times more pathologic EAT scores among adolescents who wish to lose weight than among those who do not wish to reduce their weight (Ø=0.237; p EAT scores were found among adolescents from different ethnic backgrounds or levels of religious observance. The prevalence of disordered eating among adolescents in Israel is higher than other countries in general, and among males in particular. There is a need for increased efforts to detect adolescents at risk for developing eating disorders, with the assistance of clinical tools. In addition an educational policy for disordered eating prevention should be instituted.
Eating disorders are severe and disabling mental disorders. The scientific study of eating disorders has expanded dramatically over the past few decades, and provided significant understanding of eating disorders and their treatments. Those significant advances notwithstanding, there is scant knowledge about key processes that are crucial to clinical improvement. The lack of understanding mechanisms that cause, maintain and change eating disorders, currently is the biggest problem facing the science of eating disorders. It hampers the development of really effective interventions that could be fine-tuned to target the mechanisms of change and, therefore, the development of more effective treatments. It is argued here that the science of eating disorders and eating disorder treatment could benefit tremendously from pure experimental studies into its mechanisms of change, that is, experimental psychopathology (EPP). To illustrate why eating disorders need more EPP research, some key symptoms - restriction of intake, binge eating and body overvaluation - will be discussed. EPP studies challenge some generally accepted views and offer a fresh new look at key symptoms. This will, consequently, better inform eating disorder treatments. Copyright © 2016. Published by Elsevier Ltd.
Striegel-Moore, Ruth H.; Rosselli, Francine; Perrin, Nancy; DeBar, Lynn; Wilson, G. Terence; May, Alexis; Kraemer, Helena C.
Objective This study examined gender differences in prevalence of eating disorder symptoms including body image concerns (body checking or avoidance), binge eating, and inappropriate compensatory behaviors. Method A random sample of members (ages 18 to 35) of a health maintenance organization was recruited to complete a survey by mail or on-line. Items were drawn from the Patient Health Questionnaire and the Body Shape Questionnaire. Results Among the 3,714 women and 1,808 men who responded, men were more likely to report overeating whereas women were more likely to endorse loss of control while eating. Although statistically significant gender differences were observe, with women significantly more likely than men to report body checking and avoidance, binge eating, fasting, and vomiting, effect sizes (“Number Needed to Treat”) were small to moderate. Conclusions Few studies of eating disorders include men, yet our findings suggest that a substantial minority of men also report eating disorder symptoms. PMID:19107833
Abd El-Azeem Taha, Azza Ali; Abu-Zaid, Hany Ahmed; El-Sayed Desouky, Dalia
Eating disorders are a common health problem among adolescents, and females are especially vulnerable to them. There is lack of information on the prevalence of eating disorders in Saudi Arabia. The current study aimed to investigate the prevalence of eating disorders among female undergraduate university students in Taif city, Saudi Arabia. The study was undertaken in the female section at Taif university from November 1, 2016 to March 30, 2017. Eating Attitudes Test (EAT-26) was used to determine the prevalence of eating disorders. The questionnaire was distributed among undergraduate students and their anthropometric measurements were assessed after obtaining their consent. The sample included 1200 university students with a median age of 21 years (range 17-33). Nonparametric tests were used to assess relationship between variables. Chi-squared test was used to compare items of the disordered eating attitudes and behaviors between positive and negative EAT respondents. Using the cutoff score of 20 on EAT-26 test, 35.4% of the students were classified at risk for eating disorders. Medical and obese students achieved the highest significant EAT scores. A high prevalence of eating disorders was found among females at Taif university, Kingdom of Saudi Arabia. Our findings call for prevention of these disorders and we recommend establishing a national screening program among Saudi university female students for early detection and management of these problems. © 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Brownley, Kimberly A.; Berkman, Nancy D.; Peat, Christine M.; Lohr, Kathleen N.; Cullen, Katherine E.; Bann, Carla M.; Bulik, Cynthia M.
Background The best treatment options for binge-eating disorder are unclear. Purpose To summarize evidence about the benefits and harms of psychological and pharmacologic therapies for adults with binge-eating disorder. Data Sources English-language publications in EMBASE, the Cochrane Library, Academic OneFile, CINAHL, and ClinicalTrials.gov through 18 November 2015, and in MEDLINE through 12 May 2016. Study Selection 9 waitlist-controlled psychological trials and 25 placebo-controlled trials that evaluated pharmacologic (n = 19) or combination (n = 6) treatment. All were randomized trials with low or medium risk of bias. Data Extraction 2 reviewers independently extracted trial data, assessed risk of bias, and graded strength of evidence. Data Synthesis Therapist-led cognitive behavioral therapy, lisdexamfetamine, and second-generation antidepressants (SGAs) decreased binge-eating frequency and increased binge-eating abstinence (relative risk, 4.95 [95% CI, 3.06 to 8.00], 2.61 [CI, 2.04 to 3.33], and 1.67 [CI, 1.24 to 2.26], respectively). Lisdexamfetamine (mean difference [MD], −6.50 [CI, −8.82 to −4.18]) and SGAs (MD, −3.84 [CI, −6.55 to −1.13]) reduced binge-eating–related obsessions and compulsions, and SGAs reduced symptoms of depression (MD, −1.97 [CI, −3.67 to −0.28]). Headache, gastrointestinal upset, sleep disturbance, and sympathetic nervous system arousal occurred more frequently with lisdexamfetamine than placebo (relative risk range, 1.63 to 4.28). Other forms of cognitive behavioral therapy and topiramate also increased abstinence and reduced binge-eating frequency and related psychopathology. Topiramate reduced weight and increased sympathetic nervous system arousal, and lisdexamfetamine reduced weight and appetite. Limitations Most study participants were overweight or obese white women aged 20 to 40 years. Many treatments were examined only in single studies. Outcomes were measured inconsistently across trials and rarely
Reas, Deborah L.; Grilo, Carlos M.
Introduction This study evaluated controlled treatment studies of pharmacotherapy for binge eating disorder (BED). Areas Covered The primary focus of the review was on phase II and III controlled trials testing medications for BED. A total of 46 studies were considered and 26 were reviewed in detail. BED outcomes included binge-eating remission, binge-eating frequency, associated eating-disorder psychopathology, associated depression, and weight loss. Expert Opinion Data from controlled trials suggests that certain medications are superior to placebo for stopping binge-eating and for producing faster reductions in binge eating, and - to varying degrees - for reducing associated eating-disorder psychopathology, depression, and weight loss over the short-term. Almost no data exist regarding longer-term effects of medication for BED. Except for topiramate, which reduces both binge eating and weight, weight loss is minimal with medications tested for BED. Psychological interventions and the combination of medication with psychological interventions produce binge-eating outcomes that are superior to medication-only approaches. Combining medications with psychological interventions does not significantly enhance binge-eating outcomes, although the addition of certain medications enhances weight losses achieved with cognitive-behavioral therapy and behavioral weight loss, albeit modestly. PMID:24460483
Masheb, Robin M; Roberto, Christina A; White, Marney A
The goal of this study was to examine the clinical utility of nibbling behavior, defined as eating in an unplanned and repetitious manner between meals and snacks without a sense of loss of control, in obese patients with Binge Eating Disorder (BED). Two-hundred seventeen (N = 217) consecutive, treatment-seeking, obese patients with BED were assessed with the Eating Disorder Examination (EDE). Nibbling frequency was examined in relation to current weight, eating disorder psychopathology and eating patterns. Results found that nibbling/picking was not related to body mass index, objective bulimic, subjective bulimic, or overeating episodes, food avoidance, sensitivity to weight gain, or any subscales of the EDE. However, nibbling/picking was significantly related to frequency of morning and afternoon snacking (r = .21, p = .002; r = .27, p < .001). The assessment of nibbling/picking behaviors among individuals with BED might not provide clinically significant information. © 2013.
On a new framework for anorexia nervosa, learning to eat is central intervention; as patients regain a normal pattern of eating their problems dissolve. Mandometer®, a development of previous methods, allows simultaneous recording of eating rate and the development of satiety as well as experimental manipulation of eating rate. By measuring eating behavior during the course of a meal with this method, women were divided into those eating at a decelerated rate and those eatin...
Lee, Darrin J.; Elias, Gavin J.B.; Lozano, Andres M.
Eating disorders and obesity adversely affect individuals both medically and psychologically, leading to reduced life expectancy and poor quality of life. While there exist a number of treatments for anorexia, morbid obesity and bulimia, many patients do not respond favorably to current behavioral, medical or bariatric surgical management. Neuromodulation has been postulated as a potential treatment for eating disorders and obesity. In particular, deep brain stimulation and transcranial non-invasive brain stimulation have been studied for these indications across a variety of brain targets. Here, we review the neurobiology behind eating and eating disorders as well as the current status of preclinical and clinical neuromodulation trials for eating disorders and obesity. PMID:29399320
Elgin, J; Pritchard, M
The goal of this study was to examine gender differences in the prevalence of disordered eating and body dissatisfaction as well as examine gender differences in several risk factors: mass media, self-esteem and perfectionism. Three hundred fifty-three undergraduates completed surveys about their body dissatisfaction, disordered eating habits, exposure to and influence of mass media, self-esteem and perfectionistic tendencies. As expected, women experienced more symptoms of disordered eating as well as body dissatisfaction than did their male counterparts. There were also gender differences in the risk factors. For women, mass media, self-esteem, and perfectionism related to disordered eating behaviors, whereas for men, only perfectionism and mass media related to disordered eating behaviors. For women, mass media and self-esteem related to body image dissatisfaction, whereas for men, mass media and perfectionism related to body image dissatisfaction. The results of the present study indicate that risk factors for disordered eating and body dissatisfaction for men and women may be different, which has implications for understanding the etiology of body dissatisfaction and disordered eating and for possible treatment interventions.
Smink, Frederique R. E.; van Hoeken, Daphne; Hoek, Hans W.
Purpose of reviewTo review the recent literature about the epidemiology, course, and outcome of eating disorders in accordance with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).Recent findingsThe residual category eating disorder not otherwise specified'
Raevuori, Anu; Keski-Rahkonen, Anna; Hoek, Hans W.
Purpose of review Research in eating disorders in males has been active lately compared to the past. This review aims to provide an overview of the recently published studies of eating disorders in males. Recent findings Publication of the Diagnostic and Statistical Manual of Mental Disorders, 5th
Smink, Frederique R. E.; van Hoeken, Daphne; Hoek, Hans W.
Purpose of reviewTo review the recent literature about the epidemiology, course, and outcome of eating disorders in accordance with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).Recent findingsThe residual category eating disorder not otherwise specified'
Full Text Available Eating disorders are some of the most severe and destructive of all psychological conditions. They are associated with restricted capacities in cognitive, emotional, physical, and spiritual development. This paper provides an examination of the practical application of Christian spirituality as a force for recovery from an eating disorder. Specifically, it expounds the transformative potential in the spiritual qualities of hope, trust, acceptance, surrender, and courage underpinning engagement with evidence-based therapeutic models of care in eating disorder recovery.
This thesis deals with nutritional therapy for eating disorders. It explores whether nutritional therapy has an irreplaceable role in treatment of these disorders or whether nutritional therapy has a marginal effect. I describe general issues of eating disorders in a theoretical part of my thesis such as etiology, epidemiology, therapy and nutrition therapy. I composed educational handout about eating in a practical part of my thesis containing fundamental dietary recommendations, menu for un...
Kristeller, Jean L; Wolever, Ruth Q
This paper reviews the conceptual foundation of mindfulness-based eating awareness training (MB-EAT). It provides an overview of key therapeutic components as well as a brief review of current research. MB-EAT is a group intervention that was developed for treatment of binge eating disorder (BED) and related issues. BED is marked by emotional, behavioral and physiological disregulation in relation to food intake and self-identity. MB-EAT involves training in mindfulness meditation and guided mindfulness practices that are designed to address the core issues of BED: controlling responses to varying emotional states; making conscious food choices; developing an awareness of hunger and satiety cues; and cultivating self-acceptance. Evidence to date supports the value of MB-EAT in decreasing binge episodes, improving one's sense of self-control with regard to eating, and diminishing depressive symptoms.
Chao, Ariana M; Grilo, Carlos M; Sinha, Rajita
To examine the moderating effects of gender and race on the relationships among food cravings, binge eating, and eating disorder psychopathology in a community sample. Data were collected from a convenience sample of 320 adults (53% male; mean age 28.5±8.2years; mean BMI 27.1±5.2kg/m(2); mean education 15.1±2.2years; 64% white, 24% black, and 13% other race) participating in a cross-sectional study examining the interactions between stress, self-control and addiction. Participants completed a comprehensive assessment panel including a demographic questionnaire, the Food Craving Inventory, and Eating Disorder Examination Questionnaire. Data were analyzed using multiple logistic regression for binge eating behavior and multiple linear regression for eating disorder psychopathology. Overall, food cravings demonstrated significant main effects for binge eating behavior (adjusted OR=2.65, ppsychopathology (B=.47±.09, ppsychopathology than males; there were no statistically significant differences by race. These findings, based on a diverse sample recruited from the community, suggest that food cravings are associated with binge eating and eating disorder psychopathology and may represent an important target for interventions. Copyright © 2015. Published by Elsevier Ltd.
Kachani, Adriana Trejger; Barroso, Lucia Pereira; Brasiliano, Silvia; Cordás, Táki Athanássios; Hochgraf, Patrícia Brunfentrinker
Compare inadequate eating behaviors and their relationship to body checking in three groups: patients with anorexia nervosa (AN), patients with bulimia nervosa (BN) and a control group (C). Eighty three outpatients with eating disorders (ED) and 40 controls completed eating attitudes and body checking questionnaires. The overall relationship between the eating attitude and body checking was statistically significant in all three groups. The worse the eating attitude, the greater the body checking behavior. However, when we look at each group individually, the relationship was only statistically significant in the AN group (r=.354, p=0.020). The lower the desired weight and the worse the eating attitude, the more people check themselves, although in the presence of an ED the relationship between body checking and food restrictions is greater. In patients displaying the AN subgroup, body checking is also related to continued dietary control. Copyright © 2015 Elsevier Ltd. All rights reserved.
Ida F. Dancyger
Full Text Available This review examines the literature during the past 10 years about suicide risk and suicide during adolescence and young adulthood of individuals with eating disorders. Epidemiological surveys are summarized, including suicide rates, parasuicidal behaviors, associated risk factors, and comorbid psychopathology. Critical implications for the comprehensive assessment and treatment planning, including safety considerations, are discussed. Two clinical cases of women with long-standing eating disorders are described to highlight both the pragmatic considerations and the complex clinical challenges of working with patients with eating disorders who become suicidal. The potentially life-threatening issues of safety have not received sufficient attention, neither in the medical literature nor by the treating clinicians. All health care professionals who are treating patients with an eating disorder must be keenly aware of the serious risks of suicidal behavior and of suicide in this population.
Sanchez-Ruiz, Maria Jose; El-Jor, Claire; Abi Kharma, Joelle; Bassil, Maya; Zeeni, Nadine
Disordered eating behaviors are on the rise among youth. The present study investigates psychosocial and weight-related variables as predictors of eating disorders (ED) through disordered eating (DE) dimensions (namely restrained, external, and emotional eating) in Lebanese university students. The sample consisted of 244 undergraduates (143 female) aged from 18 to 31 years (M = 20.06; SD = 1.67). Using path analysis, two statistical models were built separately with restrained and emotional eating as dependent variables, and all possible direct and indirect pathways were tested for mediating effects. The variables tested for were media influence, perfectionism, trait emotional intelligence, and the Big Five dimensions. In the first model, media pressure, self-control, and extraversion predicted eating disorders via emotional eating. In the second model, media pressure and perfectionism predicted eating disorders via restrained eating. Findings from this study provide an understanding of the dynamics between DE, ED, and key personality, emotion-related, and social factors in youth. Lastly, implications and recommendations for future studies are advanced.
Wilson, Jenny L; Peebles, Rebecka; Hardy, Kristina K; Litt, Iris F
adolescents' learning about and adopting disordered eating behaviors.
Tomotake, Masahito; Ohmori, Tetsuro
The present review focused on the personality profiles of patients with eating disorders. Studies using the Structured Clinical Interview for DSM-III-R Personality Disorder showed high rates of diagnostic co-occurrence between eating disorders and personality disorders. The most commonly observed were histrionic, obsessive-compulsive, avoidant, dependent and borderline personality disorders. Studies using the Cloninger’s personality theory suggested that high Harm Avoidance might be relevant ...
Schulte, Erica M.; Grilo, Carlos M.; Gearhardt, Ashley N.
Scientific interest in “food addiction” is growing, but the topic remains controversial. One critique of “food addiction” is its high degree of phenotypic overlap with binge eating disorder (BED). In order to examine associations between problematic eating behaviors, such as binge eating and “food addiction,” we propose the need to move past examining similarities and differences in symptomology. Instead, focusing on relevant mechanisms may more effectively determine whether “food addiction” contributes to disordered eating behavior for some individuals. This paper reviews the evidence for mechanisms that are shared (i.e., reward dysfunction, impulsivity) and unique for addiction (i.e., withdrawal, tolerance) and eating disorder (i.e., dietary restraint, shape/weight concern) frameworks. This review will provide a guiding framework to outline future areas of research needed to evaluate the validity of the “food addiction” model and to understand its potential contribution to disordered eating. PMID:26879210
Preti, Antonio; Usai, Ambra; Miotto, Paola; Petretto, Donatella Rita; Masala, Carmelo
Fashion models are thought to be at an elevated risk for eating disorders, but few methodologically rigorous studies have explored this assumption. We have investigated the prevalence of eating disorders in a group of 55 fashion models born in Sardinia, Italy, comparing them with a group of 110 girls of the same age and of comparable social and cultural backgrounds. The study was based on questionnaires and face-to-face interviews, to reduce the bias due to symptom under-reporting and to social desirability responding. When compared on three well-validated self-report questionnaires (the EAT, BITE, BAT), the models and controls did not differ significantly. However, in a detailed interview (the Eating Disorder Examination), models reported significantly more symptoms of eating disorders than controls, and a higher prevalence of partial syndromes of eating disorders was found in models than in controls. A body mass index below 18 was found for 34 models (54.5%) as compared with 14 controls (12.7%). Three models (5%) and no controls reported an earlier clinical diagnosis of anorexia nervosa. Further studies will be necessary to establish whether the slight excess of partial syndromes of eating disorders among fashion models was a consequence of the requirement in the profession to maintain a slim figure or if the fashion modeling profession is preferably chosen by girls already oriented towards symptoms of eating disorders, since the pressure to be thin imposed by this profession can be more easily accepted by people predisposed to eating disorders.
Becker, Daniel F; Grilo, Carlos M
Binge-eating disorder (BED) is associated with elevated rates of mood and substance use disorders, but the significance of such comorbidity is ambiguous. We compared personality disorder and eating disorder psychopathology in four subgroups of BED patients: those with mood disorders, those with substance use disorders, those with both, and those with neither. Subjects were 347 patients who met DSM-IV research criteria for BED. Semistructured interviews evaluated lifetime DSM-IV axis I disorders, DSM-IV personality disorder features, and eating disorder psychopathology. Among these patients, 129 had co-occurring mood disorder, 34 had substance use disorder, 60 had both, and 124 had neither. Groups differed on personality disorder features, with those having mood disorder and both mood and substance use disorders showing the highest frequencies. Although groups did not differ in body mass index or binge eating frequency, they did differ on eating disorder psychopathology-with the groups having mood disorder and both comorbidities demonstrating higher eating, weight, and shape concerns. No differences were observed between groups with respect to ages of onset for specific eating behaviors, but some differences were observed for ages of disorder onset. Mood and substance use disorders co-occur frequently among patients with BED. Compared with a previous work, the additional comparison group (those with both mood and substance use disorders) and the control group (those with neither) afforded better discrimination regarding the significance of these comorbidities. Our findings suggest approaches to subtyping BED based on psychiatric comorbidity, and may also have implications for treatment. Copyright © 2015 Elsevier Inc. All rights reserved.
Ben-Porath, Denise D; Wisniewski, Lucene; Warren, Mark
Studies have reported conflicting findings regarding the impact on treatment for eating disorder patients comorbidly diagnosed with borderline personality disorder. The current investigation sought to investigate whether individuals diagnosed with an eating disorder vs. those comorbidly diagnosed with an eating disorder and borderline personality disorder differ on measures of eating disorders symptoms and/or general distress over the course of treatment. In light of the success of DBT in treating individuals diagnosed with borderline personality disorder, a group known to have considerable difficulties in regulating affect, the current study also sought to examine whether these two groups would differ on expectancies to regulate affect over the course of DBT-informed treatment. Results indicated that while a comorbid diagnosis of borderline personality disorder did not impact eating disorder treatment outcomes, those comorbidly diagnosed did present overall with higher levels of general distress and psychological disturbance. With respect to affect regulation, results indicated that at the beginning of treatment, eating disordered individuals who carried a comorbid diagnosis of BPD were significantly less able to regulate affect than patients without a comorbid borderline diagnosis. However, at the end of treatment there was no statistically significant difference between the two groups. The role of affect regulation in treating eating disordered individuals with a comorbid borderline personality disorder diagnosis is discussed.
Harvey, Kate; Rosselli, Francine; Wilson, G. Terence; DeBar, Lynn L.; Striegel-Moore, Ruth H.
Objective We sought to describe meal and snack frequencies of individuals with recurrent binge eating and examine the association between these eating patterns and clinical correlates. Method Data from 106 women with a minimum diagnosis of recurrent binge eating were utilized. Meal and snack frequencies were correlated with measures of weight, eating disorder features, and depression. Participants who ate breakfast every day (n=25) were compared with those who did not (n=81) on the same measures. Results Breakfast was the least, and dinner the most, commonly consumed meal. Evening snacking was the most common snacking occasion. Meal patterns were not significantly associated with clinical correlates; however, evening snacking was associated with binge eating. Discussion Our findings largely replicated those reported in earlier research. More research is needed to determine the role of breakfast consumption in binge eating. PMID:21661003
Stojek, Monika M. K.; Tanofsky-Kraff, Marian; Shomaker, Lauren B.; Kelly, Nichole R.; Thompson, Katherine A.; Mehari, Rim D.; Marwitz, Shannon E.; Demidowich, Andrew P.; Galescu, Ovidiu A.; Brady, Sheila M.; Yanovski, Susan Z.; Yanovski, Jack A.
Objective Adolescent emotional-eating, referring to eating in response to negative affective states, is frequently reported by those with loss of control (LOC) eating. Although LOC eating has been shown to predict exacerbated disordered eating and excess weight/adiposity gain, the extent to which emotional-eating, either alone or in combination with LOC, predicts adverse outcomes has not been determined. Thus, we examined associations of baseline emotional-eating with changes in disordered eating, BMI, and adiposity over 1-year, and to what degree the presence or absence of baseline LOC moderated these associations. Methods 189 non-treatment-seeking youth (15.4±1.4y; 66% female; 67% non-Hispanic White, 38% overweight [BMI ≥85th %ile]) completed the emotional-eating Scale for Children/Adolescents and the Eating Disorder Examination interview at baseline and again at 1-year. Air displacement plethysmography assessed adiposity at both time points. Results Baseline emotional-eating alone was not significantly associated with the development of objective binge eating or changes in disordered eating attitudes, BMI or adiposity 1-year later. However, baseline emotional-eating interacted with the presence of baseline LOC in the prediction of 1-year outcomes. Among adolescents with LOC eating, greater baseline emotional-eating was related to increased disordered eating attitudes (p=.03), BMI (p=.04), and adiposity (p=.04) at 1-year, after correcting for false discovery rate. Discussion Emotional-eating among youth also reporting LOC was associated with adverse outcomes over 1-year. Adolescents who report both behaviors may represent a subset of individuals at especially high risk for exacerbated disordered eating and excess weight gain. PMID:27753140
Bernardi, Fabiana; Harb, Ana Beatriz Cauduro; Levandovski, Rosa Maria; Hidalgo, Maria Paz Loayza
Este artigo tem como objetivo revisar aspectos relacionados a transtornos alimentares e suas relações com as alterações no ritmo circadiano. Realizou-se uma busca sistematizada das informações nas bases de dados PubMed usando os seguintes descritores: eating disorders, circadian rhythm, night eating syndrome, binge eating disorder e sleep patterns. Os transtornos alimentares, como a síndrome do comer noturno e o transtorno da compulsão alimentar periódica, têm sido considerados e relacionados...
Yarborough, Bobbi Jo; DeBar, Lynn L.; Firemark, Alison; Leung, Sue; Clarke, Gregory N.; Wilson, G. Terence
Whereas effective treatments exist for adults with recurrent binge eating, developmental factors specific to adolescents point to the need for a modified treatment approach for youth. We adapted an existing cognitive behavioral therapy treatment manual for adults with bulimia nervosa and binge eating disorder (Fairburn, 2008) for use with…
de Krom, Mariken; Bauer, Florianne; Collier, David; Adan, R. A. H.; la Fleur, Susanne E.
Feeding is a physiological process, influenced by genetic factors and the environment. In recent years, many studies have been performed to unravel the involvement of genetics in both eating behavior and its pathological forms: eating disorders and obesity. In this review, we provide a condensed
Bardone-Cone, Anna M.; Sturm, Katrina; Lawson, Melissa A.; Robinson, D. Paul; Smith, Roma
Objective This study examined perfectionism in relation to recovery from eating disorders by comparing different conceptualizations of perfectionism across healthy controls and fully recovered, partially recovered, and active eating disorder cases, where full recovery was defined using physical, behavioral, and psychological indices. Method Participants were primarily young adult females; 53 active eating disorder cases, 15 partially recovered cases, 20 fully recovered cases, and 67 healthy controls. Participants completed questionnaires assessing trait perfectionism, perfectionistic self-presentation style, and frequency of perfectionism cognitions, as well as a diagnostic interview to determine lifetime and current eating disorder diagnoses. Results A robust pattern emerged whereby the fully recovered eating disorder individuals and healthy controls had similar levels of perfectionism that were significantly lower than the perfectionism levels of the partially recovered and active eating disorder individuals, who were comparable to each other. Conclusion These findings have implications for more clearly defining eating disorder recovery and for the role perfectionism may play in achieving full recovery. PMID:19308994
Full Text Available Eating disorders should be understood in a multidimensional perspective, emphasizing a biopsicossocial context. In these pathologies it`s the body, in the first instance, that reveals the disease, being in this way the target of the conflict, revealing a disturbed body experience and as a consequence a weak conception of their personal body image. The body image is conceptualised as a subjective image that the individuals form in their own mind, about their body, in relation with differ- ent contexts of life. The intent of the studies is to comprehend the level of body image disturbance, which have concluded that in the majority of the cases, significant changes on perceptive capacity of the patients do not exist. In this way it`s important to study in a more effective and qualitative way the affective and personal factors. The authors pretend with this bibliographic revision, make a research of body image assessment to the Eating Disorders (Anorexia Nervosa and Bulimia Nervosa, and to reflect which are the best ones to adapt for Portuguese reality.
Full Text Available The research aims to establish the main characteristics of subjects prone to compulsive overeating (experimental group, EG, and the differences between them and the girls who are not prone to any kind of eating disorders (control group, CG. The results of the research are in accordance with the expectations. Girls from the EG exhibit personality characteristics which are signifficantly different from the girls in the CG. These characteristics may be either possible predispositions for development of overeating, or they may already be the consequences of the girls' struggles with overeating and their perception of being overweight. The responses given by the girls from the EG confirm the generaly accepted characteristics of overeating individuals. It can be said that the girls from the ES show the pre-clinical picture of overeating, while some of them have already developed the clinical picture. The results of the research strongly support the view that overeating must be defined as a form of eating disorder just as important as anorexia and bulimia nervosa.
Jáuregui Lobera, I; Bolaños Ríos, P; Garrido Casals, O
The aim of the study was to analyse the parental bonding profiles in patients with eating disorders (ED), as well as the relationship among the different styles of parenting and some psychological and psychopathological variables. In addition, the association between the perceived parental bonding and different coping strategies was analysed. Perception of parenting styles was analysed in a sample of 70 ED patients. The Parental Bonding Instrument, Self-Esteem Scale of Rosenberg, Coping Strategies Inventory, State-Trait Anxiety Inventory, Beck Depression Inventory and Eating Disorders Inventory-2 were used. Kruskal-Wallis test (comparisons), Spearman correlation coefficients (association among different variables) and χ(2)-test (parental bonding profiles differences) were applied. The stereotyped style among ED patients is low care-high control during the first 16 years, and the same can be said about current styles of the mothers. Between 8.6% and 12.9% of the patients perceive their parents' styles as neglectful. The neglectful parenting is the style mainly involved in the specific ED symptoms as drive for thinness, body dissatisfaction and bulimia. In order to achieve a better balanced parents' role during the treatment, it would be necessary to improve the role of the mothers as caregivers, decreasing their role mainly based on the overprotection. © 2011 Blackwell Publishing.
Describes bulimia, a disorder involving binge eating and purging increasingly prevalent in young women. Reviews the literature and describes symptoms, etiological factors, and treatment considerations and approaches for the disorder. (Author)
... of the American Dietetic Association. 2011:111:1236. Gabbard GO, ed. Evidence-based psychological treatments for eating disorders. In: Gabbard's Treatments of Psychiatric Disorders. 5th ed. Arlington, Va.: ...
Okamoto, Yuri; Miyake, Yoshie; Nagasawa, Ichie; Shishida, Kazuhiro
Cognitive-behavioral therapy (CBT) has been recommended for the treatment of eating disorders, and group therapy is known to have certain advantages over individual therapy. The aim of the current study was to compare the 10-year prognosis of patients who completed integrated group CBT with those who dropped out and to examine the effect of completion of group CBT on the prognosis. The participants were 65 adult patients with eating disorders. All patients were women and Japanese. The average age (19-37) of the patients was 25.1 ± 3.8 years, and the average body mass index (BMI) was 17.7 ± 2.0. We conducted integrated group CBT with the patients and compared eating disorder symptoms, mood states, coping styles, and self-esteem before and after therapy. Furthermore, we compared clinical features and the 10-year prognosis of patients who completed the treatment and those who dropped out. After 10 sessions of group therapy, Eating Attitudes Test scores, Profile of Mood States depression scores, and Coping Inventory for Stressful Situations emotion-oriented scores decreased, while Rosenberg's Self-Esteem Scale scores increased. Regarding the results of the 10-year follow up, the completer group had more patients with a good prognosis. In contrast, the dropout group had more patients with a poor prognosis. Those who completed the integrated group CBT had a good prognosis. Group therapy gives the patients an opportunity to form peer relationships, and helps them to develop communication and socialization skills. Furthermore, in the group therapy sessions, the patients develop self-awareness by listening to other members of the group and they also develop interpersonal relationships. This effect may be temporary, but experience of group therapy may provide hope for the patient and increase the chance of the patient continuing treatment. Retrospectively registered in University Hospital Medical Information Network in Japan: No. 000028868 (May 19th, 2017).
Simpson, H Blair; Wetterneck, Chad T; Cahill, Shawn P; Steinglass, Joanna E; Franklin, Martin E; Leonard, Rachel C; Weltzin, Theodore E; Riemann, Bradley C
Eating disorders and obsessive-compulsive disorder (OCD) commonly co-occur, but there is little data for how to treat these complex cases. To address this gap, we examined the naturalistic outcome of 56 patients with both disorders, who received a multimodal treatment program designed to address both problems simultaneously. A residential treatment program developed a cognitive-behavioral approach for patients with both OCD and an eating disorder by integrating exposure and response prevention (ERP) treatment for OCD with ERP strategies targeting eating pathology. Patients also received a supervised eating plan, medication management, and social support. At admission and discharge, patients completed validated measures of OCD severity (the Yale-Brown Obsessive-Compulsive Scale--Self Report [Y-BOCS-SR]), eating disorder severity (the Eating Disorders Examination-Questionnaire), and depressive severity (the Beck Depression Inventory II [BDI-II]). Body mass index (BMI) was also measured. Paired-sample t-tests examined change on these measures. Between 2006 and 2011, 56 individuals completed all study measures at admission and discharge. Mean length of stay was 57 days (SD = 27). Most (89%) were on psychiatric medications. Significant decreases were observed in OCD severity, eating disorder severity, and depression. Those with bulimia nervosa showed more improvement than those with anorexia nervosa. BMI significantly increased, primarily among those underweight at admission. Simultaneous treatment of OCD and eating disorders using a multimodal approach that emphasizes ERP techniques for both OCD and eating disorders can be an effective treatment strategy for these complex cases.
Radziwiłłowicz, Wioletta; Czarniak, Katarzyna
Objectives: Studies of development psychopathology and psychia try have shown that personality variables are greatly associated with eating disorders. Sociotropy and autonomy may be features that facilitate the occurrence and persistence of the eating disturbances. Theoretical framework for own research was mainly the A. Beck’s concept of autonomy and sociotropy. The aim of the study was to answer the research question whether a person suffering from an eating disorder is characterized by ...
Roberto, Christina A.; Grilo, Carlos M.; Masheb, Robin M.; White, Marney A.
Objective This study aimed to compare bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) on clinically significant variables and examine the utility of once versus twice-weekly diagnostic thresholds for disturbed eating behaviors. Method 234 women with BN, BED, or PD were identified through self-report measures via an online survey and categorized based on either once-weekly or twice-weekly disturbed eating behaviors. Results BN emerged as a more severe disorder than BED and PD. The three groups differed significantly in self-reported restraint and disinhibition and the BN and BED groups reported higher levels of depression than PD. For BN, those engaging in behaviors twice-weekly versus once-weekly were more symptomatic. Discussion The BN, BED, and PD groups differed in clinically meaningful ways. Future research need to clarify the relationship between mood disturbances and eating behaviors. Reducing the twice-weekly behavior threshold for BN would capture individuals with clinically significant eating disorders, though the twice-weekly threshold may provide important information about disorder severity for both BN and BED. PMID:19862702
Davidsen, Annika Helgadóttir; Poulsen, Stig; Lindschou, Jane
-generated allocation sequence concealed to the investigators. One-hundred and 59 adult participants, diagnosed with bulimia nervosa, binge eating disorder, or eating disorder not otherwise specified according to DSM-IV, were included. Eighty participants were allocated to the experimental group, and 79 participants...
Binge eating disorder (BED), a chronic condition characterized by eating disorder psychopathology and physical and social disability, represents a significant public health problem. Guided self-help (GSH) treatments for BED appear promising and may be more readily disseminable to mental health care providers, accessible to patients, and…
In this review we synthesised current literature on the psychopharmacological management of eating disorders (EDs) in children and adolescents (C&As). We focus specifically on anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). The treatment of EDs is determined by physical and ...
Tromp, Marilou Dp; Donners, Anouk Amt; Garssen, Johan; Verster, Joris C
OBJECTIVE: To investigate the relationship between eating disorders, body mass index (BMI), sleep disorders, and daytime functioning. DESIGN: Survey. SETTING: The Netherlands. PARTICIPANTS: N=574 Dutch young adults (18-35 years old). MEASUREMENTS: Participants completed a survey on eating and sleep
Derenne, Jennifer L.; Beresin, Eugene V.
Objective: Eating disorders, including obesity, are a major public health problem today. Throughout history, body image has been determined by various factors, including politics and media. Exposure to mass media (television, movies, magazines, Internet) is correlated with obesity and negative body image, which may lead to disordered eating. The…
Madsen, Ida Ringsborg; Hørder, Kirsten; Støving, René Klinkby
Eating disorder during pregnancy is associated with a diversity of adverse outcomes and is of potential danger to both mother and child. There is, however, a tendency for remission of the eating disorder during pregnancy with improvement of symptoms such as restrictive dieting, binging and purgin...
Zerwas, Stephanie; Larsen, Janne Tidselbak; Petersen, Liselotte; Thornton, Laura M; Quaranta, Michela; Koch, Susanne Vinkel; Pisetsky, David; Mortensen, Preben Bo; Bulik, Cynthia M
Identifying factors associated with risk for eating disorders is important for clarifying etiology and for enhancing early detection of eating disorders in primary care. We hypothesized that autoimmune and autoinflammatory diseases would be associated with eating disorders in children and adolescents and that family history of these illnesses would be associated with eating disorders in probands. In this large, nationwide, population-based cohort study of all children and adolescents born in Denmark between 1989 and 2006 and managed until 2012, Danish medical registers captured all inpatient and outpatient diagnoses of eating disorders and autoimmune and autoinflammatory diseases. The study population included 930 977 individuals (48.7% girls). Cox proportional hazards regression models and logistic regression were applied to evaluate associations. We found significantly higher hazards of eating disorders for children and adolescents with autoimmune or autoinflammatory diseases: 36% higher hazard for anorexia nervosa, 73% for bulimia nervosa, and 72% for an eating disorder not otherwise specified. The association was particularly strong in boys. Parental autoimmune or autoinflammatory disease history was associated with significantly increased odds for anorexia nervosa (odds ratio [OR] = 1.13, confidence interval [CI] = 1.01-1.25), bulimia nervosa (OR = 1.29; CI = 1.08-1.55) and for an eating disorder not otherwise specified (OR = 1.27; CI = 1.13-1.44). Autoimmune and autoinflammatory diseases are associated with increased risk for eating disorders. Ultimately, understanding the role of immune system disturbance for the etiology and pathogenesis of eating disorders could point toward novel treatment targets. Copyright © 2017 by the American Academy of Pediatrics.
Gonçalves, Sónia F; Silva, Elsa; Gomes, A Rui
This study aims to compare eating behaviors, body satisfaction, exercise, and life satisfaction between normal-weight and overweight postmenopausal women and to examine the predictors of disordered eating and life satisfaction among postmenopausal women (n = 294). The overweight group had more eating disordered behavior, more body dissatisfaction, and lower physical quality of life. The increase of age predicted less disordered eating. Higher BMI, the perception of an ideal weight lower than the current one, lower body satisfaction, and physical quality of life predicted disordered eating. Higher body satisfaction, less psychosocial discomfort, and a greater degree of sexual symptom discomfort predicted life satisfaction.
Leonardo de Sousa Fortes
Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2017v19n1p84 The aim of this study was to analyze the influence of coach’s leadership style on eating disorders (ED in female volleyball athletes. This is a prospective study with 73 participants of sub-17 state of Pernambuco Championship. The Eating Attitudes Test was applied to evaluate ED. The perception of the coach’s leadership style was evaluated with Leader Sport Scale subscales. Triceps and subscapular skinfolds were measured to estimate body fat percentage. The findings showed no influence of “Training-Instruction” on ED (F(3, 70=45.02; R²=0.12; p=0.34. The “Social Support” subscale showed statically significant influence on ED (F(4, 69=59.77; R²=-0.16; p=0.02. However, the results indicated no statically significant relationship of “Reforce” subscale with ED (F(5, 68=52.40; R²=0.13; p=0.17. The “Democratic” subscale so showed no influence on ED F(6, 67=49.08; R²=0.10; p=0.21. Finally, the “Autocratic” subscale showed influence on ED (F(7, 66=67.23; R²=0.18; p=0.01. We concluded that the coach’s leadership style (social support and autocratic influenced the adoption of DEB in young female volleyball athletes.
Bayer, Alan E.; Baker, Daniel H.
This document presents an overview of anorexia nervosa and bulimia in adolescents. A brief review of the historical background of these eating disorders is included. Causes of anorexia and bulimia are discussed and physical, behavioral, emotional, and perceptual characteristics of the disorders are listed in a section on symptoms. The need for a…
Reas, Deborah L.; Grilo, Carlos M.
Introduction Binge-eating disorder (BED), a formal eating-disorder diagnosis in the DSM-5, is characterized by recurrent binge-eating, marked distress about binge-eating, and the absence of extreme weight compensatory behaviors. BED is more prevalent than other eating-disorders, with broader distribution across age, sex, and ethnic/racial groups, and is associated strongly with obesity and heightened risk for psychiatric/medical comorbidities. Areas Covered This article provides an overview of pharmacotherapy for BED with a focus on III randomized controlled trials (RCTs). The search with minimal methodological inclusion requirements yielded 22 RCTs investigating several different medication classes; most were pharmacotherapy-only trials with eight trials testing combination approaches with psychological-behavioral methods. Expert Opinion The evidence base regarding pharmacotherapy for BED remains limited, although this year the FDA approved the first medication (i.e., lisdexamfetamine dimesylate; LDX) specifically for moderate-to-severe BED. Data from RCTs suggests certain medications are superior to placebo for reducing binge-eating over the short-term; almost no data exist regarding longer-term effects of pharmacotherapy for BED. Except for topiramate, which significantly reduces both binge-eating and weight, tested medications yield minimal weight loss and LDX is not indicated for weight loss. Psychological-behavioral and combination approaches with certain medications yield superior outcomes to pharmacotherapy-only acutely and over longer-term follow-up. PMID:26044518
Elran-Barak, Roni; Sztainer, Maya; Goldschmidt, Andrea B; Le Grange, Daniel
Previous studies on family meals and disordered eating have mainly drawn their samples from the general population. The goal of the current study is to determine family meal frequency among children and adolescents with anorexia nervosa (AN), bulimia nervosa (BN), and feeding or eating disorder not elsewhere classified (FED-NEC) and to examine whether family meal frequency is associated with eating disorder psychopathology. Participants included 154 children and adolescents (M = 14.92 ± 2.62), who met criteria for AN (n = 60), BN (n = 32), or FED-NEC (n = 62). All participants completed the Eating Disorder Examination and the Family Meal Questionnaire prior to treatment at the University of Chicago Eating Disorders Program. AN and BN participants significantly differed in terms of family meal frequency. A majority of participants with AN (71.7%), compared with less than half (43.7%) of participants with BN, reported eating dinner with their family frequently (five or more times per week). Family meal frequency during dinner was significantly and negatively correlated with dietary restraints and eating concerns among participants with BN (r = -.381, r = -.366, p meal frequency may be explained by their parents' relatively greater vigilance over eating, whereas families of BN patients may be less aware of eating disorder behaviors and hence less insistent upon family meals. Additionally, children and adolescents with AN may be more inhibited and withdrawn and therefore are perhaps more likely to stay at home and eat together with their families. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Lahortiga-Ramos, Francisca; De Irala-Estévez, Jokin; Cano-Prous, Adrián; Gual-García, Pilar; Martínez-González, Miguel Angel; Cervera-Enguix, Salvador
To estimate the overall annual incidence and age group distribution of eating disorders in a representative sample of adolescent female residents of Navarra, Spain. We studied a representative sample of 2734 adolescent Navarran females between 13 and 22 years of age who were free of any eating disorder at the start of our study. Eighteen months into the study, we visited the established centers and the eating attitudes test (EAT-40) and eating disorder inventory (EDI) Questionnaires were administered to the entire study population. We obtained a final response of 92%. All adolescents whose EAT score was over 21 points and a randomized sample of those who scored 21 or below, were interviewed. Any person meeting the DSM-IV diagnostic criteria for Anorexia Nervosa (AN), Bulimia Nervosa (BN) or eating disorder not otherwise specified (EDNOS) was considered a case. We detected 90 new cases of eating disorders. Taking into consideration the randomly selected group whose EAT score was 21 points or below, we estimated the overall weighted incidence of eating disorders to be 4.8% (95% CI: 2.8-6.8), after 18 months of observation, in which EDNOS predominated with an incidence of 4.2% (95% CI: 2.0-6.3). The incidence of AN was 0.3% (95% CI: 0.2-0.5), while that of BN was also found to be 0.3% (95% CI: 0.2-0.5). The highest incidence was observed in the group of adolescents between 15 and 16 years of age. The overall incidence of ED in a cohort of 2509 adolescents after 18 months of follow-up was 4.8% (95% CI: 2.8-6.8), with EDNOS outweighing the other diagnoses. The majority of new cases of eating disorders were diagnosed between ages 15 and 16.
Rotella, Francesco; Mannucci, Edoardo; Gemignani, Sara; Lazzeretti, Lisa; Fioravanti, Giulia; Ricca, Valdo
Growing evidence shows that temperamental features and emotional dysregulation are linked to Eating Disorders (EDs). Aim of this study was to explore the possible relationship between temperament and emotional eating (EE) from a dimensional standpoint, and the association of specific temperamental dimensions with overeating triggered by specific emotions. We enrolled 253 women with Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. Of those, 189 (74.7%), 73 (28.8%), and 80 (31.6%) reported binge eating, purging, or restrictive behaviors, respectively (the categories are not mutually exclusive). Participants completed the Emotional Eating Scale (EES), the Temperament and Character Inventory, the Eating Disorder Examination Questionnaire (EDE-Q) and the Symptom Checklist 90-Revised (SCL-90-R). Higher Persistence scores were found in the Restriction group, while the Binge group reported lower Persistence and higher Novelty Seeking scores. The Purge group showed lower Reward Dependence, Self Directedness and Cooperativeness scores. Patients with Purge also reported lower BMI and higher scores on EDE-Q restriction and eating concern subscales as well as higher scores for all SCL 90-R subscales. Patterns of association between temperamental traits and specific emotions were found in each group. Therefore, some temperamental features could be considered predictors of specific associations between emotions and the tendency to eat. Copyright © 2018. Published by Elsevier B.V.
Full Text Available OBJECTIVE: The Eating Disorder Examination-Questionnaire (EDE-Q is a self-report instrument assessing the specific psychopathology and key behaviors of eating disorders. This study sought to determine the prevalence of eating disturbances, and to provide psychometric properties and norms of the EDE-Q, in a representative German population sample. METHODS: A total of 2520 individuals (1166 men, 1354 women were assessed with the EDE-Q. RESULTS: Eating disorder psychopathology was higher and most key behaviors were more prevalent in women than in men. Psychopathology declined with age ≥65 in both sexes, and showed a peak at age 55-64 in men. Overall, 5.9% of the women and 1.5% of the men revealed eating disturbances. The prevalence of eating disturbances decreased with age in women and was significantly higher in obese than in normal-weight individuals. Psychometric analyses showed favorable item characteristics. Internal consistencies of EDE-Q composite scores were ≥.80 for women and ≥.70 for men. The factor structure of the EDE-Q was partially reproduced. Sex- and age-specific population norms are reported. DISCUSSION: This study provides population norms of the EDE-Q for both sexes and across the age range, demonstrates demographic variations in symptomatology, and reveals satisfactory psychometric properties. Further research is warranted on eating disturbances in older adults.
Arzu Onal Sonmez
Full Text Available Eating disorders are relatively common and serious disorders in adolescent and pre-adolescent age. The aim of this review is to update new findings related with mostly seen feeding and eating disorders in child and adolescents. The article focuses specifically on anorexia nervosa and bulimia nervosa. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(3.000: 301-316
Eating is necessary for survival, gives great pleasure and can be perturbed leading to undernutrition, overnutrition and eating disorders. The development of feeding in humans relies on complex interplay between homeostatic mechanisms; neural reward systems; and child motor, sensory and socio-emotional capability. Furthermore, parenting, social influences and the food environment influence the development of eating behavior. The rapid expansion of new knowledge in this field, from basic science to clinical and community-based research, is expected to lead to urgently needed research in support of effective, evidence-based prevention and treatment strategies for undernutrition, overnutrition and eating disorders in early childhood. Using a biopsychosocial approach, this review covers current knowledge of the development of eating behavior from the brain to the individual child, taking into account important contextual influences. PMID:22472944
Piquero, Nicole Leeper; Fox, Kristan; Piquero, Alex R.; Capowich, George; Mazerolle, Paul
Much of the prior work on General Strain Theory (GST) has focused on how strain and negative emotions interrelate to produce criminal--especially violent--activity. Very little research has extended GST to examine other types of non-criminal, negative behavior, such as self-harming behaviors associated with disordered eating, a traditionally…
Claes, Laurence; Bijttebier, Patricia; Mitchell, James E; de Zwaan, Martina; Mueller, Astrid
The aim of the present study was to investigate the relationship between compulsive buying (CB), eating disorder symptoms, and temperament (controlling for depression) in a sample of female students. We assessed 211 female undergraduate students using the Compulsive Buying Scale, the Eating Disorder Inventory, the Behavioral Inhibition System and Behavioral Activation System scales, the Adult Temperament Questionnaire, and the Physical Health Questionnaire-Depression. The results show a positive association between CB and the Eating Disorder Inventory-II drive for thinness and bulimia subscales. Both CB and eating disorder symptoms were related to low levels of effortful control. Finally, CB was also related to high levels of Behavioral Activation Scale reactivity (impulsivity), whereas eating disorder symptoms (especially drive for thinness) were more strongly related to high levels of Behavioral Inhibition Scale reactivity (anxiety). The implications of these findings for the treatment of CB and eating disorder symptoms will be discussed. © 2011 Elsevier Inc. All rights reserved.
The article presented peculiarities of applying the method of autogenic training in the correction of eating disorders. Described stages of correction work with desadaptive eating behavior. Author makes accent on the rules self-assembly formula intentions.
Full Text Available Background. Symptoms of celiac disease negatively impact social activities and emotional state. Aim was to investigate the prevalence of altered eating behaviour in celiac patients. Methods. Celiac patients and controls completed a dietary interview and the Binge Eating Staircases, Eating Disorder Inventory (EDI-2, Eating Attitudes Test, Zung Self-Rating Depression Scale, State Trait Anxiety Inventory Forma Y (STAI-Y1 and STAI-Y2, and Symptom Check List (SCL-90. Results. One hundred celiac adults and 100 controls were not statistically different for gender, age, and physical activity. STAI-Y1 and STAI-Y2, Somatization, Interpersonal, Sensitivity, and Anxiety scores of the SLC-90 were higher in CD patients than controls. EDI-2 was different in pulse thinness, social insecurity, perfectionism, inadequacy, ascetisms, and interpersonal diffidence between CD and HC women, whilst only in interceptive awareness between CD and HC men. A higher EAT-26 score was associated with the CD group dependently with gastrointestinal symptoms. The EAT26 demonstrated association between indices of diet-related disorders in both CD and the feminine gender after controlling for anxiety and depression. Conclusion. CD itself and not gastrointestinal related symptoms or psychological factors may contribute pathological eating behavior in celiac adults. Eating disorders appear to be more frequent in young celiac women than in CD men and in HC.
Zerwas, Stephanie; Larsen, Janne Tidselbak; Petersen, Liselotte
higher hazards of eating disorders for children and adolescents with autoimmune or autoinflammatory diseases: 36% higher hazard for anorexia nervosa, 73% for bulimia nervosa, and 72% for an eating disorder not otherwise specified. The association was particularly strong in boys. Parental autoimmune...... or autoinflammatory disease history was associated with significantly increased odds for anorexia nervosa (odds ratio [OR] = 1.13, confidence interval [CI] = 1.01-1.25), bulimia nervosa (OR = 1.29; CI = 1.08-1.55) and for an eating disorder not otherwise specified (OR = 1.27; CI = 1.13-1.44). CONCLUSIONS: Autoimmune...
Full Text Available Group models are commonly used to treat eating disorders; however, research in this area remains largely underdeveloped. Interest in group work is likely to increase due to the demands on the public health system and the cost-effectiveness of group modalities. This scoping review sought to explore the evidence underpinning group therapy for adolescents living with an eating disorder. A literature search of 10 academic databases and four gray literature databases was undertaken in 2013. Selected Internet resources were searched and the author consulted professionals from Eating Disorders Victoria, the Butterfly Foundation, and the University of Melbourne. A total of 11 peer-reviewed articles published between 2003 and 2013 were included for review. There was an overall lack of research with no randomized-controlled trials available. Six program evaluations and five program descriptions were found, and they reported on a range of eating disorders and group modalities. The program evaluations suggested the utility of group therapy for promoting weight restoration in underweight individuals living with an eating disorder. Cognitive behavioral therapy groups were found to be more effective for bulimia nervosa and multifamily group therapy showed promise for anorexia nervosa. More rigorous research is needed to establish the effectiveness of group therapy for adolescents living with an eating disorder.
Larsen, Pernille Stemann; Strandberg-Larsen, Katrine; Micali, Nadia; Andersen, Anne-Marie Nybo
After participating in this activity, learners should be better able to: Evaluate the evidence regarding parental and child characteristics related to early-onset disordered eating. Eating disorders are rare in children, but disordered eating is common. Understanding the phenomenology of disordered eating in childhood can aid prevention of full-blown eating disorders. The purpose of this review is to systematically extract and synthesize the evidence on parental and child characteristics related to early-onset disordered eating. Systematic searches were conducted in PubMED/MEDLINE, EMBASE, and PsycInfo using the following search terms: eating disorder, disordered eating, problem eating, anorexia nervosa, bulimia nervosa, binge eating, child, preadolescent, and early onset. Studies published from 1990 to 2013 addressing parental and child characteristics of disordered eating in children aged 6 to 12 years were eligible for inclusion. The search was restricted to studies with cross-sectional, case-control, or longitudinal designs, studies in English, and with abstracts available. Forty-four studies fit these criteria. Most studies were based on community samples with a cross-sectional design. The included studies varied considerably in size, instruments used to assess early-onset disordered eating, and parental and child characteristics investigated. Important determinants included the following: higher body weight, previously reported disordered eating, body dissatisfaction, depression, parental disordered eating, and parental comments/concerns about child's weight and eating. The findings were inconsistent for sex, age, socioeconomic status, ethnicity, self-esteem/worth, and parental body weight. In conclusion, characteristics related to early-onset disordered eating have mainly been explored with a cross-sectional design. Full understanding of causal pathways will require good-quality longitudinal studies designed to address the influence of parental eating
Eichen, Dawn M; Matheson, Brittany E; Appleton-Knapp, Sara L; Boutelle, Kerri N
Recent research has highlighted executive function and neurocognitive deficits among individuals with eating and weight disorders, identifying a potential target for treatment. Treatments targeting executive function for eating and weight disorders are emerging. This review aims to summarize the recent literature evaluating neurocognitive/executive function-oriented treatments for eating and weight disorders and highlights additional work needed in this area. Cognitive remediation therapy (CRT) for anorexia nervosa has been the most extensively studied neurocognitive treatment for eating disorders. Results demonstrate that CRT improves executive function and may aid in the reduction of eating disorder symptomatology. Computer training programs targeting modifying attention and increasing inhibition are targeting reduction of binge eating and weight loss with modest success. Neurocognitive treatments are emerging and show initial promise for eating and weight disorders. Further research is necessary to determine whether these treatments can be used as stand-alone treatments or whether they need to be used as an adjunct to or in conjunction with other evidence-based treatments to improve outcomes.
Warren, M P; Voussoughian, F; Geer, E B; Hyle, E P; Adberg, C L; Ramos, R H
Because the exact etiology of functional, or idiopathic, hypothalamic amenorrhea (FHA) is still unknown, FHA remains a diagnosis of exclusion. The disorder may be stress induced. However, mounting evidence points to a metabolic/nutritional insult that may be the primary causal factor. We explored the thyroid, hormonal, dietary, behavior, and leptin changes that occur in FHA, as they provide a clue to the etiology of this disorder. Fourteen cycling control and amenorrheic nonathletic subjects were matched for age, weight, and height. The amenorrheic subjects denied eating disorders; only after further, detailed questioning did we uncover a higher incidence of anorexia and bulimia in this group. The amenorrheic subjects demonstrated scores of abnormal eating twice those found in normal subjects (P < 0.05), particularly bulimic type behavior (P < 0.01). They also expended more calories in aerobic activity per day and had higher fiber intakes (P < 0.05); lower body fat percentage (P < 0.05); and reduced levels of free T4 (P < 0.05), free T3 (P < 0.05), and total T4 (P < 0.05), without a significant change in rT3 or TSH. Cortisol averaged higher in the amenorrheics, but not significantly, whereas leptin values were significantly lower (P < 0.05). Bone mineral density was significantly lower in the wrist (P < 0.05), with a trend to lower BMD in the spine (P < 0.08). Scores of emotional distress and depression did not differ between groups. The alterations in eating patterns, leptin levels, and thyroid function present in subjects with FHA suggest altered nutritional status and the suppression of the hypothalamic-pituitary-thyroid axis or the alteration of feedback set-points in women with FHA. Both lower leptin and thyroid levels parallel changes seen with caloric restriction. Nutritional issues, particularly dysfunctional eating patterns and changes in thyroid metabolism, and/or leptin effects may also have a role in the metabolic signals suppressing GnRH secretion and
Ida F. Dancyger; Victor M. Fornari
This review examines the literature during the past 10 years about suicide risk and suicide during adolescence and young adulthood of individuals with eating disorders. Epidemiological surveys are summarized, including suicide rates, parasuicidal behaviors, associated risk factors, and comorbid psychopathology. Critical implications for the comprehensive assessment and treatment planning, including safety considerations, are discussed. Two clinical cases of women with long-standing eating dis...
Shouse, Sarah H.; Nilsson, Johanna
Self-silencing (or the suppression of expressing one's thoughts, feelings, and needs) can have a negative impact on the mental health of women, from depression to disordered eating behaviors. The authors examined the relationship between self-silencing and disordered eating as well as intuitive eating. The authors also explored whether emotional…
Kamińska, Katarzyna; Rybakowski, Filip
Eating disorders--anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified (EDNOS) occur usually in young females. The significant pathogenic differences between patients who only restrict food, and patients with binge eating and compensatory behaviours, such as vomiting and purging were described. The prevalence of bipolar affective disorders--especially bipolar II and bipolar spectrum disorders (BS) may reach 5% in the general population. About half of the depressive episodes are associated with a "mild" bipolar disorder, and such a diagnosis is suggested by impulsivity and mood-instability. Previously, majority of research on the comorbidity between eating and affective disorders focused on depressive symptomatology, however difficulties in the reliable assessment of hypomania may obfuscate the estimation of the co-occurrence of eating disorders with BS. Epidemiological studies suggest the association between BS and eating disorders with binge episodes (bulimia nervosa, anorexia- bulimic type and EDNOS with binge episodes). Co-occurrence of such disorders with depressive symptoms probably suggests the diagnosis of BS, not recurrent depression. Bulimic behaviours, impulsivity and affective disorders might be related to the impairment of the serotonergic neurotransmission, which may result from the genetic vulnerability and early life trauma. Currently, the first-line pharmacological treatment of co-occurring eating disorders with binge episodes and BS are selective serotonin reuptake inhibitors. However in some cases, the use of mood-stabilising agents as monotherapy or in combination with serotonergic drugs may be helpful.
Smink, Frédérique R E; van Hoeken, Daphne; Hoek, Hans W
To review the recent literature about the epidemiology, course, and outcome of eating disorders in accordance with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The residual category 'eating disorder not otherwise specified' (EDNOS) was the most common DSM-IV eating disorder diagnosis in both clinical and community samples. Several studies have confirmed that the DSM-5 criteria for eating disorders effectively reduce the proportion of EDNOS diagnoses. The lifetime prevalence of DSM-5 anorexia nervosa among women might be up to 4%, and of bulimia nervosa 2%. In a cross-national survey, the average lifetime prevalence of binge eating disorder (BED) was 2%. Both anorexia nervosa and bulimia nervosa are associated with increased mortality. Data on long-term outcome, including mortality, are limited for BED. Follow-up studies of BED are scarce; remission rates in randomized controlled trials ranged from 19 to 65% across studies. On a community level, 5-year recovery rates for DSM-5 anorexia nervosa and bulimia nervosa are 69 and 55%, respectively; little is known about the course and outcome of BED in the community. Applying the DSM-5 criteria effectively reduces the frequency of the residual diagnosis EDNOS, by lowering the threshold for anorexia nervosa and bulimia nervosa, and adding BED as a specified eating disorder. Course and outcome studies of both anorexia nervosa and bulimia nervosa show that no significant differences exist between DSM-5 and DSM-IV definitions.
The original and enhanced cognitive model of eating disorders proposes that cognitive-behavioral therapy (CBT) "works" through modifying dietary restraint and dysfunctional attitudes towards shape and weight. However, evidence supporting the validity of this model is limited. This meta-analysis examined whether CBT can effectively modify these proposed maintaining mechanisms. Randomized controlled trials that compared CBT to control conditions or non-CBT interventions, and reported dietary restraint and shape and weight concern outcomes were searched. Twenty-nine trials were included. CBT was superior to control conditions in reducing shape (g=0.53) and weight (g=0.63) concerns, and dietary restraint (g=0.36). These effects occurred across all diagnoses and treatment formats. Improvements in shape and weight concerns and restraint were also greater in CBT than non-CBT interventions (g's=0.25, 0.24, 0.31, respectively) at post-treatment and follow-up. The magnitude of improvement in binge/purge symptoms was related to the magnitude of improvement in these maintaining mechanisms. Findings demonstrate that CBT has a specific effect in targeting the eating disorder maintaining mechanisms, and offers support to the underlying cognitive model. If changes in these variables during treatment are shown to be causal mechanisms, then these findings show that CBT, relative to non-CBT interventions, is better able to modify these mechanisms.
Seidenfeld, Marjorie E Kaplan; Sosin, Elyse; Rickert, Vaughn I
Adequate nutrition is essential during adolescence, since growth and development during this period play key roles in achieving normal adult size and reproductive capacity. This article briefly reviews recommended caloric intake; the healthy balance of carbohydrates, fat and protein; and the appropriate dietary intake of iron, folic acid and calcium for the adolescent. A major potential obstacle to good nutrition for an adolescent is the development of an eating disorder such as anorexia nervosa or bulimia nervosa. Anorexia nervosa, characterized by severe underweight, fear of gaining weight, and low self-esteem and amenorrhea, is associated with many physiological and psychological complications with which the provider must be familiar. Similarly, bulimia nervosa, which presents with eating binges followed by compensatory behaviors such as vomiting, diet pill abuse and overexercise, may be harder to detect, but can also have devastating consequences, both physically and emotionally, for a young person. Both of these disorders are best treated by a multidisciplinary team of specialists to address the medical, psychological, and nutritional components of these illnesses.
Hilbert, Anja; Hildebrandt, Thomas; Agras, W Stewart; Wilfley, Denise E; Wilson, G Terence
Analysis of short- and long-term effects of rapid response across 3 different treatments for binge eating disorder (BED). In a randomized clinical study comparing interpersonal psychotherapy (IPT), cognitive-behavioral therapy guided self-help (CBTgsh), and behavioral weight loss (BWL) treatment in 205 adults meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; APA, 1994) criteria for BED, the predictive value of rapid response, defined as ≥70% reduction in binge eating by Week 4, was determined for remission from binge eating and global eating disorder psychopathology at posttreatment, 6-, 12-, 18-, and 24-month follow-ups. Rapid responders in CBTgsh, but not in IPT or BWL, showed significantly greater rates of remission from binge eating than nonrapid responders, which was sustained over the long term. Rapid and nonrapid responders in IPT and rapid responders in CBTgsh showed a greater remission from binge eating than nonrapid responders in CBTgsh and BWL. Rapid responders in CBTgsh showed greater remission from binge eating than rapid responders in BWL. Although rapid responders in all treatments had lower global eating disorder psychopathology than nonrapid responders in the short term, rapid responders in CBTgsh and IPT were more improved than those in BWL and nonrapid responders in each treatment. Rapid responders in BWL did not differ from nonrapid responders in CBTgsh and IPT. Rapid response is a treatment-specific positive prognostic indicator of sustained remission from binge eating in CBTgsh. Regarding an evidence-based, stepped-care model, IPT, equally efficacious for rapid and nonrapid responders, could be investigated as a second-line treatment in case of nonrapid response to first-line CBTgsh. (c) 2015 APA, all rights reserved).
Heaner, Martica K; Walsh, B Timothy
During the last 25 years, the careful examination of the eating behavior of individuals with eating disorders has provided critical insights into the nature of these disorders. Crucially, studies investigating components of different eating behaviors have documented that Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED) are characterized by objective disturbances in eating patterns that are significantly different than behaviors exhibited by individuals who do not have these eating disorders. The detailed description of the disturbances in eating behavior has helped to identify diagnostic criteria associated with each disorder, and has led to important hypotheses about the underlying pathophysiology. These advances in understanding have provided, and continue to provide, a foundation for translational research and for the development of novel treatment interventions. This review is based on a presentation given by B. Timothy Walsh, M.D. at the 40th anniversary symposium of the Columbia University Appetite talks outlining the evolution of the discovery of the characteristic eating disturbances seen with each disorder. Copyright © 2013 Elsevier Ltd. All rights reserved.
Linardon, Jake; Braithwaite, Rachel; Cousins, Rachel; Brennan, Leah
Previous research has established a robust relationship between symptoms of social anxiety and disordered eating. However, the mechanisms that may underpin this relationship are unclear. Appearance-based rejection sensitivity (ABRS)-the tendency to anxiously expect and overreact to signs of appearance-based rejection-may be a crucial explanatory mechanism, as ABRS has been shown to maintain social anxiety symptoms and predict disordered eating. We therefore tested whether ABRS mediated the relationship between social anxiety symptoms and various indices of disordered eating (over-evaluation of weight/shape, restraint, binge eating, compulsive exercise, and vomiting). Data from community-based females (n=299) and males (n=87) were analyzed. ABRS was shown to mediate the relationship between social anxiety and the over-evaluation, restraint, binge eating, and compulsive exercise frequency, but not vomiting. These effects also occurred for both females and males separately. Findings demonstrated that ABRS may be an important mechanism explaining why socially anxious individuals report elevated symptoms of disordered eating. Future research testing all proposed mediating variables of the social anxiety-disordered eating link in a single, integrative model is required to identify the most influential mechanisms driving this relationship. Copyright © 2017 Elsevier Ltd. All rights reserved.
Enten, Roni S; Golan, Moria
Our objective was to investigate the association between parenting style and eating disorder symptoms in patients treated in an intensive outpatient center for eating disorders. The study design is a cross-sectional survey set in a community-based facility for eating disorders. Participants included 53 families, including 32 with a child meeting the DSM-IV criteria for anorexia nervosa, 18 for bulimia nervosa, and 3 diagnosed ED-NOS. Data was collected using the Parental Authority Questionnaire (PAQ), the Eating Disorders Inventory-2 (EDI-2) and the Eating Attitudes Test (EAT-26). Significant, negative correlations were found between drive for thinness scores and body dissatisfaction scores and the patient's perception of the father as authoritative. Total patient EDI score was significantly and positively correlated with patient's perception of the father as authoritarian and inversely correlated with her perception of him as authoritative. These results emphasize the importance of fathers' role in the eating disorder pathology, a relatively untapped area of research.
Schousboe, Birgitte Hartvig
Mennesker med Binge Eating Disorder indtager større mængder mad uden at være sultne. Overspisningen kan dulme svære følelser, men medfører typisk ekstremt ubehag og skam. Mennesker, der lider af spiseforstyrrelsen Binge Eating Disorder (i daglig tale kaldet BED), har ofte problemer med overvægt, og...
Leonardo de Sousa Fortes
Full Text Available OBJECTIVE: The aim of this study was to compare the inappropriate eating behaviors of adolescents as a function of habitual level of physical activity. METHODS: Participants were 462 youth of both genders aged 10 to 19 years. The Eating Attitudes Test-26 was used for inappropriate eating behaviors assessment. A short version of the International Physical Activity Questionnaire was used for classifying the habitual level of physical activity. RESULTS: No statistically significant differences were found for the comparison of inappropriate eating behaviors in the multivariate covariance model either for females or males. Moreover, the level of physical activity had no significant influence on the inappropriate eating behaviors of these adolescents. CONCLUSION: In conclusion, inappropriate eating behaviors in both genders were similar regardless of the habitual level of physical activity.
Weinbach, Noam; Sher, Helene; Bohon, Cara
Emotion regulation appears to play a key role in eating disorders. However, prior attempts to associate specific emotion regulation abilities with specific types of eating disorders resulted in inconsistent findings. Moreover, far less is known about emotion regulation in eating disorders during adolescence, a critical period of emotional development. The current study addresses this gap, comparing emotion regulation characteristics between adolescents with restrictive types of eating disorders and those with binge eating or purging types of eating disorders. Ninety-eight adolescents with eating disorders (49 with restrictive and 49 with binge eating/purging eating disorders) completed a set of questionnaires including the Difficulties in Emotion Regulation Scale (DERS). The results revealed that binge eating/purging types of eating disorders were associated with greater difficulties in a variety of emotion regulation dimensions including impulse control, goal-directed behavior and access to effective emotion regulation strategies. Awareness and clarity of emotions were also worse in the binge eating/purging types of eating disorders, but this difference did not remain when comorbid psychopathology measures were controlled for. Moreover, the emotion regulation profile of adolescents with anorexia nervosa-binging/purging type was more similar to that of adolescents with bulimia nervosa than to that of adolescents with anorexia nervosa-restrictive type. While both restrictive and binge eating/purging eating disorders have been associated with emotion regulation difficulties, the current study shows that the presence of binge eating or purging episodes is linked with greater severity of emotion regulation deficits among adolescents with eating disorders.
Cesa, Gian Luca; Manzoni, Gian Mauro; Bacchetta, Monica; Castelnuovo, Gianluca; Conti, Sara; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; Cárdenas-López, Georgina; Riva, Giuseppe
Recent research identifies unhealthful weight-control behaviors (fasting, vomiting, or laxative abuse) induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. In particular, according to the allocentric lock hypothesis, individuals with obesity may be locked to an allocentric (observer view) negative memory of the body that is no longer updated by contrasting egocentric representations driven by perception. In other words, these patients may be locked to an allocentric negative representation of their body that their sensory inputs are no longer able to update even after a demanding diet and a significant weight loss. To test the brief and long-term clinical efficacy of an enhanced cognitive-behavioral therapy including a virtual reality protocol aimed at unlocking the negative memory of the body (ECT) in morbidly obese patients with binge eating disorders (BED) compared with standard cognitive behavior therapy (CBT) and an inpatient multimodal treatment (IP) on weight loss, weight loss maintenance, BED remission, and body satisfaction improvement, including psychonutritional groups, a low-calorie diet (1200 kcal/day), and physical training. 90 obese (BMI>40) female patients with BED upon referral to an obesity rehabilitation center were randomly assigned to conditions (31 to ECT, 30 to CBT, and 29 to IP). Before treatment completion, 24 patients discharged themselves from hospital (4 in ECT, 10 in CBT, and 10 in IP). The remaining 66 inpatients received either 15 sessions of ECT, 15 sessions of CBT, or no additional treatment over a 5-week usual care inpatient regimen (IP). ECT and CBT treatments were administered by 3 licensed psychotherapists, and patients were blinded to conditions. At start, upon completion of the inpatient treatment, and at 1-year follow-up, patients' weight, number of binge eating episodes during the previous month, and body satisfaction were assessed by self-report questionnaires and
Walsh, Judith M E; Wheat, Mary E; Freund, Karen
OBJECTIVE To describe how primary care clinicians can detect an eating disorder and identify and manage the associated medical complications. DESIGN A review of literature from 1994 to 1999 identified by a medlinesearch on epidemiology, diagnosis, and therapy of eating disorders, including anorexia nervosa and bulimia nervosa. MEASUREMENTS AND MAIN RESULTS Detection requires awareness of risk factors for, and symptoms and signs of, anorexia nervosa (e.g., participation in activities valuing thinness, family history of an eating disorder, amenorrhea, lanugo hair) and bulimia nervosa (e.g., unsuccessful attempts at weight loss, history of childhood sexual abuse, family history of depression, erosion of tooth enamel from vomiting, partoid gland swelling, and gastroesophageal reflux). Providers must also remain alert for disordered eating in female athletes (the female athlete triad) and disordered eating in diabetics. Treatment requires a multidisciplinary team including a primary care practitioner, nutritionist, and mental health professional. The role of the primary care practitioner is to help determine the need for hospitalization and to manage medical complications (e.g., arrhythmias, refeeding syndrome, osteoporosis, and electrolyte abnormalities such as hypokalemia). CONCLUSION Primary care providers have an important role in detecting and managing eating disorders. PMID:10940151
Nash, J.; Skinner, T. C.
There is some debate in the literature as to whether there is an increased risk of developing eating disorders in individuals with type 1 diabetes. This review located 12 empirical studies of eating pathology in females with type 1 diabetes. Review of these papers indicates...... that there is no evidence for an increase in the rates of anorexia or bulimia, in females with type 1 diabetes. However, the data do suggest that eating disorders not otherwise specified (EDNOS) are more prevalent in individuals with type 1 diabetes. Key features of these articles are reviewed and discussed....
Ana Paula Hermont
Full Text Available BACKGROUND: Eating disorders are associated with the highest rates of morbidity and mortality of any mental disorders among adolescents. The failure to recognize their early signs can compromise a patient's recovery and long-term prognosis. Tooth erosion has been reported as an oral manifestation that might help in the early detection of eating disorders. OBJECTIVES: The aim of this systematic review and meta-analysis was to search for scientific evidence regarding the following clinical question: Do eating disorders increase the risk of tooth erosion? METHODS: An electronic search addressing eating disorders and tooth erosion was conducted in eight databases. Two independent reviewers selected studies, abstracted information and assessed its quality. Data were abstracted for meta-analysis comparing tooth erosion in control patients (without eating disorders vs. patients with eating disorders; and patients with eating disorder risk behavior vs. patients without such risk behavior. Combined odds ratios (ORs and a 95% confidence interval (CI were obtained. RESULTS: Twenty-three papers were included in the qualitative synthesis and assessed by a modified version of the Newcastle-Ottawa Scale. Fourteen papers were included in the meta-analysis. Patients with eating disorders had more risk of tooth erosion (OR = 12.4, 95%CI = 4.1-37.5. Patients with eating disorders who self-induced vomiting had more risk of tooth erosion than those patients who did not self-induce vomiting (OR = 19.6, 95%CI = 5.6-68.8. Patients with risk behavior of eating disorder had more risk of tooth erosion than patients without such risk behavior (Summary OR = 11.6, 95%CI = 3.2-41.7. CONCLUSION: The scientific evidence suggests a causal relationship between tooth erosion and eating disorders and purging practices. Nevertheless, there is a lack of scientific evidence to fulfill the basic criteria of causation between the risk behavior for eating disorders and tooth erosion.
Tiffany A. Brown
Full Text Available Eating disorders are a significant source of psychiatric morbidity in young women and demonstrate high comorbidity with mood, anxiety, and substance use disorders. Thus, clinicians may encounter eating disorders in the context of treating other conditions. This review summarizes the efficacy of current and emerging treatments for anorexia nervosa (AN, bulimia nervosa (BN, and binge eating disorder (BED. Treatment trials were identified using electronic and manual searches and by reviewing abstracts from conference proceedings. Family based therapy has demonstrated superiority for adolescents with AN but no treatment has established superiority for adults. For BN, both 60 mg fluoxetine and cognitive behavioral therapy (CBT have well-established efficacy. For BED, selective serotonin reuptake inhibitors, CBT, and interpersonal psychotherapy have demonstrated efficacy. Emerging directions for AN include investigation of the antipsychotic olanzapine and several novel psychosocial treatments. Future directions for BN and BED include increasing CBT disseminability, targeting affect regulation, and individualized stepped-care approaches.
Spoor, Sonja T P; Bekker, Marrie H J; Van Heck, Guus L; Croon, Marcel A; Van Strien, Tatjana
This study investigated the associations of appearance orientation and eating disorder symptoms with internal body awareness in an eating-disordered group of women and a general sample of women. In the eating-disordered group, appearance orientation was positively associated with internal body awareness. Eating disorders symptoms were negatively related to the awareness of bodily signals. No significant associations were found in the general sample of women. The results indicate that in eating-disordered individuals preoccupation with the body and eating-disordered behaviors are not only negatively associated with hunger, but with awareness of other bodily signals as well.
Agnieszka Maria Bień
Full Text Available Introduction. Nutrition is one of the fundamental human needs, which allows for the proper functioning of the body. Nowadays, people are increasingly turning attention to the type and quantity of food intake, in order to preserve health and slim. Rigorous adherence to the principles of nutrition only healthy meals can lead to disorder orthorexia nervosa, which can lead to many complications (such as weight loss, vitamin deficiencies and mineral, hormonal disorders, psychological problems. The aim of the study was to investigate the prevalence of eating disorders such orthorexia nervosa in women of childbearing age and to check whether there is a relationship between the occurrence of eating disorders and a global orientation of life of respondents. Material and method. The study included 280 women aged between 18 and 35 years old who voluntarily joined the study. The study used the questionnaire technique, consisting of the author's questionnaire and standardized research tools (ORTO-15 Questionnaire, the SCOFF Eating Disorders Questionnaire and the Sense of Coherence Scale SOC-29. Results. After conducting these studies found an association between the occurrence of eating disorders such as orthorexia nervosa to religion, and between type of eating disorder anorexia and bulimia and marital status, and body mass index (BMI. It was also shown that the lower the overall level of sense of coherence and its components is more common in individuals at risk of developing anorexia or bulimia. Conclusion. There is a relationship between the occurrence of eating disorders such as orthorexia nervosa to religion. There is a relationship between the occurrence of eating disorders such as anorexia and bulimia marital status and body mass index of women.
Mustelin, L; Hedman, A M; Thornton, L M; Kuja-Halkola, R; Keski-Rahkonen, A; Cantor-Graae, E; Almqvist, C; Birgegård, A; Lichtenstein, P; Mortensen, P B; Pedersen, C B; Bulik, C M
The risk of certain psychiatric disorders is elevated among immigrants. To date, no population studies on immigrant health have addressed eating disorders. We examined whether risk of eating disorders in first- and second-generation immigrants differs from native-born Danes and Swedes. All individuals born 1984-2002 (Danish cohort) and 1989-1999 (Swedish cohort) and residing in the respective country on their 10th birthday were included. They were followed up for the development of eating disorders based on out-patient and in-patient data. The risks of all eating disorder types were lower among first-generation immigrants compared to the native populations: Incidence-rate ratio (95% confidence interval) was 0.39 (0.29, 0.51) for anorexia nervosa, 0.60 (0.42, 0.83) for bulimia nervosa, and 0.62 (0.47, 0.79) for other eating disorders in Denmark and 0.27 (0.21, 0.34) for anorexia nervosa, 0.30 (0.18, 0.51) for bulimia nervosa, and 0.39 (0.32, 0.47) for other eating disorders in Sweden. Likewise, second-generation immigrants by both parents were at lower risk, whereas those with only one foreign-born parent were not. The decreased risk of eating disorders among immigrants is opposite to what has been observed for other psychiatric disorders, particularly schizophrenia. Possible explanations include buffering sociocultural factors and underdetection in health care. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Gerbasi, Margaret E.; Richards, Lauren K.; Thomas, Jennifer J.; Agnew-Blais, Jessica C.; Thompson-Brenner, Heather; Gilman, Stephen E.; Becker, Anne E.
Objective The increasing global health burden imposed by eating disorders warrants close examination of social exposures associated with globalization that potentially elevate risk during the critical developmental period of adolescence in low- and middle-income countries (LMICs). The study aim was to investigate the association of peer influence and perceived social norms with adolescent eating pathology in Fiji, a LMIC undergoing rapid social change. Method We measured peer influence on eating concerns (with the Inventory of Peer Influence on Eating Concerns; IPIEC), perceived peer norms associated with disordered eating and body concerns, perceived community cultural norms, and individual cultural orientations in a representative sample of school-going ethnic Fijian adolescent girls (n=523). We then developed a multivariable linear regression model to examine their relation to eating pathology (measured by the Eating Disorder Examination-Questionnaire; EDE-Q). Results We found independent and statistically significant associations between both IPIEC scores and our proxy for perceived social norms specific to disordered eating (both p disordered eating may elevate risk for disordered eating in Fiji, during the critical developmental period of adolescence. Replication and extension of these research findings in other populations undergoing rapid social transition—and where globalization is also influencing local social norms—may enrich etiologic models and inform strategies to mitigate risk. PMID:25139374
Gerbasi, Margaret E; Richards, Lauren K; Thomas, Jennifer J; Agnew-Blais, Jessica C; Thompson-Brenner, Heather; Gilman, Stephen E; Becker, Anne E
The increasing global health burden imposed by eating disorders warrants close examination of social exposures associated with globalization that potentially elevate risk during the critical developmental period of adolescence in low- and middle-income countries (LMICs). The study aim was to investigate the association of peer influence and perceived social norms with adolescent eating pathology in Fiji, a LMIC undergoing rapid social change. We measured peer influence on eating concerns (with the Inventory of Peer Influence on Eating Concerns; IPIEC), perceived peer norms associated with disordered eating and body concerns, perceived community cultural norms, and individual cultural orientations in a representative sample of school-going ethnic Fijian adolescent girls (n = 523). We then developed a multivariable linear regression model to examine their relation to eating pathology (measured by the Eating Disorder Examination-Questionnaire; EDE-Q). We found independent and statistically significant associations between both IPIEC scores and our proxy for perceived social norms specific to disordered eating (both p peer influence as well as perceived social norms relevant to disordered eating may elevate risk for disordered eating in Fiji, during the critical developmental period of adolescence. Replication and extension of these research findings in other populations undergoing rapid social transition--and where globalization is also influencing local social norms--may enrich etiologic models and inform strategies to mitigate risk. © 2014 Wiley Periodicals, Inc.
Ascensión Palomares Ruiz
Full Text Available RESUMEN: Este artículo resume las investigaciones realizadas sobre los Trastornos de la Conducta Alimentaria (TCA en la sociedad actual y tiene, como objetivos básicos, reflexionar sobre la obsesión por la delgadez o búsqueda incesante de la misma, como característica esencial de los Trastornos de la Conducta Alimentaria; la tendencia a tener pensamientos o a darse comilonas -o atracones- incontrolables; así como, averiguar la insatisfacción del alumnado que padece TCA con la forma general de su cuerpo o con las partes del mismo que, en la adolescencia, más le preocupan. En la investigación, realizada en Granada, durante los años 2007-2010, se ha utilizado una metodología ecléctica. La selección de la muestra responde al criterio normativo de la edad; en este caso, 11 a 17 años, momento decisivo para estas personas al encontrarse ante la toma de decisiones importantes de cara a su futuro profesional y personal, al finalizar la escolarización obligatoria. El número de alumnos y alumnas que han realizado los Cuestionarios EPQ-J y EDI-2, ha sido de 700.Como conclusión más significativa, habría que destacar que no existe la necesaria educación y orientación psicopedagógica preventiva ante los trastornos de la conducta alimentaria, obteniéndose diferencias de género en los resultados. Resulta importante resaltar que el alumnado de los centros de Educación Secundaria analizados presenta carencias en algunas áreas, a nivel personal, que les exponen a padecer un TCA, obteniendo a los 13 años su mayor representatividad, lo que nos indica el momento en que se muestran más débiles y propensos a verse envueltos en este tipo de trastornos. ABSTRACT:This article summarizes the research on the disorders of eating behavior in today's society and has as main objectives, reflect on the obsession with thinness and relentless pursuit of the same essential feature of the Eating Disorders food, the tendency to binge-thoughts or be
Hutson, Peter H; Balodis, Iris M; Potenza, Marc N
Binge-eating disorder (BED) is the most prevalent eating disorder with estimates of 2-5% of the general adult population. Nonetheless, its pathophysiology is poorly understood. Furthermore, there exist few therapeutic options for its effective treatment. Here we review the current state of binge-eating neurobiology and pharmacology, drawing from clinical therapeutic, neuroimaging, cognitive, human genetic and animal model studies. These studies, which are still in their infancy, indicate that while there are many gaps in our knowledge, several key neural substrates appear to underpin binge-eating and may be conserved between human and animals. This observation suggests that behavioral intermediate phenotypes or endophenotypes relevant to BED may be modeled in animals, facilitating the identification and testing of novel pharmacological targets. The development of novel, safe and effective pharmacological therapies for the treatment of BED will enhance the ability of clinicians to provide optimal care for people with BED. Copyright © 2017 Elsevier Inc. All rights reserved.
Brody, Michelle L; Masheb, Robin M; Grilo, Carlos M
The current study examined the treatment preferences of obese patients with binge eating disorder (BED). Participants were 103 consecutive patients with BED who responded to advertisements for treatment studies looking for persons who wanted to "stop binge eating and lose weight." In addition to completing comprehensive assessment batteries, participants were provided descriptions of cognitive-behavioral therapy (CBT) and behavioral weight loss therapy (BWL) after which they were asked to choose and rate their preferred treatment. Sixty-three percent of participants stated they preferred CBT. Treatment preferences were not associated with (1) histories of obesity, dieting, binge eating, or weight cycling, (2) current obesity or eating disorder features, or (3) psychological features such as depression or self-esteem levels. In contrast, participants' stated treatment preferences were aligned with their perception of their primary problem (eating disorder vs. obesity) and their primary goals for treatment (stop binge eating vs. lose weight). The patients who preferred CBT based their treatment selection more on their problem perception than on their primary treatment goal, whereas the patients who preferred BWL selected treatment based more on their primary treatment goal (weight loss) than on their problem perception. Obese patients with BED express treatment preferences that are not associated with variability in their clinical characteristics but are aligned with their perception of their primary problem and with their primary goals for treatment. Copyright 2005 by Wiley Periodicals, Inc
Hilbert, Anja; Hildebrandt, Thomas; Agras, W. Stewart; Wilfley, Denise E.; Wilson, G. Terence
Objective Analysis of short- and long-term effects of rapid response across three different treatments for binge-eating disorder (BED). Method In a randomized clinical study comparing interpersonal psychotherapy (IPT), cognitive-behavioral guided self-help (CBTgsh), and behavioral weight loss (BWL) treatment in 205 adults meeting DSM-IV criteria for BED, the predictive value of rapid response, defined as ≥ 70% reduction in binge-eating by week four, was determined for remission from binge-eating and global eating disorder psychopathology at posttreatment, 6-, 12-, 18-, and 24-month follow-up. Results Rapid responders in CBTgsh, but not in IPT or BWL, showed significantly greater rates of remission from binge-eating than non-rapid responders, which was sustained over the long term. Rapid and non-rapid responders in IPT and rapid responders in CBTgsh showed a greater remission from binge-eating than non-rapid responders in CBTgsh and BWL. Rapid responders in CBTgsh showed greater remission from binge-eating than rapid responders in BWL. Although rapid responders in all treatments had lower global eating disorder psychopathology than non-rapid responders in the short term, rapid responders in CBTgsh and IPT were more improved than those in BWL and non-rapid responders in each treatment. Rapid responders in BWL did not differ from non-rapid responders in CBTgsh and IPT. Conclusions Rapid response is a treatment-specific positive prognostic indicator of sustained remission from binge-eating in CBTgsh. Regarding an evidence-based stepped care model, IPT, equally efficacious for rapid and non-rapid responders, could be investigated as a second-line treatment in case of non-rapid response to first-line CBTgsh. PMID:25867446
Hebebrand, Johannes; Albayrak, Özgür; Adan, Roger; Antel, Jochen; Dieguez, Carlos; de Jong, Johannes; Leng, Gareth; Menzies, John; Mercer, Julian G; Murphy, Michelle; van der Plasse, Geoffrey; Dickson, Suzanne L
"Food addiction" has become a focus of interest for researchers attempting to explain certain processes and/or behaviors that may contribute to the development of obesity. Although the scientific discussion on "food addiction" is in its nascent stage, it has potentially important implications for treatment and prevention strategies. As such, it is important to critically reflect on the appropriateness of the term "food addiction", which combines the concepts of "substance-based" and behavioral addiction. The currently available evidence for a substance-based food addiction is poor, partly because systematic clinical and translational studies are still at an early stage. We do however view both animal and existing human data as consistent with the existence of addictive eating behavior. Accordingly, we stress that similar to other behaviors eating can become an addiction in thus predisposed individuals under specific environmental circumstances. Here, we introduce current diagnostic and neurobiological concepts of substance-related and non-substance-related addictive disorders, and highlight the similarities and dissimilarities between addiction and overeating. We conclude that "food addiction" is a misnomer because of the ambiguous connotation of a substance-related phenomenon. We instead propose the term "eating addiction" to underscore the behavioral addiction to eating; future research should attempt to define the diagnostic criteria for an eating addiction, for which DSM-5 now offers an umbrella via the introduction on Non-Substance-Related Disorders within the category Substance-Related and Addictive Disorders. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Fortes,Leonardo de Sousa; Morgado,Fabiane Frota da Rocha; Almeida,Sebastião de Sousa; Ferreira,Maria Elisa Caputo
OBJECTIVE: The aim of this study was to compare the inappropriate eating behaviors of adolescents as a function of habitual level of physical activity. METHODS: Participants were 462 youth of both genders aged 10 to 19 years. The Eating Attitudes Test-26 was used for inappropriate eating behaviors assessment. A short version of the International Physical Activity Questionnaire was used for classifying the habitual level of physical activity. RESULTS: No statistically significant differences w...
Davis, Heather A; Smith, Gregory T
Binge eating and purging behaviors are associated with significant harm and distress among adolescents. The process by which these behaviors develop (often in the high school years) is not fully understood. We tested the Acquired Preparedness (AP) model of risk involving transactions among biological, personality, and psychosocial factors to predict binge eating and purging behavior in a sample of 1,906 children assessed in the spring of 5th grade (the last year of elementary school), the fall of 6th grade (the first year of middle school), spring of 6th grade, and spring of 10th grade (second year of high school). Pubertal onset in spring of 5th grade predicted increases in negative urgency, but not negative affect, in the fall of 6th grade. Negative urgency in the fall of 6th grade predicted increases in expectancies for reinforcement from eating in the spring of 6th grade, which in turn predicted increases in binge eating behavior in the spring of 10th grade. Negative affect in the fall of 6th grade predicted increases in thinness expectancies in the spring of 6th grade, which in turn predicted increases in purging in the spring of 10th grade. Results demonstrate similarities and differences in the development of these two different bulimic behaviors. Intervention efforts targeting the risk factors evident in this model may prove fruitful in the treatment of eating disorders characterized by binge eating and purging. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Felipe Q. da Luz
Full Text Available Obesity and eating disorders are each associated with severe physical and mental health consequences, and individuals with obesity as well as comorbid eating disorders are at higher risk of these than individuals with either condition alone. Moreover, obesity can contribute to eating disorder behaviors and vice-versa. Here, we comment on the health complications and treatment options for individuals with obesity and comorbid eating disorder behaviors. It appears that in order to improve the healthcare provided to these individuals, there is a need for greater exchange of experiences and specialized knowledge between healthcare professionals working in the obesity field with those working in the field of eating disorders, and vice-versa. Additionally, nutritional and/or behavioral interventions simultaneously addressing weight management and reduction of eating disorder behaviors in individuals with obesity and comorbid eating disorders may be required. Future research investigating the effects of integrated medical, psychological and nutritional treatment programs addressing weight management and eating disorder psychopathology in individuals with obesity and comorbid eating disorder behaviors—such as binge eating—is necessary.
Gómez Candela, Carmen; Palma Milla, Samara; Miján-de-la-Torre, Alberto; Rodríguez Ortega, Pilar; Matía Martín, Pilar; Loria Cohen, Viviana; Campos Del Portillo, Rocío; Virgili Casas, M ª Nuria; Martínez Olmos, Miguel Á; Mories Álvarez, M ª Teresa; Castro Alija, M ª José; Martín-Palmero, Ángela
Bulimia nervosa and binge eating disorder are unique nosological entities. Both show a large variability related to its presentation and severity which involves different therapeutic approaches and the need to individualize the treatment, thus it is indispensable a multidisciplinary approach. Patients with bulimia nervosa may suffer from malnutrition and deficiency states or even excess weight, while in binge eating disorders, it is common overweight or obesity, which determine other comorbidities. Many of the symptoms and complications are associated with compensatory behaviors. There are many therapeutic tools available for the treatment of these patients. The nutritional approach contemplates the individualized dietary advice which guarantees an adequate nutritional state and nutritional education. Its objective is to facilitate the voluntary adoption of eating behaviors that promote health and allow the long-term modification of eating habits and the cessation of purgatory and bingeing behaviors. Psychological support is a first-line treatment and it must address the frequent disorder of eating behavior and psychiatric comorbidities. Psychotropic drugs are effective and widely used although these drugs are not essential. The management is carried out mainly at an outpatient level, being the day hospital useful in selected patients. Hospitalization should be reserved to correct serious somatic or psychiatric complications or as a measure to contain non-treatable conflict situations. Most of the guidelines' recommendations are based on expert consensus, with little evidence which evaluates clinical results and cost-effectiveness.
The primary objective of this review of literature was to examine the relationship of eating disorders and disordered eating among female collegiate athletes. Since the institution of Title IX in 1972, the Educational Amendment to the Civil Rights Act of 1964, female participation in sports has been consistently rising at all levels of…
Schaumberg, Katherine; Welch, Elisabeth; Breithaupt, Lauren; Hübel, Christopher; Baker, Jessica H; Munn-Chernoff, Melissa A; Yilmaz, Zeynep; Ehrlich, Stefan; Mustelin, Linda; Ghaderi, Ata; Hardaway, Andrew J; Bulik-Sullivan, Emily C; Hedman, Anna M; Jangmo, Andreas; Nilsson, Ida A K; Wiklund, Camilla; Yao, Shuyang; Seidel, Maria; Bulik, Cynthia M
In 2015, the Academy for Eating Disorders collaborated with international patient, advocacy, and parent organizations to craft the 'Nine Truths About Eating Disorders'. This document has been translated into over 30 languages and has been distributed globally to replace outdated and erroneous stereotypes about eating disorders with factual information. In this paper, we review the state of the science supporting the 'Nine Truths'. The literature supporting each of the 'Nine Truths' was reviewed, summarized and richly annotated. Most of the 'Nine Truths' arise from well-established foundations in the scientific literature. Additional evidence is required to further substantiate some of the assertions in the document. Future investigations are needed in all areas to deepen our understanding of eating disorders, their causes and their treatments. The 'Nine Truths About Eating Disorders' is a guiding document to accelerate global dissemination of accurate and evidence-informed information about eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
Maguen, Shira; Hebenstreit, Claire; Li, Yongmei; Dinh, Julie V; Donalson, Rosemary; Dalton, Sarah; Rubin, Emma; Masheb, Robin
To develop a primary care eating disorder screen with greater accuracy and greater potential for generalizability, compared to existing screens. Cross-sectional survey to assess discriminative accuracy of a new screen, Screen for Disordered Eating (SDE), compared to Eating Disorders Screen for Primary Care (EDS-PC) and SCOFF screener, using prevalence rates of Binge Eating Disorder (BED), Bulimia Nervosa (BN), Anorexia Nervosa (AN), and Any Eating Disorder (AED), as measured by the Eating Disorder Examination Questionnaire (EDE-Q). The SDE correctly classified 87.2% (CI: 74.3%-95.2%) of BED cases, all cases of BN and AN, and 90.5% (CI: 80.4%-96.4%) of AED cases. Sensitivity estimates were higher than the SCOFF, which correctly identified 69.6% (CI: 54.2%-82.3%) of BED, 77.8% (CI: 40.0%-97.2%) of BN, 37.5% (CI: 8.52%-75.5%) of AN, and 66.1% (CI: 53%-77.7%) of AED. While the EDS-PC had slightly higher sensitivity than the SDE, the SDE had better specificity. The SDE outperformed the SCOFF in classifying true cases, the EDS-PC in classifying true non-cases, and the EDS-PC in distinguishing cases from non-cases. The SDE is the first screen, inclusive of BED, valid for detecting eating disorders in primary care. Findings have broad implications to address eating disorder screening in primary care settings. Published by Elsevier Inc.
Brawley, Larra; Henk, Jennifer
Young children's eating behaviors have a direct link to their future health and attitudes regarding food. Similarly, positive nutrition during the toddler years leads to increased brain development and thus children are generally healthier (Weaver, More, & Harris, 2008). This makes eating behaviors extremely important. During the toddler…
Eddy, Kamryn T; Celio Doyle, Angela; Hoste, Renee Rienecke; Herzog, David B; le Grange, Daniel
To examine the frequency, type, and clinical severity of eating disorder not otherwise specified (EDNOS) in adolescents seeking treatment through an outpatient eating disorders service. Two hundred eighty-one consecutive referrals to an eating disorders program were assessed using the Eating Disorder Examination (EDE) and self-report measures of depression and self-esteem. The majority of adolescents presented with EDNOS (59.1%; n = 166) relative to anorexia nervosa (AN; 20.3%; n = 57) and bulimia nervosa (BN; 20.6%; n = 58). Most EDNOS youths could be described as subthreshold AN (SAN; 27.7%; n = 46), subthreshold BN (SBN; 19.9%; n = 33), EDNOS purging (27.7%; n = 46), or EDNOS bingeing (6.0%; n = 10); yet 31 (18.7%) could not be categorized as such (EDNOS "other"). Overall differences in eating disorder pathology, depressive symptoms, and self-esteem emerged between the EDNOS types, wherein adolescents with EDNOS bulimic variants (SBN, EDNOS purging, and EDNOS bingeing) had more pathology than youths with SAN or EDNOS "other." There were no differences in these variables between AN and SAN; in contrast, compared with BN, youths with EDNOS bulimic variants reported lower EDE scores and higher self-esteem, although there were no between-group differences in depression. As in adults with eating disorders, EDNOS predominates and is heterogeneous with regard to eating disorder pathology and associated features in an adolescent clinical sample. Lack of differences between AN and SAN suggests that the strict criteria for AN could be relaxed; differences between BN and EDNOS bulimic variants do not support their combination.
Sysko, Robyn; Hildebrandt, Tom; Wilson, G. Terence; Wilfley, Denise E.; Agras, W. Stewart
Objective: The purpose of the study was to explore heterogeneity and differential treatment outcome among a sample of patients with binge eating disorder (BED). Method: A latent class analysis was conducted with 205 treatment-seeking, overweight or obese individuals with BED randomized to interpersonal psychotherapy (IPT), behavioral weight loss…
Aviña, Vanessa; Day, Susan X.
The authors explored Hispanic and Caucasian college women's (N = 264) behavioral and attitudinal symptoms of eating disorders after controlling for body mass index and internalization of the thinness ideal, as well as the roles of ethnicity and ethnic identity in symptomatology. Correlational analysis, multivariate analysis of variance, and…
Nagel, Deborah L.; Black, David R.; Leverenz, Larry J.; Coster, Daniel C.
Objective: To develop a screening test to detect female college athletes with eating disorders/disordered eating (ED/ DE). No validated eating disorder screening tests specifically for athletes have been available. Design and Setting: In this cross-sectional study, subjects from a large midwestern university completed 3 objective tests and a structured diagnostic interview. Measurements: A new test, developed and pilot tested by the researchers (Athletic Milieu Direct Questionnaire, AMDQ), and 2 tests normed for the general population (Eating Disorder Inventory-2, Bulimia Test-Revised) were used to identify ED/DE athletes. A structured, validated, diagnostic interview (Eating Disorder Examination, version 12.OD) was used to determine which test was most effective in screening female college athletes. Subjects: Subjects included 149 female athletes, ages 18 to 25 years, from 11 Division I and select club sports. Results: ED/DE subjects (35%) were found in almost every sport. Of the ED/DE subjects, 65% exhibited disordered eating, 25% were bulimic, 8% were classified as eating disordered not otherwise specified (NOS), and 2% were anorexic. The AMDQ more accurately identified ED/DE than any test or combination of items. The AMDQ produced superior results on 7 of 9 epidemiologic analyses; sensitivity was 80% and specificity was 77%, meaning that it correctly classified approximately 4 of every 5 persons who were truly exhibiting an eating disorder or disordered eating. Conclusions: We recommend that the AMDQ subsets, which met statistical criteria, be used to screen for ED/DE to enable early identification of athletes at the disordered eating or NOS stage and to initiate interventions before the disorder progresses. PMID:16558658
Rouzitalab, Tohid; Pourghassem Gargari, Bahram; Amirsasan, Ramin; Asghari Jafarabadi, Mohammad; Farsad Naeimi, Alireza; Sanoobar, Meisam
Abnormal eating behavior, unhealthy weight control methods, and eating disordered symptoms have risen among college students. The aim of this study was to examine disordered eating attitudes and their relationship with anthropometric and body composition indices in physical education students in Tabriz, the capital of East Azerbaijan province, Iran. This cross-sectional study was conducted on 210 physical education students, 105 males and 105 females aged 18 to 25, who were selected by systematic random sampling from physical education faculty of Tabriz University in Tabriz, Iran, in 2013. Eating attitude test (EAT-26) was used for the assessment of disordered eating attitudes. In addition, anthropometric and body composition indices were assessed. About 10% of the studied subject had disturbed eating attitudes; significantly more males (15.4%) reported an EAT-26 ≥ 20 (disordered eating attitudes) than females (4.8%) (P EAT-26 score was positively correlated with weist perimeter (WP) (r = 0.21, P EAT-26 score was positively correlated with weight (r = 0.19, P eating attitude and healthy subjects, while in males there was no significant difference between the two groups regarding the anthropometric and body composition indices. Abnormal eating attitude was notable among physical education students in Tabriz, Iran. It seems that some anthropometric indices such as BMI and central obesity indices were related to the increase of disordered eating attitude.
Stachowitz, Annie L.; Choi, Hee-Sook; Schweinle, Amy
Eating disorders, disordered eating, and body dissatisfaction prevalence rates are on the rise among adolescent females. The present study examined the potential use of a commonly used social--emotional instrument, the Behavior Assessment System for Children-Second Edition (BASC-2), for detecting the presence of possible eating disorders in…
Becker, Carolyn Black; Middlemass, Keesha; Taylor, Brigitte; Johnson, Clara; Gomez, Francesca
The primary aim of this study was to investigate eating disorder (ED) pathology in those living with food insecurity. A secondary aim was to investigate whether any-reason dietary restraint, weight self-stigma, and worry increased as level of food insecurity increased. Participants (N = 503) seeking food from food pantries completed questionnaires assessing level of food insecurity, demographics, ED pathology, dietary restraint, weight self-stigma, and worry. Consistent with hypotheses, participants with the highest level of food insecurity (i.e., adults who reported having hungry children in their household) also endorsed significantly higher levels of binge eating, overall ED pathology, any-reason dietary restraint, weight self-stigma, and worry compared to participants with lower levels of food insecurity. Contrary to hypotheses, compensatory behaviors also increased as level of food insecurity worsened. Overall, 17% of those in the child hunger food insecurity group reported clinically significant ED pathology. This is the first study to assess the full spectrum of ED pathology in a low-income, marginalized population with food insecurity. Given that food insecurity is a global concern, results from this study suggest that greater attention to the association between ED pathology and food insecurity is warranted by researchers around the world. © 2017 Wiley Periodicals, Inc.
Domínguez-Vásquez, P; Olivares, S; Santos, J L
Eating behavior involves all actions that define the relation between human beings and food. It is accepted that feeding habits are acquired through eating experiences and practices learned from the familiar and social context in early childhood. Besides the role of the social context, it is also assumed that familiar factors, both common family environment and genetic inheritance, have an important influence on food intake and eating behavior linked with childhood obesity. Research on food intake and childhood obesity has been traditionally focused on the amount and type of foods in the usual diet. However, it is an increasing interest to understand the link between eating behavior and obesity using questionnaires. There are several psychometric tools that have been developed specifically to deal with human eating behavior. This review summarizes the family influences, both genetic and non-genetic, on childhood feeding behavior and their relation to childhood obesity.
Full Text Available Marilou DP Tromp,1 Anouk AMT Donners,1 Johan Garssen,1,2 Joris C Verster1,31Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; 2Nutricia Research, Utrecht, the Netherlands; 3Center for Human Psychopharmacology, Swinburne University, Melbourne, VIC, AustraliaObjective: To investigate the relationship between eating disorders, body mass index (BMI, sleep disorders, and daytime functioning.Design: Survey.Setting: The Netherlands.Participants: N=574 Dutch young adults (18–35 years old.Measurements: Participants completed a survey on eating and sleep habits including the Eating Disorder Screen for Primary care (ESP and SLEEP-50 questionnaire subscales for sleep apnea, insomnia, circadian rhythm disorder (CRD, and daytime functioning. SLEEP-50 outcomes of participants who screened negative (≤2 and positive (>2 on the ESP were compared. In addition, SLEEP-50 scores of groups of participants with different ESP scores (0–4 and different BMI groups (ie, underweight, healthy weight, overweight, and obese were compared using nonparametric statistics.Results: Almost 12% (n=67 of participants screened positive for having an eating disorder. Relative to participants without eating disorders, participants who screened positive for eating disorders reported significantly higher scores on sleep apnea (3.7 versus 2.9, P=0.012, insomnia (7.7 versus 5.5, P<0.0001, CRD (2.9 versus 2.3, P=0.011, and impairment of daytime functioning (8.8 versus 5.8, P=0.0001. ESP scores were associated with insomnia (r=0.117, P=0.005, sleep apnea (r=0.118, P=0.004, sleep quality (r=−0.104, P=0.012, and daytime functioning (r=0.225, P<0.0001, but not with CRD (r=0.066, P=0.112. BMI correlated significantly with ESP scores (r=0.172, P<0.0001 and scores on sleep apnea (r=0.171, P<0.0001. When controlling for BMI, the partial correlation between ESP and sleep apnea remained significant (r=0.10, P=0.015.Conclusion
Van Son, Gabrielle E.; Van Hoeken, Daphne; Bartelds, Aad I. M.; Van Furth, Eric F.; Hoek, Hans W.
The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose-response
Son, G.E. van; Hoeken, D. van; Bartelds, A.I.M.; Furth, E.F. van; Hoek, H.W.
The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose response
Morgan, J F; Marsden, P; Lacey, J H
We describe the cases of four patients with eating disorders in whom complex interactions occurred among religious faith, pathogenesis of the eating disorder, and clinical management. In some of the cases, religious beliefs seemed to provide a containment of maladaptive behaviors, partly through prayer and through a sense of belonging to the religious community. In other cases, it proved difficult to separate the concept of a punitive God from the illness process. The cases are discussed with reference to a limited empirical literature. Similarities are noted between some religious institutions and eating disorder treatment regimes. This paper explores management issues, including the use of pastoral counseling and the ethics of addressing religious beliefs in therapy. We note the benefits of a rapprochement between psychiatry and religion. Copyright 2000 by John Wiley & Sons, Inc.
Gibson, Dennis; Drabkin, Anne; Krantz, Mori J; Mascolo, Margherita; Rosen, Elissa; Sachs, Katherine; Welles, Christine; Mehler, Philip S
Eating disorders are unique in that they inherently have much medical comorbidity both as a part of restricting-type eating disorders and those characterized by purging behaviors. Over the last three decades, remarkable progress has been made in the understanding and treatment of the medical complications of eating disorders. Yet, unfortunately, there is much research that is sorely needed to bridge the gap between current medical knowledge and more effective and evidence-based medical treatment knowledge. These gaps exist in many different clinical areas including cardiology, electrolytes, gastrointestinal and bone disease. In this paper, we discuss some of the knowledge gap areas, which if bridged would help develop more effective medical intervention for this population of patients.
Korinth, Anne; Schiess, Sonja; Westenhoefer, Joachim
Sometimes the suspicion is put forward that nutrition students show more disordered eating patterns, which may be among the motivating factors to study nutrition. At the same time, it is not clear whether the students' increasing knowledge about diet and nutrition is associated with a more healthy eating behaviour or with an unhealthy obsession with food choices. Cross-sectional comparison of nutrition students from German universities during the first year of their studies (n 123) and during higher semesters (n 96), with a control group from other study programmes (n 68 and n 46, respectively). Dietary restraint, disinhibition, the tendency towards orthorexia nervosa and healthy food choices were assessed using a questionnaire. Nutrition students showed higher levels of dietary restraint than the control group. Disinhibition and orthorexia nervosa did not differ between nutrition students and controls. Orthorexic tendencies were lower in the more advanced nutrition students. Healthy food choices did not differ among students in the first year. More advanced nutrition students showed healthier food choices, whereas the corresponding controls showed slightly more unhealthy food choices. Nutrition students, more than other students, tend to restrict their food intake in order to control their weight, but they do not have more disturbed or disordered eating patterns than other students. Moreover, during the course of their studies, they adopt slightly more healthy food choices and decrease their tendency to be obsessive in their eating behaviour.
Binge eating disorder (BED) is the most common eating disorder, with an estimated lifetime prevalence of 2.6% among U.S. adults, yet often goes unrecognized. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), BED is defined by recurrent episodes of binge eating (eating in a discrete period of time an amount of food larger than most people would eat in a similar amount of time under similar circumstances and a sense of lack of control over eating during the episode), occurring on average at least once a week for 3 months, and associated with marked distress. It can affect both men and women, regardless if they are at normal weight, overweight, or obese, and regardless of their ethnic or racial group. Psychiatric comorbidities are very common, with 79% of adults with BED also experiencing anxiety disorders, mood disorders, impulse control disorders, or substance use disorders; almost 50% of persons with BED have ≥ 3 psychiatric comorbidities. Multiple neurobiological explanations have been proffered for BED, including dysregulation in reward center and impulse control circuitry, with potentially related disturbances in dopamine neurotransmission and endogenous μ-opioid signaling. Additionally, there is interplay between genetic influences and environmental stressors. Psychological treatments such as cognitive behavioral interventions have been recommended as first line and are supported by meta-analytic reviews. Unfortunately, routine medication treatments for anxiety and depression do not necessarily ameliorate the symptoms of BED; however, at present, there is one approved agent for the treatment of moderate to severe BED-lisdexamfetamine, a stimulant that was originally approved for the treatment of attention deficit hyperactivity disorder.
Froreich, Franzisca V; Vartanian, Lenny R; Zawadzki, Matthew J; Grisham, Jessica R; Touyz, Stephen W
Unfulfilled basic psychological needs have been associated with disordered eating behaviours, but the mechanisms underlying that associations are not well understood. This study examined a two-stage path model linking basic psychological need satisfaction to disordered eating behaviours via issues of control. Female university students (N = 323; M age = 19.61), community participants (N = 371; M age = 29.75), and women who self-reported having been diagnosed with an eating disorder (ED; N = 41; M age = 23.88) completed measures of psychological need satisfaction (i.e., autonomy and competence), issues of control (i.e., feelings of ineffectiveness and fear of losing self-control [FLC]), and ED pathology. Path analysis revealed that unsatisfied needs of autonomy and competence were indirectly related to disordered eating behaviours through feelings of ineffectiveness and FLC. The results indicate that issues of control might be one of the mechanisms through which lack of psychological need satisfaction is associated with disordered eating. Although the model was constructed using cross-sectional data, these findings suggest potential targets for prevention and treatment efforts aimed at reducing disordered eating in young females. Our results indicate that young women with chronically unfulfilled basic psychological needs might be vulnerable to developing disordered eating behaviours. The observed patterns suggest that persistent experience of need frustration may engender an internal sense of ineffectiveness and lack of control, which then compels individuals to engage in disordered eating behaviours in an attempt to regain autonomy and competence. Interventions for eating disorders may be most effective when emphasizing the promotion of people's needs for autonomy and competence. Limitations The model was constructed using cross-sectional data. Future experimental and longitudinal studies are needed to confirm the temporal sequence from basic
Hepworth, Natasha S
The objective of this study was to investigate potential benefits of a Mindful Eating Group as an adjunct to long-term treatment for a variety of eating disorders. Individuals (N = 33) attending treatment at an outpatient treatment facility participated in the 10-week intervention designed to enhance awareness around hunger and satiety cues. Disordered eating symptoms were assessed pre- and post-intervention using the EAT-26. Significant reductions were found on all subscales of the EAT-26 with large effect sizes. No significant differences were identified between eating disorder diagnoses. Results suggest potential benefits of an adjunct mindfulness group intervention when treating a variety of eating disorders. Limitations are discussed.
Mayara Freitas Monteiro
Full Text Available Objective: To describe the prevalence of eating disorders symptoms among classical ballet dancers. Methods: This is an analytical, observational, cross-sectional study, conducted in 2009, that investigated eating disorder symptoms using the Eating Attitudes Test (EAT-26 and Bulimic Investigatory Test, Edinburgh (BITE. The body image of the study population was assessed by the Body Shape Questionnaire (BSQ. In addition, the anthropometric assessment was performed – measurement of weight, height and skin folds, calculation of body mass index (BMI and body fat percentage. Results: Of all the 139 emale adolescents assessed, 4.4% (n=6 had nutrition problems and 23% (n=23 presented abnormal values of body fat. The analysis of the EAT concluded that 12.3% (n=17 of the girls presented positive results for anorexia nervosa (AN. The BITE results showed that 13.7% (n=19 ofthe girls had unusual eating habits and 6.5% (n=9 presented subclinical bulimia nervosa (BN. As for severity, 3.6% (n=5 of the girls presented clinically significant results and 1.4% (n=2 were diagnosed with high severity. Concerning the results of the BSQ, 15.7% (n=21 of the girls were slightly concerned about body image; 5.2% (n=7 were moderately worried, and 6.7% (n=9 were severely concerned about it. Conclusion: This study did not diagnose the occurrence of eating disorders but found symptoms of AN (Anorexia Nervosa and BN (Bulimia Nervosa. Its main purpose was to alert about the prevalence of the possible development of eating disorders due to the influences of the environment where the teenagers are inserted – under a model defined by the classic ballet dance and the psychological turmoil of adolescence. doi:10.5020/18061230.2013.p396
Kuipers, Greet S; van Loenhout, Zara; van der Ark, L Andries; Bekker, Marrie H J
To investigate the relationships of attachment security and mentalization with core and co-morbid symptoms in eating disorder patients. We compared 51 eating disorder patients at the start of intensive treatment and 20 healthy controls on attachment, mentalization, eating disorder symptoms, depression, anxiety, personality disorders, psycho-neuroticism, autonomy problems and self-injurious behavior, using the Adult Attachment Interview, the SCID-I and II and several questionnaires. Compared with the controls, the eating disorder patients showed a higher prevalence of insecure attachment; eating disorder patients more often than controls received the AAI classification Unresolved for loss or abuse. They also had a lower level of mentalization and more autonomy problems. In the patient group eating disorder symptoms, depression, anxiety, psycho-neuroticism and autonomy problems were neither related to attachment security nor to mentalization; self-injurious behavior was associated with lesser attachment security and lower mentalization; borderline personality disorder was related to lower mentalization. In the control group no relations were found between attachment, mentalization and psychopathologic variables. Eating disorder patients' low level of mentalization suggests the usefulness of Mentalization Based Treatment techniques for eating disorder treatment, especially in case of self-injurious behavior and/or co-morbid borderline personality disorder.
Courtney, Elizabeth A; Gamboz, Julie; Johnson, Jeffrey G
Previous research has indicated that low self-esteem may be an important risk factor for the development of eating disorders. Few longitudinal studies have examined the relationships between low self-esteem, depressive symptoms, and eating disorders in adolescents. The present study investigated whether low self-esteem was associated with depressive symptoms and problematic eating behaviors. Measures of low self-esteem and problematic eating behaviors were administered to a sample of 197 adolescent primary-care patients. Depressive symptoms and problematic eating behaviors were assessed ten months later. Youths with low self-esteem were at greater risk for high levels of depressive symptoms and eating disorder symptoms. In addition, depressive symptoms mediated the association of low self-esteem with problematic eating behaviors.
Turton, Robert; Chami, Rayane; Treasure, Janet
The objective of this paper is to review the role that hedonic factors, emotions and self-regulation systems have over eating behaviours from animal models to humans. Evidence has been found to suggest that for some high-risk individuals, obesity/binge eating may develop as an impulsive reaction to negative emotions that over time becomes a compulsive habit. Animal models highlight the neural mechanisms that might underlie this process and suggest similarities with substance use disorders. Emotional difficulties and neurobiological factors have a role in the aetiology of eating and weight disorders. Precise treatments targeted at these mechanisms may be of help for people who have difficulties with compulsive overeating.
To determine the prevalence of binge eating disorder (BED) and night eating syndrome (NES) among applicants to the Look AHEAD (Action for Health in Diabetes) study. The Eating Disorders Examination-Questionnaire (EDE-Q) and the Night Eating Questionnaire (NEQ) were used to screen patients. Phone int...
Norbert Dahmen; Julia Becht; Alice Engel; Monika Thommes; Peter Tonn
Norbert Dahmen, Julia Becht, Alice Engel, Monika Thommes, Peter TonnPsychiatry Department, University of Mainz, GermanyAbstract: Narcoleptic patients suffer frequently from obesity and type II diabetes. Most patients show a deficit in the energy balance regulating orexinergic system. Nevertheless, it is not known, why narcoleptic patients tend to be obese. We examined 116 narcoleptic patients and 80 controls with the structured interview for anorectic and bulimic eating disorders (SIAB) to te...
Wilfley, Denise E; Citrome, Leslie; Herman, Barry K
Denise E Wilfley,1 Leslie Citrome,2 Barry K Herman3 1Department of Psychiatry, Washington University School of Medicine, St Louis, MO, 2Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla, NY, 3Global Medical Affairs, Shire, Lexington, MA, USA 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 (D...
Lena Guimarães Ribeiro
Full Text Available INTRODUÇÃO E OBJETIVO: A grande preocupação com a aparência e a forma física e a constante pressão para manterem baixo peso corporal são fatores que levam a distorções da imagem corporal e tornam os bailarinos um grupo de risco para o desenvolvimento de transtornos alimentares (TA. O objetivo deste estudo foi avaliar a percepção da imagem corporal e sua associação com comportamentos de risco para TA em bailarinos profissionais. MÉTODOS: Foram estudados 61 bailarinos (39 mulheres e 22 homens de uma instituição representante da elite do balé clássico brasileiro. A avaliação dos comportamentos de risco para TA foi feita com base nas versões em português dos questionários Eating Attitudes Test (EAT-26 e Bulimic Investigatory Test Edinburgh (BITE. A Escala de Silhuetas de Stunkard foi utilizada para avaliação da percepção da imagem corporal. A associação entre as variáveis foi avaliada com base na razão de prevalência (RP e seus respectivos intervalos de confiança (IC de 95%. RESULTADOS: Trinta e um bailarinos (50,8% gostariam de ter a silhueta menor que a autopercebida como usual. A presença de comportamentos de risco para TA foi 2,71 vezes maior (IC 95% = 1,02 - 7,18 entre os que desejavam ter silhueta menor que a usual e 2,64 vezes maior (IC 95% = 1,20 - 5,80 entre aqueles que desejavam ter silhueta menor que a considerada mais saudável, quando comparados com os que estavam satisfeitos com a sua silhueta. CONCLUSÃO: A alta frequência de insatisfação com o corpo encontrada pode estar colaborando para ocorrência de comportamentos de risco para TA nos bailarinos investigados.INTRODUCTION AND OBJECTIVE: Great concern with physical appearance and fitness as well as constant pressure in maintaining low body weight make ballet dancers a risk group for the development of eating disorders (ED. The objective of the present study was to evaluate the body image perception and its association with risk behavior for ED
Gan, Wan Ying; Yeoh, Wei Ching
Intuitive eating, which can be defined as reliance on physiological hunger and satiety cues to guide eating, has been proposed as a healthy weight management strategy. To date, there has not been a published study on intuitive eating in the context of Malaysia. Therefore, this cross-sectional study aims to determine associations between body weight status, psychological well-being and disordered eating behaviors with intuitive eating among undergraduate university students. A total of 333 undergraduate respondents (21.3% males and 78.7% females) from three randomly selected faculties in a public university in Malaysia participated in this study. Respondents completed a self-administered questionnaire which featured socio-demographic characteristics, intuitive eating, self-esteem, body appreciation, general unconditional acceptance, body acceptance by others, body function and disordered eating. Body weight, height, body fat percentage and waist circumference were measured. The results from this study revealed that there was no difference (t = 0.067, p = 0.947) in intuitive eating scores between males (75.69 ± 7.16) and females (75.62 ± 7.90). Multiple linear regression results have shown that body appreciation (β = 0.385, p < 0.001) and disordered eating (β = -0.168, p = 0.001) were significant predictors of intuitive eating, which accounted for 19.6% of the variance in intuitive eating. Health promotion programs should highlight the importance of enhancing body appreciation and preventing disordered eating behaviors among university students in order to promote intuitive eating as one of the healthy weight management approaches.
Brechan, Inge; Kvalem, Ingela Lundin
The purpose of this study was to investigate the hypothesis that the effect of body dissatisfaction on disordered eating behavior is mediated through self-esteem and depression. If the effect of body dissatisfaction on disordered eating can be explained by self-esteem and depression, treatment may benefit from focusing more on self-esteem and depression than body dissatisfaction. We also hypothesized body image importance to be associated with lower self-esteem, stronger symptoms of depression, and more disordered eating. The results showed that the effect of body dissatisfaction on disorder eating was completely mediated, whereas the effect of body image importance was partly mediated. Both self-esteem and depression were significant mediators. Body image importance and self-esteem had a direct effect on restrained eating and compensatory behavior. Depression had a direct effect on binge eating. This effect was significantly stronger among women. Depression also had a direct effect on restrained eating. This effect was positive among women, but negative among men. The results support emotion regulation and cognitive behavioral theories of eating disorders, indicating that self-esteem and depression are the most proximal factors, whereas the effect of body dissatisfaction is indirect. The results point out the importance of distinguishing between different symptoms of bulimia. Depression may cause binge eating, but compensatory behavior depends on self-esteem and body image importance. The results suggest that women may turn to both binge eating and restrained eating to escape awareness of negative emotions, whereas men focus on eating to a lesser extent than women. Existing treatment focuses on eating behavior first and mechanisms such as self-esteem and depression second. The results from this study suggest that an earlier focus on self-esteem and depression may be warranted in the treatment of disordered eating. Copyright © 2015 Elsevier Ltd. All rights
Gaetani, Silvana; Romano, Adele; Provensi, Gustavo; Ricca, Valdo; Lutz, Thomas; Passani, Maria Beatrice
The central nervous system and viscera constitute a functional ensemble, the gut-brain axis, that allows bidirectional information flow that contributes to the control of feeding behavior based not only on the homeostatic, but also on the hedonic aspects of food intake. The prevalence of eating disorders, such as anorexia nervosa, binge eating and obesity, poses an enormous clinical burden, and involves an ever-growing percentage of the population worldwide. Clinical and preclinical research is constantly adding new information to the field and orienting further studies with the aim of providing a foundation for developing more specific and effective treatment approaches to pathological conditions. A recent symposium at the XVI Congress of the Societá Italiana di Neuroscienze (SINS, 2015) 'Eating disorders: from bench to bedside and back' brought together basic scientists and clinicians with the objective of presenting novel perspectives in the neurobiology of eating disorders. Clinical studies presented by V. Ricca illustrated some genetic aspects of the psychopathology of anorexia nervosa. Preclinical studies addressed different issues ranging from the description of animal models that mimic human pathologies such as anorexia nervosa, diet-induced obesity, and binge eating disorders (T. Lutz), to novel interactions between peripheral signals and central circuits that govern food intake, mood and stress (A. Romano and G. Provensi). The gut-brain axis has received increasing attention in the recent years as preclinical studies are demonstrating that the brain and visceral organs such as the liver and guts, but also the microbiota are constantly engaged in processes of reciprocal communication, with unexpected physiological and pathological implications. Eating is controlled by a plethora of factors; genetic predisposition, early life adverse conditions, peripheral gastrointestinal hormones that act directly or indirectly on the central nervous system, all are
Bauer, Stephanie; Kindermann, Sally Sophie; Moessner, Markus
Eating disorders are severe mental illnesses that are challenging to treat and often follow a chronic course. They are associated with immense impairment on the psychological, physical, interpersonal, and social level as well as signifi cant direct and indirect cost. Therefore, prevention and early intervention are of utmost importance. Based on a qualitative literature review, we summarized the empirical evidence for the effi cacy of universal and selective prevention of eating disorders. Programs available in German and/or English were included in the review. In addition to research on effi cacy and effectiveness, the areas of implementation, dissemination, and reach were identifi ed as key issues for future studies. Furthermore, more research is needed on the relationship of cost, benefi t, and risks of eating disorder prevention.
Davidsen, Annika Helgadóttir; Hoyt, William T.; Poulsen, Stig Bernt
Purpose: The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. Methods: The study included 159 patients...... was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically. Results: Duration of illness significantly moderated the relationship between eating disorder severity and functional...... impairment; the relationship was strongest for patients with a shorter duration of illness. Psychological distress partly mediated the relationship between eating disorder severity and functional impairment. Duration of illness significantly moderated the relationship between psychological distress...
Lindeman, A K
Self-esteem, a hierarchical and multifactorial perception, can be described as the extent to which a person feels positive about himself or herself. Social factors such as life satisfaction, sex, age, and strongly held values can affect self-esteem. Low self-esteem is a well-recognized trait of those with eating disorders and may be associated with a heightened self-awareness. Body dissatisfaction, common among women in Western society, may enhance this awareness. Athletes, especially those with eating disorders, are perfectionists and have acute body awareness and a sense of loss of control. Control is a crucial issue with these athletes. Before any nutrition counseling starts, readiness to listen should be assessed in conjunction with a mental health professional. Various tools are available to assess the eating disordered athlete's self-esteem, body image, and eating behavior. Nutrition counseling can help the athlete overcome an eating disorder by clarifying misconceptions and focusing on the role of nutrition in promoting health and athletic performance.
The past few years have seen a steep increase in journal articles relating to feeding and eating disorders in children, making a succinct overview timely. The relevance of this review is enhanced by the recent publication of revised feeding and eating disorder diagnostic criteria in DSM-5. These have significant implications for younger patients, in particular through the inclusion of the new diagnostic category Avoidant/Restrictive Food Intake Disorder (ARFID). It is likely that this will encourage increased research interest in this field. Recent publications included in this article cover a broad range of topics relevant to childhood feeding and eating disorders, to include: presentation, diagnosis and classification; epidemiology; risk factors; assessment measures; treatment, prognosis and outcome. The area of feeding and eating disorders in children remains relatively under-researched, with significant gaps in knowledge about epidemiology, course and prognosis as well as a limited evidence base for treatment. However, important and promising avenues are increasingly being explored. In relation to clinical practice, there is now a much better recognition of these disorders and a greater awareness of their complexity, severity and potential impact in both the short and the longer term if not appropriately managed.
syndrome eating disorders in adulthood ( Kotler , Cohen, Davies, Pine, & Walsh, 2001). For this reason, early identification of pathological overeating...eating (Iancu, Cohen, Ben Yehuda, & Kotler , 2006; Schmidt, Jiwany, & Treasure, 1993). Such research indicates that alexithymia may be a stable trait...CT: Yale University. Iancu, I., Cohen, E., Ben Yehuda, Y., & Kotler , M. (2006). Treatmetn of eating disorders improves eating symptoms but not
Lewis, Stephen P; Klauninger, Laura; Marcincinova, Ivana
Pro eating disorder websites often contain celebrity-focused content (e.g., images) used as thinspiration to engage in unhealthy eating disorder behaviours. The current study was conducted to examine whether news media stories covering eating disorder disclosures of celebrities corresponded with increases in Internet searches for pro eating disorder material. Results indicated that search volumes for pro eating disorder terms spiked in the month immediately following such news coverage but only for particularly high-profile celebrities. Hence, there may be utility in providing recovery-oriented resources within the search results for pro-eating disorder Internet searches and within news stories of this nature.
Full Text Available Eating disorders, including anorexia and bulimia nervosa, are potentially life-threatening syndromes characterized by severe disturbances in eating behavior. An effective treatment strategy for these conditions remains to be established, as patients with eating disorders tend to suffer from multiple relapses. Because ghrelin was originally discovered in the stomach mucosa, it has been widely studied over the past decade in an effort to uncover its potential roles; these studies have shed light on the mechanism by which ghrelin regulates food intake. Thus, studying ghrelin in the context of eating disorders could improve our understanding of the pathogenesis of eating disorders, possibly resulting in a promising new pharmacological treatment strategy for these patients. In addition, early detection and treatment of eating disorders are critical for ensuring recovery of young patients. Oral symptoms, including mucosal, dental, and saliva abnormalities, are typically observed in the early stages of eating disorders. Although oral care is not directly related to the treatment of eating disorders, knowledge of the oral manifestations of eating disorder patients may aid in early detection, resulting in earlier treatment; thus, oral care might contribute to overall patient management and prognosis. Moreover, ghrelin has also been found in saliva, which may be responsible for oral hygiene and digestion-related functions. This review discusses the pharmacological potential of ghrelin in regulating food-intake and the role of saliva and oral care in young patients with eating disorders.
Full Text Available Introduction: Eating disorder symptomatology, comprising both psychological and behavioral aspects of subclinical eating concerns, constitutes a clear precursor of developing eating disorders. It is crucial to investigate its antecedents and correlates to subsequently inform eating disorder prevention programs. The present study focused on identity formation, a core developmental task in adolescence, that has increasingly been linked to eating disorder development. Our main aim was to examine the temporal sequence between eating disorder symptomatology and identity formation.Methods: Data on eating disorder symptomatology and identity formation were collected in 530 high school students (at Time 1: mean age = 15 years; SD = 1.84; range: 12–18 years; 50.6% females using self-report questionnaires at three annual measurement points. Cross-lagged structural equation modeling was performed to examine the directionality of effects.Results: Results indicated bidirectional effects between eating disorder symptomatology and identity formation. Identity confusion seemed to increase vulnerability to body dissatisfaction and bulimia symptoms, whereas identity synthesis seemed to protect against their development. Additionally, identity synthesis seemed to protect against the development of drive for thinness as well. At the same time, body dissatisfaction and bulimia symptoms positively predicted identity confusion and negatively predicted identity synthesis over time.Conclusion: The present study adds to the growing body of literature on identity and eating disorders by focusing on their temporal interplay in a community sample of adolescents. As bidirectional effects emerged, a greater emphasis on identity formation in eating disorder prevention programs is advocated.
Verschueren, Margaux; Claes, Laurence; Bogaerts, Annabel; Palmeroni, Nina; Gandhi, Amarendra; Moons, Philip; Luyckx, Koen
Introduction: Eating disorder symptomatology, comprising both psychological and behavioral aspects of subclinical eating concerns, constitutes a clear precursor of developing eating disorders. It is crucial to investigate its antecedents and correlates to subsequently inform eating disorder prevention programs. The present study focused on identity formation, a core developmental task in adolescence, that has increasingly been linked to eating disorder development. Our main aim was to examine the temporal sequence between eating disorder symptomatology and identity formation. Methods: Data on eating disorder symptomatology and identity formation were collected in 530 high school students (at Time 1: mean age = 15 years; SD = 1.84; range: 12-18 years; 50.6% females) using self-report questionnaires at three annual measurement points. Cross-lagged structural equation modeling was performed to examine the directionality of effects. Results: Results indicated bidirectional effects between eating disorder symptomatology and identity formation. Identity confusion seemed to increase vulnerability to body dissatisfaction and bulimia symptoms, whereas identity synthesis seemed to protect against their development. Additionally, identity synthesis seemed to protect against the development of drive for thinness as well. At the same time, body dissatisfaction and bulimia symptoms positively predicted identity confusion and negatively predicted identity synthesis over time. Conclusion: The present study adds to the growing body of literature on identity and eating disorders by focusing on their temporal interplay in a community sample of adolescents. As bidirectional effects emerged, a greater emphasis on identity formation in eating disorder prevention programs is advocated.
Mohammed Anisul eIslam
Full Text Available The study provides a systematic review that explores the current literature on olfactory capacity in abnormal eating behavior to present a basis for discussion on whether research in olfaction in eating disorders may offer additional insights with regard to the complex etiopathology of ED and abnormal eating behaviors. Electronic databases (Medline, PsycINFO, PubMed, Science Direct and Web of Science were searched using the components in relation to olfaction and combining them with the components related to abnormal eating behavior. Out of 1,352 articles, 14 articles were selected (820 patients and 385 control participants for this review. The highest number of existing literature on olfaction in ED were carried out with AN patients (78.6% followed by BN (35.7% and obesity (14.3%. The general findings support that olfaction is altered in AN and Obesity and indicates towards there being no differences in olfactory capacity between BN patients and the general population. Due to the limited number of studies and heterogeneity this review stresses on the importance of more research on olfaction and abnormal eating behavior.
Tomotake, Masahito; Ohmori, Tetsuro
The present review focused on the personality profiles of patients with eating disorders. Studies using the Structured Clinical Interview for DSM-III-R Personality Disorder showed high rates of diagnostic co-occurrence between eating disorders and personality disorders. The most commonly observed were histrionic, obsessive-compulsive, avoidant, dependent and borderline personality disorders. Studies using the Cloninger's personality theory suggested that high Harm Avoidance might be relevant to the pathology of anorexia nervosa and high Novelty Seeking and Harm Avoidance to bulimia nervosa. Moreover, high Self-Directedness was suggested to be associated with favorable outcome in bulimia nervosa. The assessment of personality in a cross-sectional study, however, might be influenced by the various states of the illness. Therefore, a sophisticated longitudinal study will be required to advance this area of research.
Martin, Rachel; Prichard, Ivanka; Hutchinson, Amanda D; Wilson, Carlene
This study examined the potential mediating roles of mindfulness and body awareness in the relationship between exercise and eating behavior. Female exercisers (N = 159) recruited from fitness centers, yoga centers, and the community completed a questionnaire incorporating measures of exercise behavior, body awareness, trait mindfulness, mindful eating, dietary intake, and disordered eating symptoms. Participation in yoga was associated with significantly lower disordered eating (mediated by body awareness), whereas the amount of time spent participating in cardio-based exercise was associated with greater eating disturbance. The relationships between amount of exercise and actual food intake were not mediated by trait mindfulness or body awareness. The differential findings for dietary intake and disordered eating indicate that the body awareness cultivated in different forms of exercise may be more beneficial for clinical populations or those at risk for eating disorders than for modifying actual dietary intake in the general population.
Lipson, S K; Sonneville, K R
We sought to estimate the prevalence of eating disorder symptoms in a large sample of U.S. college students and variations therein across student characteristics. Participants were 9713 students from 12 colleges and universities participating in the Healthy Bodies Study. We used gender-stratified logistic regression to estimate bivariate correlates of elevated eating disorder symptoms, past-month objective binge eating, and past-month compensatory behaviors across student characteristics including age, degree-level, sexual orientation, race/ethnicity, first-generation status, citizenship, academic and extracurricular characteristics, and weight status. Eating disorder outcomes were based on the Eating Disorder Examination Questionnaire. We observed higher prevalence of objective binge eating among females relative to males (49% versus 30%, pobesity. When compared to individuals with a healthy weight, those with overweight had greater eating disorder risk (males OR=3.5; females OR=2.0), binge eating (males OR=2.1; females OR=1.9), and use of compensatory behaviors (males OR=1.5; females OR=1.3). This study suggests smaller gender difference in prevalence of eating disorder symptoms than previously reported and identifies students with overweight/obesity as salient targets for campus-based eating disorder screening and early intervention efforts. Copyright © 2016 Elsevier Ltd. All rights reserved.
Stachowitz, Annie L.
Eating disorders, disordered eating, and body dissatisfaction prevalence rates are on the rise among adolescent females. The present study sought to examine a commonly used social-emotional instrument, the Behavior Assessment System for Children-Second Edition, Self-Report of Personality (BASC-2, SRP), for the emergence of a common profile of…
Corning, Alexandra F.; Krumm, Angela J.; Smitham, Lora A.
On the basis of predictions from social comparison theory (L. Festinger, 1954) and informed by findings from the social comparison and eating disorder literatures, hypotheses were tested regarding the social comparison behaviors of women with eating disorder symptoms and their asymptomatic peers. Results indicated differentiating social-cognitive…
Kenny, Maureen E.; Hart, Kathleen
Examined relationship between parental attachment and eating disorder symptoms for 68 inpatient women with eating disorders and for 162 college women. College women described themselves as more securely attached to parents and reported lower levels of weight and dieting preoccupation, bulimic behavior, and feelings of ineffectiveness. (Author/NB)
Full Text Available El objetivo de este estudio es evaluar conductas, cogniciones específicas relacionadas con los trastornos de la conducta alimentaria (TCA y creencias básicas en adolescentes, y compararlas por género y grupos de edad. Participaron 553 estudiantes de escuelas medias de la Ciudad de Buenos Aires y Conurbano Bonaerense (42.3% hombres y 57.7% mujeres. La edad media fue 14.83 años (DE = 1.5 y el IMC promedio fue 20.60 (DE = 2.8. Se administraron: una encuesta de síntomas alimentarios, el inventario ICA de conductas alimentarias y los cuestionarios de esquemas SQ y MAC-R de cogniciones. Un 13.79% de las mujeres y un 11.11% de los varones mostrarían sintomatología compatible con un TCA de acuerdo a la escala ICA y, un 11.2% de mujeres y un 10.68% de varones conforme a la MAC-R. Las mujeres y el grupo de 16 a 18 años mostraron conductas y cogniciones específicas de los TCA más severas.The aim of this study is to assess behaviors, specific cognitions related to eating disorders (ED and core beliefs in adolescents, and to compare them by gender and age groups. The sample was composed of 553 students of middle schools of Buenos Aires city (42.3% men and 57.7% women. The mean age was 14.83 years old (SD = 1.5 and mean BMI was 20.60 (SD = 2.8. The instruments used were: an eating habits self-report, the Rosenberg self-esteem scale, the MAC-R eating cognitions ´ questionnaire, and the SQ schema questionnaire. A 13.79% of women and 11.11% of men showed symptoms related to ED according to the ICA scale, whereas an 11.2% of women and a 10.68% of men showed ED symptoms according to MAC-R. Women and the age group of 16 to 18 years old had more severe behaviors and specific cognitions related to ED.
Body composition, disordered eating and menstrual regularity in a group of South African ... e between body composition and disordered eating in irregular vs normal menstruating athletes. ... measured by air displacement plethysmography.
Montano, C Brendan; Rasgon, Natalie L; Herman, Barry K
Binge eating disorder (BED), now recognized as a distinct eating disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is the most prevalent eating disorder. Although nearly half of individuals with BED are obese, BED also occurs in nonobese individuals. Despite the relatively high percentage of weight loss treatment-seeking individuals meeting BED criteria, primary care physicians may not be familiar with or have ever diagnosed BED. Many providers may also have difficulty distinguishing BED as a contributory factor in obesity. This review differentiates BED from other causes of obesity by describing how obese individuals with BED differ from obese individuals without BED and from nonobese individuals with BED in areas including psychopathology, behavior, genetics, physiology, quality of life and productivity. The ways in which health-care providers can identify individuals who may have BED are also highlighted so the proper course of treatment is pursued. Overall, obese individuals with BED demonstrate a number of key characteristics that differentiate them from obese individuals without eating disorders, including increased impulsivity in response to food stimuli with loss of control over eating, resulting in the consumption of more calories. They also experience significant guilt and other negative emotions following a meal. In addition, individuals with BED patients have more psychiatric comorbidity, display more psychopathology, exhibit longer binge durations, consume more meals as snacks during the day and have less dietary restraint compared with individuals with BED who are not obese. However, the differences between individuals with BED who are obese versus not obese are not as prominent. Taken together, the evidence appears to support the conclusion that BED is a unique and treatable neurobehavioral disorder associated with distinct behavioral and psychological profiles and distinct medical and functional outcomes, and that
Valls, M; Callahan, S; Rousseau, A; Chabrol, H
The objective of the study was to evaluate the incidence of eating disorders, including not otherwise specified eating disorders (EDNOS) and subthreshold disorders, inappropriate compensatory behaviors (such as self-induced vomiting, strict dieting, fasting) along with depressive symptoms among young French adult males. The sample was composed of 458 young men in age ranging from 18 to 30 years (mean age=21.9±2.4). The average body mass index was 22.8±3. Participants completed two questionnaires: the Questionnaire for Eating Disorders Diagnoses (Q-EDD) assessing full-criteria eating disorder symptoms based on DSM-IV criteria (i.e. clinical eating disorders) and subthreshold disorders, and the Center for Epidemiological Studies-Depression scale (CES-D) assessing depressive symptoms. Out of the 458 surveyed respondents, eating disorders were reported by approximately 17% of the overall sample, with 1.5% meeting diagnostic criteria for serious clinical disorders, 3% meeting diagnostic criteria for EDNOS and 12% meeting diagnostic criteria for subthreshold disorders. Exercise bulimia represented 1% of the overall sample and binge-eating disorder 2%. The most frequent subthreshold disorder was subthreshold nonbinging bulimia (7%). Participants with eating disorders were equally divided between those desiring weight gain, those desiring weight loss and those wanting to keep their current weight. Participants without eating disorders were more likely to want to gain weight compared to participants with eating disorders (45.5% versus 30% respectively; Peating episodes (recurrent or not) were reported by 8% of young men, including 32% of participants with eating disorders and 3% of participants without eating disorder. Six percent reported repeated binging (at least twice a week for at least once a month). Inappropriate compensatory behaviors were mostly used by participants with eating disorders, except for excessive exercise (34% versus 35% for participants without
Jones, Candace; Pearce, Brad; Barrera, Ingrid; Mummert, Amanda
Fetal programming describes the process by which environmental stimuli impact fetal development to influence disease development later in life. Our analysis summarizes evidence for the role of fetal programming in eating disorder etiology through review of studies demonstrating specific obstetric complications and later eating risk of anorexia or bulimia. Using Pubmed, we found thirteen studies investigating obstetric factors and eating disorder risk published between 1999 and 2016. We then discuss modifiable maternal risk factors, including nutrition and stress, that influence anorexia or bulimia risk of their offspring. Translation of these findings applies to preventative strategies by health organizations and physicians to provide optimal health for mothers and their children to prevent development of medical and psychiatric illnesses. Copyright © 2017 Elsevier Ltd. All rights reserved.
Park, Emma C; Waller, Glenn; Gannon, Kenneth
The personality disorders are commonly comorbid with the eating disorders. Personality disorder pathology is often suggested to impair the treatment of axis 1 disorders, including the eating disorders. This study examined whether personality disorder cognitions reduce the impact of cognitive behavioural therapy (CBT) for eating disorders, in terms of treatment dropout and change in eating disorder attitudes in the early stages of treatment. Participants were individuals with a diagnosed eating disorder, presenting for individual outpatient CBT. They completed measures of personality disorder cognitions and eating disorder attitudes at sessions one and six of CBT. Drop-out rates prior to session six were recorded. CBT had a relatively rapid onset of action, with a significant reduction in eating disorder attitudes over the first six sessions. Eating disorder attitudes were most strongly associated with cognitions related to anxiety-based personality disorders (avoidant, obsessive-compulsive and dependent). Individuals who dropped out of treatment prematurely had significantly higher levels of dependent personality disorder cognitions than those who remained in treatment. For those who remained in treatment, higher levels of avoidant, histrionic and borderline personality disorder cognitions were associated with a greater change in global eating disorder attitudes. CBT's action and retention of patients might be improved by consideration of such personality disorder cognitions when formulating and treating the eating disorders.
Mangweth-Matzek, Barbara; Hoek, Hans W; Rupp, Claudia I; Lackner-Seifert, Kerstin; Frey, Nadja; Whitworth, Alexandra B; Pope, Harrison G; Kinzl, Johann
Little is known about the prevalence and correlates of eating disorders (ED) in middle-aged women. We mailed anonymous questionnaires to 1,500 Austrian women aged 40-60 years, assessing ED (defined by DSM-IV), subthreshold ED, body image, and quality of life. We broadly defined "subthreshold ED" by the presence of either (1) binge eating with loss of control or (2) purging behavior, without requiring any of the other usual DSM-IV criteria for frequency or severity of these symptoms. Of the 715 (48%) responders, 33 [4.6%; 95% confidence interval (CI): 3.3-6.4%] reported symptoms meeting full DSM-IV criteria for an ED [bulimia nervosa = 10; binge eating disorder = 11; eating disorder not otherwise specified (EDNOS) = 12]. None displayed anorexia nervosa. Another 34 women (4.8%; CI: 3.4-6.6%) displayed subthreshold ED. These women showed levels of associated psychopathology virtually equal to the women with full-syndrome diagnoses. ED appear common in middle-aged women, with a preponderance of binge eating disorder and EDNOS diagnoses as compared to the "classical" diagnoses of anorexia and bulimia nervosa. Interestingly, middle-aged women with even very broadly defined subthreshold ED showed distress and impairment comparable to women with full-scale ED. Copyright © 2013 Wiley Periodicals, Inc.
Raevuori, Anu; Lukkariniemi, Laura; Suokas, Jaana T; Gissler, Mika; Suvisaari, Jaana M; Haukka, Jari
We examined the use of antimicrobial medication as a proxy for infections in large patient cohort treated for binge-eating disorder (BED), bulimia nervosa (BN), and anorexia nervosa (AN) over the five-year period preceding eating disorder treatment. Patients (N = 1592) at the Eating Disorder Unit of Helsinki University Central Hospital between 2000 and 2010 were compared with matched general population controls (N = 6368). The study population was linked to the prescription data of antibacterial, antifungal and antiviral medication from the Register on Reimbursed Prescription Medicine. Data were analyzed using regression models. Individuals with BN and BED had received more often antimicrobial medication prescriptions compared to their controls (OR: 1.7, 95% CI: 1.3-2.1; OR: 2.6, 95% CI: 1.4-4.6, respectively), while no significant difference emerged in AN (OR: 0.9, 95% CI: 0.7-1.0, p = 0.10). Of the main drug categories, the respective pattern was seen in antibacterial and antifungal medication, while increased use for antivirals appeared only in BN (OR: 1.6, 95% CI: 1.1-2.3). Measured with the mean number of prescriptions or mean Defined Daily Doses per individual, patients with BN, BED and males with AN had also higher total antimicrobial medication use. Indicating increased infections, we found elevated use of antimicrobial medication in BN, BED and in males with AN. Infections may be consequence of hyperglycemia, weight gain, or dysregulation of intestinal microbiota associated with core eating disorder behaviors. Or the other way round; changes in intestinal microbiota due to infections, inflammation, or antibacterial medications might contribute to eating disorders in multiple ways. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:542-552). © 2016 Wiley Periodicals, Inc.
Riva, G; Bacchetta, M; Baruffi, M; Defrance, C; Gatti, F; Galimberti, C; Nugues, P; Ferretti, G S; Tonci, A
Virtual Reality Environments for Psychoneurophysiological Assessment and Rehabilitation (VREPAR) are two European Community funded projects (Telematics for health-HC 1053/HC 1055-http://www.psicologia.net) whose aim is (a) to develop a PC based virtual reality system (PC-VRS) for the medical market that can be marketed at a price that is accessible to its possible endusers (hospitals, universities, and research centres) and that would have the modular, connectability and interoperability characteristics that the existing systems lack; and (b) to develop three hardware/software modules for the application of the PC-VRS in psychoneurophysiological assessment and rehabilitation. The chosen development areas are eating disorders (bulimia, anorexia, and obesity), movement disorders (Parkinson's disease and torsion dystonia), and stroke disorders (unilateral neglect and hemiparesis). In particular, the VREPAR 2 project is now testing the eating disorders module on a clinical sample.
Folkvord, F.; Anschutz, D.J.; Boyland, E.J.; Kelly, B.; Buijzen, M.A.
Systematic research reviews have repeatedly shown that food advertising affects children's eating behavior. Given that most food advertising promotes unhealthy, palatable, and rewarding food products, it is considered to be a significant contributor to the current obesity epidemic. This review
Panagiota Kaisari; Colin T. Dourish; Pia Rotshtein; Suzanne Higgs
IntroductionIt is unclear whether core symptoms of attention deficit hyperactivity disorder (ADHD) relate to specific types of disordered eating and little is known about the mediating mechanisms. We investigated associations between core symptoms of ADHD and binge/disinhibited eating and restrictive eating behavior and assessed whether negative mood and/or deficits in awareness and reliance on internal hunger/satiety cues mediate these relationships.MethodsIn two independent studies, we used...
Dubovi, Abigail S; Li, Yue; Martin, Jessica L
Men remain largely underrepresented in the eating disorder literature and few studies have investigated risk factors for disordered eating among men. The current study examined associations between Big Five personality traits and eating disorder symptoms in a sample of college men (N = 144). Participants completed the Eating Disorder Diagnostic Scale and Ten Item Personality Inventory online. Results suggested that openness was positively associated with purging-type behaviors and that emotional stability was positively related to symptoms of anorexia nervosa and global eating pathology. Findings highlight the prevalence of eating disorder symptoms among college men and suggest that these symptoms are associated with a different constellation of personality traits than is typically reported among women. Implications for targeted prevention and intervention programs and future research are discussed. © The Author(s) 2015.
Mazzeo, Suzanne E.; Mitchell, Karen S.; Williams, Larry J.
This study evaluated structural equation models of the associations among family functioning, childhood abuse, depression, anxiety, alexithymia, and eating disorder symptomatology in a sample of 412 European American and 192 African American female undergraduates. Additionally, the specific roles of anxiety, depression, and alexithymia as…
... Med J 1995; 85: 588-590. Eating disorders, especially anorexia nervosa, have .... body image there did not appear to be any distortion, and she claimed to .... it has been noted that fatness is tolerated rather than accepted by young Chinese.
Winkler, Laura Vad; Christiansen, Erik; Lichtenstein, Mia Beck
to general population norm data and to investigate potential differences between ED diagnostic groups. A systematic review of the current literature was conducted using a keyword-based search in PubMed and PsychInfo. The search covered anorexia nervosa (AN), bulimia nervosa (BN), eating disorders...
Abbate-Daga, Giovanni; Quaranta, Michela; Marzola, Enrica; Cazzaniga, Giovanna; Amianto, Federico; Fassino, Secondo
Eating Disorders (ED) are often severe illnesses entailing a heavy burden for families. Family therapy is recommended for young patients, but only a few studies have investigated therapeutic interventions with families tailored also to adult and longstanding patients. We recruited 87 families with daughters affected by an ED, aiming to assess the…
Halmi, Katherine A.
Background: Etiological hypotheses of eating disorders, anorexia nervosa and bulimia nervosa have not produced informative research for predictably effective treatment. Methods: The rationale for applying a model of allostasis, a dysregulation of reward circuits with activation of brain and hormonal stress responses to maintain apparent stability,…
Full Text Available Zeynep Yilmaz,1 J Andrew Hardaway,1 Cynthia M Bulik1–3 1Department of Psychiatry, 2Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Abstract: Eating disorders (EDs are serious psychiatric conditions influenced by biological, psychological, and sociocultural factors. A better understanding of the genetics of these complex traits and the development of more sophisticated molecular biology tools have advanced our understanding of the etiology of EDs. The aim of this review is to critically evaluate the literature on the genetic research conducted on three major EDs: anorexia nervosa, bulimia nervosa, and binge eating disorder. We will first review the diagnostic criteria, clinical features, prevalence, and prognosis of anorexia nervosa, bulimia nervosa, and binge eating disorder, followed by a review of family, twin, and adoption studies. We then review the history of genetic studies of EDs covering linkage analysis, candidate-gene association studies, genome-wide association studies, and the study of rare variants in EDs. Our review also incorporates a translational perspective by covering animal models of ED-related phenotypes. Finally, we review the nascent field of epigenetics of EDs and a look forward to future directions for ED genetic research. Keywords: anorexia nervosa, binge eating disorder, bulimia nervosa, animal models, genome-wide association studies, high-throughput sequencing
Eiber, R; Mirabel-Sarron, C; Urdapilleta, I
Cognitions are of crucial importance in the -aetiology and the maintenance of eating disorders. Dysfunctional cognitions in eating disorders are related to body image, self-esteem and feeding. The aim of this paper is to review the actual knowledge in this area. First, we will display -cognitive models in eating disorders. Cognitive factors in -eating disorders are logical errors, cognitive slippage and conceptual complexity. Eating disorder patients seem to have a deficient cognitive development. Some cognitive models stipulate that eating disorder patients may develop organised cognitive structures schemas concerning the issues of weight and its implications for the self. These schemas can account for the persistence and for the understanding the "choice of the eating disorder symptomatology. Cognitive pheno-mena of interest are self-schema, weight-related schema and weight-related self-schema. The maintenance model of ano-rexia nervosa argued that, initially there is an extreme need to control eating which is supported by low self-esteem. The maintenance of the disorder is reinforced by three mechanisms: dietary restriction enhances the sense of being in control; aspects of starvation encourage further dietary restriction; concerns about shape and weight encourage restriction. The development and maintenance of bulimic symptomatology are explained by placing a high value on attaining an idealised weight and body shape accompanied by inaccurate beliefs. The cognitive model of specific family of origin experiences puts forward the development of -maladaptative expectancies for eating and thinness. Second, we discuss distortions in information processing. a) In feeding laboratories, bulimics show a wide range of caloric intake and a disruption of circadian feeding patterns. In overeating bulimics, large meals occurred mainly during afternoon and evening with high fat and carbohydrate intake, but the majority of meals were of normal size and frequency. Responsivity
Talleyrand, Regine M.
There is little attention devoted to studying eating disorder symptoms in racially and ethnically diverse groups despite the fact that the prevalence rates among women of color for eating disorder symptoms are similar to those of European American women. This article reviews research related to eating disorders in women of color, including a…
Peck, Lisa D.; Lightsey, Owen Richard
Among 261 undergraduate women, increased severity of eating disorders along a continuum was associated with decreased self-esteem, increased perfectionism, and increased scores on 7 subscales of the Eating Disorders Inventory-2. Women with eating disorders differed from both symptomatic women and asymptomatic women on all variables, whereas…
de Bruin, A.P.; Bakker, F.C.; Oudejans, R.R.D.
Objectives: To examine the relationships between disordered eating in female gymnasts and dancers and their perspective towards achievement in sport and dance, respectively. With an emphasis on outperforming others (ego involvement), more disordered eating was expected than when personal progress
Fairburn, Christopher G; Rothwell, Emily R
Smartphone applications (apps) are proliferating and health-related apps are particularly popular. The aim of this study was to identify, characterize, and evaluate the clinical utility of apps designed either for people with eating disorders or for eating disorder professionals. A search of the major app stores identified 805 potentially relevant apps, of which 39 were primarily designed for people with eating disorders and five for professionals. The apps for people with eating disorders had four main functions. Most common was the provision of advice, the quality of which ranged from sound to potentially harmful. Five apps included self-assessment tools but only two used methods that would generally be viewed as reliable. Four apps had the self-monitoring of eating habits as a major feature. Entering information into these apps could be accomplished with varying degrees of ease, but viewing it was more difficult. One app allowed the transfer of information between patients and clinicians. The enthusiasm for apps outstrips the evidence supporting their use. Given their popularity, it is suggested that clinicians evaluate app use as part of routine assessment. The clinical utility of the existing apps is not clear. Some are capable of tracking key features over time, but none has the functions required for analytic self-monitoring as in cognitive behavioral treatments. The full potential of apps has yet to be realized. Specialized apps could be designed to augment various forms of treatment, and there is the possibility that they could deliver an entire personalized intervention. © 2015 The Authors. International Journal of Eating Disorders published by Wiley Periodicals, Inc.
Melin, Anna; Torstveit, Monica Klungland; Burke, Louise
availability, reproductive function and bone health in female athletes, has recently been expanded to recognise that Relative Energy Deficiency in Sport (RED-S) has a broader range of negative effects on body systems with functional impairments in both male and female athletes. Athletes in leanness......-demanding sports have an increased risk for RED-S and for developing EDs/DE. Special risk factors in aquatic sports related to weight and body composition management include the wearing of skimpy and tight-fitting bathing suits, and in the case of diving and synchronized swimming, the involvement of subjective...... judgements of performance. The reported prevalence of DE and EDs in athletic populations including athletes from aquatic sports ranges from 18-45 % in female athletes and 0-28 % in male athletes. To prevent EDs, aquatic athletes should practice healthy eating behaviour at all periods of development pathway...
Barnett, Michaela J; Dripps, Weston R; Blomquist, Kerstin K
The alternative food network (AFN) refers to connections between consumers, producers, and sellers of organic, local/regional, "sustainably grown," and other artisanal and niche food not produced by the conventional system (Goodman & Goodman, 2007). Alternative foods are often viewed as the "right" consumption choice while conventional counterparts are positioned as ethically "wrong." A moral positioning of food, avoidance of certain food groups, and anxiety elicited by food consumption choices bears similarities to disordered eating behaviors (Hesse-Biber, Leavy, Quinn, & Zoino, 2006), including a newly proposed eating syndrome, orthorexia nervosa (ON; Vandereycken, 2011; Zamora, Bonaechea, Sánchez, & Rial, 2005). This study examines the relationship among engagement in the AFN, disordered eating behaviors, and special diets. We hypothesized that individuals with higher AFN engagement would be more likely report disordered eating behaviors as well as to follow a special diet. Adult men and women (N = 284) completed a series of measures assessing engagement in the AFN and eating behaviors. We found that individuals with higher AFN engagement were more likely to report ON tendencies but not significantly likely to engage in other disordered eating behaviors. Individuals following a special diet were significantly more engaged in the AFN, more likely to report ON tendencies, and more likely to self-report an eating disorder. Our findings suggest that the most engaged consumers participate in the AFN for the purported benefits reaped by society and the environment and not to moderate their consumption or mask disordered eating behaviors. Future research should prospectively explore associations between AFN engagement, ON and disordered eating behaviors, and special diets as well as consider the utility of incorporating AFN engagement into existing disordered eating prevention programs. Copyright © 2016 Elsevier Ltd. All rights reserved.
Sominsky, Luba; Spencer, Sarah J.
Stress causes or contributes to a huge variety of diseases and disorders. Recent evidence suggests obesity and other eating-related disorders may be among these. Immediately after a stressful event is experienced, there is a corticotropin-releasing-hormone (CRH)-mediated suppression of food intake. This diverts the body’s resources away from the less pressing need to find and consume food, prioritizing fight, flight, or withdrawal behaviors so the stressful event can be dealt with. In the hou...
Knoph, Cecilie; Holle, Ann Von; Zerwas, Stephanie; Torgersen, Leila; Tambs, Kristian; Stoltenberg, Camilla; Bulik, Cynthia M; Reichborn-Kjennerud, Ted
Objective To investigate course and predictors of eating disorders in the postpartum period. Method A total of 77,807 women, participating in the Norwegian Mother and Child Cohort Study (MoBa), completed questionnaires during pregnancy including items covering DSM-IV criteria for pre-pregnancy anorexia nervosa (AN), bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS-P), and binge eating disorder (BED). Additional questionnaires were completed at 18 and 36 months postpartum. Results Proportions of women remitting at 18 months and 36 months postpartum were 50% and 59% for AN, 39% and 30% for BN, 46% and 57% for EDNOS-P, and 45% and 42% for BED, respectively. However, disordered eating persisted in a substantial proportion of women meeting criteria for either full or subthreshold eating disorders. BN during pregnancy increased the risk for continuation of BN. BMI and psychological distress were significantly associated with course of BED. Discussion This is the first large-scale population-based study on course of eating disorders in the postpartum period. The results indicated that disordered eating persists in a substantial proportion of women with pre-pregnancy eating disorders. Health care professionals working with women in this phase of life need to pay specific attention to eating disorder symptoms and behaviors. PMID:23307499
Harney, Megan B.; Fitzsimmons-Crafr, Ellen E.; Maldonado, Christine R.; Bardone-Cone, Anna M.
The purpose of this study was to examine a collection of negative affect symptoms in relation to stages of eating disorder recovery. Depressive symptoms, anxiety symptoms, loneliness, and perceived stress are known to be present in individuals with eating disorders; however, less is known about the presence of such constructs throughout the recovery process. Does this negative affect fog continue to linger in individuals who have recovered from an eating disorder? Female participants seen at some point for an eating disorder at a primary care clinic were categorized into one of three groups using a stringent definition of eating disorder recovery based on physical, behavioral, and psychological criteria: active eating disorder (n =53), partially recovered (n =15; psychological criteria not met), and fully recovered (n =20; all recovery criteria met). Additionally, data were obtained from 67 female controls who had no history of an eating disorder. Self-report data indicated that controls and women fully recovered from an eating disorder scored significantly lower than partially recovered and active eating disorder groups in perceived stress, depression, and anxiety. Controls and the fully recovered group were statistically indistinguishable from each other in these domains, as were the partially recovered and active eating disorder groups, suggesting an interesting divide depending on whether psychological criteria (e.g., normative levels of weight/shape concern) were met. In contrast, controls and fully recovered and partially recovered groups all reported feeling significantly less lonely relative to those with an active eating disorder suggesting that improved perceptions of interpersonal, social support may act as a stepping stone toward more comprehensive eating disorder recovery. Future research may want to longitudinally determine if an increase in actual or perceived social support facilitates the movement toward full recovery and whether this, in turn, has
Harney, Megan B; Fitzsimmons-Craft, Ellen E; Maldonado, Christine R; Bardone-Cone, Anna M
The purpose of this study was to examine a collection of negative affect symptoms in relation to stages of eating disorder recovery. Depressive symptoms, anxiety symptoms, loneliness, and perceived stress are known to be present in individuals with eating disorders; however, less is known about the presence of such constructs throughout the recovery process. Does this negative affect fog continue to linger in individuals who have recovered from an eating disorder? Female participants seen at some point for an eating disorder at a primary care clinic were categorized into one of three groups using a stringent definition of eating disorder recovery based on physical, behavioral, and psychological criteria: active eating disorder (n=53), partially recovered (n=15; psychological criteria not met), and fully recovered (n=20; all recovery criteria met). Additionally, data were obtained from 67 female controls who had no history of an eating disorder. Self-report data indicated that controls and women fully recovered from an eating disorder scored significantly lower than partially recovered and active eating disorder groups in perceived stress, depression, and anxiety. Controls and the fully recovered group were statistically indistinguishable from each other in these domains, as were the partially recovered and active eating disorder groups, suggesting an interesting divide depending on whether psychological criteria (e.g., normative levels of weight/shape concern) were met. In contrast, controls and fully recovered and partially recovered groups all reported feeling significantly less lonely relative to those with an active eating disorder suggesting that improved perceptions of interpersonal functioning and social support may act as a stepping stone toward more comprehensive eating disorder recovery. Future research may want to longitudinally determine if an increase in actual or perceived social support facilitates the movement toward full recovery and whether this
Juarascio, Adrienne; Shaw, Jena; Forman, Evan; Timko, C. Alix; Herbert, James; Butryn, Meghan; Bunnell, Douglas; Matteucci, Alyssa; Lowe, Michael
Eating disorders are among the most challenging disorders to treat, with even state-of-the-art cognitive-behavioral treatments achieving only modest success. One possible reason for the high rate of treatment failure for eating disorders is that existing treatments do not attend sufficiently to critical aspects of the disorder such as high…
Rodríguez Lazo, María; Hernández Camacho, Juan Diego; Bolaños Ríos, Patricia; Ruiz-Prieto, Inmaculada; Jáuregui Lobera, Ignacio
factors related to food, shape, weight and exercise, transmitted from parents to children, and media sociocultural factors, such as social networks, also influence the development of Eating Disorders (ED). to analyse the influence of family eating habits and the parents perception about the influence of social networks on the development and maintenance of ED. 30 parents of ED patients participated voluntarily in this study fulfilling a series of questionnaires, as well as reporting their weight and height. it is observed an underestimation of weight in the case of overweight (33.33%) and obesity (35%) without considering the fact of going on diet in the future (χ2 = 11.31; p habits seem to be more relevant (e.g. snacking, intake of a single dish) (p eating habits of ED patients' families improve by means of the nutrition education included in the treatment. Relatives do not perceive adequately the risk of the social networks in their children, which might contribute to the maintenance and future relapses of ED. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Behar A, Rosa; Manzo G, Rodrigo; Casanova Z, Dunny
Low self-assertion has been noted as an important feature among patients with eating disorders. To verify, in a female population, if assertiveness is related or has a predictive capacity for the development of eating disorders. An structured clinical interview, the Eating Attitudes Test (EAT-40) and the Rathus Assertiveness Scale (RAS) were administered to 62 patients that fulfilled the DSM-IV diagnostic criteria for eating disorders and to 120 female students without eating problems. Patients with eating disorders ranked significantly higher on the EAT-40 and its factors (p assertiveness on the RAS (p Assertiveness measured by RAS and its factors was inversely related to EAT-40 and its items (r= -0.21). The predictive capability of the lack of self-assertion in the development of an eating disorder reached 53%, when patients with eating disorders and subjects at risk were considered together and compared to students without such disorder. Lack of assertiveness is a significant trait in patients with eating disorders; it may worsen its outcome and even perpetuate symptoms. Low self-assertion may be considered a predictive factor in the development of an eating disorder and must be managed from a preventive or therapeutic point of view.
Goldschmidt, Andrea B.; Le Grange, Daniel; Powers, Pauline; Crow, Scott J.; Hill, Laura L.; Peterson, Carol B.; Crosby, Ross D.; Mitchell, Jim E.
Although normal-weight individuals comprise a substantial minority of the binge eating disorder (BED) population, little is known about their clinical presentation. This study sought to investigate the nature and severity of eating disturbances in normal-weight adults with BED. We compared 281 normal-weight (n = 86) and obese (n = 195) treatment-seeking adults with BED (mean age = 31.0; s.d. = 10.8) on a range of current and past eating disorder symptoms using ANOVA and χ2 analyses. After con...
Studies examining development of eating behavior in different age groups are reviewed. Determinants of disordered eating attitudes from infancy to adolescent are particularly examined. Family environment and social context are general factors. Knowledge, attitudes and food preferences are individual factors. Eating habits in infancy, early childhood and preschool period related to parent’s eating attitudes; peers and social context are dominant in school period and adolescents. The most effec...
Hogan, Marjorie J; Strasburger, Victor C
Adolescence is a time of tremendous change in physical appearance. Many adolescents report dissatisfaction with their body shape and size. Forming one's body image is a complex process, influenced by family, peers, and media messages. Increasing evidence shows that the combination of ubiquitous ads for foods and emphasis on female beauty and thinness in both advertising and programming leads to confusion and dissatisfaction for many young people. Sociocultural factors, specifically media exposure, play an important role in the development of disordered body image. Of significant concern, studies have revealed a link between media exposure and the likelihood of having symptoms of disordered eating or a frank eating disorder. Pediatricians and other adults must work to promote media education and make media healthier for young people. More research is needed to identify the most vulnerable children and adolescents.
Calzo, Jerel P; Austin, S Bryn; Micali, Nadia
Much of the research on sexual orientation disparities in eating disorder behaviors has been conducted in the USA, Canada, and Australia. Data on the associations of sexual orientation and eating disorder symptoms among adolescents in the UK are lacking. Participants were children from the Avon Longitudinal Study of Parents and Children, a youth cohort born 1991-1992 (n = 5048; 53% female; 12% sexual minority). Sexual orientation was assessed at 16 years. Eating disorder symptoms were assessed at 14 and 16 years. Multivariable regression models (adjusting for BMI, ethnicity, socioeconomic status) examined associations between sexual orientation and (1) odds of past-year purging and binge eating, and (2) mean differences in body dissatisfaction, pressure to increase muscularity (boys only), and Dutch Eating Behavior Questionnaire subscales. At age 14, gay and bisexual boys and mostly heterosexual girls reported greater body dissatisfaction than their same-gender heterosexual peers. All sexual minority boys and mostly heterosexual girls reported greater mean dysfunctional eating behaviors than their same-gender heterosexual peers. At age 16, gay and bisexual boys had 12.5 times the odds of heterosexual boys of binge eating; mostly heterosexual boys had over three times the odds of reporting binge eating. Sexual minority girls had over twice the odds of heterosexual girls of purging and binge eating. By mid-adolescence, sexual minority youth in the UK had elevated risk for eating disorder symptoms, suggesting the need for early prevention efforts.
Fuglestad, Paul T.; Bruening, Meg; Graham, Dan J.; Eisenberg, Marla E.; Neumark-Sztainer, Dianne R.
This study used balance theory to illuminate the relations of eating-related attitudinal consistency between self and friends to psychological well-being and eating behaviors. It was hypothesized that attitudinal inconsistency, relative to consistency, would predict lower well-being and poorer eating habits. A population-based sample of 2287 young adults participating in Project EAT-III (Eating Among Teens and Young Adults) completed measures of psychological well-being, eating behaviors, and...
Díaz-Marsa, M; Lozano, C; Herranz, A S; Asensio-Vegas, M J; Martín, O; Revert, L; Saiz-Ruiz, J; Carrasco, J L
This work describes the rational bases justifying the use of acute tryptophan depletion technique in eating disorders (ED) and the methods and design used in our studies. Tryptophan depletion technique has been described and used in previous studies safely and makes it possible to evaluate the brain serotonin activity. Therefore it is used in the investigation of hypotheses on serotonergic deficiency in eating disorders. Furthermore, and given the relationship of the dysfunctions of serotonin activity with impulsive symptoms, the technique may be useful in biological differentiation of different subtypes, that is restrictive and bulimic, of ED. 57 female patients with DSM-IV eating disorders and 20 female controls were investigated with the tryptophan depletion test. A tryptophan-free amino acid solution was administered orally after a two-day low tryptophan diet to patients and controls. Free plasma tryptophan was measured at two and five hours following administration of the drink. Eating and emotional responses were measured with specific scales for five hours following the depletion. A study of the basic characteristics of the personality and impulsivity traits was also done. Relationship of the response to the test with the different clinical subtypes and with the temperamental and impulsive characteristics of the patients was studied. The test was effective in considerably reducing plasma tryptophan in five hours from baseline levels (76%) in the global sample. The test was well tolerated and no severe adverse effects were reported. Two patients withdrew from the test due to gastric intolerance. The tryptophan depletion test could be of value to study involvement of serotonin deficits in the symptomatology and pathophysiology of eating disorders.
Full Text Available The study aimed to evaluate oral health in women with eating disorders. The clinical study covered 30 patients aged 14-36 years suffering from diagnosed eating disorders and treated in closed psychiatric institutions. The control group comprised 30 healthy women at the mean age corresponding to that of the patient group. No relationships were confirmed between eating disorders and the intensity of dental caries. Eating disorders contribute to increased loss of dental hard tissues. In women suffering from eating disorders non-specific lesions in oral cavity are more common than in healthy women.
O'Brien, Amy; Watson, Hunna J; Hoiles, Kimberley J; Egan, Sarah J; Anderson, Rebecca A; Hamilton, Matthew J; Shu, Chloe; McCormack, Julie
The factor structure of the eating disorder examination (EDE) has never been tested in a clinical pediatric sample, and no normative data exist. The factor structure of an adapted EDE was examined in a clinical sample of 665 females aged 9-17 years with anorexia nervosa spectrum (70%), bulimia nervosa spectrum (12%), purging disorder (3%), and unspecified feeding and eating disorders (15%). The original four-factor model was a good fit in a confirmatory factor analysis as well a higher order model with three dimensions of restraint, eating concern, and combined weight concern/shape concern. Normative data are reported for clinicians to identify the percentiles in which their patients' score. The findings support dimensions of restraint, eating concern, weight concern, and shape concern in a clinical pediatric sample. This supports the factorial validity of the EDE, and the norms may assist clinicians to evaluate symptoms in females under 18 years. © 2015 Wiley Periodicals, Inc.
Full Text Available IntroductionIt is unclear whether core symptoms of attention deficit hyperactivity disorder (ADHD relate to specific types of disordered eating and little is known about the mediating mechanisms. We investigated associations between core symptoms of ADHD and binge/disinhibited eating and restrictive eating behavior and assessed whether negative mood and/or deficits in awareness and reliance on internal hunger/satiety cues mediate these relationships.MethodsIn two independent studies, we used a dimensional approach to study ADHD and disordered eating. In Study 1, a community-based sample of 237 adults (72.6% female, 18–60 years [M = 26.8, SE = 0.6] completed an online questionnaire, assessing eating attitudes/behaviors, negative mood, awareness, and reliance on internal hunger/satiety cues and ADHD symptomatology. In Study 2, 142 students (80.3% female, 18–32 years [M = 19.3, SE = 0.1] were recruited to complete the same questionnaires and complete tasks assessing interoceptive sensitivity and impulsivity in the laboratory.ResultsIn each study, core symptoms of ADHD correlated positively with both binge/disinhibited and restrictive eating and negative mood mediated the relationships. Deficits in awareness and reliance on internal hunger/satiety signals also mediated the association between inattentive symptoms of ADHD and disordered eating, especially binge/disinhibited eating. The results from both studies demonstrated that inattentive symptoms of ADHD were also directly related to binge/disinhibited eating behavior, while accounting for the indirect pathways of association via negative mood and awareness and reliance on internal hunger/satiety signals.ConclusionThis research provides evidence that core symptoms of ADHD are associated with both binge/disinhibited eating and restrictive eating behavior. Further investigation of the role of inattentive symptoms of ADHD in disordered eating may be helpful in developing novel
Kaisari, Panagiota; Dourish, Colin T; Rotshtein, Pia; Higgs, Suzanne
It is unclear whether core symptoms of attention deficit hyperactivity disorder (ADHD) relate to specific types of disordered eating and little is known about the mediating mechanisms. We investigated associations between core symptoms of ADHD and binge/disinhibited eating and restrictive eating behavior and assessed whether negative mood and/or deficits in awareness and reliance on internal hunger/satiety cues mediate these relationships. In two independent studies, we used a dimensional approach to study ADHD and disordered eating. In Study 1, a community-based sample of 237 adults (72.6% female, 18-60 years [M = 26.8, SE = 0.6]) completed an online questionnaire, assessing eating attitudes/behaviors, negative mood, awareness, and reliance on internal hunger/satiety cues and ADHD symptomatology. In Study 2, 142 students (80.3% female, 18-32 years [M = 19.3, SE = 0.1]) were recruited to complete the same questionnaires and complete tasks assessing interoceptive sensitivity and impulsivity in the laboratory. In each study, core symptoms of ADHD correlated positively with both binge/disinhibited and restrictive eating and negative mood mediated the relationships. Deficits in awareness and reliance on internal hunger/satiety signals also mediated the association between inattentive symptoms of ADHD and disordered eating, especially binge/disinhibited eating. The results from both studies demonstrated that inattentive symptoms of ADHD were also directly related to binge/disinhibited eating behavior, while accounting for the indirect pathways of association via negative mood and awareness and reliance on internal hunger/satiety signals. This research provides evidence that core symptoms of ADHD are associated with both binge/disinhibited eating and restrictive eating behavior. Further investigation of the role of inattentive symptoms of ADHD in disordered eating may be helpful in developing novel treatments for both ADHD and binge eating.
Goldschmidt, Andrea B; Crosby, Ross D; Cao, Li; Moessner, Markus; Forbush, Kelsie T; Accurso, Erin C; Le Grange, Daniel
Classifying eating disorders in youth is challenging in light of developmental considerations and high rates of diagnostic migration. Understanding the transactional relationships among eating disorder symptoms, both across the transdiagnostic spectrum and within specific diagnostic categories, may clarify which core eating disorder symptoms contribute to, and maintain, eating-related psychopathology in youth. We utilized network analysis to investigate interrelationships among eating disorder symptoms in 636 treatment-seeking children and adolescents (90.3% female) ages 6-18 years (M age = 15.4 ± 2.2). An undirected, weighted network of eating disorder symptoms was created using behavioral and attitudinal items from the Eating Disorder Examination. Across diagnostic groups, symptoms reflecting appearance-related concerns (e.g., dissatisfaction with shape and weight) and dietary restraint (e.g., a desire to have an empty stomach) were most strongly associated with other eating disorder symptoms in the network. Binge eating and compensatory behaviors (e.g., self-induced vomiting) were strongly connected to one another but not to other symptoms in the network. Network connectivity was similar across anorexia nervosa, bulimia nervosa, and otherwise specified feeding or eating disorder subgroups. Among treatment-seeking children and adolescents, dietary restraint and shape- and weight-related concerns appear to play key roles in the psychopathology of eating disorders, supporting cognitive-behavioral theories of onset and maintenance. Similarities across diagnostic categories provide support for a transdiagnostic classification scheme. Clinical interventions should seek to disrupt these symptoms early in treatment to achieve maximal outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Ålgars, Monica; Ramberg, Carin; Moszny, Josefine; Hagman, Jessica; Rintala, Hanna; Santtila, Pekka
Readiness and motivation for change were examined in 32 women with broadly defined eating disorders who took part in a 10-week Cognitive Behavioral Therapy (CBT)-based group intervention. Readiness for change and eating disorder psychopathology were assessed before and after the intervention. The results revealed significant negative associations between degree of eating disorder symptoms and degree of readiness for change before the intervention started. In particular, higher levels of eating concern, shape concern, and body dissatisfaction were associated with lower motivation for change. No significant associations between degree of readiness for change before the intervention started and changes in eating disorder symptoms at the end of intervention were found. Readiness for change increased from the beginning to the end of the intervention, indicating that group CBT may be a cost-effective and time-efficient way of enhancing readiness and motivation for change in individuals with eating psychopathology.
Supporting someone with an eating disorder: a systematic review of caregiver experiences of eating disorder treatment and a qualitative exploration of burnout management within eating disorder services
Aims: Eating disorder recovery is often supported by caregivers and mental health professionals. This research portfolio focuses on the experiences of supporting someone with an eating disorder from the perspective of the caregivers and also mental health professionals. The aims of this research portfolio are: Firstly, to systematically review the published qualitative literature relating to the experiences of caregivers supporting someone during eating disorder treatment; and ...
Yamaguchi, N; Kobayashi, J; Tachikawa, H; Sato, S; Hori, M; Suzuki, T; Shiraishi, H
We examined parental, personality, and symptomatological characteristics in relation to suicide attempts among eating disorder patients. Fifty-one eating disorder inpatients, divided into two groups according to lifetime suicide attempts, and 107 non-psychiatric subjects were compared on the following variables: Parental Bonding Instrument (PBI), Global Clinical Score (GCS), Eating Disorder Inventory-91 (EDI-91), Eating Attitudes Test-26 (EAT), clinical and personality characteristics, and family backgrounds. Suicidal patients reported significantly higher overprotection by both parents than non-suicidal patients and non-psychiatric subjects. Suicidal patients had a more prevalent history of child abuse, affective instability, unstable self-image, avoidance of abandonment, maladaptive perfectionism, personality disorder, and mood disorder. There were no differences in symptomatological factors or the severity of the eating disorders. The results suggest that high overprotection is associated with suicidal behaviour in eating disorder patients. The association between overprotective parenting and personality characteristics, and methods of suicide prevention are discussed briefly.
Powers, Margaret A; Richter, Sara A; Ackard, Diann M; Cronemeyer, Catherine
Through focus groups, we examined the development and maintenance of an eating disorder in 16 females with type 1 diabetes and an eating disorder. The quotes and qualitative data summaries provide rich insights into understanding why those with type 1 diabetes are at increased risk for eating disorders. Content analyses revealed five themes pertinent to the dual diagnosis (feeling different, difficulty with control/coping, body image, feelings, and quality of life) of which four themes were relevant to eating disorder development. Findings support early identification of those at risk and inform interventions to mitigate development of an eating disorder. © The Author(s) 2015.
Full Text Available Ignacio Jáuregui-Lobera,1 Patricia Bolaños-Ríos,2 Inmaculada Ruiz-Prieto21Department of Nutrition and Bromatology, Pablo de Olavide University, Seville, Spain; 2Behavioral Sciences Institute, Seville, SpainPurpose: The aim of this study was to analyze the relationships among thought–shape fusion (TSF, specific instruments to assess body image disturbances, and body image quality of life in eating disorder patients in order to improve the understanding of the links between body image concerns and a specific bias consisting of beliefs about the consequences of thinking about forbidden foods.Patients and methods: The final sample included 76 eating disorder patients (mean age 20.13 ± 2.28 years; 59 women and seven men. After having obtained informed consent, the following questionnaires were administered: Body Appreciation Scale (BAS, Body Image Quality of Life Inventory (BIQLI-SP, Body Shape Questionnaire (BSQ, Eating Disorders Inventory-2 (EDI-2, State-Trait Anxiety Inventory (STAI, Symptom Checklist-90-Revised (SCL-90-R and Thought-Shape Fusion Questionnaire (TSF-Q.Results: Significant correlations were found between TSF-Q and body image-related variables. Those with higher scores in TSF showed higher scores in the BSQ (P < 0.0001, Eating Disorder Inventory – Drive for Thinness (EDI-DT (P < 0.0001, and Eating Disorder Inventory – Body Dissatisfaction (EDI-BD (P < 0.0001. The same patients showed lower scores in the BAS (P < 0.0001. With respect to the psychopathological variables, patients with high TSF obtained higher scores in all SCL-90-R subscales as well as in the STAI.Conclusion: The current study shows the interrelations among different body image-related variables, TSF, and body image quality of life.Keywords: cognitive distortions, quality of life, body appreciation, psychopathology, anorexia nervosa, bulimia nervosa
Warren, Cortney S; Castillo, Linda G; Gleaves, David H
White American cultural values of appearance are implicated in the development of body dissatisfaction. This study examined whether the relationships between awareness of White American appearance ideals, internalization of such ideals, and body dissatisfaction are moderated by behavioral acculturation and attitudinal marginalization in a sample of 94 Mexican American women. Results indicated that behavioral acculturation moderated the relationship between awareness and internalization and cognitive marginalization moderated the relationship between internalization and body dissatisfaction. Body size was positively correlated with body dissatisfaction and negatively correlated with behavioral acculturation. These findings have important implications for clinical practice and research with Mexican American women.
Fuglestad, Paul T.; Bruening, Meg; Graham, Dan J.; Eisenberg, Marla E.; Neumark-Sztainer, Dianne R.
This study used balance theory to illuminate the relations of eating-related attitudinal consistency between self and friends to psychological well-being and eating behaviors. It was hypothesized that attitudinal inconsistency, relative to consistency, would predict lower well-being and poorer eating habits. A population-based sample of 2287 young adults participating in Project EAT-III (Eating Among Teens and Young Adults) completed measures of psychological well-being, eating behaviors, and eating-related attitudes from the standpoint of self and friends. Of participants who cared about healthy eating, those who perceived that their friends did not care about healthy eating had lower well-being and less-healthy eating behaviors (fewer fruits and vegetables and more sugary beverages per day) than those who perceived that their friends cared about healthy eating. Conversely, among participants who did not care about healthy eating, those who perceived that their friends cared about healthy eating had lower well-being and less-healthy eating behaviors (more snacks per day) than those who perceived that their friends did not care about healthy eating. In accord with balance theory, young adults who perceived inconsistent eating attitudes between themselves and their friends had lower psychological well-being and generally less-healthy eating behaviors than people who perceived consistent eating attitudes. PMID:24587589
Shisslak, Catherine M.; And Others
Summarizes current understanding of anorexia nervosa and bulimia (clinical symptoms and outcome, prevalence and risk factors), offering suggestions for the primary prevention of these disorders at the individual, family, and community levels, and emphasizing prevention in the schools. (Author/KS)
Mason, Tyler B; Lavender, Jason M; Wonderlich, Stephen A; Crosby, Ross D; Engel, Scott G; Strauman, Timothy J; Mitchell, James E; Crow, Scott J; Le Grange, Daniel; Klein, Marjorie H; Smith, Tracey L; Peterson, Carol B
This study examined self-discrepancy, a construct of theoretical relevance to eating disorder (ED) psychopathology, across different types of EDs. Individuals with anorexia nervosa (AN; n = 112), bulimia nervosa (BN; n = 72), and binge eating disorder (BED; n = 199) completed semi-structured interviews assessing specific types of self-discrepancies. Results revealed that actual:ideal (A:I) discrepancy was positively associated with AN, actual:ought (A:O) discrepancy was positively associated with BN and BED, and self-discrepancies did not differentiate BN from BED. Across diagnoses, A:O discrepancy was positively associated with severity of purging, binge eating, and global ED psychopathology. Further, there were significant interactions between diagnosis and A:O discrepancy for global ED psychopathology and between diagnosis and A:I discrepancy for binge eating and driven exercise. These results support the importance of self-discrepancy as a potential causal and maintenance variable in EDs that differentiates among different types of EDs and symptom severity. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
The aim of this study was to explore the role of parenting styles and the risk to develop an eating disordered behavior among teenage girls. This study was designed to test the hypotheses that parenting style are correlated with the risk to have an eating disordered behavior among female teenagers. It was predicted that the teenage girls at risk for developing an eating disorder would report experiencing their parents style as high in control and low in warmth or low in control and high in wa...
Talleyrand, Regine M.
Given the recent focus on eating disorders in children, it is imperative that counselors consider eating concerns that affect children of all racial and ethnic groups and hence are effective in working with this population. The author discusses risk factors that potentially contribute to eating disorders in African American girls given their…
Schaffner, Angela D.; Buchanan, Linda Paulk
This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…
The Eating Disorder Inventory and the Three-Factor Eating Questionnaire's cognitive dietary restraint subscale were used to measure disordered eating behaviour. Body composition was measured with dual-energy X-ray absorptiometry. Estimated energy availability (estEA) was determined from a three-day diet and ...
Karin Louise Lenz Dunker
Full Text Available OBJETIVO: Investigar comportamentos de risco para transtornos alimentares (TA em adolescentes de diferentes níveis socioeconômicos. MÉTODO: 183 adolescentes do sexo feminino de 15 a 18 anos de duas escolas (pública e particular foram avaliadas quanto à renda e escolaridade dos pais, estado nutricional, comport