Adult picky eaters with symptoms of avoidant/restrictive food intake disorder: comparable distress and comorbidity but different eating behaviors compared to those with disordered eating symptoms.

PubMed

Zickgraf, Hana F; Franklin, Martin E; Rozin, Paul

2016-01-01

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, and were more likely to eat from a narrow range of foods, compared to picky eaters without ARFID. Adult picky eaters can be differentiated from those with symptoms of anorexia and bulimia by their stronger endorsement of food neophobia and inflexible eating behaviors, and by eating from a very narrow range of foods. Picky eaters with ARFID symptoms can be differentiated from picky eaters without these symptoms on the basis of these three eating behaviors, and by their higher endorsement of internalizing distress, OCD symptoms, and eating-related quality of life impairment. This study provides evidence that ARFID symptoms exist independently of symptoms of other eating disorders and are characterized by several distinct eating behaviors. In a clinical analogue sample of disordered eaters, ARFID symptoms were associated with distress and impairment at levels comparable to symptoms of anorexia and bulimia.

Picking or nibbling: frequency and associated clinical features in bulimia nervosa, anorexia nervosa, and binge eating disorder.

PubMed

Conceição, Eva M; Crosby, Ross; Mitchell, James E; Engel, Scott G; Wonderlich, Stephen A; Simonich, Heather K; Peterson, Caroline B; Crow, Scott J; Le Grange, Daniel

2013-12-01

Picking or ribbling (P&N) is a newly studied eating behavior characterized by eating in an unplanned and repetitious manner in between meals and snacks. This behavior seems to be related to poorer weight loss outcomes after bariatric surgery for weight loss in severely obese patients, but clarification is still required regarding its value in other clinical samples. The purpose of this study was to investigate the frequency of P&N across different eating disorder samples, as well as to examine its association with psychopathological eating disorder features. Our sample included treatment-seeking adult participants, recruited for five different clinical trials: 259 binge eating disorder (BED); 264 bulimia nervosa (BN), and 137 anorexia nervosa (AN). Participants were assessed using the Eating Disorders Examination interview before entering the clinical trials. P&N was reported by 44% of the BED; 57.6% of the BN; and 34.3% of the AN participants. No association was found between P&N and BMI, the presence of compensatory behaviors, binge eating, or any of the eating disorder examination subscales. This study suggests that P&N behavior is highly prevalent across eating disorder diagnoses, but it is not associated with psychopathology symptoms or other eating disordered behaviors. Copyright © 2013 Wiley Periodicals, Inc.

Cognitive-Behavioral Theories of Eating Disorders

ERIC Educational Resources Information Center

Williamson, Donald A.; White, Marney A.; York-Crowe, Emily; Stewart, Tiffany M.

2004-01-01

This article presents an integrated cognitive-behavioral theory of eating disorders that is based on hypotheses developed over the past 30 years. The theory is evaluated using a selected review of the eating disorder literature pertaining to cognitive biases, negative emotional reactions, binge eating, compensatory behaviors, and risk factors for…

[Impact of eating psychopathology, obsessive-compulsion and depression on self-harm behavior in patients with eating disorders].

PubMed

Kong, Seong Sook

2009-08-01

The purpose of the study was to investigate psychological factors such as eating psychopathology, depression, and obsessive-compulsion that might influence self-harm behavior in patients with eating disorders. Patients with eating disorders (n=135) who visited "M" clinic for eating disorders participated in the study. Data were collected from March to August 2007 using the Eating Disorder Inventory-2, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Self-Harm Inventory (SHI). The participants scored high on self-harm as well as on depression and obsessive-compulsion. On the SHI, a high frequency of self harm behavior such as 'torturing self with self-defeating thoughts', 'abused alcohol', 'hit self', and 'suicide attempt' were found for the participants. There were significant correlations between most eating psychopathology variables, depression, obsessive-compulsion, and self-harm behavior. 'Interoceptive awareness' (eating psychopathology), depression, and 'checking' (obsessive-compulsion) were significant predictors of self-harm behavior. Future interventions for patients with eating disorders should focus on assessing the possibility of self-harm and suicidal attempts, especially in those patients with high levels of eating psychopathology, depression, or obsessive-compulsion. Early intervention for depression and obsessive-compulsion could contribute to preventing self-harm and suicide in patients with eating disorders.

A history of the identification of the characteristic eating disturbances of Bulimia Nervosa, Binge Eating Disorder and Anorexia Nervosa.

PubMed

Heaner, Martica K; Walsh, B Timothy

2013-06-01

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.

A comparison of disordered eating attitudes and behaviors among Filipino and American college students.

PubMed

Madanat, H N; Hawks, S R; Novilla, M L

2006-09-01

The purpose of this study was to compare the levels of eating disordered attitudes and behaviors among college students in the United States and the Philippines. A convenience-based cross-sectional survey. General education classes in one college in Manila and another in the Western US. 340 college students. A paper-pencil survey was given to the students in the classroom consisting of Eating Attitudes Test (EAT-26) and demographic variables. Eating disordered attitudes and behaviors (scoring 20 or more on EAT-26) was the dependent variable, while gender and country of residence were the two main independent variables. Frequency distributions, chi-squares, and logistic regression analysis were employed to summarize and analyze the data. Filipino students were 10.9 times (p-value <0.0001) more likely to have eating disordered attitudes and behaviors than their American counterparts controlling for the demographics collected. This relationship remained significant when regression models were done for each gender separately. In addition, married students and more specifically married female students were more likely to have eating disordered attitudes and behaviors than single students or single females. Arguments are made as to why higher levels of eating disordered attitudes and behaviors are observed among Filipino college students. These results provide important information about the levels of eating disordered attitudes and behaviors in the Philippines and may be useful for developing future education programs.

Neural correlates of eating disorders: translational potential

PubMed Central

McAdams, Carrie J; Smith, Whitney

2015-01-01

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. PMID:26767185

Dialectical Behavior Therapy Modified for Adolescent Binge Eating Disorder: A Case Report

ERIC Educational Resources Information Center

Safer, Debra L.; Couturier, Jennifer L.; Lock, James

2007-01-01

Given the lack of empirically supported treatments available for adolescents with eating disorders, it is important to investigate the clinical utility of extending treatments for adults with eating disorders to younger populations. Dialectical behavior therapy for binge eating disorder, based on the affect-regulation model, conceptualizes binge…

The Effect of Body Mass Index, Negative Affect, and Disordered Eating on Health-Related Quality of Life in Preadolescent Youth.

PubMed

Mitchell, Tarrah B; Steele, Ric G

2016-08-01

To examine the indirect effect of body mass index z-score (BMIz) on health-related quality of life (HRQOL) through disordered eating attitudes and behaviors in a community sample of preadolescent children, and the degree to which negative affect moderated the association between BMIz and disordered eating attitudes and behaviors. Participants included 165 children between 8 and 12 years of age (M = 9.41). HRQOL, disordered eating attitudes and behaviors, and negative affect were assessed using self-report measures. Height and weight were collected by research staff. Consistent with previous research in treatment-seeking and adolescent samples, the indirect effect of BMIz on HRQOL through disordered eating attitudes and behaviors was significant. Negative affect did not moderate the relationship between BMIz and disordered eating attitudes and behaviors. Intervening on disordered eating attitudes and behaviors in preadolescents with higher weight status is critical to prevent the risk for poor HRQOL. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Dysfunctional eating behaviors, anxiety, and depression in Italian boys and girls: the role of mass media.

PubMed

Barcaccia, Barbara; Balestrini, Viviana; Saliani, Angelo M; Baiocco, Roberto; Mancini, Francesco; Schneider, Barry H

2018-01-01

Extensive research has implicated identification with characters in mass media in the emergence of disordered eating behavior in adolescents. We explored the possible influence of the models offered by television (TV) on adolescents' body image, body uneasiness, eating-disordered behavior, depression, and anxiety. Three hundred and one adolescents (aged 14-19) from southern Italy participated. They completed a questionnaire on media exposure and body dissatisfaction, the Eating Disorder Inventory-2, the Body Uneasiness Test, the Beck Depression Inventory, and the State-Trait Anxiety Inventory - Form Y. The main factors contributing to females' eating-disordered behaviors were their own desires to be similar to TV characters, the amount of reality and entertainment TV they watched, and the discrepancy between their perceptions of their bodies and those of TV characters. Friends' desire to be similar to TV characters contributed most to depression, anxiety, body uneasiness, and eating disorders for both males and females. Our data confirm that extensive watching of reality and entertainment TV correlates with eating-disordered behavior among females. Moreover, the well-known negative effects of the media on adolescents' eating-disordered behaviors may also be indirectly transmitted by friends who share identification with TV characters.

A Systematic Review of Bright Light Therapy for Eating Disorders.

PubMed

Beauchamp, Marshall T; Lundgren, Jennifer D

2016-10-27

Bright light therapy is a noninvasive biological intervention for disorders with nonnormative circadian features. Eating disorders, particularly those with binge-eating and night-eating features, have documented nonnormative circadian eating and mood patterns, suggesting that bright light therapy may be an efficacious stand-alone or adjunctive intervention. The purpose of this systematic literature review, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, was (1) to evaluate the state of the empirical treatment outcome literature on bright light therapy for eating disorders and (2) to explore the timing of eating behavior, mood, and sleep-related symptom change so as to understand potential mechanisms of bright light therapy action in the context of eating disorder treatment. A comprehensive literature search using PsycInfo and PubMed/MEDLINE was conducted in April 2016 with no date restrictions to identify studies published using bright light therapy as a treatment for eating disorders. Keywords included combinations of terms describing disordered eating (eating disorder, anorexia nervosa, bulimia nervosa, binge eating, binge, eating behavior, eating, and night eating) and the use of bright light therapy (bright light therapy, light therapy, phototherapy). After excluding duplicates, 34 articles were reviewed for inclusion. 14 published studies of bright light therapy for eating disorders met inclusion criteria (included participants with an eating disorder/disordered-eating behaviors; presented as a case study, case series, open-label clinical trial, or randomized/nonrandomized controlled trial; written in English; and published and available by the time of manuscript review). Results suggest that bright light therapy is potentially effective at improving both disordered-eating behavior and mood acutely, although the timing of symptom response and the duration of treatment effects remain unknown. Future research should systematically control for placebo response, assess symptom change frequently and across a broad range of systems, and evaluate the longer-term efficacy of bright light therapy for eating disorders. © Copyright 2016 Physicians Postgraduate Press, Inc.

Dimensions of impulsivity in relation to eating disorder recovery.

PubMed

Bardone-Cone, Anna M; Butler, Rachel M; Balk, Margaret R; Koller, Katherine A

2016-11-01

Impulsivity is associated with eating pathology, but different dimensions of impulsivity have not been extensively studied in the eating disorders. The current study examined the relationship between four facets of impulsivity and eating disorder recovery status. Females formerly seen for an eating disorder were categorized as having an eating disorder (n = 53), partially recovered (n = 15), or fully recovered (n = 20) based on a diagnostic interview and physical, behavioral, and psychological indices. These groups and non-eating disorder controls were compared on impulsivity facets from the UPPS Impulsive Behavior Scale (UPPS): Urgency (negative urgency), Premeditation (lack of), Perseverance (lack of), and Sensation Seeking. Negative urgency (the tendency to engage in impulsive behavior to alleviate negative affect) was related to recovery. The fully recovered group and controls experienced significantly less negative urgency than those with a current eating disorder; the partially recovered group did not differ from the eating disorder group. Findings suggest that negative urgency may be a particularly important facet of impulsivity to target in therapeutic intervention for eating disorders, especially among those with a history of binge eating and/or purging. Future longitudinal work is needed to test a potential causal relationship between negative urgency and eating disorder recovery. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1027-1031). © 2016 Wiley Periodicals, Inc.

How specific are the relationships between eating disorder behaviors and perfectionism?

PubMed

Luo, Jing; Forbush, Kelsie T; Williamson, J Austin; Markon, Kristian E; Pollack, Lauren O

2013-08-01

Perfectionism is associated with several mental disorders, including depression, anxiety, and eating disorders. The goal of this study was to test the specificity of the associations between perfectionism facets and eating disorder behaviors, by examining whether neuroticism and conscientiousness mediated or moderated associations between these variables. Participants from a representative community sample (N = 407; 47% female) completed questionnaires assessing perfectionism, neuroticism, conscientiousness, and eating disorder behaviors. Neuroticism partially mediated associations between binge eating, restraint, body dissatisfaction, and maladaptive perfectionism facets. Neuroticism did not mediate associations between restriction and achievement striving perfectionism facets. Conscientiousness did not mediate any associations between perfectionism facets and eating disorder behaviors, yet Doubts about Actions interacted with conscientiousness to predict body dissatisfaction. Results indicate that neuroticism is key for understanding general risk factors that lead to myriad internalizing disorders, whereas maladaptive perfectionism has limited usefulness as a specific risk factor for eating disorder behaviors. Nevertheless, there is a unique association between dietary restraint and achievement striving dimensions of perfectionism that cannot be explained by higher-order personality traits. Copyright © 2013 Elsevier Ltd. All rights reserved.

Organivore or organorexic? Examining the relationship between alternative food network engagement, disordered eating, and special diets.

PubMed

Barnett, Michaela J; Dripps, Weston R; Blomquist, Kerstin K

2016-10-01

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.

Psychological Correlates of Help Seeking for Eating-Disorder Symptoms in Female College Students

ERIC Educational Resources Information Center

Meyer, Dinah F.

2005-01-01

This study investigated the psychological correlates of treatment seeking for eating disorders in female college students. Results indicated that 56% of the 106 participants with eating-disorder symptomatology did not believe their behaviors warranted therapy. Women with eating-disorder symptoms who did not believe their behaviors warranted…

Eating behavior, weight problems and eating disorders in 101 long-term survivors of childhood-onset craniopharyngioma.

PubMed

Hoffmann, Anika; Postma, Frank P; Sterkenburg, Anthe S; Gebhardt, Ursel; Müller, Hermann L

2015-01-01

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 (BMI<3 SD; n=48). Craniopharyngioma 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.

Eating Behaviors and Obesity in African American and Caucasian Women

DTIC Science & Technology

2010-08-16

Disorder Diagnostic Scale [23] is a 22-item scale that is useful as a screening tool for Anorexia Nervosa , Bulimia Nervosa , and Binge Eating Disorder...Agreement between eating disorder diagnoses from the Eating Disorder Diagnostic Scale and those by clinical interview is high: 99% for Anorexia , 96...Diagnostic Scale revealed that only 24% of the total sample met criteria for Bulimia Nervosa or Binge Eating Disordered behavior (sub- or threshold

Disordered eating behaviors among transgender youth: Probability profiles from risk and protective factors.

PubMed

Watson, Ryan J; Veale, Jaimie F; Saewyc, Elizabeth M

2017-05-01

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.

Tooth erosion and eating disorders: a systematic review and meta-analysis.

PubMed

Hermont, Ana Paula; Oliveira, Patrícia A D; Martins, Carolina C; Paiva, Saul M; Pordeus, Isabela A; Auad, Sheyla M

2014-01-01

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. 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? 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. 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). 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.

Problematic eating behaviors in adolescents with low self-esteem and elevated depressive symptoms.

PubMed

Courtney, Elizabeth A; Gamboz, Julie; Johnson, Jeffrey G

2008-12-01

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.

Cognitive-behavioral therapy for binge eating disorder in adolescents: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

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 gold standard treatment for adults with binge eating disorder. Methods/design 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. Discussion 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 availability of evidence-based treatment of adolescent binge eating disorder. Trial registration German Clinical Trials Register: DRKS00000542 PMID:24066704

Cognitive-behavioral therapy for binge eating disorder in adolescents: study protocol for a randomized controlled trial.

PubMed

Hilbert, Anja

2013-09-25

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 availability of evidence-based treatment of adolescent binge eating disorder. German Clinical Trials Register: DRKS00000542.

Chewing and spitting out food as a compensatory behavior in patients with eating disorders.

PubMed

Song, Youn Joo; Lee, Jung-Hyun; Jung, Young-Chul

2015-10-01

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.

Are food restriction and pressure-to-eat parenting practices associated with adolescent disordered eating behaviors?

PubMed

Loth, Katie A; MacLehose, Richard F; Fulkerson, Jayne A; Crow, Scott; Neumark-Sztainer, Dianne

2014-04-01

To examine associations between parental pressure-to-eat and food restriction and adolescent disordered eating behaviors, within a sample of parent-adolescent pairs. Adolescents (N = 2,231) and their parents (N = 3,431) participated in two, coordinated, population-based studies designed to examine factors associated with weight and weight-related behaviors in adolescents. Overall, higher levels of pressure-to-eat or food restriction were significantly and positively associated with use of disordered eating behaviors among boys. For every one unit increase [Scale Range: 1 (low control) to 4 (high control)] in mothers' food restriction, boys were twice as likely to engage in extreme weight control behaviors (p ≤ .01). Examination of the association between food-related parenting practices and disordered eating behaviors among girls revealed fewer significant associations. However, analyses revealed that for every one unit increase in mothers' food restriction, girls were 1.33 times more likely to engage in extreme weight control behaviors (p = .04). Study findings provide evidence of an association between controlling food-related parenting practices and adolescent disordered eating behaviors, particularly in boys. Future longitudinal research is needed to establish directionality of observed associations. Copyright © 2013 Wiley Periodicals, Inc.

Are food restriction and pressure-to-eat parenting practices associated with adolescent disordered eating behaviors?

PubMed Central

Loth, Katie A.; MacLehose, Richard F.; Fulkerson, Jayne A.; Crow, Scott; Neumark-Sztainer, Dianne

2014-01-01

Objective To examine associations between parental pressure-to-eat and food restriction and adolescent disordered eating behaviors, within a sample of parent-adolescent pairs. Method Adolescents (N=2231) and their parents (N=3431) participated in two, coordinated, population-based studies designed to examine factors associated with weight and weight-related behaviors in adolescents. Results Overall, higher levels of pressure-to-eat or food restriction was significantly and positively associated with use of disordered eating behaviors among boys. For every one unit increase [Scale Range: 1-(low control) to 4 – (high control)] in mothers’ food restriction, boys were twice as likely to engage in extreme weight control behaviors (p≤0.01). Examination of the association between food-related parenting practices and disordered eating behaviors among girls revealed fewer significant associations. However, analyses did reveal that for every one unit increase in mothers’ food restriction, girls were 1.33 times more likely to engage in extreme weight control behaviors (p=0.04). Discussion Study findings provide evidence of an association between controlling food-related parenting practices and adolescent disordered eating behaviors, particularly in boys. Future longitudinal research is needed to establish directionality of observed associations. PMID:24105668

Recollections of pressure to eat during childhood, but not picky eating, predict young adult eating behavior.

PubMed

Ellis, Jordan M; Galloway, Amy T; Webb, Rose Mary; Martz, Denise M; Farrow, Claire V

2016-02-01

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.

Cognitive-behavioral treatment of adult rumination behavior in the setting of disordered eating: A single case experimental design.

PubMed

Thomas, Jennifer J; Murray, Helen B

2016-10-01

The integration of feeding and eating disorders into a single DSM-5 chapter introduces an opportunity to explore common mechanisms and transdiagnostic treatment approaches. In contrast to a robust literature on the evidence-based treatment of eating disorders, very few data guide the treatment of rumination disorder (RD). In a single case experimental design, we describe the treatment of a 27-year-old woman who presented to an eating-disorder clinic with a 15-year history of untreated rumination and intermittent binge eating. According to time series analysis, she reduced rumination frequency at trend-level during the initial baseline phase (self-monitoring only), and exhibited significant reductions during the active intervention phase (self-monitoring + cognitive-behavioral techniques including diaphragmatic breathing and behavioral experimentation). She maintained these gains at 23 weeks post-intervention. Although more rigorous systematic investigation is needed, these data suggest that selected cognitive and behavioral techniques already familiar to eating-disorder clinicians may have heuristic value for RD treatment. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:967-972). © 2016 Wiley Periodicals, Inc.

Disordered Eating Behaviors Among Transgender Youth: Probability Profiles from Risk and Protective Factors

PubMed Central

Watson, Ryan J.; Veale, Jaimie F.; Saewyc, Elizabeth M.

2017-01-01

Purpose 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. Methods 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. Results 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. Conclusions 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. PMID:27862124

Eating behavior and psychological profile: associations between daughters with distinct eating disorders and their mothers.

PubMed

Vázquez-Velázquez, Verónica; Kaufer-Horwitz, Martha; Méndez, Juan Pablo; García-García, Eduardo; Reidl-Martínez, Lucy María

2017-09-06

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.

Behavioral and Neurodevelopmental Precursors to Binge-Type Eating Disorders: Support for the Role of Negative Valence Systems

PubMed Central

Vannucci, Anna; Nelson, Eric E.; Bongiorno, Diana M.; Pine, Daniel S.; Yanovski, Jack A.; Tanofsky-Kraff, Marian

2015-01-01

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

Prevalence of obesity and comorbid eating disorder behaviors in South Australia from 1995 to 2015.

PubMed

da Luz, F Q; Sainsbury, A; Mannan, H; Touyz, S; Mitchison, D; Hay, P

2017-07-01

Obesity and eating disorders are often studied and treated separately. While the increases in obesity prevalence are well known, examination of its co-occurrence with eating disorders, a problem also of public health concern, is important because eating disorder behaviors are known to contribute to obesity onset and maintenance, and vice versa. Data from large cross-sectional representative statewide community samples of people in the years of 1995 (n=3001), 2005 (n=3047) and 2015 (n=3005) were analyzed. Data were collected using a structured, self-report interview that included demographic, health-related, weight, height and eating disorder behavior questions. Eating behavior questions assessed binge eating, very strict dieting/fasting and purging, and were derived from the Eating Disorder Examination. Logistic regression analyses were conducted comparing prevalence of obesity, eating disorder behaviors and their co-occurrence. The prevalence of obesity or binge eating, or obesity with comorbid binge eating, each increased significantly from 1995 to 2005 (P<0.001 for each comparison) and continued to increase significantly from 2005 to 2015 (P<0.001 for each comparison). The highest increases from 1995 to 2015 were in the prevalence of obesity with comorbid binge eating (7.3-fold), or obesity with comorbid very strict dieting/fasting (11.5-fold). The prevalence of very strict dieting/fasting also increased significantly from 1995 to 2015 (3.8-fold). The prevalence of purging, or obesity with comorbid purging, did not change significantly from 1995 to 2015. There were statewide increases during the 20 years from 1995 to 2015 in the independent prevalence of obesity, binge eating and very strict dieting/fasting, and even higher increases in the prevalence of obesity with comorbid binge eating, and obesity with comorbid very strict dieting/fasting. These findings support the need for more integrated approaches to both the prevention and treatment of obesity and eating disorder behaviors, namely binge eating and very strict dieting/fasting.

Attachment insecurity, mentalization and their relation to symptoms in eating disorder patients.

PubMed

Kuipers, Greet S; van Loenhout, Zara; van der Ark, L Andries; Bekker, Marrie H J

2016-01-01

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.

Disordered eating behavior and mental health correlates among treatment seeking obese women.

PubMed

Altamura, M; Rossi, G; Aquilano, P; De Fazio, P; Segura-Garcia, C; Rossetti, M; Petrone, A; Lo Russo, T; Vendemiale, G; Bellomo, A

2015-01-01

Previous research has suggest that obesity is associated with increased risk for psychopathological disorders, however, little is known about which obese patients are most vulnerable to psychopathological disorders. We therefore investigated 126 treatment-seeking obese women to describe eating disorder pathology and mental health correlates, and to identify disordered eating behaviors that may place obese at increased risk for psychopathological disorders. The Structured Clinical Interview for DSM-IV (SCID) was used to identify Eating Disorders (ED). A battery of psychological tests, including the Anxiety Scale Questionnaire (ASQ,) Clinical Depression Questionnaire (CDQ), Eating Disorder Inventory-2 (EDI-2) Eating Attitudes Test-26 (EAT-26) scales and structured clinical interview were administered to all the patients. We analyzed the link between psychopathological disorders and eating attitudes by using both multiple regression analysis and non-parametric correlation. Disordered eating behaviors and emotional behavioral aspects related to Anorexia Nervosa, such as ineffectiveness, are strongly linked to the depression and anxiety in obese subjects. No correlation was found between psychopathological disorders and age or anthropometric measurements. Findings corroborate earlier work indicating that psychological distress is elevated in obese treatment seeking, bolstering the need for mental health assessment of such individuals. The feeling of ineffectiveness constitutes the major predictor of psychopathological aspects. This is an important result which may inform the development of effective interventions for obese patients and prevention of psychopathological disorders.

Psychosocial correlates, outcome, and stability of abnormal adolescent eating behavior in community samples of young people.

PubMed

Steinhausen, Hans-Christoph; Gavez, Silvia; Winkler Metzke, Christa

2005-03-01

The current study investigated psychosocial correlates of abnormal adolescent eating behavior at three times during adolescence and young adulthood and its association with psychiatric diagnosis in young adulthood in a community sample. Sixty-four (10.5%) high-risk subjects (mean age 15 years) with abnormal eating behavior were identified at Time 1, another 252 (16.9%) were identified at Time 2 (mean age 16.2 years), and 164 (16.9%) were identified at Time 3 (mean age 19.7 years) and compared with three control groups matched for age and gender. Dependent measures included emotional and behavioral problems, life events, coping capacities, self-related cognition, social network, and family functions. Outcome was measured additionally by structured psychiatric interviews, and stability of abnormal eating behavior was studied in a longitudinal sample of 330 subjects. Few subjects showed more than one of five criteria of abnormal eating behavior. High-risk subjects shared a very similar pattern at all three times. They were characterized by higher scores for emotional and behavioral problems, more life events including more negative impact, less active coping, lower self-esteem, and less family cohesion. Among 10 major psychiatric disorders, only clinical eating disorders at Time 3 shared a significant association with abnormal eating disorder at the same time whereas high-risk status at Times 1 and 2 did not predict any psychiatric disorder at Time 3. Stability of abnormal eating behavior across time was very low. Stability of abnormal eating behavior across time was very low. Abnormal eating behavior in adolescence and young adulthood is clearly associated with various indicators of psychosocial maladaption. In adolescence, it does not significantly predict any psychiatric disorder including eating disorder in young adulthood and it is predominantly a transient feature. (c) 2005 by Wiley Periodicals, Inc.

Dietary Restriction Behaviors and Binge Eating in Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder: Trans-diagnostic Examination of the Restraint Model.

PubMed

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

2015-08-01

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.

Longitudinal associations between parenting style and adolescent disordered eating behaviors.

PubMed

Zubatsky, Max; Berge, Jerica; Neumark-Sztainer, Dianne

2015-06-01

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.

Childhood body-focused behaviors and social behaviors as risk factors of eating disorders.

PubMed

Mangweth, Barbara; Hausmann, Armand; Danzl, Claudia; Walch, Thomas; Rupp, Claudia I; Biebl, Wilfried; Hudson, James I; Pope, Harrison G

2005-01-01

The risk factors for adolescent eating disorders are poorly understood. It is generally agreed, however, that interactions with one's body and interactions with others are two important features in the development of anorexia and bulimia nervosa. Therefore, we assessed a variety of childhood body-focused behaviors and childhood social behaviors in eating-disordered patients as compared to non-eating-disordered subjects. We compared 50 female inpatients with eating disorders (anorexia or bulimia nervosa), 50 female inpatients with polysubstance dependence, and 50 nonpatient female control subjects with no history of eating or substance abuse disorders (all defined by DSM-IV criteria), using a semi-structured interview of our own design. We asked questions about (1) childhood body-focused behaviors (e.g. thumb-sucking) and body-focused family experiences (e.g. bodily caresses), and (2) childhood social behaviors (e.g. numbers of close friends) and family social styles (e.g. authoritarian upbringing). Many body-focused measures, such as feeding problems, auto-aggressive behavior, lack of maternal caresses, and family taboos regarding nudity and sexuality, characterized eating-disordered patients as opposed to both comparison groups, as did several social behaviors, such as adjustment problems at school and lack of close friends. However, nail-biting, insecure parental bonding, and childhood physical and sexual abuse were equally elevated in both psychiatric groups. It appears that eating-disordered patients, as compared to substance-dependent patients and healthy controls, show a distinct pattern of body-focused and social behaviors during childhood, characterized by self-harm, a rigid and 'body-denying' family climate, and lack of intimacy. Copyright (c) 2005 S. Karger AG, Basel.

Defining Recovery from an Eating Disorder: Conceptualization, Validation, and Examination of Psychosocial Functioning and Psychiatric Comorbidity

PubMed Central

Bardone-Cone, Anna M.; Harney, Megan B.; Maldonado, Christine R.; Lawson, Melissa A.; Robinson, D. Paul; Smith, Roma; Tosh, Aneesh

2009-01-01

Conceptually, eating disorder recovery should include physical, behavioral, and psychological components, but such a comprehensive approach has not been consistently employed. Guided by theory and recent recovery research, we identified a “fully recovered” group (n=20) based on physical (body mass index), behavioral (absence of eating disorder behaviors), and psychological (Eating Disorder Examination-Questionnaire) indices, and compared them with groups of partially recovered (n=15), active eating disorder (n=53), and healthy controls (n=67). The fully recovered group was indistinguishable from controls on all eating disorder-related measures used, while the partially recovered group was less disordered than the active eating disorder group on some measures, but not on body image. Regarding psychosocial functioning, both the fully and partially recovered groups had psychosocial functioning similar to the controls, but there was a pattern of more of the partially recovered group reporting eating disorder aspects interfering with functioning. Regarding other psychopathology, the fully recovered group was no more likely than the controls to experience current Axis I pathology, but they did have elevated rates of current anxiety disorder. Results suggest that a stringent definition of recovery from an eating disorder is meaningful. Clinical implications and future directions regarding defining eating disorder recovery are discussed. PMID:19945094

Description of an Intensive Dialectical Behavior Therapy Program for Multidiagnostic Clients with Eating Disorders

ERIC Educational Resources Information Center

Federici, Anita; Wisniewski, Lucene; Ben-Porath, Denise

2012-01-01

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…

Chocolate craving and disordered eating. Beyond the gender divide?

PubMed

Hormes, Julia M; Orloff, Natalia C; Timko, C Alix

2014-12-01

Chocolate craving in women has previously been linked to disordered eating behaviors. A relatively higher prevalence of eating disorder pathology may account for the fact that chocolate craving is significantly more common in women in North America, compared to many other countries. While support for a causal role of disordered eating in the etiology of craving in women is growing, little is known about the extent to which food cravings are associated with disordered eating behaviors in men. This study was designed to systematically assess the impact of gender and chocolate craving on measures of attitudes to chocolate, responsiveness to food cues in the environment, body shape dissatisfaction, dietary restraint, and eating disorder and general pathology. Undergraduate men and women (n = 645, 37.2% male) were invited to complete self-report questionnaires assessing demographics, height and weight, food cravings, dietary attitudes and behaviors, along with eating disorder and general pathology. Data suggest that the relationship between chocolate craving and disordered eating behaviors in men is the opposite of what has previously been observed in women: compared to non-cravers, male chocolate cravers reported significantly more guilt related to craving, but were significantly less likely to diet and reported lower levels of dietary restraint, less frequent weight fluctuations, and fewer symptoms of eating disorders. Findings indicate that a positive relationship between disordered eating behaviors and chocolate craving may be unique to women (and potentially women in North America). Findings have important implications for our understanding of cultural and psychosocial factors involved in the etiology of food cravings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Marital Conflict in Early Childhood and Adolescent Disordered Eating: Emotional Insecurity about the Marital Relationship as an Explanatory Mechanism

PubMed Central

George, Melissa W.; Fairchild, Amanda J.; Cummings, E. Mark; Davies, Patrick T.

2017-01-01

Disordered eating behaviors, including frequent dieting, unhealthy weight control behaviors (e.g., vomiting and skipping meals for weight loss) and binge eating are prevalent among adolescents. While negative, conflict-ridden family environments have long been implicated as problematic and a contributing factor to the development of disordered eating, few studies have examined the influence of marital conflict exposure in childhood to understand the development of these behaviors in adolescence. The current study investigates the impact of marital conflict, children’s emotional insecurity about the marital relationship, and disordered eating behaviors in early adolescence in a prospective, longitudinal study of a community sample of 236 families in Midwest and Northeast regions of the U.S. Full structural mediation analyses utilizing robust latent constructs of marital conflict and emotional insecurity about the marital relationship, support children’s emotional insecurity as an explanatory mechanism for the influence of marital conflict on adolescent disordered eating behaviors. Findings are discussed with important implications for the long-term impact of marital conflict and the development of disordered eating in adolescence. PMID:25113902

Binge Eating, Purging, or Both: Eating Disorder Psychopathology Findings from an Internet Community Survey

PubMed Central

Roberto, Christina A.; Grilo, Carlos M.; Masheb, Robin M.; White, Marney A.

2010-01-01

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

Marital conflict in early childhood and adolescent disordered eating: emotional insecurity about the marital relationship as an explanatory mechanism.

PubMed

George, Melissa W; Fairchild, Amanda J; Mark Cummings, E; Davies, Patrick T

2014-12-01

Disordered eating behaviors, including frequent dieting, unhealthy weight control behaviors (e.g., vomiting and skipping meals for weight loss) and binge eating are prevalent among adolescents. While negative, conflict-ridden family environments have long been implicated as problematic and a contributing factor to the development of disordered eating, few studies have examined the influence of marital conflict exposure in childhood to understand the development of these behaviors in adolescence. The current study investigates the impact of marital conflict, children's emotional insecurity about the marital relationship, and disordered eating behaviors in early adolescence in a prospective, longitudinal study of a community sample of 236 families in Midwest and Northeast regions of the U.S. Full structural mediation analyses utilizing robust latent constructs of marital conflict and emotional insecurity about the marital relationship, support children's emotional insecurity as an explanatory mechanism for the influence of marital conflict on adolescent disordered eating behaviors. Findings are discussed with important implications for the long-term impact of marital conflict and the development of disordered eating in adolescence. Copyright © 2014 Elsevier Ltd. All rights reserved.

Eating disorder symptoms in middle-aged and older men.

PubMed

Mangweth-Matzek, Barbara; Kummer, Kai K; Pope, Harrison G

2016-10-01

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 < 18.5; (2) binge eating; (3) binge eating and purging; or (4) purging without binge eating. Of the 470 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.

Youth internalizing symptoms, sleep-related problems, and disordered eating attitudes and behaviors: A moderated mediation analysis.

PubMed

Chardon, Marie L; Janicke, David M; Carmody, Julia K; Dumont-Driscoll, Marilyn C

2016-04-01

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.

A Cross-Lagged Evaluation of Eating Disorder Symptomatology and Substance-Use Problems*

PubMed Central

Dunn, Erin C.; Neighbors, Clayton; Fossos, Nicole; Larimer, Mary E.

2009-01-01

Objective: The purpose of this study was to conduct a temporal examination of the associations among disordered eating behaviors, substance use, and use-related negative consequences in female college students—a population at high risk for developing eating and substance-use disorders. Method: Participants completed assessments of disordered eating behaviors, alcohol and drug use, and use-related negative consequences. Results: Results support previous research suggesting that disordered eating behaviors are more strongly associated with alcohol- and substance-related problems rather than use per se. With respect to temporal precedence, results indicated that binge eating preceded alcohol-use problems, but a bidirectional relationship was found for vomiting. With regard to drug problems, laxatives use preceded drug problems, whereas drug problems preceded fasting. These associations were not better accounted for by pre-existing eating or substance-use problems or psychiatric distress (e.g., depression, anxiety). Conclusions: This study further supports the importance of assessing consequences, in addition to use patterns, when examining substance use in individuals demonstrating threshold and subthreshold eating-disordered behaviors. PMID:19118399

Parent Conversations about Healthful Eating and Weight: Associations with Adolescent Disordered Eating Behaviors

PubMed Central

Berge, Jerica M.; MacLehose, Rich; Loth, Katie A.; Eisenberg, Marla; Bucchianeri, Michaela M.; Neumark-Sztainer, Dianne

2013-01-01

Objective The prevalence of weight-related problems in adolescents is high. Parents of adolescents may wonder whether talking about eating habits and weight is useful or detrimental. This study aimed to examine the associations between parent conversations about healthful eating and weight and adolescent disordered eating behaviors. Design Cross-sectional analysis using data from two linked multi-level population-based studies. Setting Anthropometric assessments and surveys completed at school by adolescents and surveys completed at home by parents in 2009–2010. Participants Socio-economically and racially/ethnically diverse sample (81% ethnic minority; 60% low income) of adolescents from EAT (Eating and Activity in Teens) 2010 (n = 2,793, mean age=14.4) and parents from F-EAT (Families and Eating and Activity in Teens) (n = 3,709, mean age = 42.3). Main Exposure Parent conversations about healthful eating and weight/size. Outcome Measures Adolescent dieting, unhealthy weight control behaviors, and binge eating. Results Mothers and fathers who engaged in weight-related conversations had adolescents who were more likely to diet, use unhealthy weight control behaviors, and engage in binge eating. Overweight/obese adolescents whose mothers engaged in conversations that were focused only on healthful eating behaviors were less likely to diet and use unhealthy weight control behaviors. Additionally, sub-analyses with adolescents with data from two parents showed that when both parents engaged in healthful eating conversations, their overweight/obese adolescent children were less likely to diet and use unhealthy weight control behaviors. Conclusion Parent conversations focused on weight/size are associated with increased risk for adolescent disordered eating behaviors, whereas conversations focused on healthful eating are protective against disordered eating behaviors. PMID:23797808

Excessive Time on Social Networking Sites and Disordered Eating Behaviors Among Undergraduate Students: Appearance and Weight Esteem as Mediating Pathways.

PubMed

Murray, Marisa; Maras, Danijela; Goldfield, Gary S

2016-12-01

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.

Associations between body mass index, weight control concerns and behaviors, and eating disorder symptoms among non-clinical Chinese adolescents

PubMed Central

2010-01-01

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 considerably weaker than when weight control behaviors were not included. Conclusions Weight control concerns and behaviors may be mediators of the association between BMI and eating disorder symptoms. Interpretation of these weight control problems is crucial to develop culturally appropriate educational and intervention programs for adolescents. PMID:20525394

Gender differences in the relationship between impulsivity and disordered eating behaviors and attitudes.

PubMed

Lundahl, Alyssa; Wahlstrom, Laura C; Christ, Christa C; Stoltenberg, Scott F

2015-08-01

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.

Diagnostic classification of eating disorders in children and adolescents: How does DSM-IV-TR compare to empirically-derived categories?

PubMed Central

Eddy, Kamryn T.; le Grange, Daniel; Crosby, Ross D.; Hoste, Renee Rienecke; Doyle, Angela Celio; Smyth, Angela; Herzog, David B.

2009-01-01

Objective The purpose of this study was to empirically derive eating disorder phenotypes in a clinical sample of children and adolescents using latent profile analysis (LPA) and compare these latent profile (LP) groups to the DSM-IV-TR eating disorder categories. Method Eating disorder symptom data collected from 401 youth (ages 7–19; mean 15.14 ± 2.35y) seeking eating disorder treatment were included in LPA; general linear models were used to compare LP groups to DSM-IV-TR eating disorder categories on pre-treatment and outcome indices. Results Three LP groups were identified: LP1 (n=144), characterized binge eating and purging (“Binge/purge”); LP2 (n=126), characterized by excessive exercise and extreme eating disorder cognitions (“Exercise-extreme cognitions”); and LP3 (n=131), characterized by minimal eating disorder behaviors and cognitions (“Minimal behaviors/cognitions”). Identified LPs imperfectly resembled DSM-IV-TR eating disorders. LP1 resembled bulimia nervosa; LP2 and LP3 broadly resembled anorexia nervosa with a relaxed weight criterion, differentiated by excessive exercise and severity of eating disorder cognitions. LP groups were more differentiated than the DSM-IV-TR categories across pre-treatment eating disorder and general psychopathology indices, as well as weight change at follow-up. Neither LP nor DSM-IV-TR categories predicted change in binge/purge behaviors. Validation analyses suggest these empirically-derived groups improve upon the current DSM-IV-TR categories. Conclusions In children and adolescents, revisions for DSM-V should consider recognition of patients with minimal cognitive eating disorder symptoms. PMID:20410717

Disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents.

PubMed

Bacopoulou, Flora; Foskolos, Elizabeth; Stefanaki, Charikleia; Tsitsami, Eleni; Vousoura, Eleni

2017-11-30

The aim of this study was to examine the relationship between disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents as well as the moderating role of gender and body mass index (BMI) in this relationship. Ninety adolescents, 11-18 years old, were assessed using anthropometric measurements; demographics, eating attitudes and level of emotional/behavioral adjustment were examined via self-reported questionnaires. Disordered eating attitudes were prevalent in 17.8% of the sample. A significant relationship was found between disordered eating attitudes and Youth Self-Report (YSR) anxiety score (r = .22, p < .05). Gender significantly moderated the relationship between YSR anxiety symptoms and Eating Attitudes Test (EAT) scores (b = .59, p = .01) and this effect held true for the EAT bulimia subscale (b = .20, p = .03), but not for the dieting or the oral control subscales. Contrary to our hypothesis, BMI did not moderate the relationship between EAT and YSR anxiety sub-scores (b = .13, p > .05). Girls with elevated anxiety levels appear to be at risk for exhibiting disordered eating attitudes, especially bulimic behaviors. This finding highlights the importance of developing gender-based preventive interventions tailored to these specific emotional/behavioral aspects. Level V, cross-sectional descriptive study.

Eating Disorders: Facts about Eating Disorders and the Search for Solutions.

ERIC Educational Resources Information Center

Spearing, Melissa

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…

Positive Psychology in the Prevention of Eating Disorders

ERIC Educational Resources Information Center

Steck, Erin L.; Abrams, Laura M.; Phelps, LeAdelle

2004-01-01

Traditionally the identification of, and treatment for, eating disorders has been based on developmental psychopathology theory and research, thereby emphasizing risk factors and the elimination of maladaptive behaviors. This article seeks to reconceptualize the prevention of, and protective factors for, eating disordered behavior from the…

Relationship between Risk Behavior for Eating Disorders and Dental Caries and Dental Erosion.

PubMed

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

2017-01-01

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.

Relationship between Risk Behavior for Eating Disorders and Dental Caries and Dental Erosion

PubMed Central

Brandt, Lorenna Mendes Temóteo; Fernandes, Liege Helena Freitas; Aragão, Amanda Silva; Cavalcanti, Sérgio D'Ávila Lins Bezerra

2017-01-01

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. PMID:29423431

Eating disorder symptoms and weight and shape concerns in a large web-based convenience sample of women ages 50 and above: results of the Gender and Body Image (GABI) study.

PubMed

Gagne, Danielle A; Von Holle, Ann; Brownley, Kimberly A; Runfola, Cristin D; Hofmeier, Sara; Branch, Kateland E; Bulik, Cynthia M

2012-11-01

Limited research exists on eating disorder symptoms and attitudes and weight and shape concerns in women in midlife to older adulthood. We conducted an online survey to characterize these behaviors and concerns in women ages 50 and above. Participants (n = 1,849) were recruited via the Internet and convenience sampling. Eating disorder symptoms, dieting and body checking behaviors, and weight and shape concerns were widely endorsed. Younger age and higher body mass index (BMI) were associated with greater endorsement of eating disorder symptoms, behaviors, and concerns. Weight and shape concerns and disordered eating behaviors occur in women over 50 and vary by age and BMI. Focused research on disordered eating patterns in this age group is necessary to develop age-appropriate interventions and to meet the developmental needs of an important, growing, and underserved population. Copyright © 2012 Wiley Periodicals, Inc.

Aspects of disordered eating continuum in elite high-intensity sports.

PubMed

Sundgot-Borgen, J; Torstveit, M K

2010-10-01

Dieting is an important risk factor for disordered eating and eating disorders. Disordered eating occurs on a continuum from dieting and restrictive eating, abnormal eating behavior, and finally clinical eating disorders. The prevalence of eating disorders is increased in elite athletes and for this group the cause of starting to diet is related to (a) perception of the paradigm of appearance in the specific sport, (b) perceived performance improvements, and (c) sociocultural pressures for thinness or an "ideal" body. Athletes most at risk for disordered eating are those involved in sports emphasizing a thin body size/shape, a high power-to-weight ratio, and/or sports utilizing weight categories, such as in some high-intensity sports. In addition to dieting, personality factors, pressure to lose weight, frequent weight cycling, early start of sport-specific training, overtraining, injuries, and unfortunate coaching behavior, are important risk factors. To prevent disordered eating and eating disorders, the athletes have to practice healthy eating, and the medical staff of teams and parents must be able to recognize symptoms indicating risk for eating disorders. Coaches and leaders must accept that disordered eating can be a problem in the athletic community and that openness regarding this challenge is important. © 2010 John Wiley & Sons A/S.

Gender differences in exercise dependence and eating disorders in young adults: a path analysis of a conceptual model.

PubMed

Meulemans, Shelli; Pribis, Peter; Grajales, Tevni; Krivak, Gretchen

2014-11-05

The purpose of our study was to study the prevalence of exercise dependence (EXD) among college students and to investigate the role of EXD and gender on exercise behavior and eating disorders. Excessive exercise can become an addiction known as exercise dependence. In our population of 517 college students, 3.3% were at risk for EXD and 8% were at risk for an eating disorder. We used Path analysis the simplest case of Structural Equation Modeling (SEM) to investigate the role of EXD and exercise behavior on eating disorders. We observed a small direct effect from gender to eating disorders. In females we observed significant direct effect between exercise behavior (r = -0.17, p = 0.009) and EXD (r = 0.34, p < 0.001) on eating pathology. We also observed an indirect effect of exercise behavior on eating pathology (r = 0.16) through EXD (r = 0.48, r2 = 0.23, p < 0.001). In females the total variance of eating pathology explained by the SEM model was 9%. In males we observed a direct effect between EXD (r = 0.23, p < 0.001) on eating pathology. We also observed indirect effect of exercise behavior on eating pathology (r = 0.11) through EXD (r = 0.49, r2 = 0.24, p < 0.001). In males the total variance of eating pathology explained by the SEM model was 5%.

Chronic Illness and Disordered Eating: A Discussion of the Literature12

PubMed Central

Quick, Virginia M.; Byrd-Bredbenner, Carol; Neumark-Sztainer, Dianne

2013-01-01

This paper describes the prevalence of eating disorders and disordered eating behaviors, the reasons why these practices are endorsed, and the potential consequences in youths and young adults with selected diet-related chronic health conditions (DRCHCs) and provides recommendations for eating disorder prevention interventions and research efforts. Although it remains unclear whether the prevalence of eating disorders is higher in those with DRCHCs compared with the general population, overall findings suggest that young people with DRCHCs may be at risk of endorsing disordered eating behaviors that may lead to diagnosis of an eating disorder and other health problems over the course of their treatment. Thus, health care providers should be aware that young people with DRCHCs may be at risk of eating disorders and carefully monitor psychological changes and the use of unhealthy weight control methods. It is also important to develop and evaluate theory-based interventions and disease-specific eating disorder risk screening tools that are effective in halting the progression of eating disorders and negative health outcomes in young people with chronic health conditions. PMID:23674793

Dieting and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study

PubMed Central

Neumark-Sztainer, Dianne; Wall, Melanie; Larson, Nicole I.; Eisenberg, Marla E.; Loth, Katie

2011-01-01

Background Disordered eating behaviors are prevalent in adolescence and can have harmful consequences. An important question is whether use of these behaviors in adolescence sets the pattern for continued use into young adulthood. Objective To examine the prevalence and tracking of dieting, unhealthy and extreme weight control behaviors, and binge eating from adolescence to young adulthood. Design Population-based, 10-year longitudinal study (Project EAT-III: Eating Among Teens and Young Adults, 1999–2010). Participants/setting The study population includes 2,287 young adults (55% female, 52% non-white). The sample includes a younger group (mean age = 12.8±0.7 years at baseline and 23.2±1.0 years at follow-up) and an older group (mean age = 15.9±0.8 at baseline and 26.2±0.9 years at follow-up). Statistical analyses performed Longitudinal trends in prevalence of behaviors were tested using generalized estimating equations. Tracking of behaviors were estimated using the relative risk of behaviors at follow-up given presence at baseline. Results In general, the prevalence of dieting and disordered eating was high and remained constant, or increased, from adolescence to young adulthood. Furthermore, behaviors tended to track within individuals and, in general, participants who engaged in dieting and disordered eating behaviors during adolescence were at increased risk for these behaviors ten years later. Tracking was particularly consistent for the older females and males transitioning from middle adolescence to middle young adulthood. Conclusions Study findings indicate that disordered eating behaviors are not just an adolescent problem, but continue to be prevalent among young adults. The tracking of dieting and disordered eating within individuals suggests that early use is likely to set the stage for ongoing use. Findings suggest a need for both early prevention efforts prior to the onset of harmful behavioral patterns, as well as ongoing prevention and treatment interventions to address the high prevalence of disordered eating throughout adolescence and young adulthood. PMID:21703378

The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis.

PubMed

Linardon, Jake; Wade, Tracey D; de la Piedad Garcia, Xochitl; Brennan, Leah

2017-11-01

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).

Do chronic medical conditions increase the risk of eating disorder? A cross-sectional investigation of eating pathology in adolescent females with scoliosis and diabetes.

PubMed

Smith, Fiona M; Latchford, Gary J; Hall, Richard M; Dickson, Robert A

2008-01-01

To investigate levels of eating pathology in female adolescents diagnosed with a chronic condition causing appearance change (adolescent-onset idiopathic scoliosis), a chronic condition affecting nutritional behavior (insulin-dependent diabetes mellitus), and healthy age-matched controls. Cross-sectional comparison of 192 females aged 11-19 years; 76 individuals diagnosed with scoliosis, 40 diagnosed with diabetes, and 76 control participants. Disordered eating behavior was quantified using the Eating Disorder Examination Questionnaire, and weight and body mass index (weight [kg]/height [m(2)]) measurements were taken for each participant. The scoliosis group weighed less and had lower BMI scores (p < .001) than control participants. Of the participants with scoliosis, 25% were severely underweight, but only two met the behavioral criteria for anorexia nervosa; in others no association with disordered eating behaviour was found. Eating disorders were significantly more common (p < .05) in the diabetes participants than in the control group, with 27.5% of the group classified as having bulimia or binge eating disorder. All those classified as overweight or obese in the diabetes group were classified as pathological in terms of eating behavior. The relationship between scoliosis and low body mass is a concern but is not a result of an eating disorder. Etiological mechanisms remain unclear and require further investigation. In the diabetes participants, bulimia and binge eating may prejudice effective condition management. Implications for successful adaptation, treatment intervention, and future research are discussed.

Behavioral and Psychophysiological Responsiveness During Child Feeding in Mothers with Histories of Eating Disorders: A Pilot Study

PubMed Central

Hoffman, Elizabeth R.; Hodges, Eric A.; Propper, Cathi; Postage, Pamela L.; Zipkin, Elana C.; Bentley, Margaret E.; Ward, Dianne S.; Hamer, Robert M.; Bulik, Cynthia M.

2013-01-01

The aim of this pilot project was to describe maternal responsiveness during child feeding in mothers with eating disorder histories through the combined use of observational, self-report, and physiologic methods. For this non-randomized cohort pilot study, 25 mothers with histories of eating disorders and 25 mothers with no history of an eating disorder with children ages 6–36 months were selected such that the groups were similar based on child age group (within 6 months) and child sex. Maternal behavioral responsiveness to child cues was assessed by video-recording and behavioral coding of both a free-play and feeding episode. Physiologic engagement was assessed through measurement of respiratory sinus arrhythmia (RSA) reactivity during free-play and feeding episodes. No differences were detected in observed behavioral responsiveness during feeding or free-play in mothers with eating disorder histories compared with controls. Mothers with eating disorder histories did report more parenting stress, increased anxiety, and exhibited a blunted physiologic stress response (less RSA reactivity) during both feeding and free-play interactions with their children. These results support future larger-scale investigations of RSA reactivity in mothers with eating disorders. PMID:24511180

Psychosocial correlates of disordered eating in female collegiate athletes: validation of the ATHLETE questionnaire.

PubMed

Hinton, Pamela S; Kubas, Karen L

2005-01-01

Female athletes may be at greater risk for disordered eating than their nonathletic peers, but the psychological antecedents of this dysfunctional behavior in athletes have yet to be elucidated. The objective of this study was to develop an athletics-oriented measure of psychological predictors of disordered eating and to test its initial reliability and validity. Female athletes from 3 National Collegiate Athletics Association (NCAA) Division I universities completed the ATHLETE, a written questionnaire designed to assess psychosocial factors associated with disordered eating in athletes. Five distinct and internally consistent factors (Drive for Thinness and Performance, Social Pressure on Eating, Performance Perfectionism, Social Pressure on Body Shape, and Team Trust) were positively associated with and predictive of disordered eating behaviors in female athletes. The ATHLETE is a reliable and valid measure of psychological predictors of disordered eating in athletics and will be useful in studying the etiology of disordered eating in female athletes.

Eating disorder symptoms among undergraduate and graduate students at 12 U.S. colleges and universities.

PubMed

Lipson, S K; Sonneville, K R

2017-01-01

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%, p<0.001), but similar prevalence of compensatory behaviors (31% versus 29%). Weight status was the most consistent predictor of eating disorder risk with significantly more symptoms seen among individuals with overweight and obesity. 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.

Relationship between body dissatisfaction and disordered eating: mediating role of self-esteem and depression.

PubMed

Brechan, Inge; Kvalem, Ingela Lundin

2015-04-01

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 reserved.

Behavioral and Psychological Aspects of Exercise across Stages of Eating Disorder Recovery

PubMed Central

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.

2016-01-01

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

Implicit affective associations predict snack choice for those with low, but not high levels of eating disorder symptomatology

PubMed Central

Ellis, Erin M.; Kiviniemi, Marc T.; Cook-Cottone, Catherine

2014-01-01

OBJECTIVE The central purpose of the current study was to examine whether eating disorder symptomatology moderates the extent to which implicitly and explicitly measured affective associations with fruits, or the feelings and emotions individuals associate with them, predict food choice. METHOD Participants (N=107) completed both implicit and explicit measures of affective associations with fruits, a self-report of eating disorder symptomatology, and their cognitive beliefs about fruits. In a subsequent snack selection task, they selected either a granola bar or fruit as a measure of their food choice behavior. RESULTS Logistic regression analyses revealed that eating disorder symptomatology moderated the relation of implicit affective associations on behavior, OR=0.27, p=.024, 95% CI (0.085, 0.84). A test of the simple effects indicated that implicit affective associations predicted snack choice at or below mean symptomatology levels [OR=2.073, p=.02, 95% CI (1.12, 3.84)], but not at high levels [OR=0.56, p=.28, 95% CI (0.18, 1.74)]. The effects of explicit measures on eating behavior were not moderated by eating disorder symptomatology (ps>.05). CONCLUSION These findings advance our understanding of both the relation of implicit affective associations on behavior, as well as the ways in which eating disorder symptomatology may impact the decision-making process, thereby perpetuating disorder-related eating behavior. These findings have implications for both health decision-making theory and practice, as well as for the study and treatment of eating disorders. PMID:24630936

Motivation to change in the eating disorders: a systematic review.

PubMed

Clausen, Loa; Lübeck, Marlene; Jones, Allan

2013-12-01

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.

Stress-induced laboratory eating behavior in obese women with binge eating disorder.

PubMed

Schulz, S; Laessle, R G

2012-04-01

Aim of the study was to compare the microstructural eating behavior of obese patients with and without binge eating disorder (BED) after stress induction in laboratory. Seventy-one female subjects were investigated (mean BMI 36.9). Thirty-five fulfilled criteria for BED. A 2×2 factorial design with repeated measurement (stress vs. no stress) on the second factor was applied. Stress was induced by the Trier Social Stress Test (TSST) and chocolate pudding served as laboratory food. Variables of eating behavior were measured by a universal eating monitor (UEM). Only in participants with BED stress was associated with an increase in the initial eating rate and a diminished deceleration of eating at the end of the meal. Generally, BED subjects ate with larger size of spoonfuls during the laboratory meal than non BED controls. The eating behavior of obese patients with binge eating disorder seems to be significantly affected by stress. The stress-induced eating behavior of BED patients is characterized by a stronger motivation to eat (indicated by a fast initial eating rate) as well as by a lack of satiety perception (indicated by less deceleration of eating rate). Copyright © 2011 Elsevier Ltd. All rights reserved.

The role of body awareness and mindfulness in the relationship between exercise and eating behavior.

PubMed

Martin, Rachel; Prichard, Ivanka; Hutchinson, Amanda D; Wilson, Carlene

2013-12-01

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.

The role of coping and general psychopathology in the prediction of treatment outcome in eating disorders.

PubMed

Davies, Michelle M; Bekker, Marrie H J; Roosen, Maries A

2011-01-01

This study examined coping and general psychopathology as possible predictors of reduction of eating disorder symptomatology. Assessment took place at pre- and post-treatment for all eating disorder patients (N = 93). Eating pattern and behavior were measured, as well as BMI and general psychopathology. As hypothesized, the coping strategies and comorbidity of respondents at pre-treatment contributed significantly to their outcome scores, and behavior aspects associated with eating disorders. Active coping strategies and low levels of general psychopathology predicted better outcome scores. This implies that active coping strategies and low levels of accompanying psychopathology at pre-treatment could be indicators of good chances for reduction of eating disorder symptomatology such as emotional eating, bulimia symptomatology, ineffectiveness, and introceptive awareness.

Connecting Eating Pathology with Risk for Engaging in Suicidal Behavior: The Mediating Role of Experiential Avoidance.

PubMed

Skinner, Kayla D; Rojas, Sasha M; Veilleux, Jennifer C

2017-02-01

Individuals with eating pathology, particularly those with diagnosed eating disorders, are at high risk for suicide. It is less clear whether undiagnosed eating pathology and subsyndromal eating disorders carry the same risk and, if so, what mechanisms may explain why higher levels of eating pathology yield greater risk for engaging in suicidal behaviors. The indirect relationship between disordered eating and risk for suicidal behaviors via facets of experiential avoidance was tested using a multiple-mediator model. The model was tested using bootstrapping estimates of indirect effects in a sample of 218 noncollege student adults (Mage = 32.33, 66.1% women) with a history of suicidal attempt and/or history of nonsuicidal self-injury (NSSI). Results revealed that disordered eating indirectly predicted risk for suicidal behaviors, distress aversion (i.e., negative attitudes or dislike of distress), and procrastination (i.e., delaying engagement with distressing activities). Results suggest that targeting experiential avoidance and helping those who have a history of engaging in suicidal behaviors and/or NSSI develop regulation strategies to use during times of distress may be of utmost importance for treatment and prevention of eating pathology. © 2016 The American Association of Suicidology.

Recognizing Disordered Eating in Primary Care Patients with Obesity

PubMed Central

Chacko, Sara A.; Chiodi, Sarah N.; Wee, Christina C.

2015-01-01

Objective In clinical practice, behavioral approaches to obesity treatment focus heavily on diet and exercise recommendations. However, these approaches may not be effective for patients with disordered eating behaviors. Little is known about the prevalence of disordered eating behaviors in primary care patients with obesity or whether they affect difficulty making dietary changes. Methods We conducted a telephone interview of 337 primary care patients aged 18–65 years with BMI≥35kg/m2 in Greater-Boston, 2009–2011 (58% response rate, 69% women). We administered the Three-Factor Eating Questionnaire R-18 (Scores 0–100) and the Impact of Weight on Quality of Life-Lite (IWQOL-lite) (Scores 0–100). We measured difficulty making dietary changes using four questions regarding perceived difficulty changing diet (Scores 0–10). Results 50% of patients reported high emotional eating (score>50) and 28% reported high uncontrolled eating (score>50). Women were more likely to report emotional [OR=4.14 (2.90, 5.92)] and uncontrolled eating [OR=2.11 (1.44, 3.08)] than men. African Americans were less likely than Caucasians to report emotional [OR=0.29 (95% CI: 0.19, 0.44)] and uncontrolled eating [OR=0.11 (0.07, 0.19)]. For every 10-point reduction in QOL score (IWQOL-lite), emotional and uncontrolled eating scores rose significantly by 7.82 and 5.48, respectively. Furthermore, participants who reported emotional and uncontrolled eating reported greater difficulty making dietary changes. Conclusions Disordered eating behaviors are prevalent among obese primary care patients and disproportionately affect women, Caucasians, and patients with poor QOL. These eating behaviors may impair patients' ability to make clinically recommended dietary changes. Clinicians should consider screening for disordered eating behaviors and tailoring obesity treatment accordingly. PMID:25572624

Disordered Eating Behaviors and Food Addiction among Nutrition Major College Students.

PubMed

Yu, Zhiping; Tan, Michael

2016-10-26

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.

Facebook Use and Disordered Eating in College-Aged Women.

PubMed

Walker, Morgan; Thornton, Laura; De Choudhury, Munmun; Teevan, Jaime; Bulik, Cynthia M; Levinson, Cheri A; Zerwas, Stephanie

2015-08-01

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.

Network analysis of pediatric eating disorder symptoms in a treatment-seeking, transdiagnostic sample.

PubMed

Goldschmidt, Andrea B; Crosby, Ross D; Cao, Li; Moessner, Markus; Forbush, Kelsie T; Accurso, Erin C; Le Grange, Daniel

2018-02-01

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).

Longitudinal Associations Among Bullying by Peers, Disordered Eating Behavior, and Symptoms of Depression During Adolescence.

PubMed

Lee, Kirsty S; Vaillancourt, Tracy

2018-06-01

Bullying by peers has been associated with disordered eating behavior and symptoms of depression among adolescents as both an antecedent and an outcome. Identification of the temporal pattern of associations among bullying by peers, disordered eating behavior, and depression in adolescence is needed for the optimal targeting of intervention and prevention. To assess the concurrent and longitudinal associations among bullying by peers, disordered eating behavior, and symptoms of depression using a cascade model that controlled for within-time and across-time (ie, stability paths) associations while examining cross-lag effects. In this 5-year longitudinal cohort study, 612 participants of the McMaster Teen Study were included. This ongoing Canadian study examines the associations among bullying, mental health, and educational outcomes. Data collection began in 2008 when students were in grade 5 (10 years of age) and have since been collected annually. Data analysis was performed between August 20 and October 18, 2017. Bullying by peers was assessed in grades 7 to 11 using a composite measure of 5 items. Disordered eating behavior was assessed in grades 7 to 11 using the Short Screen for Eating Disorders, and depressive symptoms were assessed in grades 7 to 11 using the Behavior Assessment System for Children-Second Edition. The 612 students included in the analytic sample had a mean age (SD) of 13.03 (0.38) years in grade 7; 331 (54.1%) were girls and 392 (71.1%) were white. Bullying by peers was concurrently associated with disordered eating behavior and depressive symptoms at every time point during the 5-year period (r range [SE], 0.15-0.48 [0.04-0.08]; P < .01). Disordered eating behavior was associated longitudinally with depressive symptoms at every time point (β range [SE], 0.14-0.19 [0.06-0.08]; P < .02) and bullying by peers at 2 time points (β range [SE], 0.12-0.22 [0.06-0.07]; P < .04) in girls and boys. Bullying by peers was proximally associated with multiple psychopathologic symptoms, whereas symptoms of disordered eating behavior were a key risk factor for future depressive symptoms and bullying by peers. Interventions aimed at reducing problematic eating behavior in adolescents may attenuate the risk of future depressive symptoms and relational problems.

Gender Differences in Exercise Dependence and Eating Disorders in Young Adults: A Path Analysis of a Conceptual Model

PubMed Central

Meulemans, Shelli; Pribis, Peter; Grajales, Tevni; Krivak, Gretchen

2014-01-01

The purpose of our study was to study the prevalence of exercise dependence (EXD) among college students and to investigate the role of EXD and gender on exercise behavior and eating disorders. Excessive exercise can become an addiction known as exercise dependence. In our population of 517 college students, 3.3% were at risk for EXD and 8% were at risk for an eating disorder. We used Path analysis the simplest case of Structural Equation Modeling (SEM) to investigate the role of EXD and exercise behavior on eating disorders. We observed a small direct effect from gender to eating disorders. In females we observed significant direct effect between exercise behavior (r = −0.17, p = 0.009) and EXD (r = 0.34, p < 0.001) on eating pathology. We also observed an indirect effect of exercise behavior on eating pathology (r = 0.16) through EXD (r = 0.48, r2 = 0.23, p < 0.001). In females the total variance of eating pathology explained by the SEM model was 9%. In males we observed a direct effect between EXD (r = 0.23, p < 0.001) on eating pathology. We also observed indirect effect of exercise behavior on eating pathology (r = 0.11) through EXD (r = 0.49, r2 = 0.24, p < 0.001). In males the total variance of eating pathology explained by the SEM model was 5%. PMID:25379689

Disordered Eating Behaviors and Sexual Harassment in Italian Male and Female University Students.

PubMed

Romito, Patrizia; Cedolin, Carlotta; Bastiani, Federica; Saurel-Cubizolles, Marie-Josèphe

2016-08-01

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.

Eating disorder symptomatology among ballet dancers.

PubMed

Ringham, Rebecca; Klump, Kelly; Kaye, Walter; Stone, David; Libman, Steven; Stowe, Susan; Marcus, Marsha

2006-09-01

The current study sought to compare eating disorder symptomatology among ballet dancers and individuals with restricting anorexia nervosa (RAN), bulimia nervosa (BN), and no eating pathology. Twenty-nine female ballet dancers completed assessments and were compared with an archival dataset of 26 women with RAN, 47 women with BN, and 44 women with no eating pathology. Eating disorder diagnoses and behaviors were assessed with a semi-structured clinical interview, the Eating Disorder Inventory (EDI), and a weight history interview. Eighty-three percent of dancers met lifetime criteria for AN (6.9%), BN (10.3%), AN+BN (10.3%), or EDNOS (55.0%). Moreover, dancers looked more similar to eating-disordered individuals than to control individuals on measures of eating pathology. Despite previous emphasis on the pathology AN, the current findings suggest that dancers frequently engage in binge eating and purging behaviors. Moreover, it appears that their pathology is as severe as that of non-dancing women with eating disorders. Copyright (c) 2006 by Wiley Periodicals, Inc.

Counseling College Women Experiencing Eating Disorder Not Otherwise Specified: A Cognitive Behavior Therapy Model

ERIC Educational Resources Information Center

Choate, Laura H.

2010-01-01

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…

Binge Eating Disorder and Bipolar Spectrum disorders in obesity: Psychopathological and eating behaviors differences according to comorbidities.

PubMed

Segura-Garcia, Cristina; Caroleo, Mariarita; Rania, Marianna; Barbuto, Elvira; Sinopoli, Flora; Aloi, Matteo; Arturi, Franco; De Fazio, Pasquale

2017-01-15

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.

Nonnormative eating behavior and psychopathology in prebariatric patients with binge-eating disorder and night eating syndrome.

PubMed

Baldofski, Sabrina; Tigges, Wolfgang; Herbig, Beate; Jurowich, Christian; Kaiser, Stefan; Stroh, Christine; de Zwaan, Martina; Dietrich, Arne; Rudolph, Almut; Hilbert, Anja

2015-01-01

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.

Development and validation of the Stirling Eating Disorder Scales.

PubMed

Williams, G J; Power, K G; Miller, H R; Freeman, C P; Yellowlees, A; Dowds, T; Walker, M; Parry-Jones, W L

1994-07-01

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.

Behavioral and psychological aspects of exercise across stages of eating disorder recovery.

PubMed

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

2016-01-01

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.

Eating disorders among patients incarcerated only for repeated shoplifting: a retrospective quasi-case-control study in a medical prison in Japan.

PubMed

Asami, Tomokuni; Okubo, Yoshiro; Sekine, Mizuho; Nomura, Toshiaki

2014-06-07

Shoplifting is a serious problem among patients with eating disorders. For more than a decade, we have treated many patients with eating disorders incarcerated in Hachioji Medical Prison only for repeated shoplifting. We analyzed the prison records and medical records of female psychiatric patients transferred to Hachioji Medical Prison between 2002 and 2011. Based on the offense listed at the time of sentencing, we extracted a shoplifting group and a drug-offense group from among all patients with eating disorders. One patient from the former group who had used substances and two from the latter group who had never shoplifted were excluded from the study. The groups had 41 and 14 patients, respectively. A control group comprised patients with other mental disorders (n = 34). We compared eating disorder histories and subtypes, weight changes, comorbidities, life histories, past behavioral problems, and clinical behavioral problems among the three groups. The shoplifting group exhibited less impulsive behavior, substance abuse, antisocial features, borderline personality disorder, and past bulimia than did the drug-offense and control groups. The shoplifting group had higher educational achievement and steadier employment; however, their eating disorder histories and interpersonal dysfunction were more severe, and they had a higher psychiatric treatment dropout rate. There were also significant relationships with low body weight, anorexia nervosa-restricting type, obsessive-compulsive behaviors, and obsessive-compulsive personality disorder in the shoplifting group. During the clinical course, food refusal, excessive exercise, food hoarding, and falsification of dietary intake amounts were more frequently observed in the shoplifting group. Conversely, drug requests and occurrences of self-harm were less frequent in the shoplifting group than in the drug-offense group. Although these results may be associated with specific characteristics of patients with eating disorders in the medical prison setting, we concluded that the repeated shoplifting by these patients is unrelated to antisocial or impulsive characteristics but is deeply rooted in these patients' severe and undertreated eating disorder psychopathology. Strong supportive treatment should be considered for patients with eating disorders who develop shoplifting behaviors. Further research is required to elucidate the mechanisms responsible for the relationship between shoplifting and eating disorders.

Prevention of Obesity and Eating Disorders: A Consideration of Shared Risk Factors

ERIC Educational Resources Information Center

Haines, Jess; Neumark-Sztainer, Dianne

2006-01-01

In response to the high prevalence of obesity, eating disorders and disordered eating behaviors among youth, researchers in both the obesity and eating disorders fields have proposed using an integrated approach to prevention that addresses the spectrum of weight-related disorders within interventions. The identification of risk factors that are…

Eating behavior and eating disorders in adults before bariatric surgery.

PubMed

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

2015-03-01

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.

Self-Silencing, Emotional Awareness, and Eating Behaviors in College Women

ERIC Educational Resources Information Center

Shouse, Sarah H.; Nilsson, Johanna

2011-01-01

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…

Eating disorders and disordered weight and shape control behaviors in sexual minority populations

PubMed Central

Calzo, Jerel P.; Blashill, Aaron J.; Brown, Tiffany A.; Argenal, Russell L.

2017-01-01

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

Reported Childhood Sexual Abuse and Eating-Disordered Cognitions and Behaviors

ERIC Educational Resources Information Center

van Gerko, K.; Hughes, M.L.; Hamill, M.; Waller, G.

2005-01-01

Objective:: This study assessed links between reported childhood sexual abuse and a range of eating behaviors and attitudes, among a large sample of eating-disordered women. It tested the hypothesis that there will be links to bulimic behaviors and body dissatisfaction, rather than restriction. Method:: The sample consisted of 299 women, meeting…

Ethnicity, ethnic identity, self-esteem, and at-risk eating disordered behavior differences of urban adolescent females.

PubMed

Rhea, Deborah J; Thatcher, W Gregory

2013-01-01

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.

[Eating disorders].

PubMed

Miyake, Yoshie; Okamoto, Yuri; Jinnin, Ran; Shishida, Kazuhiro; Okamoto, Yasumasa

2015-02-01

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.

Longitudinal Associations Among Posttraumatic Stress Disorder, Disordered Eating, and Weight Gain in Military Men and Women

PubMed Central

Mitchell, K. S.; Porter, B.; Boyko, E. J.; Field, A. E.

2016-01-01

Abstract Obesity is a major health problem in the United States and a growing concern among members of the military. Posttraumatic stress disorder (PTSD) has been associated with overweight and obesity and may increase the risk of those conditions among military service members. Disordered eating behaviors have also been associated with PTSD and weight gain. However, eating disorders remain understudied in military samples. We investigated longitudinal associations among PTSD, disordered eating, and weight gain in the Millennium Cohort Study, which includes a nationally representative sample of male (n = 27,741) and female (n = 6,196) service members. PTSD at baseline (time 1; 2001–2003) was associated with disordered eating behaviors at time 2 (2004–2006), as well as weight change from time 2 to time 3 (2007–2008). Structural equation modeling results revealed that the association between PTSD and weight change from time 2 to time 3 was mediated by disordered eating symptoms. The association between PTSD and weight gain resulting from compensatory behaviors (vomiting, laxative use, fasting, overexercise) was significant for white participants only and for men but not women. PTSD was both directly and indirectly (through disordered eating) associated with weight change. These results highlight potentially important demographic differences in these associations and emphasize the need for further investigation of eating disorders in military service members. PMID:27283146

Internalized weight bias mediates the relationship between depressive symptoms and disordered eating behavior among women who think they are overweight.

PubMed

Sienko, Rachel M; Saules, Karen K; Carr, Meagan M

2016-08-01

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.

The Effects of Peer Influence on Disordered Eating Behavior

ERIC Educational Resources Information Center

Meyer, Tiffany A.; Gast, Julie

2008-01-01

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…

Desire for Thinness among High School Cheerleaders: Relationship to Disordered Eating and Weight Control Behaviors.

ERIC Educational Resources Information Center

Lundholm, Jean K.; Littrell, John M.

1986-01-01

Examined cheerleaders' desire for thinness in relationship to disordered eating and weight control behaviors. A Desire for Thinness Scale and selected scales from three eating disorder instruments were administered to 751 high school cheerleaders. Cheerleaders who expressed a strong desire for thinness had significantly higher scores on seven of…

Two Distinct Mediated Pathways to Disordered Eating in Response to Weight Stigmatization and Their Application to Prevention Programs

ERIC Educational Resources Information Center

Simone, Melissa; Lockhart, Ginger

2016-01-01

Objective: Disordered eating behaviors among undergraduate women are common and, thus, are an important public health concern. Weight stigmatization, stress, and social withdrawal are often associated with disordered eating behaviors; however, it is unclear whether stress and social withdrawal act as mediators between weight stigmatization and…

The relationship between weight stigma and eating behavior is explained by weight bias internalization and psychological distress.

PubMed

O'Brien, Kerry S; Latner, Janet D; Puhl, Rebecca M; Vartanian, Lenny R; Giles, Claudia; Griva, Konstadina; Carter, Adrian

2016-07-01

Weight stigma is associated with a range of negative outcomes, including disordered eating, but the psychological mechanisms underlying these associations are not well understood. The present study tested whether the association between weight stigma experiences and disordered eating behaviors (emotional eating, uncontrolled eating, and loss-of-control eating) are mediated by weight bias internalization and psychological distress. Six-hundred and thirty-four undergraduate university students completed an online survey assessing weight stigma, weight bias internalization, psychological distress, disordered eating, along with demographic characteristics (i.e., age, gender, weight status). Statistical analyses found that weight stigma was significantly associated with all measures of disordered eating, and with weight bias internalization and psychological distress. In regression and mediation analyses accounting for age, gender and weight status, weight bias internalization and psychological distress mediated the relationship between weight stigma and disordered eating behavior. Thus, weight bias internalization and psychological distress appear to be important factors underpinning the relationship between weight stigma and disordered eating behaviors, and could be targets for interventions, such as, psychological acceptance and mindfulness therapy, which have been shown to reduce the impact of weight stigma. The evidence for the health consequences resulting from weight stigma is becoming clear. It is important that health and social policy makers are informed of this literature and encouraged develop anti-weight stigma policies for school, work, and medical settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nutrient Intakes of Men and Women Collegiate Athletes with Disordered Eating

PubMed Central

Hinton, Pamela S.; Beck, Niels C.

2005-01-01

The objective of this study was to assess the macro- and micronutrient intakes of men and women collegiate athletes with disordered eating behaviors and to compare the nutrient intakes of athletes with restrictive- versus binge-eating behaviors. National Collegiate Athletic Association (NCAA) Division I University athletes (n = 232) were administered an anonymous, written questionnaire to compare nutrient intakes, desired weight change, and weight control behaviors in athletes with restrictive- (R) and binge- (B) eating behaviors to those in asymptomatic (A) athletes. T-tests, χ2 statistic, and ANOVA were used to test for differences among disordered eating groups within genders (p < 0.05). Data are means ± standard error of the mean. Among men athletes, those with disordered eating consumed a smaller percentage of energy from carbohydrate compared to controls (R = 49.7 ± 1.5; B = 48.7 ± 2.3; A = 53.4 ± 0.7%). Among female athletes, those with disordered eating wanted to lose a greater percentage of their current body weight than did asymptomatic athletes (B = -6.1 ± 1.4; R = -6.7 ± 1.1; A = -3.7 ± 0.4%). Women who were classified with binge eating consumed significantly more alcohol than did controls (B = 6.8 ± 1.3; A = 3.9 ± 0.4 g alcohol per day). Athletes with disordered eating were more likely to report restricting their intake of carbohydrate and fat and using supplements to control their weight than asymptomatic athletes. Disordered eating was not associated with greater frequencies of inadequate micronutrient intake in either gender. Athletes with disordered eating may be at significantly greater risk for nutritional inadequacies than athletes who are asymptomatic due to macronutrient restriction and greater alcohol consumption. Key Points Athletes with disordered eating were more likely to report restricting their intake of carbohydrate and fat and using supplements to control their weight than asymptomatic athletes Among female athletes, those with disordered eating wanted to lose a greater percentage of their current body weight than did asymptomatic athletes Disordered eating was not associated with greater frequencies of inadequate micronutrient intake in either gender Athletes with disordered eating may be at significantly greater risk for nutritional inadequacies than athletes who are asymptomatic due to macronutrient restriction and greater alcohol consumption. PMID:24453529

Disordered Eating Behaviors and Food Addiction among Nutrition Major College Students

PubMed Central

Yu, Zhiping; Tan, Michael

2016-01-01

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

Eating Disorders

MedlinePlus

Eating disorders are serious behavior problems. They can include severe overeating or not consuming enough food to stay ... concern about your shape or weight. Types of eating disorders include Anorexia nervosa, in which you become too ...

Shared and unique mechanisms underlying binge eating disorder and addictive disorders

PubMed Central

Schulte, Erica M.; Grilo, Carlos M.; Gearhardt, Ashley N.

2018-01-01

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

Male Eating Disorder Symptom Patterns and Health Correlates From 13 to 26 Years of Age.

PubMed

Calzo, Jerel P; Horton, Nicholas J; Sonneville, Kendrin R; Swanson, Sonja A; Crosby, Ross D; Micali, Nadia; Eddy, Kamryn T; Field, Alison E

2016-08-01

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. Participants were 7,067 males from the prospective Growing Up Today Study. Surveys from 1999 to 2007 (spanning ages 13-26 years) provided repeated measures data on muscularity and leanness concerns, eating disorder behaviors (purging, overeating, binge eating, use of muscle-building products), and health correlates (obesity, non-marijuana drug use, binge drinking, and depressive symptoms). Latent class analyses of observations at ages 13 to 15, 16 to 18, 19 to 22, and 23 to 26 years identified 1 large Asymptomatic class and 4 symptomatic patterns: Body Image Disturbance (high appearance concerns, low eating disorder behaviors; 1.0%-6.0% per age period); Binge Eating/Purging (binge eating and purging, use of muscle-building products, low appearance concerns; 0.1%-2.5%); Mostly Asymptomatic (low levels of muscularity concern, product use, and overeating; 3.5%-5.0%); and Muscularity Concerns (high muscularity concerns and use of products; 0.6%-1.0%). The Body Image Disturbance class was associated with high estimated prevalence of depressive symptoms. Males in the Binge Eating/Purging and Muscularity Concerns classes had high prevalence of binge drinking and drug use. Despite exhibiting modestly greater appearance concerns and eating disorder behaviors than the Asymptomatic class, being in the Mostly Asymptomatic class was prospectively associated with adverse health outcomes. Results underscore the importance of measuring concerns about leanness, muscularity, and use of muscle-building products when assessing eating disorder presentations among males in research and clinical settings. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Male Eating Disorder Symptom Patterns and Health Correlates From 13 to 26 Years of Age

PubMed Central

Calzo, Jerel P.; Horton, Nicholas J.; Sonneville, Kendrin R.; Swanson, Sonja; Crosby, Ross D.; Micali, Nadia; Eddy, Kamryn T.; Field, Alison E.

2016-01-01

Objective 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 were 7,067 males from the prospective Growing Up Today Study. Surveys from 1999–2007 (spanning ages 13–26 years) provided repeated measures data on: muscularity and leanness concerns; eating disorder behaviors (purging, overeating, binge eating, use of muscle-building products); and health correlates (obesity, non-marijuana drug use, binge drinking, and depressive symptoms). Results Latent class analyses of observations at ages 13–15, 16–18, 19–22, and 23–26 identified one large Asymptomatic class and four symptomatic patterns: Body Image Disturbance (high appearance concerns, low eating disorder behaviors; 1.0%–6.0% per age period); Binge Eating/Purging (binge eating and purging, use of muscle-building products, low appearance concerns; 0.1%–2.5%); Mostly Asymptomatic (low levels of muscularity concern, product use, and overeating; 3.5%–5.0%); and Muscularity Concerns (high muscularity concerns and use of products; 0.6%–1.0%). The Body Image Disturbance class was associated with high estimated prevalence of depressive symptoms. Males in the Binge Eating/Purging and Muscularity Concerns classes had high prevalence of binge drinking and drug use. Despite exhibiting modestly greater appearance concerns and eating disorder behaviors than the Asymptomatic class, being in the Mostly Asymptomatic class was prospectively associated with adverse health outcomes. Conclusion Results underscore the importance of measuring concerns about leanness, muscularity, and use of muscle-building products when assessing eating disorder presentations among males in research and clinical settings. PMID:27453083

Survey on eating disorder-related thoughts, behaviors, and their relationship with food intake and nutritional status in female high school students in Taiwan.

PubMed

Chang, Yu-Jhen; Lin, Wei; Wong, Yueching

2011-02-01

Eating disorders are now a global health problem for adolescents and young female adults. The level of eating disorders among young female adults is growing in Asian countries. Therefore, the purpose of this study was to investigate body image, weight concerns, eating attitudes, dietary intake, and nutritional status related to eating disorders of female high school students in Taiwan. A total of 1605 female high school students participated in this study. The written questionnaire included respondents' demographics and weight concerns, the Eating Attitudes Test-26 (EAT-26), and 24-hour dietary recall. Blood chemistry data were also collected. The data were analyzed using a Student t test, χ(2) analysis, and logistic regression. Disturbed eating attitudes and behaviors were found in 17.11% of participants (measured by an EAT-26 score ≥20). Logistic regression analyses showed that disturbed eating attitudes/behaviors were significantly associated with overestimation of body weight, unrealistic body weight goal, dissatisfaction with body weight, and weight loss experiences. The reported intakes of energy, protein, carbohydrate, zinc, and vitamins B6 and B12 were significantly lower in participants with disturbed eating patterns than in participants without disturbance issues. Conversely, participants with disturbed eating patterns had higher dietary and crude fiber intake than participants without disturbed eating issues. The percentage of participants with abnormal values of total iron-binding capacity and serum iron was significantly higher in those with disturbed eating patterns than in those without disturbed eating patterns. Disturbed eating attitudes/behaviors exist among female adolescents in Taiwan, and these behaviors jeopardize their nutritional status. The possibility of using the EAT-26 as a reference to predict the quality and quantity of food intake among female adolescents is worthy of further study.

Disordered eating and injuries among adolescent ballet dancers.

PubMed

Thomas, J J; Keel, P K; Heatherton, T F

2011-09-01

Ballet dancers are at elevated risk for eating disorders, but the extent to which disordered eating attitudes and behaviors represent a relatively benign adaptation to an environment that values extreme thinness, or a functionally impairing form of psychopathology, has sparked considerable debate. To determine whether disordered eating is associated with role impairment in dancers, we evaluated its association with musculoskeletal injuries among 239 adolescent female ballet students. Dance students reported a variety of lifetime disordered eating behaviors to control weight including fasting (29.3%), vomiting (9.6%), and laxative use (4.2%). More than half (52.3%) reported a lifetime history of injury (stress fracture, broken bone, and/or medically treated tendonitis). A greater number of lifetime disordered eating behaviors was associated with a greater number of lifetime injuries (p=0.01). Moreover, vomiting history was associated with greater likelihood of injury (p=0.004) and increased time to recover from injury (median difference=22.8 days, p=0.006). Although the direction of causality cannot be determined from this retrospective design, these results suggest that disordered eating is associated with role-relevant functional impairment, even among members of a subculture that values extreme thinness.

Weight-Related Sports Involvement in Girls: Who Is at Risk for Disordered Eating?

ERIC Educational Resources Information Center

Sherwood, Nancy E.; Neumark-Sztainer, Dianne; Story, Mary; Beuhring, Trish; Resnick, Michael D.

2002-01-01

Examined the relationship between weight-related sport involvement, disordered eating, health behavior, and psycho-social factors in female adolescents. Survey data indicated that girls in weight-related sports were at increased risk for disordered eating, though the majority did not report disordered eating. This group was also at decreased risk…

Gender Related Attitudes towards Eating and Health among College Students.

ERIC Educational Resources Information Center

Papini, Dennis R.; Lloyd, Paul J.

Heightened concern about eating behavior has been expressed in recent surveys of high school and college students. There have been increased requests for treatment of eating disorders among college students and many colleges have developed programs that provide treatment for students afflicted with an eating disorder. The Eating Disorder Inventory…

Eating Disorders among College Women.

ERIC Educational Resources Information Center

Basow, Susan A.; Schneck, Renae

In the past 10 years, eating disorders among adolescent females have become of increasing concern. To assess the prevalence of eating disorders, unusual eating-related behaviors and attitudes, and psychological states among college women, 677 women, from three private northeastern United States colleges, completed a questionnaire assessing…

Pathological and non-pathological variants of restrictive eating behaviors in middle childhood: A latent class analysis.

PubMed

Schmidt, Ricarda; Vogel, Mandy; Hiemisch, Andreas; Kiess, Wieland; Hilbert, Anja

2018-08-01

Although restrictive eating behaviors are very common during early childhood, their precise nature and clinical correlates remain unclear. Especially, there is little evidence on restrictive eating behaviors in older children and their associations with children's shape concern. The present population-based study sought to delineate subgroups of restrictive eating patterns in N = 799 7-14 year old children. Using Latent Class Analysis, children were classified based on six restrictive eating behaviors (for example, picky eating, food neophobia, and eating-related anxiety) and shape concern, separately in three age groups. For cluster validation, sociodemographic and objective anthropometric data, parental feeding practices, and general and eating disorder psychopathology were used. The results showed a 3-cluster solution across all age groups: an asymptomatic class (Cluster 1), a class with restrictive eating behaviors without shape concern (Cluster 2), and a class showing restrictive eating behaviors with prominent shape concern (Cluster 3). The clusters differed in all variables used for validation. Particularly, the proportion of children with symptoms of avoidant/restrictive food intake disorder was greater in Cluster 2 than Clusters 1 and 3. The study underlined the importance of considering shape concern to distinguish between different phenotypes of children's restrictive eating patterns. Longitudinal data are needed to evaluate the clusters' predictive effects on children's growth and development of clinical eating disorders. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Eating disorders and depressive symptoms: an epidemiological study in a male population].

PubMed

Valls, M; Callahan, S; Rousseau, A; Chabrol, H

2014-06-01

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; P<0.05). After controlling for body mass index, 30% of participants tended to perceive themselves as thinner than they actually were and 6% tended to perceive themselves as fatter. Regarding normal-weight participants, 28% perceived themselves as thinner and 8% as fatter than in reality. Overeating episodes were reported by 19% of participants. Binge-eating 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 eating disorders). The most typical compensatory behavior was fasting (11%). According to the cut-off score of 22, 18% of young men had a moderate to severe depressive symptomatology, including 5% of participants who also reported an eating disorder (i.e. 30 participants). A one-way ANOVA was conducted to examine differences in depressive symptoms as a function of eating disorder groups, namely the clinical eating disorders sample (n=22), the subthreshold disorders sample (n=54) and the asymptomatic sample (participants without eating disorder; n=382). Results were statistically significant, (F(2,455)=7.27, P<0.001) and post-hoc tests (Scheffé tests) were used to examine the group differences. The mean CES-D scores for the clinical eating disorders sample (19.45±8.2; P<0.05) and the subthreshold disorders sample (18.15±10.9; P<0.05) were significantly higher than for the asymptomatic sample (14.19±8.9). There was no significant difference between the two eating disorder groups (P>0.05). The results demonstrate that a significant proportion of men with eating disorders manifest comorbid depressive symptomatology. These results suggest that EDNOS and subthreshold disorders should be taken into consideration, as they represent 15% of the total sample. Participants reported high rate of excessive exercise and fasting, which could reflect the importance of muscle tone or strategies to increase muscle mass. Further research is necessary in order to better understand male eating behaviors and disorders. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Body image and eating disordered behavior in a community sample of Black and Hispanic women.

PubMed

Hrabosky, Joshua I; Grilo, Carlos M

2007-01-01

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.

Will the real vegetarian please stand up? An investigation of dietary restraint and eating disorder symptoms in vegetarians versus non-vegetarians.

PubMed

Timko, C Alix; Hormes, Julia M; Chubski, Janice

2012-06-01

Adherence to a vegetarian diet has been hypothesized to be a factor in the onset and maintenance of disordered eating behavior; however, evidence to support this assumption has been largely mixed. The two studies presented here sought to address the causes of inconsistent findings in previous research, including: small samples of true vegetarians, lack of appropriate operational definitions of "vegetarianism", and uncertainty about the appropriateness of existing assessments of eating behaviors for semi-vegetarians. Study 1 assessed eating behaviors in the largest samples of confirmed true vegetarians and vegans surveyed to date, and compared them to semi-vegetarians and omnivores. Semi-vegetarians reported the highest levels of eating-related pathology; true vegetarians and vegans appeared to be healthiest in regards to weight and eating. Study 2 examined differences between semi-vegetarians and omnivores in terms of restraint and disordered eating and found little evidence for more eating-related pathology in semi-vegetarians, compared to omnivores. Semi-vegetarians' higher scores on traditional assessments of eating behaviors appeared artificially inflated by ratings of items assessing avoidance of specific food items which should be considered normative in the context of a vegetarian diet. Findings shed light on the sources of inconsistencies in prior research on eating behaviors in vegetarians and suggest that semi-vegetarianism - as opposed to true vegetarianism or veganism - is the most likely related to disordered eating. Copyright © 2012 Elsevier Ltd. All rights reserved.

Food cravings, binge eating, and eating disorder psychopathology: Exploring the moderating roles of gender and race

PubMed Central

Chao, Ariana M.; Grilo, Carlos M.; Sinha, Rajita

2016-01-01

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, p<.001) and global eating disorder psychopathology (B=.47±.09, p<.001). Females had a stronger relationship between food cravings and eating 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

Food cravings, binge eating, and eating disorder psychopathology: Exploring the moderating roles of gender and race.

PubMed

Chao, Ariana M; Grilo, Carlos M; Sinha, Rajita

2016-04-01

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, p<.001) and global eating disorder psychopathology (B=.47±.09, p<.001). Females had a stronger relationship between food cravings and eating disorder psychopathology 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.

Eating disorders and weight control behaviors change over a collegiate sport season.

PubMed

Thompson, Alexandra; Petrie, Trent; Anderson, Carlin

2017-09-01

Determine whether the prevalence of eating disorder classifications (i.e., clinical eating disorder, subclinical eating disorder, and asymptomatic) and pathogenic weight control behaviors (e.g., bingeing, vomiting) change over a five-month sport season. Longitudinal study. Female collegiate gymnasts and swimmers (N=325) completed the Questionnaire for Eating Disorder Diagnoses as well as six items from the Bulimia Test-Revised at Time 1 (two weeks into the beginning of their athletic season) and Time 2 (final two weeks of the athletic season); data collections were separated by five months. Over the course of the season, 90% of the athletes (18 out of 20) retained a clinical eating disorder diagnosis or moved to the subclinical classification. Of the 83 subclinical athletes at Time 1, 37.3% persisted with that classification and 10.8% developed a clinical eating disorder; the remainder became asymptomatic/healthy eaters by Time 2. The majority of Time 1 asymptomatic athletes (92.3%) remained so at Time 2. Exercise and dieting/fasting were the most frequent forms of weight control behaviors, though each was used less frequently at Time 2 (exercise=35.4%; dieting=9.2%) than at Time 1 (exercise=42.5%; dieting=12.3%). Eating disorder classifications, particularly clinical and subclinical, remain stable across a competitive season, supporting the need for early detection and purposeful intervention. Athletes engage in weight control behaviors that may be reinforced in the sport environment (e.g., supplemental exercise), making identification more challenging for sports medicine professionals. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Risk for exercise dependence, eating disorder pathology, alcohol use disorder and addictive behaviors among clients of fitness centers.

PubMed

Müller, Astrid; Loeber, Sabine; Söchtig, Johanna; Te Wildt, Bert; De Zwaan, Martina

2015-12-01

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.

Risk for exercise dependence, eating disorder pathology, alcohol use disorder and addictive behaviors among clients of fitness centers

PubMed Central

Müller, Astrid; Loeber, Sabine; Söchtig, Johanna; Te Wildt, Bert; De Zwaan, Martina

2015-01-01

Background and Aims 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. Methods 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). Results 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. Discussion 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. PMID:26690622

A description of disordered eating behaviors in Latino males

PubMed Central

Reyes-Rodríguez, Mae Lynn; Sala, Margarita; Von Holle, Ann; Unikel, Claudia; Bulik, Cynthia M.; Cámara-Fuentes, Luis; Suárez-Torres, Alba

2011-01-01

Objective To explore disordered eating and eating disorders (ED) in Latino males. Participants 722 male college students from a larger prevalence study conducted in the University of Puerto Rico (UPR) system. Method Participants were selected from a list of sections of required courses for first-year students on each campus. Self report instruments were used to explore ED symptoms (EAT-26 & BULIT-26) and depression (BDI). Results Overall, 2.26% scored above the cut-off point on the BULIT-R and 5.08% score above the cut-off point on the EAT-26. Of the males, 4.43% reported sufficient frequency and severity to approximate DSM-IV criteria for BN. Depression symptomatology was found in those who scored above the cut-off point on both instruments of ED. Conclusion College health practitioners should be aware of disordered eating in Latino males and include them in efforts to detect disordered eating behaviors in college students. PMID:21308586

Eating disorders among patients incarcerated only for repeated shoplifting: a retrospective quasi-case-control study in a medical prison in Japan

PubMed Central

2014-01-01

Background Shoplifting is a serious problem among patients with eating disorders. For more than a decade, we have treated many patients with eating disorders incarcerated in Hachioji Medical Prison only for repeated shoplifting. Methods We analyzed the prison records and medical records of female psychiatric patients transferred to Hachioji Medical Prison between 2002 and 2011. Based on the offense listed at the time of sentencing, we extracted a shoplifting group and a drug-offense group from among all patients with eating disorders. One patient from the former group who had used substances and two from the latter group who had never shoplifted were excluded from the study. The groups had 41 and 14 patients, respectively. A control group comprised patients with other mental disorders (n = 34). We compared eating disorder histories and subtypes, weight changes, comorbidities, life histories, past behavioral problems, and clinical behavioral problems among the three groups. Results The shoplifting group exhibited less impulsive behavior, substance abuse, antisocial features, borderline personality disorder, and past bulimia than did the drug-offense and control groups. The shoplifting group had higher educational achievement and steadier employment; however, their eating disorder histories and interpersonal dysfunction were more severe, and they had a higher psychiatric treatment dropout rate. There were also significant relationships with low body weight, anorexia nervosa-restricting type, obsessive–compulsive behaviors, and obsessive–compulsive personality disorder in the shoplifting group. During the clinical course, food refusal, excessive exercise, food hoarding, and falsification of dietary intake amounts were more frequently observed in the shoplifting group. Conversely, drug requests and occurrences of self-harm were less frequent in the shoplifting group than in the drug-offense group. Conclusions Although these results may be associated with specific characteristics of patients with eating disorders in the medical prison setting, we concluded that the repeated shoplifting by these patients is unrelated to antisocial or impulsive characteristics but is deeply rooted in these patients’ severe and undertreated eating disorder psychopathology. Strong supportive treatment should be considered for patients with eating disorders who develop shoplifting behaviors. Further research is required to elucidate the mechanisms responsible for the relationship between shoplifting and eating disorders. PMID:24907848

Enhanced Cognitive Behavior Therapy: A Single Treatment for All Eating Disorders

ERIC Educational Resources Information Center

Fursland, Anthea; Byrne, Sharon; Watson, Hunna; La Puma, Michelle; Allen, Karina; Byrne, Susan

2012-01-01

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…

Eating Disorders among Athletes: Public Policy To Promote Social and Individual Behavioral Change.

ERIC Educational Resources Information Center

Moriarty, Dick; Moriarty, Mary

Eating disorders are a complex physiological, psychological, and social illness. Since teachers and coaches should know the signs of eating disorders, some of the ways in which educators can recognize or prevent eating disorders are presented in this paper. Emphasis is placed on teachers and coaches familiarizing themselves with the five…

Missing and discrepant data on the Eating Disorder Examination Questionnaire (EDE-Q): Quantity, quality, and implications.

PubMed

Kelly, Nichole R; Cotter, Elizabeth W; Lydecker, Janet A; Mazzeo, Suzanne E

2017-01-01

The aim of this study was to examine relations among missing and discrepant data on the Eating Disorders Examination Questionnaire (EDE-Q; Fairburn & Beglin, 1994) and individual demographic factors and eating disorder symptoms. Data from 3968 men and women collected in five independent studies were examined. Descriptive statistics were used to detect the quantity of missing and discrepant data, as well as independent samples t-tests and chi-square analyses to examine group differences between participants with and without missing or discrepant data. Results indicated significant differences in data completeness by participant race/ethnicity and severity of eating disorder symptoms. White participants were most likely to provide complete survey responses, and Asian American participants were least likely to provide complete survey responses. Participants with incomplete surveys reported greater eating disorder symptoms and behaviors compared with those with complete surveys. Similarly, those with discrepant responses to behavioral items reported greater eating disorder symptoms and behaviors compared with those with congruent responses. Practical implications and recommendations for reducing and addressing incomplete data on the EDE-Q are discussed. Copyright © 2016. Published by Elsevier Ltd.

Patterns of Compensatory Behaviors and Disordered Eating in College Students

ERIC Educational Resources Information Center

Schaumberg, Katherine; Anderson, Lisa M.; Reilly, Erin; Anderson, Drew A.

2014-01-01

Objective: The current study investigated rates of endorsement of eating-related compensatory behaviors within a college sample. Participants: This sample included male and female students (N = 1,158). Methods: Participants completed the Eating Disorder Examination Questionnaire (EDE-Q). The study defined 3 groups of students: those who did not…

An Assessment of Perceived Emotional Intelligence and Eating Attitudes among College Students

ERIC Educational Resources Information Center

Pettit, Michele L.; Jacobs, Sue C.; Page, Kyle S.; Porras, Claudia V.

2010-01-01

Background: Disordered eating patterns continue to surface on college campuses. Studies are needed to examine the potential influence of emotional intelligence on disordered eating behavior. Purpose: The purpose of this study was to assess relationships between perceived emotional intelligence factors and eating disorder symptoms among male and…

The Medical Complications Associated with Purging

PubMed Central

Forney, K. Jean; Buchman-Schmitt, Jennifer M.; Keel, Pamela K.; Frank, Guido K.W.

2015-01-01

Objective Purging behaviors, including self-induced vomiting, laxative abuse, and diuretic abuse, are present across many of the eating disorders. Here we review the major medical complications of these behaviors. Method Although we identified over 100 scholarly articles describing medical complications associated with purging, most papers involved case studies or small, uncontrolled samples. Given the limited evidence base, we conducted a qualitative (rather than systematic) review to identify medical complications that have been attributed to purging behaviors. Results Medical conditions affecting the teeth, esophagus, gastrointestinal system, kidneys, skin, cardiovascular system, and musculoskeletal system were identified, with self-induced vomiting causing the most medical complications. Conclusions Purging behavior can be associated with severe medical complications across all body systems. Mental health professionals should refer patients with purging behaviors to medical providers for screening and treatment as needed. The medical work-up for individuals with eating disorders should include a comprehensive metabolic panel, complete blood count, and a full body exam including the teeth to prevent severe complications. Medical providers should screen patients for purging behaviors and associated medical complications, even in the absence of an eating disorder diagnosis, to increase the detection of eating disorders. Recognizing the link between purging and medical complications can aid in identifying potential eating disorders, particularly those that often elude detection such as purging disorder. PMID:26876429

Driven exercise in the absence of binge eating: Implications for purging disorder.

PubMed

Lydecker, Janet A; Shea, Megan; Grilo, Carlos M

2018-02-01

Purging disorder (PD) is characterized by recurrent purging without objectively large binge-eating episodes. PD has received relatively little attention, and questions remain about the clinical significance of "purging" by exercise that is driven or compulsive (i.e., as extreme compensatory or weight-control behavior). The little available research suggests that individuals who use exercise as a compensatory behavior might have less eating-disorder psychopathology than those who purge by vomiting or laxatives, but those studies have had smaller sample sizes, defined PD using low-frequency thresholds, and defined exercise without weight-compensatory or driven elements. Participants (N = 2,017) completed a web-based survey with established measures of eating-disorder psychopathology, depression, and physical activity. Participants were categorized (regular compensatory driven exercise, PD-E, n = 297; regular compensatory vomiting/laxatives, PD-VL, n = 59; broadly defined anorexia nervosa, AN, n = 20; and no eating-disordered behaviors, NED, n = 1,658) and compared. PD-E, PD-VL, and AN had higher eating-disorder psychopathology and physical activity than NED but did not significantly differ from each other on most domains. PD-VL and AN had higher depression than PD-E, which was higher than NED. Findings suggest that among participants with regularly compensatory behaviors without binge eating, those who use exercise alone have similar levels of associated eating-disorder psychopathology as those who use vomiting/laxatives, although they have lower depression levels and overall frequency of purging. Findings provide further support for the clinical significance of PD. Clinicians and researchers should recognize the severity of driven exercise as a compensatory behavior, and the need for further epidemiological and treatment research. © 2017 Wiley Periodicals, Inc.

[FEATURES OF EATING BEHAVIOR IN PERSONS WITH NORMAL AND INCREASED BODY WEIGHT].

PubMed

Shevchenko, Yu; Vesnina, L; Kaydashev, I

2015-01-01

Using the Dutch Eating Behavior Questionnaire (DEBQ) and Three-factor Eating Questionnaire-R18 (TFEQ-RI8), we defined the peculiarities of eating behavior and their impact on quality of life in young people aged 18-25 years. All participants were divided into two groups according to body mass index (BMI). The control group included 41 persons with normal body weight (BMI 18.5-24.9 kg/m2). The group of young adults with increased body weight (BMI over 25 kg/M2) consisted of 27 persons. We found eating behavior disorders in 85,19 % of overweight people and in 41,46 % of persons with normal weight. The restrictive eating behaviors as well as a significant percentage of violations by external type had predominated in overweight individuals by the structure of disorders. The external and restrictive types of eating behavior disorders were predominated in persons with normal weight. Investigation of quality of life using the SF-36 questionnaire showed a significantly decline in the physical role functioning and pain. Index of general physical health component, being not high enough in both groups, was significantly lower in overweight people with 52.70 points against 56.11. We concluded that the eating behavior disorders in persons with normal weight and in overweight people required an individual approach to forming healthy lifestyle and fixing broken food stereotype. It will counteract the further increase of body weight and contribute to improving the quality of life.

Disgust sensitivity and eating disorder symptoms in a non-clinical population.

PubMed

Mayer, Birgit; Muris, Peter; Bos, Arjan E R; Suijkerbuijk, Chantal

2008-12-01

In order to further explore the relationship between disgust sensitivity and eating disorder symptoms, 2 studies were carried out. In the first study, 352 higher education students (166 women, 186 men) completed a set of questionnaires measuring various aspects of disgust sensitivity and eating disorder symptoms. A correlational analysis revealed that there were few significant correlations between disgust scales and eating pathology scores. One exception was the relation between disgust sensitivity and external eating behavior, although this link only emerged in women. To investigate this relationship in more detail, Study 2 confronted women high (n=29) and low (n=30) on external eating behavior with a series of disgusting and neutral pictures. It was hypothesized that women who scored high on external eating would display shorter viewing times of disgusting pictures (i.e., show more avoidance behavior) than women scoring low on external eating. However, this hypothesis was not confirmed by the data. Altogether, the results of these studies suggest that there seems to be no convincing relationship between disgust sensitivity and eating disorder symptomatology, thereby casting doubts on the role of this individual difference factor in the development of eating pathology.

The effect of parental monitoring on trajectories of disordered eating attitudes and behaviors among adolescents: An individual growth curve analysis.

PubMed

Martinson, Laura E; Esposito-Smythers, Christianne; Blalock, Dan V

2016-12-01

The primary aim of the present study was to examine whether parental monitoring, as reported by adolescents and their parents, predicts more or less favorable trajectories of disordered eating behavior and attitudes over the course of one year in a sample of adolescent males and females. An additional aim was to explore whether these trajectories vary when study analyses are limited to females. Participants included 87 adolescents (mean age = 15.5 ± 1.4) in mental health treatment and their parents. Self-report measures included the Parental Monitoring Questionnaire, completed at baseline, and the Eating Attitudes Test-Dieting Subscale, completed at baseline as well as 6-month and 12-month follow-ups. Individual growth curve (IGC) analyses were used to examine change in disordered eating behavior and attitudes. Adolescents who reported lower parental monitoring showed trajectories characterized by increases in disordered eating attitudes and behaviors. The same pattern emerged when using parent report of monitoring, though only a trend was evident. When analyses were restricted to females, the main effect of parental and adolescent report of monitoring on disordered eating were equally strong. Results may suggest that parents who are less knowledgeable about their adolescents' daily lives, may be less aware of potential disordered eating attitudes and behaviors, and thus less likely to intervene. Findings could be used to inform family-based interventions for this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

Examining Convergence of Retrospective and Ecological Momentary Assessment Measures of Negative Affect and Eating Disorder Behaviors

PubMed Central

Wonderlich, Joseph A.; Lavender, Jason M.; Wonderlich, Stephen A.; Peterson, Carol B.; Crow, Scott J.; Engel, Scott G.; Le Grange, Daniel; Mitchell, James E.; Crosby, Ross D.

2017-01-01

Objective Data gathered via retrospective forms of assessment are subject to various recall biases. Ecological momentary assessment (EMA) is an alternative approach involving repeated momentary assessments within a participant's natural environment, thus reducing recall biases and improving ecological validity. EMA has been used in numerous prior studies examining various constructs of theoretical relevance to eating disorders. Method This investigation includes data from three previously published studies with distinct clinical samples: (a) women with anorexia nervosa (N=118), (b) women with bulimia nervosa (N=133), and (c) obese men and women (N=50; 9 with current binge eating disorder). Each study assessed negative affective states and eating disorder behaviors using traditional retrospective assessments and EMA. Spearman rho correlations were used to evaluate the concordance of retrospective versus EMA measures of affective and/or behavioral constructs in each sample. Bland-Altman plots were also used to further evaluate concordance in the assessment of eating disorder behaviors. Results There was moderate to strong concordance for the measures of negative affective states across all three studies. Moderate to strong concordance was also found for the measures of binge eating and exercise frequency. The strongest evidence of concordance across measurement approaches was found for purging behaviors. Discussion Overall, these preliminary findings support the convergence of retrospective and EMA assessments of both negative affective states and various eating disorder behaviors. Given the advantages and disadvantages associated with each of these assessment approaches, the specific questions being studied in future empirical studies should inform decisions regarding selection of the most appropriate method. PMID:25195932

Patterns and prevalence of disordered eating and weight control behaviors in women ages 25-45.

PubMed

Reba-Harrelson, L; Von Holle, A; Hamer, R M; Swann, R; Reyes, M L; Bulik, C M

2009-12-01

The current study describes detailed eating behaviors, dieting behaviors, and attitudes about shape and weight in 4023 women ages 25 to 45. The survey was delivered on-line and participants were identified using a national quota-sampling procedure. Disordered eating behaviors, extreme weight loss measures, and negative cognitions about shape and weight were widely endorsed by women in this age group and were not limited to White participants. Thirty-one percent of women without a history of anorexia nervosa or binge eating reported having purged to control weight, and 74.5% of women reported that their concerns about shape and weight interfered with their happiness. Unhealthy approaches to weight control and negative attitudes about shape and weight are pervasive even among women without eating disorders. The development of effective approaches to address the impact of these unhealthy behaviors and attitudes on the general well-being and functioning of women is required.

Features Associated with Diet Pill Use in Individuals with Eating Disorders

PubMed Central

Reba-Harrelson, Lauren; Von Holle, Ann; Thornton, Laura M.; Klump, Kelly L.; Berrettini, Wade H.; Brandt, Harry; Crawford, Steven; Crow, Scott; Fichter, Manfred M.; Goldman, David; Halmi, Katherine A.; Johnson, Craig; Kaplan, Allan S.; Keel, Pamela; LaVia, Maria; Mitchell, James; Plotnicov, Katherine; Rotondo, Alessandro; Strober, Michael; Treasure, Janet; Woodside, D. Blake; Kaye, Walter H.; Bulik, Cynthia M.

2008-01-01

We investigated the relation between diet pill use and eating disorder subtype, purging and other compensatory behaviors, body mass index (BMI), tobacco and caffeine use, alcohol abuse or dependence, personality characteristics, and Axis I and Axis II disorders in 1,345 participants from the multisite Price Foundation Genetics Studies. Diet pill use was significantly less common in women with restricting type of AN than in women with other eating disorder subtypes. In addition, diet pill use was associated with the use of multiple weight control behaviors, higher BMI, higher novelty seeking, and the presence of anxiety disorders, alcohol abuse or dependence, and borderline personality disorder. Findings suggest that certain clinical and personality variables distinguish individuals with eating disorders who use diet pills from those who do not. In the eating disorder population, vigilant screening for diet pill use should be routine clinical practice. PMID:18167325

Eating disorders during pregnancy.

PubMed

Cardwell, Michael S

2013-04-01

Eating disorders during pregnancy, once thought to be rare, occur in a significant number of women. The incidences of the major eating disorders-anorexia nervosa and bulimia nervosa-are increasing because of cultural pressures on the drive for thinness. Because the age range for these major eating disorders overlaps with the age range for reproductive function, it is not unusual for a clinician to encounter a pregnant patient with a major eating disorder. Eating disorders attributable to the pregnant state include pregnancy sickness, pica, and ptyalism. The diagnostic criteria, etiology, nutritional behavioral influences, evolutionary psychological considerations where elucidated, and treatment of these disorders will be presented. Obstetricians and gynecologists, family physicians After completing this CME activity, physicians should be better able to review how the major eating disorders impact pregnancy, to diagnose eating disorders during pregnancy using the diagnostic criteria, and to treat eating disorders during pregnancy.

Dieting and encouragement to diet by significant others: associations with disordered eating in young adults

PubMed Central

Eisenberg, Marla E.; Berge, Jerica M.; Neumark-Sztainer, Dianne

2013-01-01

Purpose Examine the role of perceived significant other's modeling or encouragement of dieting in young adults' disordered eating behaviors. Design Online survey data were collected (2008–2009) as part of an ongoing study examining weight and related issues in young people. Setting Participants were originally recruited as students at middle and high schools in Minnesota (1998–1999). Subjects 1,030 young adults (mean age 25.3, 55% female, 50% white) with significant others. Measures Participants were asked if their significant other diets or encourages them to diet. Behaviors included unhealthy weight control, extreme weight control, and binge eating. Analysis General linear models estimated the predicted probability of using each behavior across levels of significant other's dieting or encouraging dieting, stratifying by gender and adjusting for demographics and BMI. Results Perceived dieting and encouragement to diet by significant others were common. Disordered eating behaviors were positively associated with significant other's dieting and encouragement to diet, particularly for females. In models including both perceived dieting and encouragement, encouragement remained significantly associated with disordered eating. For example, women's binge eating was almost doubled if their significant other encouraged dieting “very much” (25.5%) compared to “not at all” (13.6%, p=.015). Conclusion There is a strong association between disordered eating behaviors and perceived modeling and encouragement to diet by significant others in young adulthood. PMID:23398133

Compulsive exercise as a mediator between clinical perfectionism and eating pathology.

PubMed

Egan, Sarah J; Bodill, Kate; Watson, Hunna J; Valentine, Emily; Shu, Chloe; Hagger, Martin S

2017-01-01

The aim of this study was to examine whether compulsive exercise mediates the relationship between clinical perfectionism and eating pathology, based on the cognitive behavioral model of compulsive exercise. Participants were 368 adults who participated regularly in sport/exercise and completed online measures of perfectionism, compulsive exercise and eating disorders. In support of the well-established link between perfectionism and eating disorders, clinical perfectionism predicted eating pathology both directly and indirectly mediated by compulsive exercise. In addition, there were also direct effects of clinical perfectionism on the avoidance/rule-driven behavior, weight control, and mood improvement subscales of the Compulsive Exercise Test (CET). There was a direct effect of the CET weight control subscale on eating pathology and a negative direct effect of the CET subscale mood improvement on eating pathology. Findings lend support to the cognitive behavioral model of compulsive exercise in which clinical perfectionism is conceptualized as related to eating disorders directly and indirectly through the mediation of compulsive exercise. Compulsive exercise was also found to have a direct effect on eating disorders. Compulsive exercise may be a symptom of eating pathology, rather than an antecedent, however causal inferences could not be established given the correlational design. Longitudinal research using cross-lagged panel designs to examine a bidirectional relationship between compulsive exercise and eating disorders is needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Disturbed eating behavior and eating disorders in preteen and early teenage girls with type 1 diabetes: a case-controlled study.

PubMed

Colton, Patricia; Olmsted, Marion; Daneman, Denis; Rydall, Anne; Rodin, Gary

2004-07-01

To compare the prevalence of eating disturbances in preteen and early teenage girls with type 1 diabetes to their nondiabetic peers. A cross-sectional, case-controlled study of 101 girls with type 1 diabetes, ages 9-14 years, and 303 age-matched, female nondiabetic control subjects was conducted. Participants completed a Children's Eating Disorder Examination interview. Socioeconomic status, BMI, and diabetes-related variables were assessed. Groups were compared using chi(2) analyses. Binge eating; the use of intense, excessive exercise for weight control; the combination of two disturbed eating-related behaviors; and subthreshold eating disorders were all more common in girls with type 1 diabetes. Metabolic control was not related to eating behavior in this study population. Eating disturbances, though mostly mild, were significantly more common in preteen and early teenage girls with type 1 diabetes. Screening and prevention programs for this high-risk group should begin in the preteen years.

Calorie counting and fitness tracking technology: Associations with eating disorder symptomatology.

PubMed

Simpson, Courtney C; Mazzeo, Suzanne E

2017-08-01

The use of online calorie tracking applications and activity monitors is increasing exponentially. Anecdotal reports document the potential for these trackers to trigger, maintain, or exacerbate eating disorder symptomatology. Yet, research has not examined the relation between use of these devices and eating disorder-related attitudes and behaviors. This study explored associations between the use of calorie counting and fitness tracking devices and eating disorder symptomatology. Participants (N=493) were college students who reported their use of tracking technology and completed measures of eating disorder symptomatology. Individuals who reported using calorie trackers manifested higher levels of eating concern and dietary restraint, controlling for BMI. Additionally, fitness tracking was uniquely associated with ED symptomatology after adjusting for gender and bingeing and purging behavior within the past month. Findings highlight associations between use of calorie and fitness trackers and eating disorder symptomatology. Although preliminary, overall results suggest that for some individuals, these devices might do more harm than good. Copyright © 2017 Elsevier Ltd. All rights reserved.

Stress is associated with exercise differently among individuals with higher and lower eating disorder symptoms: An ecological momentary assessment study.

PubMed

Sala, Margarita; Brosof, Leigh C; Rosenfield, David; Fernandez, Katya C; Levinson, Cheri A

2017-12-01

Stress is associated with the maintenance of eating disorders and exercise behaviors. However, it is unclear how stress is associated with exercise and vice-versa among individuals with higher levels of eating disorder symptoms in daily life. The current study tested the moderating effect of eating disorder symptoms on the relationships between (1) daily stress and later exercise behavior and (2) daily exercise behavior and later stress. Female college students [N = 129, mean age = 19.19 (SD = 1.40)] completed the Eating Disorder Inventory-2. Participants then completed measures of stress and exercise four times daily across seven days using an automated telephone ecological momentary assessment system. Data were analyzed using multilevel models. Drive for thinness, bulimic symptoms, and body dissatisfaction significantly moderated the relationship between daily stress and later exercise (ps = .01-.05), such that higher daily stress predicted higher later exercise only in individuals who were low (but not average or high) in drive for thinness, bulimic symptoms, and body dissatisfaction symptoms. Stress is associated with exercise differentially depending on individuals' eating disorder symptoms. Our findings suggest that only individuals with lower levels of eating disorder symptoms exercise when stressed. © 2017 Wiley Periodicals, Inc.

The role of negative urgency and expectancies in problem drinking and disordered eating: testing a model of comorbidity in pathological and at-risk samples.

PubMed

Fischer, Sarah; Settles, Regan; Collins, Brittany; Gunn, Rachel; Smith, Gregory T

2012-03-01

The aim of this study was to test hypotheses derived from a model that explains both the comorbidity of problem drinking and eating disorder symptoms and the difference in risk process between the two disorders. In Study One, the authors examined four personality constructs typically associated with rash action (sensation seeking, lack of planning, lack of persistence, and negative urgency) and disorder-specific expectancies in samples of women with eating disorders, substance dependence disorders, comorbid conditions, and no symptoms (N = 104). Negative urgency, the tendency to act rashly when distressed, differentiated the disordered groups from the control group. In contrast, learned expectancies differentiated among clinical groups. Women with eating disorders endorsed high levels of eating and dieting expectancies and women with substance use disorders endorsed high levels of alcohol expectancies, while comorbid women endorsed high levels of both. In Study Two, this pattern of findings was replicated in a sample of fifth grade girls (N = 905). Girls who had engaged in binge eating, alcohol use, or both had higher levels of negative urgency than asymptomatic girls, and the pattern of outcome expectancy endorsement was disorder specific. Negative urgency may represent a general, personality influence on both eating disordered behaviors and symptoms of alcohol dependence, which, when combined with learned, behavior-specific expectancies, leads to specific addictive behavior patterns. PsycINFO Database Record (c) 2012 APA, all rights reserved.

A description of disordered eating behaviors in Latino males.

PubMed

Reyes-Rodriguez, Mae Lynn; Sala, Margarita; Von Holle, Ann; Unikel, Claudia; Bulik, Cynthia M; Camara-Fuentes, Luis; Suarez-Torres, Alba

2011-01-01

To explore disordered eating and eating disorders (EDs) in Latino males. Participants are 722 male college students from a larger prevalence study conducted in the University of Puerto Rico system. Participants were selected from a list of sections of required courses for first-year students on each campus. Self-report instruments were used to explore ED symptoms (the Eating Attitudes Test [EAT-26] and the Bulimia Test-Revised [BULIT-26-R] and the Beck Depression Inventory depression (BDI). Overall, 2.26% scored above the cut-off point on the BULIT-R and 5.08% score above the cut-off point on the EAT-26. Of the males, 4.43% reported sufficient frequency and severity to approximate DSM-IV criteria for bulimia nervosa. Depression symptomatology was found in those who scored above the cut-off point on both instruments of EDs. College health practitioners should be aware of disordered eating in Latino males and include them in efforts to detect disordered eating behaviors in college students.

The Use of the BASC-2 for the Identification of Female Adolescents at Risk for Developing an Eating Disorder

ERIC Educational Resources Information Center

Stachowitz, Annie L.; Choi, Hee-Sook; Schweinle, Amy

2014-01-01

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…

The effect of exercise absence on affect and body dissatisfaction as moderated by obligatory exercise beliefs and eating disordered beliefs and behaviors

PubMed Central

LePage, Marie L.; Price, Matthew; O’Neil, Patrick; Crowther, Janis H.

2012-01-01

Aim Research suggests that exercise absence is frequently associated with greater guilt and negative affect, particularly when obligatory exercise beliefs and eating disordered psychopathology are considered. Two separate studies used ecological momentary assessment (EMA) to examine differences in mood on exercise and non-exercise days and the moderating impact of obligatory exercise beliefs and eating disordered beliefs and behaviors. Method Both studies recruited female university students who endorsed frequent exercise behavior and study two also recruited based on level of eating disordered psychopathology. Participants completed the Obligatory Exercise Questionnaire at baseline and EMA measures of affect and exercise behavior for approximately one week. Study two participants also completed measures of body dissatisfaction and cognitions. Results Results of study one suggest that obligation to exercise appears to have a greater impact on general level of affect than does exercise absence or the interaction of these two. In addition, in study two, eating disorder symptomatology was significantly associated with affect and cognition while exercise absence and obligatory exercise beliefs were not. Conclusions The present studies suggest that the absence of exercise is not associated with significant changes in affect or cognitions. However, obligation to exercise and eating disorder symptomatology do impact affect and cognitions. PMID:22930654

Sleep and Eating Disorders.

PubMed

Allison, Kelly C; Spaeth, Andrea; Hopkins, Christina M

2016-10-01

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.

Pica and rumination behavior among individuals seeking treatment for eating disorders or obesity.

PubMed

Delaney, Charlotte B; Eddy, Kamryn T; Hartmann, Andrea S; Becker, Anne E; Murray, Helen B; Thomas, Jennifer J

2015-03-01

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.

Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive–compulsive spectrum

PubMed Central

Dell’Osso, Liliana; Abelli, Marianna; Carpita, Barbara; Pini, Stefano; Castellini, Giovanni; Carmassi, Claudia; Ricca, Valdo

2016-01-01

Eating disorders have been defined as “characterized by persistence disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs health or psychosocial functioning”. The psychopathology of eating disorders changed across time under the influence of environmental factors, determining the emergence of new phenotypes. Some of these conditions are still under investigation and are not clearly identified as independent diagnostic entities. In this review, the historic evolution of the eating disorder concept up to the recent Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has been evaluated. We also examined literature supporting the inclusion of new emergent eating behaviors within the eating disorder spectrum, and their relationship with anorexia, autism, and obsessive–compulsive disorder. In particular, we focused on what is known about the symptoms, epidemiology, assessment, and diagnostic boundaries of a new problematic eating pattern called orthorexia nervosa that could be accepted as a new psychological syndrome, as emphasized by an increasing number of scientific articles in the last few years. PMID:27462158

Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive-compulsive spectrum.

PubMed

Dell'Osso, Liliana; Abelli, Marianna; Carpita, Barbara; Pini, Stefano; Castellini, Giovanni; Carmassi, Claudia; Ricca, Valdo

2016-01-01

Eating disorders have been defined as "characterized by persistence disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs health or psychosocial functioning". The psychopathology of eating disorders changed across time under the influence of environmental factors, determining the emergence of new phenotypes. Some of these conditions are still under investigation and are not clearly identified as independent diagnostic entities. In this review, the historic evolution of the eating disorder concept up to the recent Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has been evaluated. We also examined literature supporting the inclusion of new emergent eating behaviors within the eating disorder spectrum, and their relationship with anorexia, autism, and obsessive-compulsive disorder. In particular, we focused on what is known about the symptoms, epidemiology, assessment, and diagnostic boundaries of a new problematic eating pattern called orthorexia nervosa that could be accepted as a new psychological syndrome, as emphasized by an increasing number of scientific articles in the last few years.

Global/local processing style: Explaining the relationship between trait anxiety and binge eating.

PubMed

Becker, Kendra R; Plessow, Franziska; Coniglio, Kathryn A; Tabri, Nassim; Franko, Debra L; Zayas, Lazaro V; Germine, Laura; Thomas, Jennifer J; Eddy, Kamryn T

2017-11-01

Anxiety is a risk factor for disordered eating, but the mechanisms by which anxiety promotes disordered eating are poorly understood. One possibility is local versus global cognitive processing style, defined as a relative tendency to attend to details at the expense of the "big picture." Anxiety may narrow attention, in turn, enhancing local and/or compromising global processing. We examined relationships between global/local processing style, anxiety, and disordered eating behaviors in a transdiagnostic outpatient clinical sample. We hypothesized that local (vs. global) processing bias would mediate the relationship between anxiety and disordered eating behaviors. Ninety-three participants completed the eating disorder examination-questionnaire (EDE-Q), State-Trait Anxiety Inventory (STAI)-trait subscale, and the Navon task (a test of processing style in which large letters are composed of smaller letters both congruent and incongruent with the large letter). The sample was predominantly female (95%) with a mean age of 27.4 years (SD = 12.1 years). Binge eating, but not fasting, purging, or excessive exercise, was correlated with lower levels of global processing style. There was a significant indirect effect between anxiety and binge eating via reduced global level global/local processing. In individuals with disordered eating, being more generally anxious may encourage a detailed-oriented bias, preventing individuals from maintaining the bigger picture and making them more likely to engage in maladaptive behaviors (e.g., binge eating). © 2017 Wiley Periodicals, Inc.

Global/local processing style: Explaining the relationship between trait anxiety and binge eating

PubMed Central

Becker, Kendra R.; Plessow, Franziska; Coniglio, Kathryn A.; Tabri, Nassim; Franko, Debra L; Zayas, Lazaro V.; Germine, Laura; Thomas, Jennifer J.; Eddy, Kamryn T.

2018-01-01

Objective Anxiety is a risk factor for disordered eating, but the mechanisms by which anxiety promotes disordered eating are poorly understood. One possibility is local versus global cognitive processing style, defined as a relative tendency to attend to details at the expense of the “big picture.” Anxiety may narrow attention, in turn, enhancing local and/or compromising global processing. We examined relationships between global/local processing style, anxiety, and disordered eating behaviors in a transdiagnostic outpatient clinical sample. We hypothesized that local (vs. global) processing bias would mediate the relationship between anxiety and disordered eating behaviors. Method Ninety-three participants completed the eating disorder examination—questionnaire (EDE-Q), State-Trait Anxiety Inventory (STAI)—trait subscale, and the Navon task (a test of processing style in which large letters are composed of smaller letters both congruent and incongruent with the large letter). The sample was predominantly female (95%) with a mean age of 27.4 years (SD = 12.1 years). Results Binge eating, but not fasting, purging, or excessive exercise, was correlated with lower levels of global processing style. There was a significant indirect effect between anxiety and binge eating via reduced global level global/local processing. Discussion In individuals with disordered eating, being more generally anxious may encourage a detailed-oriented bias, preventing individuals from maintaining the bigger picture and making them more likely to engage in maladaptive behaviors (e.g., binge eating). PMID:28963792

Body dissatisfaction, bulimic symptoms, and clothing practices among college women.

PubMed

Trautmann, Julianne; Worthy, Sheri Lokken; Lokken, Kristine L

2007-09-01

Clothing use may be a behavioral avoidance strategy for individuals with body dissatisfaction and eating pathology. The authors administered the Body Image Avoidance Questionnaire (J. C. Rosen, D. Srebnik, E. Saltzberg, & S. Wendt, 1991), the Bulimia Test-Revised (M. Thelen, J. Farmer, S. Wonderlich, & M. Smith, 1991), and the Body dissatisfaction subscale of the Eating Disorder Inventory (D. M. Garner, M. P. Olmstead, & J. Polivy, 1983) to undergraduate college women from two universities (N = 540). Results indicated that women who were more dissatisfied with their bodies (beta = .396) and had greater disordered eating behaviors (beta = .378) were more likely to engage in clothing-related appearance-management behaviors (p < .001), including wearing apparel to camouflage their bodies; avoiding revealing, brightly colored, or tightly fitting clothing; and avoiding shopping for clothing. These findings suggest that the presence of certain clothing-related appearance-management behaviors may be a warning sign that an individual is at risk for developing an eating disorder or may currently have an eating disorder.

Emotional maltreatment and disordered eating in adolescents: testing the mediating role of emotion regulation.

PubMed

Mills, Pamela; Newman, Emily Frances; Cossar, Jill; Murray, George

2015-01-01

The present study aimed to determine if emotion regulation mediates the relationship between emotional maltreatment and disordered eating behavior in adolescents. Participants were 222 secondary school pupils (aged 14-18 years) from a state high school in the UK. Standardized questionnaire measures were used to gather self-report data on emotional abuse and emotional neglect, functional and dysfunctional emotion regulation strategies and disordered eating behavior. Results showed that disordered eating was associated with emotional abuse, dysfunctional emotion regulation and being female. Multiple mediation analysis found an indirect relationship between emotional abuse and disordered eating through dysfunctional emotion regulation. Interestingly, emotional neglect predicted lower levels of functional emotion regulation. The findings support previous research showing emotion regulation to mediate the relationship between childhood abuse and disordered eating in adults and a differential effect of abuse and neglect on emotion regulation. Longitudinal studies are required to confirm the direction of relationships; however these data suggest that dysfunctional emotion regulation is a significant variable in the development of disordered eating and may be a useful target for intervention. Copyright © 2014. Published by Elsevier Ltd.

Effectiveness of cognitive behavioral therapy supported by virtual reality in the treatment of body image in eating disorders: one year follow-up.

PubMed

Marco, José H; Perpiñá, Conxa; Botella, Cristina

2013-10-30

Body image disturbance is a significant maintenance and prognosis factor in eating disorders. Hence, existing eating disorder treatments can benefit from direct intervention in patients' body image. No controlled studies have yet compared eating disorder treatments with and without a treatment component centered on body image. This paper includes a controlled study comparing Cognitive Behavioral Treatment (CBT) for eating disorders with and without a component for body image treatment using Virtual Reality techniques. Thirty-four participants diagnosed with eating disorders were evaluated and treated. The clinical improvement was analyzed from statistical and clinical points of view. Results showed that the patients who received the component for body image treatment improved more than the group without this component. Furthermore, improvement was maintained in post-treatment and at one year follow-up. The results reveal the advantage of including a treatment component addressing body image disturbances in the protocol for general treatment of eating disorders. The implications and limitations of these results are discussed below. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Cognitive behavior therapy for eating disorders versus normalization of eating behavior.

PubMed

Södersten, P; Bergh, C; Leon, M; Brodin, U; Zandian, M

2017-05-15

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.

Eating disorder pathology in elite adolescent athletes.

PubMed

Giel, Katrin Elisabeth; Hermann-Werner, Anne; Mayer, Jochen; Diehl, Katharina; Schneider, Sven; Thiel, Ansgar; Zipfel, Stephan

2016-06-01

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.

Shame and guilt in women with eating-disorder symptomatology.

PubMed

Burney, J; Irwin, H J

2000-01-01

The relationship of shame and guilt to eating-disorder symptomatology was investigated in a sample of 97 Australian women. In terms of the objective of predicting the severity of eating disturbance, the study explored the predictive utility of proneness to shame and guilt in a global sense, shame and guilt associated specifically with eating contexts, and shame associated with the body. The study also sought to determine if shame is a more prominent emotion than guilt among women who have eating difficulties. Shame associated with eating behavior was the strongest predictor of the severity of eating-disorder symptomatology. Other effective predictors were guilt associated with eating behavior and body shame. Eating disturbance was unrelated to proneness to shame and guilt in a global sense. Discussion of these findings focuses on the issue of determining whether self-conscious affects are best regarded as causes or as consequences of eating disturbance.

Disordered eating behavior, health and motives to exercise in young men: cross-sectional population-based MOPO study.

PubMed

Nurkkala, Marjukka; Keränen, Anna-Maria; Koivumaa-Honkanen, Heli; Ikäheimo, Tiina M; Ahola, Riikka; Pyky, Riitta; Mäntysaari, Matti; Korpelainen, Raija

2016-06-08

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. 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. 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). 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 as non-health-related motives to exercise. In order to recognize those at risk for disordered eating behavior, evaluating these factors could be beneficial.

Individual Differences and Short-Term Military Factors Associated With Unhealthy Weight Control Behaviors Among Active Duty and Reserve Army Soldiers

DTIC Science & Technology

2009-03-01

syndrome eating disorders (Eisenberg & Neumark-Sztainer, 2008; Neumark-Sztainer et al., 2002; Rukavina & Pokrajac-Bulian, 2006). Although the...risk for developing full- syndrome eating disorders. Repeated periods of extreme weight loss behavior may reinforce that purging, fasting, or excessive...exercise are “good” ways to lose weight. In fact, many individuals with full syndrome eating disorders start by engaging in repeated periods of

Alcohol Expectancies and Drinking Behaviors among College Students with Disordered Eating

ERIC Educational Resources Information Center

Rush, Christina C.; Curry, John F.; Looney, John G.

2016-01-01

Objective: The authors investigated binge drinking, alcohol expectancies, and risky and protective drinking behaviors in relation to disordered eating behaviors in male and female college students. Participants: The full sample consisted of 7,720 undergraduate students, 18 to 22 years of age. Drinking behaviors were analyzed in 4,592 recent…

Effect of management of patients with Anorexia and Bulimia nervosa on symptoms and impulsive behavior.

PubMed

Sernec, Karin; Tomori, Martina; Zalar, Bojan

2010-12-01

The aim of the study was to provide further and up to date information on the evaluation of the management of Anorexia and Bulimia nervosa at the Eating Disorders Unit (EDU) of the Ljubljana Psychiatric Clinic, based upon detailed assessment of the eating disorders specific and non specific symptoms of impulsive behaviors, highly correlated with these entities. 34 female patients with anorexia (restrictive or purgative type) and 38 female patients with Bulimia nervosa (purgative or non-purgative type) undergoing hospital treatment at the EDU were evaluated upon admission, as well as upon discharge and three and six months after discharge, using the Eating Disorder Questionnaire. Upon discharge a marked decrease in the overall symptoms was noted. The differences in symptoms incidences between the two groups were significantly specific for the individual form of eating disorder, especially upon admission, and were more pronounced in anorexia group. In later measurements, performed during the period of three and six months after discharge, a mild trend of increase in the disorder specific symptoms was detected in both groups, but was not statistically significant. In addition to binging on food, striking, quarreling and spending sprees are characteristics of patients with eating disorders, which in particular apply to the Bulimia nervosa group. Apart from the disorder specific symptoms, impulsive behavior was also reduced during study period, while the difference in its occurrence between the two groups gradually became non-significant. The management of patients with eating disorders at the EDU was successful in both groups, confirmed by an intense reduction of the disorder specific symptoms, impulsive behavior and increased stability recorded three and six months after discharge. The study strongly suggests that the effect of treatment regime for eating disorders can be predicted by careful assessment of the relevant symptoms and impulsive behavioral patterns.

Eating disorder emergencies: understanding the medical complexities of the hospitalized eating disordered patient.

PubMed

Cartwright, Martina M

2004-12-01

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.

Prevention of eating disorders in female athletes

PubMed Central

Coelho, Gabriela Morgado de Oliveira; Gomes, Ainá Innocencio da Silva; Ribeiro, Beatriz Gonçalves; Soares, Eliane de Abreu

2014-01-01

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. PMID:24891817

COMT met allele differentially predicts risk versus severity of aberrant eating in a large community sample.

PubMed

Donofry, Shannon D; Roecklein, Kathryn A; Wildes, Jennifer E; Miller, Megan A; Flory, Janine D; Manuck, Stephen B

2014-12-15

Prefrontal dopamine (DA) transmission participates in the reinforcement of reward-driven behaviors like eating. Because catechol-O-methyltransferase (COMT) degrades DA and is expressed in the prefrontal cortex, variation in the COMT gene may modulate eating behavior. Previous studies have shown that the met allele of the COMT val158met single nucleotide polymorphism (SNP) is associated with Bulimia Nervosa (BN). The specific aim of this study was to test whether the met allele increased risk for, and severity of, eating disorder symptomatology in community volunteers. Caucasian adults (N=1003; 51.2% female) from the University of Pittsburgh Adult Health and Behavior Project (AHAB) were genotyped and completed the Eating Disorders Inventory (EDI). Logistic and Poisson regression analyses assessed genotype-dependent presence and severity of eating disorder symptomatology. The met allele was significantly associated with the presence of symptoms on the Bulimia subscale and the severity of Body Dissatisfaction scores. All EDI subscales significantly predicted BMI. To our knowledge, these are the first data indicating that the COMT met allele increases risk for some symptoms of disordered eating, while increasing severity of others, in a community sample. These novel findings may have important implications for understanding the etiology of heterogeneous disordered eating phenotypes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Rapid Response Predicts Treatment Outcomes in Binge Eating Disorder: Implications for Stepped Care

ERIC Educational Resources Information Center

Masheb, Robin M.; Grilo, Carlos M.

2007-01-01

The authors examined rapid response in 75 overweight patients with binge eating disorder (BED) who participated in a randomized clinical trial of guided self-help treatments (cognitive-behavioral therapy [CBTgsh] and behavioral weight loss [BWLgsh]). Rapid response, defined as a 65% or greater reduction in binge eating by the 4th treatment week,…

Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviors

ERIC Educational Resources Information Center

Greenleaf, Christy; Petrie, Trent A.; Carter, Jennifer; Reel, Justine J.

2009-01-01

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…

Sexual orientation disparities in eating disorder symptoms among adolescent boys and girls in the UK.

PubMed

Calzo, Jerel P; Austin, S Bryn; Micali, Nadia

2018-03-17

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.

Trends and Disparities in Disordered Eating among Heterosexual and Sexual Minority Adolescents

PubMed Central

Watson, Ryan J.; Adjei, Jones; Saewyc, Elizabeth; Homma, Yuko; Goodenow, Carol

2018-01-01

Objective Disordered eating has decreased for all youth over time, but studies have not focused specifically on lesbian, gay, and bisexual(LGB) youth. Research has found that LGB youth report disordered eating behaviors more often compared to their heterosexual counterparts, but no studies have documented trends over time for LGB youth and considered whether these disparities are narrowing or widening across sexual orientation groups. Method We use pooled data from the 1999–2013 Massachusetts Youth Risk Behavior Surveys (N = 26,002) to investigate trends in purging, fasting, and using diet pills to lose or control weight for heterosexual and sexual minority youth. We used cross tabs, logistic regression, and interactions in regression models, stratified by sex. Results The prevalence of disordered eating has decreased on all three measures across nearly all groups of heterosexual and sexual minority youth. However, we found disparities in reported disordered eating behaviors for LGB youth persisted across all survey years, with LGB students reporting significantly higher prevalence of disordered eating than heterosexuals. The disparities in fasting to control weight widened between the first and last survey waves between lesbian and heterosexual females. Discussion The significant reductions over time in prevalence of disordered eating among some youth are encouraging, but the disparities remain. Indeed, the increasing prevalence of fasting, diet pill use, and purging to control weight among lesbians may warrant targeted prevention and intervention programs. PMID:27425253

Children of parents with BED have more eating behavior disturbance than children of parents with obesity or healthy weight.

PubMed

Lydecker, Janet A; Grilo, Carlos M

2017-06-01

A limited literature suggests an association between parental eating disorders and child eating-disorder behaviors although this research has focused primarily on restrictive-type eating disorders and very little is known about families with binge-eating disorder (BED). The current study focused on parents (N = 331; 103 fathers and 226 mothers), comparing parents with core features of BED (n = 63) to parents with obesity and no eating disorder (OB; n = 85) and parents with healthy-weight and no eating disorder (HW; n = 183). Parents with BED were significantly more likely than OB and HW parents to report child binge eating, and more likely than HW parents to report child overeating. Parents with BED felt greater responsibility for child feeding than OB parents, and felt more concern about their child's weight than OB and HW parents. Dietary restriction of the child by the parents was related to child binge eating, overeating, and child overweight, and parental group was related to child binge eating (parental BED), overeating (parental BED), and child weight (parental OB). Parents with BED report greater disturbance in their children's eating than OB and HW parents, and OB parents report higher child weight than HW parents. This suggests that it is important to consider both eating-disorder psychopathology and obesity in clinical interventions and research. Our cross-sectional findings, which require experimental and prospective confirmations, provide preliminary evidence suggesting potential factors in families with parental BED and obesity to address in treatment and prevention efforts for pediatric eating disorders and obesity. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:648-656). © 2016 Wiley Periodicals, Inc.

Attention-deficit/hyperactivity disorder-specific stimulant misuse, mood, anxiety, and stress in college-age women at high risk for or with eating disorders.

PubMed

Gibbs, Elise L; Kass, Andrea E; Eichen, Dawn M; Fitzsimmons-Craft, Ellen E; Trockel, Mickey; Wilfley, Denise E

2016-01-01

To examine the misuse of attention-deficit/hyperactivity disorder (ADHD)-specific stimulants in a college population at high risk for or with clinical or subclinical eating disorders. Four hundred forty-eight college-age women aged 18-25 at high risk for or with a clinical or subclinical eating disorder. Participants completed assessments of stimulant misuse and psychopathology from September 2009 to June 2010. Greater eating disorder pathology, objective binge eating, purging, eating disorder-related clinical impairment, depressive symptoms, perceived stress, and trait anxiety were associated with an increased likelihood of stimulant misuse. Subjective binge eating, excessive exercise, and dietary restraint were not associated with stimulant misuse. ADHD-specific stimulant misuse is associated with eating disorder and comorbid pathology among individuals at high risk for or with clinical or subclinical eating disorders. Screening for stimulant misuse and eating disorder pathology may improve identification of college-age women who may be engaging in maladaptive behaviors and inform prevention efforts.

Eating avoidance disorder and Wernicke-Korsakoff syndrome following gastric bypass: an under-diagnosed association.

PubMed

Fandiño, Julia N; Benchimol, Alexander K; Fandiño, Leila N; Barroso, Fernando L; Coutinho, Walmir F; Appolinário, José C

2005-09-01

Wernicke-Korsakoff syndrome (WKS) and disordered eating behavior have been reported separately after bariatric surgery. We report a patient who following a bariatric operation developed WKS associated with a disturbed eating behavior without vomiting. This morbidly obese man developed an intense fear of gaining weight in the postoperative period and engaged in an extreme form of "food avoidance behavior". 2 months postoperatively after severe weight loss, he was hospitalized with disorientation and an amnesic syndrome. He was discharged 2 months later with stable weight and regular eating habits. Despite this, at the last follow-up visit 2 years postoperatively, he still had a residual partial amnesic syndrome. The surgical team must be aware of peculiar forms of pathological eating that may appear after bariatric surgery; the emergence of an eating avoidance disorder may be associated with the development of WKS.

Population-based prevention of eating disorders: an application of the Rose prevention model.

PubMed

Austin, S B

2001-03-01

Several decades of concerted research on eating disorders have generated a broad range of proposed causal influences, but much of this etiologic research does not elucidate practical avenues for preventive interventions. Translating etiologic theory into community health interventions depends on the identification of key leverage points, factors that are amenable to public health intervention and provide an opportunity to maximize impact on the outcome of interest. Population-based preventive strategies, elaborated by epidemiologist Geoffrey Rose, can maximize the impact of public health interventions. In the case of eating disorders, Rose's model is instructive: Dieting stands out as risk behavior that may both fit Rose's model well and be a key leverage point for preventive intervention. Grounded in Rose's work, this article lodges a theoretical argument for the population-based prevention of eating disorders. In the introductory section, existing research on the epidemiology of dieting is reviewed, showing that it is extremely common among adolescent girls and women and that the behavior has been implicated as a causal factor for disordered eating. Next, new evidence is offered to build a case for how a population-wide reduction in dieting may be an effective strategy for prevention of eating pathology. Finally Rose's prevention framework is used to introduce a unique and provocative perspective on the prevention of eating disorders. Dieting is a normative behavior in our culture with psychological and physiological effects in the causal chain leading to eating pathology. This behavior may represent an ideal target for population-based prevention. Theoretical and empirical evidence suggests that a population-wide reduction in dieting may be a justifiable and effective strategy for prevention of eating pathology. Copyright 2001 American Health Foundation and Academic Press.

Test-retest reliability of the eating disorder examination-questionnaire (EDE-Q) in a college sample

PubMed Central

2013-01-01

Background The Eating Disorder Examination-Questionnaire (EDE-Q), a widely used self-report instrument, is often used for measuring change in eating disorder symptoms over the course of treatment. However, limited data exist about test-retest reliability, particularly for men. The current study evaluated EDE-Q 7-day test-retest reliability in male (n = 47) and female (n = 44) undergraduate students together and separately by gender. Results Internal consistency was consistently higher for women and at Time 2, but remained acceptable for both men and women at both time points. Cronbach’s α ranged from .75 (Restraint at Time 1) to .93 (Shape Concern at Time 2) for women and from .73 (Eating Concern at Time 2) to .89 (Shape Concern at Time 2) for men. With the exception of some of the eating disorder behaviors, test re-test reliability was fairly strong for both men and women. Shape Concern and the global EDE-Q score were highest for both men and women (Spearman’s rho > 0.89 with the exception of Shape Concern for women for which Spearman’s rho = .86). Test re-test reliability was lower for the eating disorder behavior measures, particularly for men, for whom Kendall’s tau-b for frequency and phi for occurrence was less than 0.70 for all but objective bulimic episodes. Conclusions Results were consistent with past research for women, indicating strong test re-test reliability in attitudinal features of eating disorders, but lower test re-test reliability in behavioral features. Internal consistency and test re-test reliability was good for the attitudinal features of eating disorder in men, but tended to be lower for men compared to women. The EDE-Q appears to be a reliable instrument for assessing eating disorder attitudes in both male and female undergraduate students, but is less reliable for assessing ED behaviors, particularly in men. PMID:24999420

Examining weight and eating behavior by sexual orientation in a sample of male veterans.

PubMed

Bankoff, Sarah M; Richards, Lauren K; Bartlett, Brooke; Wolf, Erika J; Mitchell, Karen S

2016-07-01

Eating disorders are understudied in men and in sexual minority populations; however, extant evidence suggests that gay men have higher rates of disordered eating than heterosexual men. The present study examined the associations between sexual orientation, body mass index (BMI), disordered eating behaviors, and food addiction in a sample of male veterans. Participants included 642 male veterans from the Knowledge Networks-GfK Research Panel. They were randomly selected from a larger study based on previously reported trauma exposure; 96% identified as heterosexual. Measures included the Eating Disorder Diagnostic Scale, the Yale Food Addiction Scale, and self-reported height and weight. Heterosexual and sexual minority men did not differ significantly in terms of BMI. However, gay and bisexual men (n=24) endorsed significantly greater eating disorder symptoms and food addiction compared to heterosexual men. Our findings that sexual minority male veterans may be more likely to experience eating disorder and food addiction symptoms compared to heterosexual male veterans highlight the importance of prevention, assessment, and treatment efforts targeted to this population. Published by Elsevier Inc.

Body image disturbance in binge eating disorder: a comparison of obese patients with and without binge eating disorder regarding the cognitive, behavioral and perceptual component of body image.

PubMed

Lewer, Merle; Nasrawi, Nadia; Schroeder, Dorothea; Vocks, Silja

2016-03-01

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.

Self-esteem, body shame and eating disorder risk in obese and normal weight adolescents: A mediation model.

PubMed

Iannaccone, Mara; D'Olimpio, Francesca; Cella, Stefania; Cotrufo, Paolo

2016-04-01

To investigate dysfunctional eating behaviors and psychological variables typically associated to eating disturbances such as low self-esteem, perfectionism, shame, perceived parental care and protectiveness in obese and normal weight adolescents and to examine how the main powerful eating disorder risk factors interact with each other which explains eating psychopathology vulnerability. 111 high school students (68 males; age range 13-19years) classified as obese and 111 age-, sex- and social status-homogeneous normal weight controls were included in the current study. All participants were asked to fill out self-report measures of parental behavior as perceived by the offspring, eating disturbance attitudes and behaviors, self-esteem, perfectionism and shame. Significant differences between the two groups in relation to dysfunctional eating behaviors emerged. Body shame had the strongest relationship to eating problems vulnerability and acted as a mediator in the relationship between low self-esteem and eating disorder risk among both obese and non-obese youngsters. These findings further our understanding of a potential underlying mechanism for eating pathology development in youngsters in general and in obese adolescents in particular, which is of great importance in terms of prevention and treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Attention deficit hyperactivity disorder and disordered eating behaviors: links, risks, and challenges faced.

PubMed

Ptacek, Radek; Stefano, George B; Weissenberger, Simon; Akotia, Devang; Raboch, Jiri; Papezova, Hana; Domkarova, Lucie; Stepankova, Tereza; Goetz, Michal

2016-01-01

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 both a historical perspective and the one based on the revealing nature of its comorbidities.

Acceptance and Commitment Therapy as a Novel Treatment for Eating Disorders: An Initial Test of Efficacy and Mediation

ERIC Educational Resources Information Center

Juarascio, Adrienne; Shaw, Jena; Forman, Evan; Timko, C. Alix; Herbert, James; Butryn, Meghan; Bunnell, Douglas; Matteucci, Alyssa; Lowe, Michael

2013-01-01

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…

Depression and coping in subthreshold eating disorders.

PubMed

Dennard, E Eliot; Richards, C Steven

2013-08-01

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.

Cognitive Treatments for Eating Disorders.

ERIC Educational Resources Information Center

Wilson, G. Terence; Fairburn, Christopher G.

1993-01-01

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…

Group behavioral activation for patients with severe obesity and binge eating disorder: a randomized controlled trial.

PubMed

Alfonsson, Sven; Parling, Thomas; Ghaderi, Ata

2015-03-01

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.

The usefulness of body image tests in the prevention of eating disorders.

PubMed

Yamamoto, Chie; Uemoto, Masaharu; Shinfuku, Naotaka; Maeda, Kiyoshi

2007-01-01

Individual psychological factors such as mental conditions and self-esteem and family relational factors are thought to be predisposing factors in the development of eating disorders. In this study, we conducted a survey of 12-15 year-old public junior high school students to extract factors related to abnormal eating behavior and determine what information could be used by schools to prevent eating disorders. Self-descriptive surveys were distributed and collected during homeroom time at school. The survey consisted of the 26-item Eating Attitude Test (EAT-26) to measure the degree of abnormal eating behavior, Stunkard, Sorensen and Schlusinger's Body Image Scale to determine predisposing factors, the Family Adaptability and Cohesion Scale III (FACES III), General Health Questionnaire (GHQ), and Rosenberg's Self-Esteem Scale. 483 students (263 boys and 220 girls) participated in the survey. School-year height and weight data was used to calculate BMI. Approximately 7% of girls and 3% of boys showed clear indications of abnormal eating behavior. We found no direct relationship between abnormal eating behavior and family factors in this study, but an indirect relationship was suggested through other factors such as psychological complaints and self-esteem. There were relationships between abnormal eating behavior and the individual factors of psychological complaints, current and ideal body image, and low self-esteem. Furthermore, cluster analysis showed that there were students with high BMI who thought of themselves as fat, as well as students who perceived themselves as fat despite having average BMI. These students had a high frequency of abnormal eating behaviors, a great deal of psychological complaints, and low self-esteem. An understanding of BMI, along with body image, is essential for students who feel that they are overweight. Schools can practice preventative education by teaching these students about healthy body weight and by screening for the eating disorders that have become so rampant in our thin-worshiping culture.

Olfaction in eating disorders and abnormal eating behavior: a systematic review

PubMed Central

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

2015-01-01

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. PMID:26483708

Olfaction in eating disorders and abnormal eating behavior: a systematic review.

PubMed

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

2015-01-01

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.

Eating behavior, depression, and self-esteem in high school students.

PubMed

Tomori, M; Rus-Makovec, M

2000-05-01

In a representative sample of 4700 Slovene high school students, we examined their eating behavior and its correlations with some psychosocial and psychological characteristics with the aim of identifying the main risk factors for disordered eating. Using a questionnaire which also included Zung's Self-rating Depression Scale and Rosenberg's Self-Esteem Scale, we compared girls (n = 2507) and boys (n = 2193) with regard to their satisfaction with their body weight, weight-reducing activities, and frequency of binge eating. We assessed their family relationships, abuse of alcohol and other psychoactive drugs, suicidal ideation, and suicidal tendences, as well as their level of depression and self-esteem. The results showed significant differences between girls and boys, between groups of those who were satisfied and those who were dissatisfied with their body weight, and also between groups which indulged in frequent binge eating and those which did not. Within a general population of adolescents, there is a substantial number of subjects with disordered eating behavior, some part of whom are at high risk for eating disorders.

Prevalence of Disordered Eating Behaviors and Bulimia Nervosa in a Sample of Mexican American Female College Students.

ERIC Educational Resources Information Center

Lester, Regan; Petrie, Trent A.

1998-01-01

Disordered eating behaviors and bulimia nervosa were examined in a sample of female Mexican Americans. Results showed that 1.45% to 4.3% could be classified with bulimia. Just over 11% indicated regular binge eating. Dieting and exercising were the primary techniques used for weight control. Implications for intervention are briefly discussed.…

Prevalence of Disordered Eating and Pathogenic Weight Control Behaviors among NCAA Division I Female Collegiate Gymnasts and Swimmers

ERIC Educational Resources Information Center

Anderson, Carlin; Petrie, Trent A.

2012-01-01

Eating disorders and related weight control behaviors, such as excessive exercising and restrictive eating, represent serious health problems for girls and women in the United States and other industrialized nations. Female athletes, in particular, have been identified as a subgroup to study because of the unique weight, performance, and body…

Examining Affect and Perfectionism in Relation to Eating Disorder Symptoms among Women with Anorexia Nervosa

PubMed Central

Lavender, Jason M.; Mason, Tyler B.; Utzinger, Linsey M.; Wonderlich, Stephen A.; Crosby, Ross D.; Engel, Scott G.; Mitchell, James E.; Le Grange, Daniel; Crow, Scott J.; Peterson, Carol B.

2016-01-01

This study examined personality and affective variables in relation to eating disorder symptoms in anorexia nervosa (AN). Women (N=118) with DSM-IV AN completed baseline questionnaires (Beck Depression Inventory, Frost Multidimensional Perfectionism Scale) and interviews (Eating Disorder Examination, Yale-Brown-Cornell Eating Disorder Scale), followed by two weeks of ecological momentary assessment (EMA) involving multiple daily reports of affective states and eating disorder behaviors. Hierarchical regression analyses were conducted using eating disorder symptoms as dependent variables (i.e., EMA binge eating, EMA self-induced vomiting, eating disorder rituals, eating disorder preoccupations, dietary restraint). Predictor variables were maladaptive perfectionism (baseline), depressive symptoms (baseline), and affect lability (EMA). Results revealed that affect lability was independently associated with binge eating, whereas depressive symptoms were independently associated with self-induced vomiting. Depressive symptoms were independently associated with eating disorder rituals, whereas both depressive symptoms and maladaptive perfectionism were independently associated with eating disorder preoccupations. Finally, maladaptive perfectionism and affect lability were both independently associated with dietary restraint. This pattern of findings suggests the importance of affective and personality constructs in relation to eating disorder symptoms in AN and may highlight the importance of targeting these variables in the context of treatment. PMID:27208513

Comparing men and women with binge-eating disorder and co-morbid obesity.

PubMed

Lydecker, Janet A; Grilo, Carlos M

2018-05-01

This study examined differences in clinical presentation of men and women with binge-eating disorder (BED) who participated in treatment research at a medical-school based program. Participants were 682 adults (n = 182 men, n = 500 women) with DSM-IV-defined BED. Doctoral-level research clinicians assessed eating-disorder psychopathology, including BED diagnosis, using the Structured Clinical Interview for DSM-IV Disorders (SCID) and Eating Disorder Examination (EDE) interview. Research clinicians measured height and weight and participants completed a battery of established self-report measures. Men had significantly higher body mass index (BMI) than women; women had significantly higher eating-disorder psychopathology (EDE scales and global score) and depression than men. Differences in eating-disorder psychopathology and depression remained higher for women than men after adjusting for race/ethnicity and BMI. Frequency of binge-eating episodes, subjective binge-eating episodes, and overeating episodes did not differ significantly by sex. Women had younger ages of onset for dieting and binge-eating behaviors than men but ages of onset for obesity and BED did not significantly differ between men and women. There are some sex differences in clinical presentation and age-of-onset timeline of adults with BED. Men and women develop obesity and BED (at diagnostic threshold) around the same age but women begin dieting and binge-eating behaviors earlier than men. At presentation for treatment for BED, men and women did not differ in binge-eating frequency and although men and women differed significantly on BMI and eating-disorder psychopathology, the magnitude of these differences was quite modest. © 2018 Wiley Periodicals, Inc.

Differential Social Comparison Processes in Women with and without Eating Disorder Symptoms

ERIC Educational Resources Information Center

Corning, Alexandra F.; Krumm, Angela J.; Smitham, Lora A.

2006-01-01

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…

American Indian Adolescents and Disordered Eating

ERIC Educational Resources Information Center

Buser, Juleen K.

2010-01-01

School counselors play an important role in identifying and intervening with students struggling with disordered eating (e.g., Bardick et al., 2004). Research has shown that American Indian adolescents report higher rates of certain disordered eating behaviors than other racial groups. The literature on the prevalence and etiology of disordered…

Psychological Treatment of Eating Disorders

ERIC Educational Resources Information Center

Wilson, G. Terence; Grilo, Carlos M.; Vitousek, Kelly M.

2007-01-01

Significant progress has been achieved in the development and evaluation of evidence-based psychological treatments for eating disorders over the past 25 years. Cognitive behavioral therapy is currently the treatment of choice for bulimia nervosa and binge-eating disorder, and existing evidence supports the use of a specific form of family therapy…

Facebook Use and Disordered Eating in College-Aged Women

PubMed Central

Walker, Morgan; Thornton, Laura; De Choudhury, Munmun; Teevan, Jaime; Bulik, Cynthia M.; Levinson, Cheri A.; Zerwas, Stephanie

2015-01-01

Purpose 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 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. Methods 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. Results 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. Conclusions 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. PMID:26206436

Emotion and eating disorder symptoms in patients with anorexia nervosa: an experimental study.

PubMed

Wildes, Jennifer E; Marcus, Marsha D; Bright, Ashley C; Dapelo, Marcela Marin; Psychol, Magister Clin

2012-11-01

To evaluate the effect of negative emotion on self-reported eating disorder symptoms and objectively-measured eating behavior in patients with anorexia nervosa (AN). Twenty-eight females with AN were randomized to a negative or neutral mood induction followed by a test meal. Participants completed assessments one week before the experimental session, before (pretest) and after (posttest) the mood induction, and after the test meal. Participants in the negative emotion condition had an increase in negative affect from pretest to posttest that was accompanied by significantly greater increases in self-reported eating disorder symptoms than were exhibited by participants in the neutral emotion condition, who had no increase in negative affect. There was no effect of emotion condition on eating behavior. Results suggest that negative emotions influence the expression of cognitive eating disorder symptoms in individuals with AN, which may have implications for the identification of treatment targets. Copyright © 2012 Wiley Periodicals, Inc.

Self-Injurious Behavior and Eating Disorders: The Extent and Nature of the Association

ERIC Educational Resources Information Center

Svirko, Elena; Hawton, Keith

2007-01-01

We have reviewed the literature on the association between self-injurious behaviors (SIB) and eating disorders from the psychological-behavioral perspective. Our aims were to investigate the extent and possible reasons for the association. A literature search was conducted using the following electronic databases (1989-2005): Medline, PsychInfo…

What Cognitive Behavioral Techniques Do Therapists Report Using when Delivering Cognitive Behavioral Therapy for the Eating Disorders?

ERIC Educational Resources Information Center

Waller, Glenn; Stringer, Hannah; Meyer, Caroline

2012-01-01

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…

Evaluation of a theory-driven e-learning intervention for future oral healthcare providers on secondary prevention of disordered eating behaviors.

PubMed

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

2013-06-01

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.

Evaluation of a theory-driven e-learning intervention for future oral healthcare providers on secondary prevention of disordered eating behaviors

PubMed Central

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

2013-01-01

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. PMID:23564725

A pilot study of maudsley family therapy with group dialectical behavior therapy skills training in an intensive outpatient program for adolescent eating disorders.

PubMed

Johnston, Jennifer A Y; O'Gara, Jesine S X; Koman, Stuart L; Baker, Christina Wood; Anderson, Drew A

2015-06-01

The goal of this study was to provide pilot clinical data on the effectiveness of an intensive outpatient treatment model for adolescent eating disorders that combines Maudsley-based family therapy and group dialectical behavior therapy skills training. Measures of physical and psychological status were gathered upon admission, discharge, and at 3 follow-up intervals. Adolescents who completed the program gained a significant amount of weight and experienced a significant decrease in eating disorder psychopathology. At the 1-year follow-up, 64% of adolescents were weight restored and menstruating normally. Measures of eating disorder psychopathology continued to improve up to a year after treatment. This pilot, multimodal program warrants further investigation and may be an effective intermediate level of care treatment option for adolescent eating disorders. © 2015 Wiley Periodicals, Inc.

Eating competence of college students in an introductory nutrition course.

PubMed

Brown, Lora Beth; Larsen, Katrina J; Nyland, Nora K; Eggett, Dennis L

2013-01-01

Describe eating competence, a positive and flexible way of conceptualizing eating attitudes and behaviors, in students enrolled in an introductory nutrition course. Online completion of the Satter Eating Competence Inventory (ecSI) and self-assessment of eating disorder status by 557 students (343 ages 18-20 years and 180 ages 21-26 years; 377 females) at the beginning of 1 semester. Analysis of variance and post hoc Tukey adjusted tests were used. The mean ecSI score was 30.7 ± 0.29; 47.4% were classified as eating competent, or ecSI ≥ 32. Mean ecSI was higher for males than females (29.4 ± 0.95 vs 27.4 ± 0.77; P < .001). Mean ecSI was higher for students who never had an eating disorder, compared with those reporting current (32.0 ± 0.43 vs 22.9 ± 1.91; P < .001) or past (28.8 ± 0.93; P < .01) eating disorders. Students had limited eating competence, but a majority of males were eating competent. Students who had never had an eating disorder had higher eating competence than students with current or past disorders. Examining nutrition courses as currently taught may reveal ways courses could contribute to eating competence. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Web-Based Cognitive Behavioral Therapy for Female Patients With Eating Disorders: Randomized Controlled Trial.

PubMed

ter Huurne, Elke D; de Haan, Hein A; Postel, Marloes G; van der Palen, Job; VanDerNagel, Joanne E L; DeJong, Cornelis A J

2015-06-18

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, P<.001, d=.82) and all secondary outcome measures (effect sizes between d=.34 to d=.49), except for Body Mass Index. WL participants also improved on most outcomes; however, effects were smaller in this group with significant between-group effects for eating disorder psychopathology (F201=9.42, P=.002, d=.44), body dissatisfaction (F201=13.16, P<.001, d=.42), physical health (F200=12.55, P<.001, d=.28), mental health (F203=4.88, P=.028, d=.24), self-esteem (F202=5.06, P=.026, d=.20), and social functioning (F205=7.93, P=.005, d=.29). Analyses for the individual subgroups BN, BED, and EDNOS showed that eating disorder psychopathology improved significantly over time among Web-based CBT participants in all three subgroups; however, the between-group effect was significant only for participants with BED (F78=4.25, P=.043, d=.61). Web-based CBT proved to be effective in improving eating disorder psychopathology and related health among female patients with eating disorders. Nederlands Trial Register (NTR): NTR2415; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2415 (Archived by WebCite at http://www.webcitation.org/6T2io3DnJ).

Web-Based Cognitive Behavioral Therapy for Female Patients With Eating Disorders: Randomized Controlled Trial

PubMed Central

de Haan, Hein A; Postel, Marloes G; van der Palen, Job; VanDerNagel, Joanne EL; DeJong, Cornelis AJ

2015-01-01

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 (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. Methods 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. Results 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 (F 97=63.07, P<.001, d=.82) and all secondary outcome measures (effect sizes between d=.34 to d=.49), except for Body Mass Index. WL participants also improved on most outcomes; however, effects were smaller in this group with significant between-group effects for eating disorder psychopathology (F 201=9.42, P=.002, d=.44), body dissatisfaction (F 201=13.16, P<.001, d=.42), physical health (F 200=12.55, P<.001, d=.28), mental health (F 203=4.88, P=.028, d=.24), self-esteem (F 202=5.06, P=.026, d=.20), and social functioning (F 205=7.93, P=.005, d=.29). Analyses for the individual subgroups BN, BED, and EDNOS showed that eating disorder psychopathology improved significantly over time among Web-based CBT participants in all three subgroups; however, the between-group effect was significant only for participants with BED (F 78=4.25, P=.043, d=.61). Conclusions Web-based CBT proved to be effective in improving eating disorder psychopathology and related health among female patients with eating disorders. Trial Registration Nederlands Trial Register (NTR): NTR2415; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2415 (Archived by WebCite at http://www.webcitation.org/6T2io3DnJ). PMID:26088580

Maladaptive eating behavior assessment among bariatric surgery candidates: Evaluation of the Eating Disorder Diagnostic Scale.

PubMed

Williams, Gail A; Hawkins, Misty A W; Duncan, Jennifer; Rummell, Christina M; Perkins, Shannon; Crowther, Janis H

2017-07-01

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 Surgery. Published by Elsevier Inc. All rights reserved.

Temperament and risk for exercise dependence: results of a pilot study in female patients with eating disorders compared to elite athletes.

PubMed

Müller, Astrid; Claes, Laurence; Wos, Katharina; Kerling, Arno; Wünsch-Leiteritz, Wally; Cook, Brian; de Zwaan, Martina

2015-01-01

The present pilot study investigated the relationship between temperament and the risk for exercise dependence (EXD). A total of 32 female patients with eating disorders (potentially at risk for secondary EXD) and 29 female elite athletes without eating disturbances (potentially at risk for primary EXD) answered the Eating Disorder Examination-Questionnaire (EDE-Q), the Exercise Dependence Scale-German version (EDS-G), the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scales, and the effortful control subscale of the Adult Temperament Questionnaire (ATQ-EC). There were significant positive correlations of the EDS-G with the BIS in women with an eating disorder and with the BAS in elite athletes. No significant association was found between the EDS-G and effortful control. The results indicate that the risk for EXD is associated with avoidance tendencies in women with eating disorders and with approach tendencies in elite athletes. Implications for secondary and primary EXD are discussed. © 2015 S. Karger AG, Basel.

Examining social physique anxiety and disordered eating in college women. The roles of social comparison and body surveillance.

PubMed

Fitzsimmons-Craft, Ellen E; Harney, Megan B; Brownstone, Lisa M; Higgins, M K; Bardone-Cone, Anna M

2012-12-01

Social physique anxiety has been found to be associated with disordered eating. However, what is not yet known is what behaviors college women may engage in that strengthen this relation. In the current study, we examined two possible moderating factors, social comparison and body surveillance. We examined whether these moderators might also generalize to trait anxiety, as well. Participants were 265 women attending a Southeastern university. Social comparison (both general and appearance-related) and body surveillance were tested as moderators of the relation between social physique anxiety and disordered eating. Results indicated that general social comparison, appearance-related social comparison, and body surveillance significantly moderated this relation. Individuals who were high in social physique anxiety and who reported high levels of general or appearance-related social comparison or body surveillance reported much higher levels of disordered eating than those with high social physique anxiety and low levels of these behaviors. Results indicated that only the trait anxiety×body surveillance interaction was significant in identifying elevated disordered eating. Results provide information regarding who may experience high levels of disordered eating in association with social physique anxiety, which has clinical implications including the conceptualization of social comparison and body surveillance as safety behaviors. Copyright © 2012 Elsevier Ltd. All rights reserved.

Desire to Be Underweight: Exploratory Study on a Weight Loss App Community and User Perceptions of the Impact on Disordered Eating Behaviors

PubMed Central

Reddy, Madhu C; Booth, Kayla M; Kvasny, Lynette; Blair, Johnna L; Li, Victor; Poole, Erika S

2017-01-01

Background Mobile health (mHealth) apps for weight loss (weight loss apps) can be useful diet and exercise tools for individuals in need of losing weight. Most studies view weight loss app users as these types of individuals, but not all users have the same needs. In fact, users with disordered eating behaviors who desire to be underweight are also utilizing weight loss apps; however, few studies give a sense of the prevalence of these users in weight loss app communities and their perceptions of weight loss apps in relation to disordered eating behaviors. Objective The aim of this study was to provide an analysis of users’ body mass indices (BMIs) in a weight loss app community and examples of how users with underweight BMI goals perceive the impact of the app on disordered eating behaviors. Methods We focused on two aspects of a weight loss app (DropPounds): profile data and forum posts, and we moved from a broader picture of the community to a narrower focus on users’ perceptions. We analyzed profile data to better understand the goal BMIs of all users, highlighting the prevalence of users with underweight BMI goals. Then we explored how users with a desire to be underweight discussed the weight loss app’s impact on disordered eating behaviors. Results We found three main results: (1) no user (regardless of start BMI) starts with a weight gain goal, and most users want to lose weight; (2) 6.78% (1261/18,601) of the community want to be underweight, and most identify as female; (3) users with underweight BMI goals tend to view the app as positive, especially for reducing bingeing; however, some acknowledge its role in exacerbating disordered eating behaviors. Conclusions These findings are important for our understanding of the different types of users who utilize weight loss apps, the perceptions of weight loss apps related to disordered eating, and how weight loss apps may impact users with a desire to be underweight. Whereas these users had underweight goals, they often view the app as helpful in reducing disordered eating behaviors, which led to additional questions. Therefore, future research is needed. PMID:29025694

Current and Emerging Drug Treatments for Binge Eating Disorder

PubMed Central

Reas, Deborah L.; Grilo, Carlos M.

2014-01-01

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

Psychological Treatments for Binge Eating Disorder

PubMed Central

Gredysa, Dana M.; Altman, Myra; Wilfley, Denise E.

2012-01-01

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

Differential criteria for binge eating disorder and food addiction in the context of causes and treatment of obesity.

PubMed

Bąk-Sosnowska, Monika

2017-04-30

To establish the differential criteria for Binge Eating Disorder (BED) and Food Addiction (FA). We performed a detailed analysis of comparative diagnostic criteria for BED and Substance use disorder contained in the Diagnostic and Statistical Manual of Mental Disorders DSM-V. We applied the diagnostic criteria for both disorders to scientific publications on the issue of excessive eating in obese people, during the years 2005-2016, available on PubMed. We isolated specific similarities and differences between Binge Eating Disorder and Food Addiction. We formulated differential criteria for BED and FA. In BED as well as FA the following characteristics are apparent: preoccupation with food, excessive eating, loss of control over the amount of food and manner of eating, inability to change behavior, continuing behavior despite negative consequences, increased impulsiveness and emotional imbalance. Differences between BED and FA relate to the function of food, reaction to omitted food, psychological mechanisms of coping with excessive eating and body image, the issue of tolerance, withdrawal syndrome and the correlation between excessive eating and other areas of life. The criteria of differentiation between BED and FA concern the following: function of food, eating circumstances, reaction to the unavailability of food, awareness of the problem. Appropriate diagnosis of these disorders and their differentiation increases the chances of adequate treatment of obese patients.

Cognitive deficits in obese persons with and without binge eating disorder. Investigation using a mental flexibility task.

PubMed

Mobbs, Olivia; Iglesias, Katia; Golay, Alain; Van der Linden, Martial

2011-08-01

Studies suggest that cognitive deficits and attentional biases play a role in the development and maintenance of obesity and eating disorders. In this study, we simultaneously examine attentional biases, as well as inhibitory control and mental flexibility, which are keys to controlling unwanted behaviors and thoughts in obese patients with and without binge eating disorder. 16 obese patients with binge eating disorder and 16 patients without binge eating disorder were compared with 16 normal-weight controls on a "food/body-mental flexibility task", which allows the investigation of inhibitory control, mental flexibility and attention for stimuli related to the body and food. All obese patients made significantly more errors (i.e., pressing a key when a distracter displayed) and more omissions (i.e., not pressing a key when a target displayed) than controls in both food and body sections of the task. Obese participants with binge eating disorder made significantly more errors and omissions than those without binge eating disorder. No difference between groups was found concerning mental flexibility and cognitive biases for food- and body-related targets. These results suggest that obese patients have a general inhibition problem and difficulty focusing attention, which do not depend on the types of stimuli processed. The results also suggest that these cognitive deficits are more severe in obese patients with binge eating disorder, which indicates that there is a continuum of increasing inhibition and cognitive problems with increasingly disordered eating. These cognitive deficits may contribute to problematic eating behaviors. Copyright © 2011 Elsevier Ltd. All rights reserved.

Dysregulation of Brain Reward Systems in Eating Disorders: Neurochemical Information from Animal Models of Binge Eating, Bulimia Nervosa, and Anorexia Nervosa

PubMed Central

Avena, Nicole M.; Bocarsly, Miriam E.

2012-01-01

Food intake is mediated, in part, through brain pathways for motivation and reinforcement. Dysregulation of these pathways may underlay some of the behaviors exhibited by patients with eating disorders. Research using animal models of eating disorders has greatly contributed to the detailed study of potential brain mechanisms that many underlie the causes or consequences of aberrant eating behaviors. This review focuses on neurochemical evidence of reward-related brain dysfunctions obtained through animal models of binge eating, bulimia nervosa, or anorexia nervosa. The findings suggest that alterations in dopamine (DA), acetylcholine (ACh) and opioid systems in reward-related brain areas occur in response to binge eating of palatable foods. Moreover, animal models of bulimia nervosa suggest that while bingeing on palatable food releases DA, purging attenuates the release of ACh that might otherwise signal satiety. Animal models of anorexia nervosa suggest that restricted access to food enhances the reinforcing effects of DA when the animal does eat. The activity-based anorexia model suggests alterations in mesolimbic DA and serotonin occur as a result of starvation coupled with excessive wheel running. These findings with animal models complement data obtained through neuroimaging and pharmacotherapy studies of clinical populations. Finally, information on the neurochemical consequences of the behaviors associated with these eating disorders will be useful in understanding these complex disorders and may inform future therapeutic approaches, as discussed here. PMID:22138162

[Consensus document about the nutritional evaluation and management of eating disorders: bulimia nervosa, binge eating disorder, and others].

PubMed

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

2018-03-07

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.

Randomized Controlled Trial of an Internet-Based Cognitive-Behavioral Treatment Program for Binge-Eating Disorder.

PubMed

Wagner, Birgit; Nagl, Michaela; Dölemeyer, Ruth; Klinitzke, Grit; Steinig, Jana; Hilbert, Anja; Kersting, Anette

2016-07-01

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.

Relationship between Parental Attachment and Eating Disorders in an Inpatient and a College Sample.

ERIC Educational Resources Information Center

Kenny, Maureen E.; Hart, Kathleen

1992-01-01

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)

A Qualitative Investigation of the Relationship between Consumption, Physical Activity, Eating Disorders, and Weight Consciousness

ERIC Educational Resources Information Center

Piazza-Gardner, Anna K.; Barry, Adam E.

2014-01-01

Background: Previous research has identified a positive relationship between alcohol consumption and disordered eating, alcohol consumption and physical activity, and physical activity and disordered eating. However, there is a paucity of published research examining the interrelatedness of all 3 behaviors together. Purpose: This study examines…

A Description of Disordered Eating Behaviors in Latino Males

ERIC Educational Resources Information Center

Reyes-Rodriguez, Mae Lynn; Sala, Margarita; Von Holle, Ann; Unikel, Claudia; Bulik, Cynthia M.; Camara-Fuentes, Luis; Suarez-Torres, Alba

2011-01-01

Objective: To explore disordered eating and eating disorders (EDs) in Latino males. Participants: Participants are 722 male college students from a larger prevalence study conducted in the University of Puerto Rico system. Methods: Participants were selected from a list of sections of required courses for first-year students on each campus.…

Puberty and the Manifestations of Loss of Control Eating in Children and Adolescents

PubMed Central

Vannucci, Anna; Tanofsky-Kraff, Marian; Ranzenhofer, Lisa M.; Kelly, Nichole R.; Hannallah, Louise M.; Pickworth, C. Katherine; Grygorenko, Mariya V.; Brady, Sheila M.; Condarco, Tania A.; Kozlosky, Merel; Demidowich, Andrew P.; Yanovski, Susan Z.; Shomaker, Lauren B.; Yanovski, Jack A.

2014-01-01

Objective We investigated the manifestations of pediatric loss of control (LOC) eating at different stages of pubertal development. Methods Participants were a non-clinical sample of 468 youth (8–17y). Physical examination determined pubertal stage. LOC eating and disordered eating attitudes were assessed with the Eating Disorder Examination. In a randomized crossover design, a subset (n=244) ate ad libitum from two test meals designed to capture normal and LOC eating. Results There were no differences in the prevalence rates or frequency of reported LOC eating episodes across pubertal stages (ps≥.50). There were, however, puberty by LOC eating interactions in disordered eating attitudes and palatable food consumption (ps≤.05), even after adjusting for age and body composition. LOC eating was associated with elevated global disordered eating attitudes, weight concern, and shape concern in post-pubertal youth (ps≤.001), but not pre-pubertal youth (ps≥.49). In late-puberty, youth with LOC eating consumed less energy from protein (p<.001) and more from carbohydrate (p=.003) and snack-type foods (p=.02) than those without LOC eating, whereas endorsement of LOC eating in pre- or early-to-mid-puberty was not associated with differences in eating behavior (ps≥.20). Conclusions Findings suggest that puberty may be a critical risk period, when LOC eating behaviors in boys and girls may become accompanied by greater weight and shape concerns and more obesogenic food consumption patterns. Interventions for LOC eating during pre-puberty should be evaluated to determine if they are particularly beneficial for the prevention of exacerbated eating disorder psychopathology and adverse weight outcomes. PMID:24888295

Differences in Emotion Regulation Difficulties Across Types of Eating Disorders During Adolescence.

PubMed

Weinbach, Noam; Sher, Helene; Bohon, Cara

2017-11-04

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.

Is there evidence that religion is a risk factor for eating disorders?

PubMed

Abraham, N K; Birmingham, C L

2008-12-01

Is there evidence that religion is a risk factor for eating disorders? A literature search was performed to examine whether there is an association between religion and eating disorders. There were some cross-sectional studies, case studies, and anthropological commentaries reporting eating disorders in various cultures and religions. Religious affiliation was usually reported as an incidental finding but not analyzed. A number of prevalence studies were reported from Islamic communities. This raises the possibility that young Muslim women have a higher prevalence of elevated EAT scores compared to non-Islamic women. This literature search raises the possibility that there is an association between Islamic affiliation and positive screening for eating disorder behaviors. This supports the hypothesis that the effect of culture on eating disorders may be religious as well as secular. Carefully designed studies of the prevalence of eating disorders in multicultural populations with multiple religious affiliations may help further clarify the relationship between religion and eating disorders.

Breaking the Silence: Disordered Eating and Big Five Traits in College Men.

PubMed

Dubovi, Abigail S; Li, Yue; Martin, Jessica L

2016-11-01

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.

Examining affect and perfectionism in relation to eating disorder symptoms among women with anorexia nervosa.

PubMed

Lavender, Jason M; Mason, Tyler B; Utzinger, Linsey M; Wonderlich, Stephen A; Crosby, Ross D; Engel, Scott G; Mitchell, James E; Le Grange, Daniel; Crow, Scott J; Peterson, Carol B

2016-07-30

This study examined personality and affective variables in relation to eating disorder symptoms in anorexia nervosa (AN). Women (N=118) with DSM-IV AN completed baseline questionnaires (Beck Depression Inventory, Frost Multidimensional Perfectionism Scale) and interviews (Eating Disorder Examination, Yale-Brown-Cornell Eating Disorder Scale), followed by two weeks of ecological momentary assessment (EMA) involving multiple daily reports of affective states and eating disorder behaviors. Hierarchical regression analyses were conducted using eating disorder symptoms as dependent variables (i.e., EMA binge eating, EMA self-induced vomiting, eating disorder rituals, eating disorder preoccupations, dietary restraint). Predictor variables were maladaptive perfectionism (baseline), depressive symptoms (baseline), and affect lability (EMA). Results revealed that affect lability was independently associated with binge eating, whereas depressive symptoms were independently associated with self-induced vomiting. Depressive symptoms were independently associated with eating disorder rituals, whereas both depressive symptoms and maladaptive perfectionism were independently associated with eating disorder preoccupations. Finally, maladaptive perfectionism and affect lability were both independently associated with dietary restraint. This pattern of findings suggests the importance of affective and personality constructs in relation to eating disorder symptoms in AN and may highlight the importance of targeting these variables in the context of treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Prevalence of abnormal eating behaviors in adolescents in Mexico: Mexican National Health and Nutrition Survey 2006.

PubMed

Barriguete-Meléndez, Jorge Armando; Unikel-Santoncini, Claudia; Aguilar-Salinas, Carlos; Córdoba-Villalobos, José Angel; Shamah, Teresa; Barquera, Simón; Rivera, Juan A; Hernández-Avila, Mauricio

2009-01-01

To describe the prevalence of abnormal eating behaviors in a population-based nationwide survey. A stratified, probabilistic, multistage design sampling process was used. The Brief Questionnaire for Risky Eating Behaviors was included in the Mexican Health and Nutrition Survey 2006 (ENSANUT 2006) and administered to participants 10-19 years old (n= 25 166). The study had the power to describe nationwide characteristics by age, regions and urban/rural settings. A high risk for having an eating disorder was found in 0.8% of the total participants (0.4% male adolescents and 1.0% female). Inhabitants in large cities showed higher risk for having an abnormal eating behavior compared to subjects living in other settings. The highest prevalences were found in males > 15 years old and females > 13 years old for all evaluated behaviors. Results show less prevalence of risky eating behaviors among adolescents in comparison to other populations. The female/male ratio was 3:1, far different from the 9:1 shown in a previous study in Mexico City, but similar to results from the US national eating disorders screening.

Dysregulation of brain reward systems in eating disorders: neurochemical information from animal models of binge eating, bulimia nervosa, and anorexia nervosa.

PubMed

Avena, Nicole M; Bocarsly, Miriam E

2012-07-01

Food intake is mediated, in part, through brain pathways for motivation and reinforcement. Dysregulation of these pathways may underlay some of the behaviors exhibited by patients with eating disorders. Research using animal models of eating disorders has greatly contributed to the detailed study of potential brain mechanisms that many underlie the causes or consequences of aberrant eating behaviors. This review focuses on neurochemical evidence of reward-related brain dysfunctions obtained through animal models of binge eating, bulimia nervosa, or anorexia nervosa. The findings suggest that alterations in dopamine (DA), acetylcholine (ACh) and opioid systems in reward-related brain areas occur in response to binge eating of palatable foods. Moreover, animal models of bulimia nervosa suggest that while bingeing on palatable food releases DA, purging attenuates the release of ACh that might otherwise signal satiety. Animal models of anorexia nervosa suggest that restricted access to food enhances the reinforcing effects of DA when the animal does eat. The activity-based anorexia model suggests alterations in mesolimbic DA and serotonin occur as a result of restricted eating coupled with excessive wheel running. These findings with animal models complement data obtained through neuroimaging and pharmacotherapy studies of clinical populations. Information on the neurochemical consequences of the behaviors associated with these eating disorders will be useful in understanding these complex disorders and may inform future therapeutic approaches, as discussed here. This article is part of a Special Issue entitled 'Central Control of Food Intake'. Copyright © 2011 Elsevier Ltd. All rights reserved.

Weight Perception, Substance Use, and Disordered Eating Behaviors: Comparing Normal Weight and Overweight High-School Students

ERIC Educational Resources Information Center

Eichen, Dawn M.; Conner, Bradley T.; Daly, Brian P.; Fauber, Robert L.

2012-01-01

Disordered eating behaviors and substance use are two risk factors for the development of serious psychopathology and health concerns in adulthood. Despite the negative outcomes associated with these risky behaviors, few studies have examined potential associations between these risk factors as they occur during adolescence. The importance of…

Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial.

PubMed

ter Huurne, Elke D; Postel, Marloes G; de Haan, Hein A; DeJong, Cor A J

2013-11-16

Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet has great potential to offer such interventions. The aim of this study is to determine whether a web-based treatment program for patients with eating disorders can improve eating disorder psychopathology among female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. This randomized controlled trial will compare the outcomes of an experimental treatment group to a waiting list control group. In the web-based treatment program, participants will communicate personally and asynchronously with their therapists exclusively via the internet. The first part of the program will focus on analyzing eating attitudes and behaviors. In the second part of the program participants will learn how to change their attitudes and behaviors. Participants assigned to the waiting list control group will receive no-reply email messages once every two weeks during the waiting period of 15 weeks, after which they can start the program. The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire. Secondary outcomes include improvements in body image, physical and mental health, body weight, self-esteem, quality of life, and social contacts. In addition, the participants' motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured. The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs. This study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. The protocol for this study is registered with the Netherlands Trial Registry NTR2415.

Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial

PubMed Central

2013-01-01

Background Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet has great potential to offer such interventions. The aim of this study is to determine whether a web-based treatment program for patients with eating disorders can improve eating disorder psychopathology among female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. Methods/design This randomized controlled trial will compare the outcomes of an experimental treatment group to a waiting list control group. In the web-based treatment program, participants will communicate personally and asynchronously with their therapists exclusively via the internet. The first part of the program will focus on analyzing eating attitudes and behaviors. In the second part of the program participants will learn how to change their attitudes and behaviors. Participants assigned to the waiting list control group will receive no-reply email messages once every two weeks during the waiting period of 15 weeks, after which they can start the program. The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire. Secondary outcomes include improvements in body image, physical and mental health, body weight, self-esteem, quality of life, and social contacts. In addition, the participants’ motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured. The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs. Discussion This study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. Trial registration The protocol for this study is registered with the Netherlands Trial Registry NTR2415. PMID:24238630

Vulnerability to exercise addiction, socio-demographic, behavioral and psychological characteristics of runners at risk for eating disorders.

PubMed

Di Lodovico, Laura; Dubertret, Caroline; Ameller, Aurely

2018-02-01

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.

The Development of Eating Behavior - Biology and Context

PubMed Central

Gahagan, Sheila

2012-01-01

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

Eating attitudes of anorexia nervosa, bulimia nervosa, binge eating disorder and obesity without eating disorder female patients: differences and similarities.

PubMed

Alvarenga, M S; Koritar, P; Pisciolaro, F; Mancini, M; Cordás, T A; Scagliusi, F B

2014-05-28

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 (p<0.001). For DEAS total score, AN and BN patients were similar and all other were different (p<0.001). Similarities suggested between BN and BED were true just for the "Relationship with food" and "Idea of normal eating." 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.

Emerging Treatments in Eating Disorders.

PubMed

Lutter, Michael

2017-07-01

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.

Eating Patterns and Disorders in a College Population: Are College Women's Eating Problems a New Phenomenon?

ERIC Educational Resources Information Center

Hesse-Biber, Sharlene

1989-01-01

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…

Neuromodulation for the treatment of eating disorders and obesity

PubMed Central

Lee, Darrin J.; Elias, Gavin J.B.; Lozano, Andres M.

2017-01-01

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

Energy Drinks, Weight Loss, and Disordered Eating Behaviors

ERIC Educational Resources Information Center

Jeffers, Amy J.; Vatalaro Hill, Katherine E.; Benotsch, Eric G.

2014-01-01

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…

Positive and negative eating expectancies in disordered eating among women and men.

PubMed

Hayaki, Jumi; Free, Sarah

2016-08-01

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.

Dimensions of Compulsive Exercise across Eating Disorder Diagnostic Subtypes and the Validation of the Spanish Version of the Compulsive Exercise Test.

PubMed

Sauchelli, Sarah; Arcelus, Jon; Granero, Roser; Jiménez-Murcia, Susana; Agüera, Zaida; Del Pino-Gutiérrez, Amparo; Fernández-Aranda, Fernando

2016-01-01

Objectives: Compulsive exercise in eating disorders has been traditionally considered as a behavior that serves the purpose of weight/shape control. More recently, it has been postulated that there may be other factors that drive the compulsive need to exercise. This has led to the development of the Compulsive Exercise Test (CET); a self-reported questionnaire that aims to explore the cognitive-behavioral underpinnings of compulsive exercise from a multi-faceted perspective. The objectives of this study were threefold: (1) to validate the Spanish version of the CET; (2) to compare eating disorder diagnostic subtypes and a healthy control group in terms of the factors that drive compulsive exercise as defined by the CET; (3) to explore how the dimensions evaluated in the CET are associated with eating disorder symptoms and general psychopathology. Methods: The CET was administered to a total of 157 patients with an eating disorder [40 anorexia nervosa, 56 bulimia nervosa (BN), and 61 eating disorder not-otherwise-specified (EDNOS)] and 128 healthy weight/eating controls. Patients were assessed via a semi-structured interview to reach a DSM-IV-TR diagnosis. Additionally, all participants completed the Symptom Checklist-90-Revised (SCL-90R) and the Eating Disorders Inventory-2 (EDI-2). Results: Confirmatory factor analysis demonstrated adequate goodness-of-fit to the original five-factor model of the CET. BN and EDNOS patients scored higher in the avoidance and rule-driven behavior, weight control, and total CET scales in comparison to the healthy controls, and higher across all scales apart from the exercise rigidity scale compared to the anorexia nervosa patients. Mean scores of the anorexia nervosa patients did not differ to those of the control participants, except for the mood improvement scale where the anorexia nervosa patients obtained a lower mean score. Mean scores between the BN and EDNOS patients were equivalent. The CET scales avoidance and rule-driven behavior, weight of control and total CET scores were positively correlated with the clinical assessment measures of the SCL-90R and EDI-2. Conclusion: Compulsive exercise is a multidimensional construct and the factors driving compulsive exercise differ according to the eating disorder diagnostic subtype. This should be taken into account when addressing compulsive exercise during the treatment of eating disorders.

Dimensions of Compulsive Exercise across Eating Disorder Diagnostic Subtypes and the Validation of the Spanish Version of the Compulsive Exercise Test

PubMed Central

Sauchelli, Sarah; Arcelus, Jon; Granero, Roser; Jiménez-Murcia, Susana; Agüera, Zaida; Del Pino-Gutiérrez, Amparo; Fernández-Aranda, Fernando

2016-01-01

Objectives: Compulsive exercise in eating disorders has been traditionally considered as a behavior that serves the purpose of weight/shape control. More recently, it has been postulated that there may be other factors that drive the compulsive need to exercise. This has led to the development of the Compulsive Exercise Test (CET); a self-reported questionnaire that aims to explore the cognitive-behavioral underpinnings of compulsive exercise from a multi-faceted perspective. The objectives of this study were threefold: (1) to validate the Spanish version of the CET; (2) to compare eating disorder diagnostic subtypes and a healthy control group in terms of the factors that drive compulsive exercise as defined by the CET; (3) to explore how the dimensions evaluated in the CET are associated with eating disorder symptoms and general psychopathology. Methods: The CET was administered to a total of 157 patients with an eating disorder [40 anorexia nervosa, 56 bulimia nervosa (BN), and 61 eating disorder not-otherwise-specified (EDNOS)] and 128 healthy weight/eating controls. Patients were assessed via a semi-structured interview to reach a DSM-IV-TR diagnosis. Additionally, all participants completed the Symptom Checklist-90-Revised (SCL-90R) and the Eating Disorders Inventory-2 (EDI-2). Results: Confirmatory factor analysis demonstrated adequate goodness-of-fit to the original five-factor model of the CET. BN and EDNOS patients scored higher in the avoidance and rule-driven behavior, weight control, and total CET scales in comparison to the healthy controls, and higher across all scales apart from the exercise rigidity scale compared to the anorexia nervosa patients. Mean scores of the anorexia nervosa patients did not differ to those of the control participants, except for the mood improvement scale where the anorexia nervosa patients obtained a lower mean score. Mean scores between the BN and EDNOS patients were equivalent. The CET scales avoidance and rule-driven behavior, weight of control and total CET scores were positively correlated with the clinical assessment measures of the SCL-90R and EDI-2. Conclusion: Compulsive exercise is a multidimensional construct and the factors driving compulsive exercise differ according to the eating disorder diagnostic subtype. This should be taken into account when addressing compulsive exercise during the treatment of eating disorders. PMID:27933021

Parents of children with eating disorders: developing theory-based health communication messages to promote caregiver well-being.

PubMed

Patel, Sheetal; Shafer, Autumn; Brown, Jane; Bulik, Cynthia; Zucker, Nancy

2014-01-01

Parents of children with eating disorders experience extreme emotional burden because of the intensity and duration of the recovery process. While parental involvement in a child's eating disorder treatment improves outcomes, parents often neglect their own well-being, which can impede their child's recovery. This study extends the research on caregivers and on health theory in practice by conducting formative research to develop a theory-based communication intervention encouraging parents to engage in adaptive coping and self-care behaviors. The Transactional Model of Stress and Coping and the Transtheoretical Model guided qualitative assessments of the determinants of parents' coping behaviors. Three focus groups with 19 parents of children with eating disorders and 19 semi-structured interviews with experts specializing in eating disorders were conducted. Findings indicate that parents and experts see parents' need for permission to take time for themselves as the main barrier to self-care. The main motivator for parents to engage in coping behaviors is awareness of a connection between self-care and their child's health outcomes. Participant evaluation of six potential messages for main themes and effectiveness revealed that theory-based elements, such as certain processes of change within the Transtheoretical Model, were important to changing health behavior.

Suboptimal Weight Loss and Weight Regain after Gastric Bypass Surgery-Postoperative Status of Energy Intake, Eating Behavior, Physical Activity, and Psychometrics.

PubMed

Amundsen, Tina; Strømmen, Magnus; Martins, Catia

2017-05-01

Suboptimal weight loss (SWL) and weight regain (WR) after gastric bypass surgery (GB) remains poorly understood. This study aims to compare GB patients experiencing SWL or significant WR (SigWR) with successful controls, regarding postoperative food intake, eating behavior, physical activity (PA), and psychometrics. Forty-nine patients with >1 year post-surgery were classified as either experiencing SWL (excess body weight loss, EWL, <50%, n = 22) or SigWR (total weight regain ≥15%, n = 38), with respective control groups. Energy intake (EI) was measured with a Food Frequency Questionnaire, eating behavior using the Dutch Eating Behavior Questionnaire and the Three-Factor Eating Questionnaire, and PA using both SenseWear Armbands and the International Physical Activity Questionnaire. Eating disorders, depression, and quality of life (QoL) were measured using the Eating Disorder Examination Questionnaire, Beck Depression Inventory II, and Impact of Weight on Quality of Life, respectively. EI, macronutrient distribution, and meal frequency were similar among groups. However, disinhibited eating behavior score was higher, while most subcategories from IWQOL were significantly lower in both SWL and SigWR groups compared with their respective controls. PA was significantly lower in the SWL and SigWR groups compared with the respective controls. There were no differences between groups regarding depression. Lower PA levels, disordered eating behavior and lower QoL are associated with unsuccessful weigh loss outcome after GB surgery. Longitudinal studies are needed to clarify the potential causal relationship between the previously described variables and SWL/SigWR after GB.

The BASC-2 Profiles of Female Adolescents At-Risk of Developing an Eating Disorder

ERIC Educational Resources Information Center

Stachowitz, Annie L.

2012-01-01

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…

Psychosocial Correlates of Disordered Eating in Female Collegiate Athletes: Validation of the Athlete Questionnaire

ERIC Educational Resources Information Center

Hinton, Pamela S.; Kubas, Karen L.

2005-01-01

Female athletes may be at greater risk for disordered eating than their nonathletic peers, but the psychological antecedents of this dysfunctional behavior in athletes have yet to be elucidated. The objective of this study was to develop an athletics-oriented measure of psychological predictors of disordered eating and to test its initial…

Policy Actions to Address Weight-Based Bullying and Eating Disorders in Schools: Views of Teachers and School Administrators

ERIC Educational Resources Information Center

Puhl, Rebecca M.; Neumark-Sztainer, Dianne; Bryn Austin, S.; Suh, Young; Wakefield, Dorothy B.

2016-01-01

Background: Weight-related bullying is prevalent among youth and associated with adverse health consequences, including increased risk for body dissatisfaction and disordered eating behaviors, which are risk factors for eating disorders. Although concerns about these problems have stimulated calls for broader intervention efforts in schools,…

Eating Disorder Behaviors, Strength of Faith, and Values in Late Adolescents and Emerging Adults: An Exploration of Associations

ERIC Educational Resources Information Center

King, Stephanie L.

2012-01-01

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…

The impact of exposure to images of ideally thin models in TV commercials on eating behavior: an experimental study with women diagnosed with bulimia nervosa.

PubMed

Rühl, Ilka; Legenbauer, Tanja; Hiller, Wolfgang

2011-09-01

This study investigates whether eating behavior in women with diagnosed bulimia nervosa is influenced by prior exposure to images of ideally thin models. Twenty-six participants diagnosed with bulimia nervosa (BN) and 30 normal controls (NC) were exposed to body-related and neutral TV commercials; then food that typically triggers binge eating was provided, and the amount of food eaten was measured. No significant difference for food intake between NC and BN could be found, but food intake for BN was predicted by the degree of thoughts related to eating behaviors during exposure to the thin ideal. No impact of general body image or eating pathology on food intake could be found. The results emphasize the importance of action-relevance of dysfunctional cognitions for the maintenance of eating-disordered behaviors in women with bulimia nervosa, when exposed to eating-disorder-specific triggers. Copyright © 2011 Elsevier Ltd. All rights reserved.

Personality, emotion-related variables, and media pressure predict eating disorders via disordered eating in Lebanese university students.

PubMed

Sanchez-Ruiz, Maria Jose; El-Jor, Claire; Abi Kharma, Joelle; Bassil, Maya; Zeeni, Nadine

2017-04-18

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.

Prader–Willi Syndrome: Genetics and Behavior

PubMed Central

Thompson, Travis; Butler, Merlin G.; MacLean, William E.; Joseph, Beth

2016-01-01

Since its inception, the John F. Kennedy Center has attempted to overcome developmental problems, which create restrictive barriers to the participation of individuals with specific disabilities in our broader society. Some of Nicholas Hobbs’s earliest efforts involved developing strategies for preventing children’s emotional and behavior problems, which interfered with their later full participation in society. Other investigators in the Kennedy Center explored ways of reducing dysfunctional repetitive movement problems and self-injury commonly associated with autism and severe mental retardation. We have become concerned about a group of people who have the potential to live largely independently (or semi-independently), to work at meaningful jobs in the community, and to make full use of the same recreational and leisure opportunities as other members of society but who are prevented from doing so because of a life-threatening behavior problem. Prader–Willi syndrome (PWS) is a genetic developmental disability characterized by a group of specific behavioral features of which an insatiable appetite is the most striking. PWS is the most commonly known genetic cause of obesity. The eating disorder associated with PWS can be so severe as to be life threatening, including eating to the point of stomach rupture and death. Though a cluster of commonly covarying clinical features are exhibited by people with this syndrome, only the eating disorder is common to all affected individuals. PWS shares behavioral features with other disorders and disabilities, such as obsessive compulsive disorder and autism, but only PWS includes the unique combination of characteristics that distinguish this syndrome. Because eating disorders such as bulimia and anorexia nervosa also share features with PWS, any light that could be shed on the causes and treatment of the eating disorder in PWS could potentially have far-reaching implications for other eating disorders as well. In this article, we review the behavioral, cognitive, and other psychological features of PWS and explore their relationships to known genetic mechanisms. PMID:27594721

Observed Family Interactions among Subtypes of Eating Disorders Using Structural Analysis of Social Behavior.

ERIC Educational Resources Information Center

Humphrey, Laura Lynn

1989-01-01

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…

Designing the user interfaces of a behavior modification intervention for obesity & eating disorders prevention.

PubMed

Moulos, Ioannis; Maramis, Christos; Mourouzis, Alexandros; Maglaveras, Nicos

2015-01-01

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.

Attachment and eating: A meta-analytic review of the relevance of attachment for unhealthy and healthy eating behaviors in the general population.

PubMed

Faber, Aida; Dubé, Laurette; Knäuper, Bärbel

2018-04-01

Attachment relationships play an important role in people's wellbeing and affliction with physical and mental illnesses, including eating disorders. Seven reviews from the clinical field have consistently shown that higher attachment insecurity-failure to form trusting and reliable relationships with others-systematically characterized individuals with eating disorders. Nevertheless, to date, it is unclear whether (and if so how) these findings apply to the population at large. Consequently, the objective of the present meta-analysis is to quantify the relationship between attachment and unhealthy and healthy eating in the general population. Data from 70 studies and 19,470 participants were converted into r effect sizes and analysed. Results showed that higher attachment insecurity (r = 0.266), anxiety (r = 0.271), avoidance (r = 0.119), and fearfulness (r = 0.184) was significantly associated with more unhealthy eating behaviors, ps = 0.000; conversely, higher attachment security correlated with lower unhealthy eating behaviors (r = -0.184, p = 0.000). This relationship did not vary across type of unhealthy eating behavior (i.e., binge eating, bulimic symptoms, dieting, emotional eating, and unhealthy food consumption). The little exploratory evidence concerning healthy eating and attachment was inconclusive with one exception-healthy eating was associated with lower attachment avoidance (r = -0.211, p = 0.000). Our results extend previous meta-analytic findings to show that lack of trusting and reliable relationships does not only set apart eating disordered individuals from controls, but also characterizes unhealthy eating behaviors in the general population. More evidence is needed to determine how attachment and healthy eating are linked and assess potential mechanisms influencing the attachment-eating relationship. Copyright © 2017 Elsevier Ltd. All rights reserved.

Associations between body weight status, psychological well-being and disordered eating with intuitive eating among Malaysian undergraduate university students.

PubMed

Gan, Wan Ying; Yeoh, Wei Ching

2017-09-13

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.

Incidence, prevalence, and risk of eating disorder behaviors in military academy cadets.

PubMed

Beekley, Matthew D; Byrne, Robert; Yavorek, Trudy; Kidd, Kelli; Wolff, Janet; Johnson, Michael

2009-06-01

Eating disorders are a particular problem for college students, as well as college athletes and military personnel. We examined the incidence, prevalence, and risk of eating disorders at the United States Military Academy (USMA) over a 7-year period (total population 12,731 cadets). The incidence per year for females was 0.02% for anorexia, 0.17% for bulimia, and 0.17% for eating disorders not otherwise specified (EDNOS) and for males was 0.0% for anorexia, 0.003% for bulimia, and 0.02% for eating disorders not otherwise specified. The total prevalence of diagnosed eating disorders for females was 5% and for males was 0.1%. For females over the 7-year period, we found a prevalence of 0.2% for anorexia, 1.2% for bulimia, 1.2% for eating disorders not otherwise specified, and for males we found a prevalence of 0.0% for anorexia, 0.02% for bulimia, and 0.03% for eating disorders not otherwise specified. Nineteen percent of females and 2% of males scored a 20 or higher on the Eating Attitudes Test (EAT)-26 survey indicating they were at risk for developing an eating disorder. We conclude that the prevalence of eating disorders at USMA is comparable to civilian colleges.

Novel and ultra-rare damaging variants in neuropeptide signaling are associated with disordered eating behaviors

PubMed Central

Bahl, Ethan; Hannah, Claire; Hofammann, Dabney; Acevedo, Summer; Cui, Huxing; McAdams, Carrie J.

2017-01-01

Objective Eating disorders develop through a combination of genetic vulnerability and environmental stress, however the genetic basis of this risk is unknown. Methods 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. Results 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. Conclusions 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. PMID:28846695

Cognitive-Behavioral Therapy, Behavioral Weight Loss, and Sequential Treatment for Obese Patients with Binge-Eating Disorder: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Grilo, Carlos M.; Masheb, Robin M.; Wilson, G. Terence; Gueorguieva, Ralitza; White, Marney A.

2011-01-01

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).…

Eating Disorders: A Problem in Athletics?

ERIC Educational Resources Information Center

Burckes-Miller, Mardie E.; Black, David R.

1988-01-01

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)

Puberty and the manifestations of loss of control eating in children and adolescents.

PubMed

Vannucci, Anna; Tanofsky-Kraff, Marian; Ranzenhofer, Lisa M; Kelly, Nichole R; Hannallah, Louise M; Pickworth, C Katie; Grygorenko, Mariya V; Brady, Sheila M; Condarco, Tania A; Kozlosky, Merel; Demidowich, Andrew P; Yanovski, Susan Z; Shomaker, Lauren B; Yanovski, Jack A

2014-11-01

We investigated the manifestations of pediatric loss of control (LOC) eating at different stages of pubertal development. Participants were a nonclinical sample of 468 youth (8-17 years). Physical examination determined pubertal stage. LOC eating and disordered eating attitudes were assessed with the Eating Disorder Examination. In a randomized crossover design, a subset (n = 244) ate ad libitum from two test meals designed to capture normal and LOC eating. There were no differences in the prevalence rates or frequency of reported LOC eating episodes across pubertal stages (ps ≥ 0.50). There were, however, puberty by LOC eating interactions in disordered eating attitudes and palatable food consumption (ps ≤ .05), even after adjusting for age and body composition. LOC eating was associated with elevated global disordered eating attitudes, weight concern, and shape concern in post-pubertal youth (ps ≤ .001), but not pre-pubertal youth (ps ≥ .49). In late-puberty, youth with LOC eating consumed less energy from protein (p < .001) and more from carbohydrate (p = .003) and snack-type foods (p = .02) than those without LOC eating, whereas endorsement of LOC eating in pre- or early-to-mid-puberty was not associated with differences in eating behavior (ps ≥ 0.20). Findings suggest that puberty may be a critical risk period, when LOC eating behaviors in boys and girls may become accompanied by greater weight and shape concerns and more obesogenic food consumption patterns. Interventions for LOC eating during pre-puberty should be evaluated to determine if they are particularly beneficial for the prevention of exacerbated eating disorder psychopathology and adverse weight outcomes. © 2014 Wiley Periodicals, Inc.

The Relationship between Maladaptive Eating Behaviors and Racial Identity among African American Women in College

ERIC Educational Resources Information Center

Flowers, Kelci C.; Levesque, Maurice J.; Fischer, Sarah

2012-01-01

Research on eating disorders has shown that European American women suffer from eating disorders and body image dissatisfaction more than African American women. However, recent meta-analyses suggest these differences may be decreasing and that some African American women may be particularly susceptible to body dissatisfaction and eating disorder…

An etiological model of disordered eating behaviors among Brazilian women.

PubMed

de Carvalho, Pedro Henrique Berbert; Alvarenga, Marle Dos Santos; Ferreira, Maria Elisa Caputo

2017-09-01

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.

Parental and Child Characteristics Related to Early-Onset Disordered Eating: A Systematic Review.

PubMed

Larsen, Pernille Stemann; Strandberg-Larsen, Katrine; Micali, Nadia; Andersen, Anne-Marie Nybo

2015-01-01

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 behaviors, mental and physical health, family interactions, and child growth patterns.

Consequences of child emotional abuse, emotional neglect and exposure to intimate partner violence for eating disorders: a systematic critical review.

PubMed

Kimber, Melissa; McTavish, Jill R; Couturier, Jennifer; Boven, Alison; Gill, Sana; Dimitropoulos, Gina; MacMillan, Harriet L

2017-09-22

Child maltreatment and eating disorders are significant public health problems. Yet, to date, research has focused on the role of child physical and sexual abuse in eating-related pathology. This is despite the fact that globally, exposure to emotional abuse, emotional neglect and intimate partner violence are the three of the most common forms of child maltreatment. The objective of the present study is to systematically identify and critically review the literature examining the association between child emotional abuse (EA), emotional neglect (EN), and exposure to intimate partner violence (IPV) and adult eating-disordered behavior and eating disorders. A systematic search was conducted of five electronic databases: Medline, Embase, PsycINFO, CINAHL, and ERIC up to October 2015 to identify original research studies that investigated the association between EA, EN and children's exposure to IPV, with adult eating disorders or eating-disordered behavior using a quantitative research design. Database searches were complemented with forward and backward citation chaining. Studies were critically appraised using the Quality in Prognosis Studies (QUIPS) tool. A total of 5556 publications were screened for this review resulting in twenty-three articles included in the present synthesis. These studies focused predominantly on EA and EN, with a minority examining the role of child exposure to IPV in adult eating-related pathology. Prevalence of EA and EN ranged from 21.0% to 66.0%, respectively. No prevalence information was provided in relation to child exposure to IPV. Samples included predominantly White women. The methodological quality of the available literature is generally low. Currently, the available literature precludes the possibility of determining the extent to which EA, EN or child exposure to IPV have independent explanatory influence in adult eating-related pathology above what has been identified for physical and sexual abuse. While a large proportion of adults with eating disorders or eating-disordered behavior report EA, EN, or child exposure to IPV , there is a paucity of high-quality evidence about these relationships.

Prospective analysis of personality and behavioral vulnerabilities and gender influences in the later development of disordered eating.

PubMed

Leon, G R; Fulkerson, J A; Perry, C L; Early-Zald, M B

1995-02-01

This article presents the 2-year findings of a prospective investigation of the precursors to the later development of an eating disorder in adolescents. The sample consisted of 852 girls and 815 boys who began to study in Grades 7-10 and participated for 3 consecutive years. For both genders, the strongest predictors of Year 3 risk status were Years 1 and 2 risk scores. When the effects of Year 1 and Year 2 risk were controlled, race (Caucasian) and poor interoceptive awareness at Year 2 were significant predictors of disordered eating at Year 3 for girls. Previous risk status was the only significant predictor of Year 3 risk for boys. Gender difference evaluations in the risk score components indicated that a significantly greater proportion of girls than boys endorsed behaviors that were similar to eating disorder diagnostic criteria. Poor interoceptive awareness may provide a vulnerability for eating disorders; possible pathways were discussed.

Psychosocial Correlates of Shape and Weight Concerns in Overweight Pre-Adolescents

PubMed Central

Sinton, Meghan M.; Goldschmidt, Andrea B.; Aspen, Vandana; Theim, Kelly R.; Stein, Richard I.; Saelens, Brian E.; Epstein, Leonard H.; Wilfley, Denise E.

2013-01-01

Shape and weight concerns among overweight pre-adolescents heighten risk for eating disorders and weight gain. Treatment and prevention efforts require consideration of psychosocial factors that co-occur with these concerns. This study involved 200 overweight pre-adolescents, aged 7–12 years (M age = 9.8; SD = 1.4), presenting for family-based weight control treatment. Hierarchical regression was used to examine the influence of pre-adolescents’ individual characteristics and social experiences, and their parents’ psychological symptoms, on shape and weight concerns as assessed by the Child Eating Disorder Examination. Findings revealed that higher levels of dietary restraint, greater feelings of loneliness, elevated experiences with weight-related teasing, and higher levels of parents’ eating disorder symptoms predicted higher shape and weight concerns among overweight pre-adolescents. Interventions addressing overweight pre-adolescents’ disordered eating behaviors and social functioning, as well as their parents’ disordered eating behaviors and attitudes, may be indicated for those endorsing shape and weight concerns. PMID:21695562

Eating behavior style predicts craving and anxiety experienced in food-related virtual environments by patients with eating disorders and healthy controls.

PubMed

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

2017-10-01

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.

Cognitive-behavioral therapy for eating disorders in primary care settings: Does it work, and does a greater dose make it more effective?

PubMed

Rose, Charlotte; Waller, Glenn

2017-12-01

This study aimed to determine whether cognitive-behavioral therapy (CBT) for eating disorders can be effective in a routine, primary care clinical setting, and to assess dose response. The participants were 47 patients who commenced treatment with a publicly-funded primary care eating disorder service. They attended 7-33 sessions of individual CBT (mean = 17), using an evidence-based approach. Routine measures were collected pre- and post-therapy. Three-quarters of the patients completed treatment. Using intention to treat analysis (multiple imputation), the patients showed substantial improvements in eating attitudes, bulimic behaviors, and depression. However, there was no association between the level of improvement and the length of therapy past the 8th to 12th session. The level of effectiveness shown here is comparable to that previously demonstrated by more specialist services in secondary and tertiary care. The nonlinear association between number of sessions and recovery highlights the importance of early change, across the eating disorders. © 2017 Wiley Periodicals, Inc.

Restrictive eating in anorexia nervosa: Examining maintenance and consequences in the natural environment.

PubMed

Fitzsimmons-Craft, Ellen E; Accurso, Erin C; Ciao, Anna C; Crosby, Ross D; Cao, Li; Pisetsky, Emily M; Le Grange, Daniel; Peterson, Carol B; Crow, Scott J; Engel, Scott G; Mitchell, James E; Wonderlich, Stephen A

2015-11-01

This study examined negative and positive affect in relation to restrictive eating episodes (i.e., meals/snacks perceived as restrictive) and whether restrictive eating was associated with likelihood of subsequent eating disorder behaviors (i.e., additional restrictive eating, binge eating, vomiting, laxative use, weighing, exercising, meal skipping, drinking fluids to curb appetite, body checking). Women with anorexia nervosa (N = 118) completed a 2-week ecological momentary assessment protocol. For both restrictive and nonrestrictive eating, negative affect significantly increased from prebehavior to the time of the behavior but remained stable thereafter, while positive affect remained stable from prebehavior to the time of the behavior but decreased significantly thereafter. Across time, negative affect was significantly lower and positive affect was significantly greater in restrictive than nonrestrictive episodes. Engagement in restrictive eating was associated with an increased likelihood of subsequent restrictive eating, laxative use, and body checking, but not other behaviors. Engagement in nonrestrictive eating was associated with a decreased likelihood of subsequent restrictive eating, binge eating, vomiting, laxative use, weighing, meal skipping, drinking fluids to curb appetite, and body checking. Despite similar patterns of affect across eating episodes over time, results suggest affect may be involved in the maintenance of restrictive eating in anorexia nervosa since restrictive episodes were associated with lower negative and greater positive affect across time compared to nonrestrictive episodes. Further, while restrictive episodes increased the likelihood of only three subsequent eating disorder behaviors, nonrestrictive episodes were protective since they decreased likelihood of all but one behavior. © 2015 Wiley Periodicals, Inc.

Pharmacological Treatment of Binge Eating Disorder: Update Review and Synthesis

PubMed Central

Reas, Deborah L.; Grilo, Carlos M.

2015-01-01

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

Competitive Memory Training (COMET) for Treating Low Self-Esteem in Patients with Eating Disorders: A Randomized Clinical Trial

ERIC Educational Resources Information Center

Korrelboom, Kees; de Jong, Martie; Huijbrechts, Irma; Daansen, Peter

2009-01-01

This study evaluates a short stepwise cognitive-behavioral intervention for the treatment of low self-esteem in patients with eating disorders. Competitive memory training (COMET) for low self-esteem is based on insights and findings from experimental psychology. A total of 52 patients with eating disorders and low self-esteem were treated with…

Gender differences in shame in patients with binge-eating disorder.

PubMed

Jambekar, Sheila A; Masheb, Robin M; Grilo, Carlos M

2003-04-01

To examine the relationship between shame and the behavioral and attitudinal features of eating disorders in men and women diagnosed with binge-eating disorder (BED). Participants were 188 consecutively evaluated adults (38 men and 150 women) who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria for BED. Participants were interviewed and completed a battery of measures assessing shame, behavioral and attitudinal features of eating disorders, and general psychological functioning. Shame did not differ significantly by gender and was not associated with BMI or binge-eating frequency. Shame was significantly associated with the attitudinal features of eating disorders, even after controlling for levels of depression and self-esteem. When considered separately by gender and controlling for depression and self-esteem, shame was associated with body dissatisfaction in men and with weight concern in women. Men and women with BED, who presented for treatment, reported similar levels of shame. Overall, while shame was related to attitudinal features, the specific associations differed by gender. For men, shame was related to how dissatisfied they felt with their bodies, whereas for women, shame was associated with concerns about weight. Interestingly, shame was not related to BMI or binge-eating frequency in men or women. These results provide preliminary support for self-conscious emotions playing different roles in men and women with BED.

Latent class analysis of eating and impulsive behavioral symptoms in Taiwanese women with bulimia nervosa.

PubMed

Tseng, Mei-Chih Meg; Hu, Fu-Chang

2012-01-01

The implications of impulsivity in its relationship with binge-eating or purging behaviors remain unclear. This study examined the patterns of eating behaviors and co-morbid impulsive behaviors in individuals with bulimia nervosa n optimally homogeneous classes using latent class analysis (LCA). All participants (n=180) were asked to complete a series of self-reported inventories of impulsive behaviors and other psychological measures. Information regarding the lifetime presence of symptoms of eating disorder was assessed by clinical interviews. LCA was conducted using eating disorder symptoms, impulsive behaviors, and the number of purging methods. Three latent classes of bulimic women were identified. These were women who exhibited relatively higher rates of purging, symptoms of impulsive behavior, and multiple purging methods (17.8%), women who used no more than one purging method with a low occurrence of impulsive behavior (41.7%), and women who showed higher rates of purging behaviors and the use of multiple purging methods with a low rate of impulsive behavior (41.7%). The impulsive sub-group had comparable severity of eating-related measures, frequency of binge-eating, and higher levels of general psychopathology than that of the other two sub-groups. This study provides empirical support for the existence of an impulsive subgroup with distinctive features among a non-Western group of BN patients. This study also suggests that mechanisms other than impulse dysregulation may exist for the development of binge-eating and purging behaviors in bulimia nervosa patients, or the mechanisms contributing to binge-eating and impulsive behaviors may be different. Copyright © 2011 Elsevier Inc. All rights reserved.

Disordered eating among preadolescent boys and girls: the relationship with child and maternal variables.

PubMed

Gonçalves, Sónia; Silva, Margarida; Gomes, A Rui; Machado, Paulo P P

2012-04-01

(i) To analyze the eating behaviors and body satisfaction of boys and girls and to examine their mothers' perceptions of these two domains; and (ii) to evaluate eating problem predictors using child body mass index (BMI), self-esteem, and body satisfaction as well as maternal BMI, eating problems, and satisfaction with their child's body. The participants included 111 children (54.1% girls aged between 9 and 12 years old) and their mothers. Assessment measures included the Child Eating Attitude Test, the Self-Perception Profile for Children, the Eating Disorders Questionnaire, and the Child Eating Behavior Questionnaire. Child and maternal measures also included BMI and Collins Figure Drawings. (i) No association between child and maternal BMI for either sex was found; (ii) no difference was found between boys and girls with regard to eating behavior; (iii) most children revealed a preference for an ideal body image over their actual body image; (iv) most mothers preferred thinner bodies for their children; (v) greater BMI was related to higher body dissatisfaction; and (vi) child BMI and dissatisfaction with body image predicted eating disturbances in boys, whereas self-esteem, maternal BMI, and eating behavior predicted them in girls. Maternal eating problems and BMI were related to female eating problems only.

Disordered Eating among Preadolescent Boys and Girls: The Relationship with Child and Maternal Variables

PubMed Central

Gonçalves, Sónia; Silva, Margarida; Gomes, A. Rui; Machado, Paulo P. P.

2012-01-01

Objective: (i) To analyze the eating behaviors and body satisfaction of boys and girls and to examine their mothers’ perceptions of these two domains; and (ii) to evaluate eating problem predictors using child body mass index (BMI), self-esteem, and body satisfaction as well as maternal BMI, eating problems, and satisfaction with their child’s body. The participants included 111 children (54.1% girls aged between 9 and 12 years old) and their mothers. Assessment measures included the Child Eating Attitude Test, the Self-Perception Profile for Children, the Eating Disorders Questionnaire, and the Child Eating Behavior Questionnaire. Child and maternal measures also included BMI and Collins Figure Drawings. Results: (i) No association between child and maternal BMI for either sex was found; (ii) no difference was found between boys and girls with regard to eating behavior; (iii) most children revealed a preference for an ideal body image over their actual body image; (iv) most mothers preferred thinner bodies for their children; (v) greater BMI was related to higher body dissatisfaction; and (vi) child BMI and dissatisfaction with body image predicted eating disturbances in boys, whereas self-esteem, maternal BMI, and eating behavior predicted them in girls. Discussion: Maternal eating problems and BMI were related to female eating problems only. PMID:22606370

"Eating addiction", rather than "food addiction", better captures addictive-like eating behavior.

PubMed

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

2014-11-01

"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.

Updates in the epidemiology of eating disorders in Asia and the Pacific.

PubMed

Thomas, Jennifer J; Lee, Sing; Becker, Anne E

2016-11-01

This review summarizes and contextualizes the recent epidemiologic data on eating disorders in the Asia and Pacific regions. Gaps in epidemiologic data on eating disorders from the Asia and Pacific regions stem, in part, from omission of eating disorder-specific assessments in large nationally representative cohort studies of mental disorders. Available data - often from clinical and school-going cohorts - support that the prevalence of both eating disorders and associated attitudes and behaviors in many Asian and Pacific regions studied may be comparable to those reported in Europe and North America. Moreover, the prevalence of eating disorders in some regions of Asia may be increasing. Some of the national and subnational regions with the highest annual percent increases in disability-adjusted life years per 100 000 caused by eating disorders over the past two decades are located in Asia. Notwithstanding sparse epidemiologic data concerning eating disorders in Asia and the Pacific, available evidence supports comparable prevalence to other global regions and that associated health burdens in some regions of Asia may be rising. This further supports that eating disorders are trans-national in distribution and challenges the previous understanding that they were primarily culture-bound to the Global North.

Gender, General Strain Theory, Negative Emotions, and Disordered Eating

ERIC Educational Resources Information Center

Piquero, Nicole Leeper; Fox, Kristan; Piquero, Alex R.; Capowich, George; Mazerolle, Paul

2010-01-01

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…

Pretreatment and Process Predictors of Outcome in Interpersonal and Cognitive Behavioral Psychotherapy for Binge Eating Disorder

ERIC Educational Resources Information Center

Hilbert, Anja; Saelens, Brian E.; Stein, Richard I.; Mockus, Danyte S.; Welch, R. Robinson; Matt, Georg E.; Wilfley, Denise E.

2007-01-01

The present study examined pretreatment and process predictors of individual nonresponse to psychological group treatment of binge eating disorder (BED). In a randomized trial, 162 overweight patients with BED were treated with either group cognitive-behavioral therapy or group interpersonal psychotherapy. Treatment nonresponse, which was defined…

Manualized-Group Treatment of Eating Disorders: Attunement in Mind, Body, and Relationship (AMBR)

ERIC Educational Resources Information Center

Cook-Cottone, Catherine; Beck, Meredith; Kane, Linda

2008-01-01

This article describes a manualized-group treatment of eating disorders, the attunement in mind, body, and relationship (AMBR) program. The cognitive behavioral and dialectic behavioral research as well as the innovative prevention interventions upon which the program is based (e.g., interactive discourse, yoga, and mediation) are introduced. The…

Effects of a cognitive dissonance-based eating disorder prevention program are similar for Asian American, Hispanic, and White participants.

PubMed

Rodriguez, Rosalía; Marchand, Erica; Ng, Janet; Stice, Eric

2008-11-01

This study explored the effects of participating in a dissonance-based eating disorder prevention program on changes in thin ideal internalization, body dissatisfaction, and eating symptoms among White, Asian American, and Hispanic participants. Participants were (n = 394), 13 to 20-year-old adolescent girls and young women who reported being White (n = 311), Hispanic/Latina (n = 61), or Asian-American/Hawaiian/Pacific Islander (n = 33). The current study used data drawn from the pre- and post assessments of an efficacy trial and an effectiveness trial of this eating disorder prevention program. The intervention reduced disordered eating behaviors and eating disorder risk factors for all three ethnic groups at post-intervention assessment; there was no evidence of significantly stronger effects in any particular ethnic group. Results suggest that a cognitive dissonance-based prevention program for eating disorders may be equally effective for Asian American, Hispanic, and White adolescent women.

The association of parental characteristics and psychological problems in obese youngsters.

PubMed

Decaluwé, V; Braet, C; Moens, E; Van Vlierberghe, L

2006-12-01

The aim of the present study was to examine to what extent parental psychological characteristics and parental behavior are related to psychological problems in obese youngsters. Data were collected from 196 families having an overweight youngster (range 10-16 years old) (mean body mass index (BMI)=31.2; s.d.=5.3) seeking weight-loss treatment and compared with data from normal weight samples. Behavior problems were measured using the Child Behavior Checklist; the Child version of the Eating Disorder Examination was used to assess eating disorder psychopathology. Parental psychopathology was measured using the Symptom Checklist-90; parenting behavior was assessed with the Ghent Parental Behavior Scale. Parental psychopathology was prevalent in 59.6% of mothers and 35.7% of fathers. Youngsters exceeding the cutoff for problem behavior ranged between 41.4 and 53.1%. Children's problem behavior was most associated with psychopathology in the mother (r=0.40 for Internalizing and r=0.37 for Externalizing; both P<0.01). The research findings further revealed that the effects of maternal psychopathology were partly mediated by a specific form of parenting behavior, namely Inconsistent discipline, although the effect was stronger for Externalizing behavior (explained variance: 10%) than for Internalizing behavior (explained variance: 4%). No evidence was found for a mediator effect from parenting behavior on the eating disorder symptoms of the obese youngsters. However, several direct relations emerged, suggesting a negative association between a child's eating disorder symptoms and Positive parenting behavior by the mother (r= -0.20 for Eating concern; r= -0.18 for Restraint eating; r= -0.16 for Shape concern; all P<0.05) as well as by the father (r= -0.25 for Eating concern; r= -0.25 for Weight concern; both P<0.01; r= -0.21 for Shape concern; P<0.05). Parental characteristics were associated with psychological problems in obese youngsters, not only in a direct way but also indirectly. The effects were partly mediated by a particular ineffective parenting style, namely inconsistent discipline on the part of the mother. Pediatric obesity treatments should focus more on parenting behaviors and parental characteristics.

Eating disorder features and quality of life: Does gender matter?

PubMed

Wagner, Allison F; Stefano, Emily C; Cicero, David C; Latner, Janet D; Mond, Jonathan M

2016-10-01

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.

Combining Pharmacological and Psychological Treatments for Binge Eating Disorder: Current Status, Limitations, and Future Directions.

PubMed

Grilo, Carlos M; Reas, Deborah L; Mitchell, James E

2016-06-01

Binge eating disorder (BED) is characterized by recurrent binge eating and marked distress about binge eating without the extreme compensatory behaviors for weight control that characterize other eating disorders. BED is prevalent, associated strongly with obesity, and is associated with heightened levels of psychological, psychiatric, and medical concerns. This article provides an overview of randomized controlled treatments for combined psychological and pharmacological treatment of BED to inform current clinical practice and future treatment research. In contrast to the prevalence and significance of BED, to date, limited research has been performed on combining psychological and pharmacological treatments for BED to enhance outcomes. Our review here found that combining certain medications with cognitive behavioral therapy (CBT) or behavioral weight loss (BWL) interventions produces superior outcomes to pharmacotherapy only but does not substantially improve outcomes achieved with CBT/BWL only. One medication (orlistat) has improved weight losses with CBT/BWL albeit minimally, and only one medication (topiramate) has enhanced reductions achieved with CBT in both binge eating and weight. Implications for future research are discussed.

Binge eating and emotional eating behaviors among adolescents and young adults with bipolar disorder.

PubMed

Martin, Katharine; Woo, Julia; Timmins, Vanessa; Collins, Jordan; Islam, Alvi; Newton, Dwight; Goldstein, Benjamin I

2016-05-01

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.

Eating disorders: Insights from imaging and behavioral approaches to treatment.

PubMed

Stice, Eric; Shaw, Heather

2017-11-01

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.

Psychological factors related to eating disordered behaviors: a study with Portuguese athletes.

PubMed

Silva, Luiz; Gomes, A Rui; Martins, Carla

2011-05-01

This study analyzes eating disordered behaviors in a sample of Portuguese athletes and explores its relationship with some psychological dimensions. Two hundred and ninety nine athletes (153 male, 51.2%) practicing collective (65.2%) or individual sports (34.8%) were included. The assessment protocol included the Eating Disorder Examination Questionnaire (EDE-Q) (Fairburn & Beglin, 1994); the Sport Condition Questionnaire (Bruin et al., 2007; Hall et al., 2007); the Sport Anxiety Scale (Smith et al., 2006); the Task and Ego Orientation in Sport Questionnaire (Duda, 1992; Duda & Whitehead, 1998); the Cognitive Evaluation of Sport-Threat Perceptions (Cruz, 1994; Lazarus, 1991); and the Self-Presentation Exercise Questionnaire (Gammage et al., 2004). Results revealed that: i) no case of clinical significance was detected in the four dimensions of the EDE-Q simultaneously; ii) females scored higher on the EDE-Q Global Score, and athletes with the better sport results scored higher on the Restraint subscale; iii) athletes with a higher desire to weigh less scored higher on the EDE-Q Global Score; iv) athletes with lower scores on EDE-Q displayed more positive results on the psychological measures; v) several psychological dimensions were identified as predictors of eating disordered behaviors. In conclusion, the prevalence of eating disordered behaviors was negligible in this study, yet the relationship of this problem with personal, sport and psychological factors was evident.

Prevalence of eating disorder risk and body image distortion among National Collegiate Athletic Association Division I varsity equestrian athletes.

PubMed

Torres-McGehee, Toni M; Monsma, Eva V; Gay, Jennifer L; Minton, Dawn M; Mady-Foster, Ashley N

2011-01-01

Participation in appearance-based sports, particularly at the collegiate level, may place additional pressures on female athletes to be thin, which may increase the likelihood of their resorting to drastic weight control measures, such as disordered eating behaviors. (1) To estimate the prevalence and sources of eating disorder risk classification by academic status (freshman, sophomore, junior, or senior) and riding discipline (English and Western), (2) to examine riding style and academic status variations in body mass index (BMI) and silhouette type, and (3) to examine these variations across eating disorder risk classification type (eg, body image disturbances). Cross-sectional study. Seven universities throughout the United States. A total of 138 participants volunteered (mean age = 19.88 ± 1.29 years). They represented 2 equestrian disciplines English riding (n = 91) and Western riding (n = 47). Participants self-reported menstrual cycle history, height, and weight. We screened for eating disorder risk behaviors with the Eating Attitudes Test and for body disturbance with sex-specific BMI silhouettes. Based on the Eating Attitudes Test, estimated eating disorder prevalence was 42.0% in the total sample, 38.5% among English riders, and 48.9% among Western riders. No BMI or silhouette differences were found across academic status or discipline in disordered eating risk. Overall, participants perceived their body images as significantly larger than their actual physical sizes (self-reported BMI) and wanted to be significantly smaller in both normal clothing and competitive uniforms. Disordered eating risk prevalence among equestrian athletes was similar to that reported in other aesthetic sports and lower than that in nonaesthetic sports. Athletic trainers working with these athletes should be sensitive to these risks and refer athletes as needed to clinicians knowledgeable about disordered eating. Professionals working with this population should avoid making negative comments about physical size and appearance.

Course and predictors of maternal eating disorders in the postpartum period

PubMed Central

Knoph, Cecilie; Holle, Ann Von; Zerwas, Stephanie; Torgersen, Leila; Tambs, Kristian; Stoltenberg, Camilla; Bulik, Cynthia M; Reichborn-Kjennerud, Ted

2012-01-01

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

Body Objectification, Social Pressure, and Disordered Eating Behavior in College Women: The Role of Sorority Membership

ERIC Educational Resources Information Center

Basow, Susan A.; Foran, Kelly A.; Bookwala, Jamila

2007-01-01

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…

Oxytocin and eating disorders: a narrative review on emerging findings and perspectives.

PubMed

Giel, Katrin; Zipfel, Stephan; Hallschmid, Manfred

2017-11-28

The hypothalamic neuropeptide oxytocin regulates reproductive behavior and mother-infant interaction, and conclusive studies in humans indicate that oxytocin is also a potent modulator of psychosocial function. Pilot experiments have yielded first evidence that this neuropeptide moreover influences eating behavior. Brain administration of oxytocin in animals with normal weight, but also with diet-induced or genetically induced obesity, attenuates food intake and reduces body weight. In normal-weight and obese individuals, acute intranasal oxytocin delivery curbs calorie intake from main dishes and snacks. Such effects might converge with the poignant social and cognitive impact of oxytocin to also improve dysfunctional eating behavior in the therapeutic context. This assumption has received support in first studies showing that oxytocin might play a role in the disease process of anorexia nervosa. In contrast, respective experiments in patients with bulimia nervosa and binge eating disorder are still scarce. We briefly summarize currently available studies on the involvement of the oxytocin system in the pathophysiology of eating disorders, as well as on the effects of oxytocin administration in patients with these disorders. We propose a framework of oxytocin's role and its therapeutic potential in eating disorders that aims at integrating social and metabolic aspects of its pharmacological profile, and ponder perspectives and limitations of oxytocin use in the clinical setting. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

A cross-sectional examination of non-suicidal self-injury, disordered eating, impulsivity, and compulsivity in a sample of adult women.

PubMed

Black, Emma B; Mildred, Helen

2014-12-01

Non-suicidal self-injury has been classed as having both impulsive and compulsive characteristics (Simeon & Favazza, 2001). These constructs have been related to disordered eating behaviors such as vomiting (Favaro & Santonastaso, 1998). Utilizing an international sample of adult females, this paper further explored this model, aiming to identify whether all types of disordered eating could be classified as impulsive or compulsive, and whether the impulsive and compulsive groupings reflect underlying trait impulsivity and compulsivity. The hypothesized impulsive and compulsive dimensions did not emerge from the data. Notably however, all self-injurious and disordered eating behaviors were linked to Urgency (an impulsivity facet) to varying degrees; no relationship with trait compulsivity was found. These findings are discussed, study limitations are noted, and relevance for clinical practice is outlined.

Binge Eating, But Not Other Disordered Eating Symptoms, Is a Significant Contributor of Binge Drinking Severity: Findings from a Cross-Sectional Study among French Students.

PubMed

Rolland, Benjamin; Naassila, Mickael; Duffau, Céline; Houchi, Hakim; Gierski, Fabien; André, Judith

2017-01-01

Many studies have suggested the co-occurrence of eating disorders and alcohol use disorders but in which extent binge eating (BE) and other disordered eating symptoms (DES) are associated with the severity of binge drinking (BD) remains unknown. We conducted a online cross-sectional study among 1,872 French students. Participants were asked their age, gender, tobacco and cannabis use status. They completed the Alcohol Use Questionnaire (AUQ), Eating Disorder Examination Questionnaire (EDE-Q), and UPPS impulsive behavior questionnaire. BD score was calculated using the AUQ. Three items of the EDE-Q were used to construct a BE score. The predictors of the BD score were determined using a linear regression model. Our results showed that the BE score was correlated with the BD score (β 0 = 0.051 ± 0.022; p = 0.019), but no other DES was associated with BD, including purging behaviors. The severity of BD was also correlated with younger age, male gender, tobacco and cannabis use, and with the 'positive urgency,' 'premeditation,' and 'sensation seeking' UPPS subscores ( R 2 of the model: 25%). Within DES, BE appeared as an independent determinant of the BD severity. This is in line with the recent hypothesis that BE is not a subtype of DES, but more a general vulnerability factor of emotional dysregulation, which could be shared by different behavioral and addictive disorders.

Prevalence of Disordered-Eating Behaviors in Undergraduate Female Collegiate Athletes and Nonathletes

PubMed Central

Reinking, Mark F; Alexander, Laura E

2005-01-01

Context: As the number of female college students participating in athletics has grown dramatically in the last few decades, sports medicine health care providers have become more aware of the unique health concerns of athletic women. These concerns include disordered eating, amenorrhea, and osteoporosis: the female athlete triad. Disordered eating appears to be central in the triad, and the literature has conflicting data regarding the influence of athletic participation on disordered-eating behaviors. Objective: To compare disordered-eating symptoms between collegiate athletes (in lean and non-lean sports) and nonathletes. Design: A volunteer, cross-sectional cohort study of female students during the 2002–2003 academic year. Setting: A National Collegiate Athletic Association Division I institution. Patients or Other Participants: Undergraduate females, including 84 collegiate athletes and 62 nonathletes. Main Outcome Measure(s): Symptoms associated with disordered eating were assessed using the Eating Disorders Inventory-2, a self-report measure of 91 items, and self-reported weight and menstrual function. Results: The athletes had significantly lower scores in body dissatisfaction (P = .01) and ineffectiveness (P = .002). No difference in mean body weight was noted between the 2 groups, but the nonathlete group had a significantly lower desired body weight (P = .004). Lean-sport athletes had a higher score on body dissatisfaction (P = .008) and lower actual (P = .024) and desired body weight (P = .002) than non–lean-sport athletes. A total of 7.1% of the collegiate athletes and 12.9% of the nonathletes were classified as having a high risk for disordered eating. Within the athlete sample, the high-risk group included 2.9% of the non–lean-sport athletes and 25% of the lean-sport athletes. Conclusions: In our study, female athletes did not exhibit more disordered-eating symptoms than women who did not participate in collegiate sports. However, our data suggest that lean-sport athletes are at greater risk for disordered eating than athletes in non-lean sports. PMID:15902324

Are children with chronic illnesses requiring dietary therapy at risk for disordered eating or eating disorders? A systematic review.

PubMed

Conviser, Jenny H; Fisher, Sheehan D; McColley, Susanna A

2018-03-01

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.

"Strong beats skinny every time": Disordered eating and compulsive exercise in women who post fitspiration on Instagram.

PubMed

Holland, Grace; Tiggemann, Marika

2017-01-01

Fitspiration is a recent Internet trend designed to motivate people to eat healthily and to exercise. The aim of the study was to investigate disordered eating and exercise in women who post fitspiration on Instagram. Participants were 101 women who post fitspiration images on Instagram and a comparison group of 102 women who post travel images. Both groups completed measures of disordered eating and compulsive exercise. Women who post fitspiration images scored significantly higher on drive for thinness, bulimia, drive for muscularity, and compulsive exercise. Almost a fifth (17.5%) of these women were at risk for diagnosis of a clinical eating disorder, compared to 4.3% of the travel group. Compulsive exercise was related to disordered eating in both groups, but the relationship was significantly stronger for women who post fitspiration images. For some women, posting fitspiration images on Instagram may signify maladaptive eating and exercise behaviors. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:76-79). © 2016 Wiley Periodicals, Inc.

The relationship between parent feeding styles and general parenting with loss of control eating in treatment-seeking overweight and obese children.

PubMed

Matheson, Brittany E; Camacho, Casandra; Peterson, Carol B; Rhee, Kyung E; Rydell, Sarah A; Zucker, Nancy L; Boutelle, Kerri N

2015-11-01

To examine differences in parent feeding behaviors and general parenting of overweight children with and without loss of control (LOC) eating. One-hundred-and-eighteen overweight and obese children (10.40 ± 1.35 years; 53% female; 52% Caucasian; BMI-z: 2.06 ± 0.39) and their parents (42.42 ± 6.20 years; 91% female; 70% Caucasian; BMI: 31.74 ± 6.96 kg/m(2) ) were seen at a baseline assessment visit for a behavioral intervention that targeted overeating. The Eating Disorder Examination, adapted for children (ChEDE) was administered to assess for LOC eating. Parents completed the Parental Feeding Styles Questionnaire (PFSQ) and the Child Feeding Questionnaire (CFQ) to assess parent feeding styles and behaviors. Children also completed a self-report measure of general parenting (Child Report of Parent Behavior Inventory, CRPBI-30). Forty-three children (36.40%) reported at least one LOC eating episode in the month prior to assessment. Parents who reported greater restriction and higher levels of pressure to eat were more likely to have children that reported LOC eating (ps < 0.05). Parents who utilized more instrumental feeding and prompting/encouragement to eat techniques were less likely to have children that reported LOC eating (ps < 0.05). Child-reported parenting behaviors were unrelated to child LOC eating (ps > 0.05). Parent feeding styles and behaviors appear to be differentially and uniquely related to LOC eating in treatment-seeking overweight and obese children. Future research is needed to determine if implementing interventions that target parent feeding behaviors may reduce LOC eating, prevent full-syndrome eating disorders, and reduce weight gain in youth. © 2015 Wiley Periodicals, Inc.

Hypothalamic expression of inflammatory mediators in an animal model of binge eating.

PubMed

Alboni, Silvia; Micioni Di Bonaventura, Maria Vittoria; Benatti, Cristina; Giusepponi, Maria Elena; Brunello, Nicoletta; Cifani, Carlo

2017-03-01

Binge eating episodes are characterized by uncontrollable, distressing eating of a large amount of highly palatable food and represent a central feature of bingeing related eating disorders. Research suggests that inflammation plays a role in the onset and maintenance of eating-related maladaptive behavior. Markers of inflammation can be selectively altered in discrete brain regions where they can directly or indirectly regulate food intake. In the present study, we measured expression levels of different components of cytokine systems (IL-1, IL-6, IL-18, TNF-α and IFN-ɣ) and related molecules (iNOS and COX2) in the preoptic and anterior-tuberal parts of the hypothalamus of a validated animal model of binge eating. In this animal model, based on the exposure to both food restriction and frustration stress, binge-like eating behavior for highly palatable food is not shown when animals are exposed to the frustration stress during the estrus phase. We found a characteristic down-regulation of the IL-18/IL-18 receptor system (with increased expression of the inhibitor of the pro-inflammatory cytokine IL-18, IL-18BP, together with a decreased expression of the binding chain of the IL-18 receptor) and a three-fold increase in the expression of iNOS specifically in the anterior-tuberal region of the hypothalamus of animals that develop a binge-like eating behavior. Differently, when food restricted animals were stressed during the estrus phase, IL-18 expression increased, while iNOS expression was not significantly affected. Considering the role of this region of the hypothalamus in controlling feeding related behavior, this can be relevant in eating disorders and obesity. Our data suggest that by targeting centrally selected inflammatory markers, we may prevent that disordered eating turns into a full blown eating disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

Disruptive patterns of eating behaviors and associated lifestyles in males with ADHD.

PubMed

Ptacek, Radek; Kuzelova, Hana; Stefano, George B; Raboch, Jiří; Sadkova, Tereza; Goetz, Michal; Kream, Richard M

2014-04-14

Attention deficit hyperactivity disorder (ADHD) is a neurological/behavioral disorder characterized by inattention or hyperactivity and impulsivity, or combined symptomatology. Children with ADHD are predisposed to irregular and/or impulsive eating patterns often leading to compromised physical condition. The goal of the present study was to statistically evaluate parental scoring of patterned eating behaviors and associated lifestyles within a cohort of 100 boys diagnosed with ADHD in comparison to age-matched male controls. The study population consisted of 100 boys aged 6-10 years diagnosed with mixed type ADHD by DSM-IV criteria and 100 aged-matched healthy male control subjects. Patterns of eating behaviors and associated lifestyles were scored by structured parental interviews using a nominal rating scale. Interview scores indicated statistically significant differences in patterned eating behaviors in subjects with ADHD in comparison to healthy controls. Notably, subjects diagnosed with ADHD exhibited markedly diminished adherence to a traditional breakfast, lunch, and dinner schedule, which was linked to a significantly higher frequency (>5/day) of irregular eating times. In the ADHD cohort, disruptive patterns of eating behaviors were associated with diminished nutritional value of ingested food (expressed as lowered content of fruits and vegetables) and increased consumption of sweetened beverages. Disruptive patterns of eating behaviors, metabolically unfavorable nutritional status, and diminished physical activities of male children diagnosed with ADHD are linked to compromised growth and development and appearance of metabolic diseases in adulthood.

The overlap between Binge Eating Behaviors and Polycystic Ovarian Syndrome: An etiological integrative model.

PubMed

Paganini, Chiara; Peterson, Gregory; Stavropoulos, Vasilis; Krug, Isabel

2017-12-04

Studies indicate that Polycystic Ovarian Syndrome (PCOS) features (e.g. insulin instability, food cravings, overproduction of androgens and menstrual irregularities) associate with increased appetite, impaired impulse control and feelings of body dissatisfaction. Counter intuitively, binge eating behaviors have been shown to reinforce PCOS symptomatology, precipitating concurrently body dissatisfaction, weight gain, insulin instability and overproduction of androgens. The present systematic literature review aspires to investigate the relationship between binge eating, in the broader context of eating disorder behaviors, and Polycystic Ovarian Syndrome (PCOS), taking into account shared characteristics between EDs (Eating Disorders) and PCOS. To address this aim the PRISMA guidelines are adopted. A total of 21 studies, which investigated the presence of binge eating in PCOS population and the presence of PCOS in EDs population, were synthesized. Findings suggested that an increased prevalence of binge eating has been reported in women with Polycystic Ovarian Syndrome (PCOS); and that women suffering from BN (Bulimia Nervosa) and BED (Binge Eating Disorder) are more likely to display polycystic ovaries. Further research on their shared liability is required in order to inform more efficient prevention and treatment initiatives for populations presenting with comorbid features. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Predictors and Moderators of Response to Cognitive Behavioral Therapy and Medication for the Treatment of Binge Eating Disorder

ERIC Educational Resources Information Center

Grilo, Carlos M.; Masheb, Robin M.; Crosby, Ross D.

2012-01-01

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,…

12-Month Follow-Up of Fluoxetine and Cognitive Behavioral Therapy for Binge Eating Disorder

ERIC Educational Resources Information Center

Grilo, Carlos M.; Crosby, Ross D.; Wilson, G. Terence; Masheb, Robin M.

2012-01-01

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.…

The accuracy of symptom recall in eating disorders.

PubMed

Peterson, Carol B; Miller, Kathryn B; Johnson-Lind, Joy; Crow, Scott J; Thuras, Paul

2007-01-01

The purpose of this study was to assess how accurately patients with eating disorders recall their symptoms after 6 to 12 months, to evaluate whether more recent symptoms are remembered more accurately, and to determine the extent to which the accuracy of recall impacts diagnostic classification. Seventy women who were enrolled in a longitudinal study of eating disorder symptoms were asked to recall their eating patterns, behaviors, and attitudes from 6 or 12 months earlier using semistructured interviews (Eating Disorders Examination and McKnight Longitudinal Follow-up Interview for Eating Disorders). Results indicated that correlations between the original and recalled data for frequency of objective binge eating episodes and vomiting ranged from r = .534 to .898 (average, r = .772), with lower correlations for subjective binge eating episodes (average, r = .335). Attitudes toward shape and weight were recalled more accurately at 6 months (average, r = .907) than 12 months (average, r = .620). kappa Coefficients were higher for eating disorder diagnoses using broad than narrow definitions, with no differences between 6- and 12-month recall. Overall, agreement for depression recall was low but better at 6 months (kappa = .423) than 12 months (kappa = .296). These findings suggest that patients with eating disorders are at least moderately accurate when recalling most symptoms from 6 to 12 months earlier. Although broadly defined eating disorder diagnoses remained consistent, depression and narrower eating disorder diagnostic classifications showed more variability.

Exercise caution: Over-exercise is associated with suicidality among individuals with disordered eating

PubMed Central

Smith, April R.; Fink, Erin L.; Anestis, Michael D.; Ribeiro, Jessica D.; Gordon, Kathryn H.; Davis, Heather; Keel, Pamela K.; Bardone-Cone, Anna M.; Peterson, Carol B.; Klein, Marjorie H.; Crow, Scott; Mitchell, James E.; Crosby, Ross D.; Wonderlich, Stephen A.; le Grange, Daniel; Joiner, Thomas E.

2017-01-01

We conducted four studies to examine the relationship between over-exercise and suicidality. Study 1 investigated whether over-exercise predicted suicidal behavior after controlling for other eating disorder behaviors in a patient sample of 204 women (144 with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Bulimia Nervosa [BN]). Study 2 tested the prospective association between over-exercise and acquired capability for suicide (ACS) in a sample of 171 college students followed for 3–4 weeks. Study 3 investigated whether pain insensitivity accounted for the relationship between over-exercise and ACS in a new sample of 467 college students. Study 4 tested whether ACS accounted for the relationship between over-exercise and suicidal behavior in a sample of 512 college students. In Study 1, after controlling for key covariates, over-exercise was the only disordered eating variable that maintained a significant relationship with suicidal behavior. In Study 2, Time 1 over-exercise was the only disordered eating behavior that was associated with Time 2 ACS. In Study 3, pain insensitivity accounted for the relationship between over-exercise and ACS. In Study 4, ACS accounted for the relationship between over-exercise and suicidal behavior. Over-exercise appears to be associated with suicidal behavior, an association accounted for by pain insensitivity and the acquired capability for suicide; notably, this association was found across a series of four studies with different populations. PMID:23219104

Rapid Response to Treatment for Binge Eating Disorder

ERIC Educational Resources Information Center

Grilo, Carlos M.; Masheb, Robin M.; Wilson, Terence G.

2006-01-01

The authors examined rapid response among 108 patients with binge eating disorder (BED) who were randomly assigned to 1 of 4 16-week treatments: fluoxetine, placebo, cognitive-behavioral therapy (CBT) plus fluoxetine, or CBT plus placebo. Rapid response, defined as 65% or greater reduction in binge eating by the 4th treatment week, was determined…

Causes and risks for obesity in children

MedlinePlus

... become obese. No single factor or behavior causes obesity . Obesity is caused by many things, including a person's ... image. Examples of eating disorders are: Anorexia Bulimia Obesity and eating disorders often occur at the same ...

The Leu72Met polymorphism of the ghrelin gene is significantly associated with binge eating disorder.

PubMed

Monteleone, Palmiero; Tortorella, Alfonso; Castaldo, Eloisa; Di Filippo, Carmela; Maj, Mario

2007-02-01

The pathophysiological mechanisms underlying binge eating disorder are poorly understood. Evidence exists for the fact that abnormalities in peptides involved in the regulation of appetite, including ghrelin, may play a role in binge eating behavior. Genes involved in the ghrelin physiology may therefore contribute to the biological vulnerability to binge eating disorder. We examined whether two polymorphisms of the ghrelin gene, the G152A (Arg51Gln) and C214A (Leu72Met), were associated with binge eating disorder. Ninety obese or nonobese women with binge eating disorder and 119 normal weight women were genotyped at the ghrelin gene. Statistical analyses showed that the Leu72Met ghrelin gene variant was significantly more frequent in binge eating disorder patients (chi2=5.940; d.f.=1, P=0.01) and was associated with a moderate, but significant risk to develop binge eating disorder (odds ratio=2.725, 95% confidence interval: 1.168-6.350). Although these data should be regarded as preliminary because of the small sample size, they suggest that the Leu72Met ghrelin gene variant may contribute to the genetic susceptibility to binge eating disorder.

Attachment and eating disorders: a research update.

PubMed

Tasca, Giorgio A

2018-03-16

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.

Readiness and motivation for change among young women with broadly defined eating disorders.

PubMed

Ålgars, Monica; Ramberg, Carin; Moszny, Josefine; Hagman, Jessica; Rintala, Hanna; Santtila, Pekka

2015-01-01

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.

The Role of Affect in the Maintenance of Anorexia Nervosa: Evidence from a Naturalistic Assessment of Momentary Behaviors and Emotion

PubMed Central

Engel, Scott G.; Wonderlich, Stephen A.; Crosby, Ross D.; Mitchell, James E.; Crow, Scott; Peterson, Carol B.; Le Grange, Daniel; Simonich, Heather K.; Cao, Li; Lavender, Jason M.; Gordon, Kathryn H.

2014-01-01

The current study examines the relationship of affect and eating disorder behavior in anorexia nervosa (AN) using ecological momentary assessment. Participants were 118 adult females recruited at three sites from eating disorder treatment centers and community advertisements. All participants met full DSM-IV criteria or sub-threshold criteria for AN. Participants were provided handheld computers and asked to report positive affect, negative affect, loss of control (LOC) eating, purging, exercise, drinking fluids to curb appetite, and weighing one's self multiple times per day as well as dietary restriction once daily over a two-week interval. Mixed-effects models were used to examine the extent to which affective states predict dietary restriction. Additionally, we used two analytic approaches to compare affect prior to and after other eating disorder behaviors. We found that higher daily ratings of negative affect were associated with a greater likelihood of dietary restriction on subsequent days. When examining the single rating immediately before and after behaviors, we found that negative affect increased significantly following LOC eating, purging, the combination of LOC and eating/purging, and weighing of one's self. Using this same analytic approach we also found negative affect to decrease significantly following the consumption of fluids to curb appetite and exercise. When examining the covariation of AN behaviors and negative affect assessed multiple times in the hours and minutes before the behaviors, we found negative affect significantly increased prior to LOC eating, purging, the combination of LOC eating/and purging, and weighing behavior. Negative affect also significantly decreased following the occurrence of these behaviors. These findings are consistent with the idea that that negative affect is potentially a critical maintenance mechanism of some AN symptoms, but that the analytic approach used to examine affect and behavior may have significant implications on the interpretation of findings. PMID:24016011

A commentary on the "eating addiction" versus "food addiction" perspectives on addictive-like food consumption.

PubMed

Schulte, Erica M; Potenza, Marc N; Gearhardt, Ashley N

2017-08-01

The food addiction construct posits that vulnerable individuals may experience an addictive-like response to certain foods, such as those high in fat and refined carbohydrates. Recently, an alternative model to food addiction was proposed, suggesting that the act of eating may be a behavioral addiction that can trigger an addictive-like response in susceptible individuals. One major rationale for the eating addiction framework is that the assessment of food addiction is based on behavioral indicators, such as consuming greater quantities of food than intended and eating certain foods despite negative consequences. It is also suggested that the lack of investigation into which foods and food attributes (e.g., sugar) may have an addictive potential is evidence that food addiction does not parallel a substance-based addiction and more closely resembles a behavioral addiction. The present paper provides a commentary suggesting that the substance-based, food-addiction framework is more appropriate than the behavioral-addiction, eating-addiction perspective to conceptualize addictive-like food consumption. In order to illustrate this point, this manuscript will discuss behavioral components characteristic of all substance-use disorders, preliminary evidence to suggest that all foods are not equally associated with addictive-like eating, and key differences between the hypothesized eating addiction phenotype and the only existing behavioral addiction in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder. Further, this paper will consider implications of applying an addiction label to food versus eating and suggest future research directions to evaluate whether food addiction is a valid and clinically useful construct. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Relationship between Binge Eating Disorder and Suicidality: A Systematic Review.

PubMed

Conti, Chiara; Lanzara, Roberta; Scipioni, Mattia; Iasenza, Marzia; Guagnano, Maria T; Fulcheri, Mario

2017-01-01

Background: We carried out a systematic review analyzing the relation between binge eating disorder (BED), a recent addition to the eating disorders in DSM-5, and suicidality (i.e., suicidal ideation or attempted and/or committed suicide) by synthesizing the relevant studies' qualitative data. Methods: We conducted, according to PRISMA guidelines, a systematic search of the literature on PubMed, Scopus, ISI Web of Science, PsycINFO, Google Scholar, and ScienceDirect. Search terms were "binge eating disorder" combined with the "AND" Boolean operator and "suicid * ." Results: The initial search identified 4,014 records, of which 17 research reports met the predefined inclusion criteria and were analyzed. BED was found to be significantly associated with a marked increase in suicidal behaviors and suicidal ideation (SI). The presence and severity of BED were found to be relevant predictive factors for suicidality, notably in association with mood disorders and specific psychological features, while a high body mass index (BMI) did not always affect suicidality. BED has usually been associated with suicide risk, particularly when occurring with another psychiatric disorder and/or in an adolescent population. Conclusion: Pursuant to these findings, it is necessary to consider both dysfunctional eating behavior and related psychopathological factors that may induce SI and suicidal behavior in BED, aiming to identify patients and subgroups of patients needing greater clinical psychological attention to most effectively prevent and treat suicidality.

Eating behaviors, body image, perfectionism, and self-esteem in a sample of Portuguese girls.

PubMed

Teixeira, Maria D; Pereira, Ana T; Marques, Mariana V; Saraiva, Jorge M; Macedo, António F de

2016-02-05

Eating disorders are an increasingly prevalent health problem among adolescent girls. It is well known that biological, psychosocial, and family-related factors interact in the development of this group of disorders. However, the mechanisms underlying the interaction between these variables are still poorly understood, especially in Portuguese adolescents. The aim of this study was to investigate the relationship between eating behaviors, body dissatisfaction, self-esteem, and perfectionism in a sample of Portuguese girls. A community sample of 575 Portuguese girls attending secondary school, answered self-report questionnaires including data on weight, height, and the Portuguese versions of the Contour Figures Rating Scale, the Child and Adolescent Perfectionism Scale, the Children Eating Attitudes Test, and the Rosenberg Self-Esteem Scale. SPSS version 20.0 for Windows was used for statistical analyses. High scores in the Children Eating Attitudes Test were associated with significantly higher levels of body dissatisfaction (r = 0.339), socially prescribed perfectionism (r = 0.175), self-oriented perfectionism (r = 0.211), and low self-esteem (r = -0.292) (all p < 0.001). Self-oriented perfectionism partially mediated the relation between body dissatisfaction and disordered eating behaviors. In this sample, dysfunctional eating behaviors appeared to correlate strongly with body dissatisfaction, low self-esteem, and perfectionism in girls. These themes should be addressed among female adolescents in the community.

Family meals and disordered eating in adolescents: are the benefits the same for everyone?

PubMed

Loth, Katie; Wall, Melanie; Choi, Chien-Wen; Bucchianeri, Michaela; Quick, Virginia; Larson, Nicole; Neumark-Sztainer, Dianne

2015-01-01

To examine the association between family meals and disordered eating behaviors within a diverse sample of adolescents and further investigate whether family-level variables moderate this association. Data from adolescents (EAT 2010: Eating and Activity in Teens) and their parents (Project F-EAT: Families and Eating and Activity among Teens) were collected in 2009-2010. Surveys were completed by 2,382 middle and high school students (53.2% girls, mean age = 14.4 years) from Minneapolis/St. Paul, MN, public schools. Parents/guardians (n = 2,792) completed surveys by mail or phone. Greater frequency of family meals was associated with decreased odds of engaging in unhealthy weight control behaviors in boys, and dieting, unhealthy and extreme weight control behaviors in girls. Results indicate that the protective effects of family meals are, in general, robust to family-level variables; 64 interactions were examined and only seven were statistically significant. For example, among girls, the protective nature of family meals against dieting and unhealthy weight control behaviors was diminished if they also reported family weight-related teasing (both p < .01). The results confirmed previous research indicating that participation in family meals is protective against disordered eating for youth, particularly girls. However, results suggest that in some cases, the protection offered by family meals may be modified by family-level variables. © 2014 Wiley Periodicals, Inc.

Family Meals and Disordered Eating in Adolescents: Are the Benefits the Same for Everyone?

PubMed Central

Loth, Katie; Wall, Melanie; Choi, Chien-Wen; Bucchianeri, Michaela; Quick, Virginia; Larson, Nicole; Neumark-Sztainer, Dianne

2016-01-01

Objective To examine the association between family meals and disordered eating behaviors within a diverse sample of adolescents and further investigate whether family-level variables moderate this association. Method Data from adolescents (EAT 2010: Eating and Activity in Teens) and their parents (Project F-EAT: Families and Eating and Activity among Teens) were collected in 2009–2010. Surveys were completed by 2,382 middle and high school students (53.2% girls, mean age = 14.4 years) from Minneapolis/St. Paul, MN, public schools. Parents/guardians (n = 2,792) completed surveys by mail or phone. Results Greater frequency of family meals was associated with decreased odds of engaging in unhealthy weight control behaviors in boys, and dieting, unhealthy and extreme weight control behaviors in girls. Results indicate that the protective effects of family meals are, in general, robust to family-level variables; 64 interactions were examined and only seven were statistically significant. For example, among girls, the protective nature of family meals against dieting and unhealthy weight control behaviors was diminished if they also reported family weight-related teasing (both p < .01). Discussion The results confirmed previous research indicating that participation in family meals is protective against disordered eating for youth, particularly girls. However, results suggest that in some cases, the protection offered by family meals may be modified by family-level variables. PMID:25130186

Tailoring Cognitive Behavioral Treatment for Binge Eating in Adolescent Girls

ERIC Educational Resources Information Center

Yarborough, Bobbi Jo; DeBar, Lynn L.; Firemark, Alison; Leung, Sue; Clarke, Gregory N.; Wilson, G. Terence

2013-01-01

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…

Associations of parents' self, child, and other "fat talk" with child eating behaviors and weight.

PubMed

Lydecker, Janet A; Riley, Kristen E; Grilo, Carlos M

2018-03-15

Fat talk, negative communication about weight, is common in the media, peer groups, and families. Little is known about parental fat talk directed at oneself or others. This study examined associations between different forms of parental fat talk and child disordered eating behaviors and weight, and differences by child sex and age. Parents of preadolescents or adolescents (n = 581) reported fat talk about themselves (self-fat talk), others (obesity-fat talk), and their child (child-fat talk). 76.0% of parents reported regular self-fat talk in front of children, 51.5% reported obesity-fat talk, and 43.6% reported child-fat talk. Fat talk did not differ significantly between parents of preadolescents and adolescents but was more common with sons than daughters. Of the three forms of fat talk, only child-fat talk was associated with all child eating and weight variables (binge eating, overeating, secretive eating, and overweight/obesity); associations were strongest for adolescent girls. Child sex was associated with secretive eating and overweight/obesity. Parents reported using different forms of fat talk frequently. Parent self- and obesity-fat talk were reported more frequently, but child-fat talk was the most strongly associated with children's eating and weight. Because of associations with disordered eating behaviors, intervening to reduce fat talk might contribute to improving pediatric disordered eating and weight-related interventions. © 2018 Wiley Periodicals, Inc.

Drive for muscularity and disordered eating among French adolescent boys: a sociocultural model.

PubMed

Rodgers, Rachel F; Ganchou, Camille; Franko, Debra L; Chabrol, Henri

2012-06-01

The pursuit of muscularity is an important body image concern among boys which has been described within sociocultural models of risk for eating disorders. This study explored a sociocultural model of disordered eating in which drive for thinness and pursuit of muscularity were both pathways to disordered eating among French adolescent boys. A sample of 146 adolescents completed a questionnaire assessing drive for thinness, drive for muscularity, media-ideal internalization, appearance comparison, and sociocultural pressure. The model was a good fit to the data and both drive for thinness and the pursuit of muscularity were related to disordered eating. Furthermore, internalization and appearance comparison mediated the relationships between pressure to increase muscle and both drive for muscularity and drive for thinness. Longitudinal research could help clarify the role of the pursuit of muscularity in the development of disordered eating and extreme body shape changing behaviors. Copyright © 2012 Elsevier Ltd. All rights reserved.

How Does the Brain Implement Adaptive Decision Making to Eat?

PubMed Central

Walsh, B. Timothy; Kaye, Walter; Geliebter, Allan

2015-01-01

Adaptive decision making to eat is crucial for survival, but in anorexia nervosa, the brain persistently supports reduced food intake despite a growing need for energy. How the brain persists in reducing food intake, sometimes even to the point of death and despite the evolution of multiple mechanisms to ensure survival by governing adaptive eating behaviors, remains mysterious. Neural substrates belong to the reward-habit system, which could differ among the eating disorders. The present review provides an overview of neural circuitry of restrictive food choice, binge eating, and the contribution of specific serotonin receptors. One possibility is that restrictive food intake critically engages goal-directed (decision making) systems and “habit,” supporting the view that persistent caloric restriction mimics some aspects of addiction to drugs of abuse. SIGNIFICANCE STATEMENT An improved understanding of the neural basis of eating disorders is a timely challenge because these disorders can be deadly. Up to 70 million of people in the world suffer from eating disorders. Anorexia nervosa affects 1–4% of women in United States and is the first cause of death among adolescents in Europe. Studies relying on animal models suggest that decision making to eat (or not) can prevail over actual energy requirements due to emotional disturbances resulting in abnormal habitual behavior, mimicking dependence. These recent studies provide a foundation for developing more specific and effective interventions for these disorders. PMID:26468187

Questionnaire-Based Maladaptive Decision-Coping Patterns Involved in Binge Eating Among 1013 College Students

PubMed Central

Yan, Wan-Sen; Zhang, Ran-Ran; Lan, Yan; Li, Zhi-Ming; Li, Yong-Hui

2018-01-01

Binge Eating Disorder (BED), considered a public health problem because of its impact on psychiatric, physical, and social functioning, merits much attention given its elevation to an independent diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Similar with substance use disorders, some neuropsychological and personality constructs are potentially implicated in the onset and development of BED, in which poor decision-making has been suggested to facilitate overeating and BED. The objective of this study was to investigate the associations between decision-coping patterns, monetary decision-making, and binge-eating behavior in young adults. A sample of 1013 college students, equally divided into binge-eating and non-binge-eating groups according to the scores on the Binge Eating Scale (BES), were administered multiple measures of decision-making including the Melbourne Decision-Making Questionnaire (MDMQ), the Delay-discounting Test (DDT), and the Probability Discounting Test (PDT). Compared with the non-binge-eating group, the binge-eating group displayed elevated scores on maladaptive decision-making patterns including Procrastination, Buck-passing, and Hypervigilance. Logistic regression model revealed that only Procrastination positively predicted binge eating. These findings suggest that different dimensions of decision-making may be distinctly linked to binge eating among young adults, with Procrastination putatively identified as a risk trait in the development of overeating behavior, which might promote a better understanding of this disorder. PMID:29765343

Food seeking in spite of harmful consequences is under prefrontal cortical noradrenergic control

PubMed Central

2010-01-01

Background Eating disorders are multifactorial psychiatric disorders. Chronic stressful experiences and caloric restriction are the most powerful triggers of eating disorders in human and animals. Although compulsive behavior is considered to characterize pathological excessive food intake, to our knowledge, no evidence has been reported of continued food seeking/intake despite its possible harmful consequences, an index of compulsive behavior. Brain monoamine transmission is considered to have a key role in vulnerability to eating disorders, and norepinephrine in medial prefrontal cortex has been shown to be critical for food-related motivated behavior. Here, using a new paradigm of conditioned suppression, we investigated whether the ability of a foot-shock-paired conditioned stimulus to suppress chocolate-seeking behavior was reversed by previous exposure to a food restriction experience, thus modeling food seeking in spite of harmful consequences in mice. Moreover, we assessed the effects of selective norepinephrine inactivation in medial prefrontal cortex on conditioned suppression test in stressed and caloric restricted mice. Results While Control (non food deprived) animals showed a profound conditioned suppression of chocolate seeking during presentation of conditioned stimulus, previously food restricted animals showed food seeking/intake despite its possible harmful consequences. Moreover, food seeking in spite of harmful consequences was prevented by selective norepinephrine inactivation, thus showing that prefrontal cortical norepinephrine is critical also for maladaptive food-related behavior. Conclusions These findings indicate that adaptive food seeking/intake can be transformed into maladaptive behaviors and point to "top-down" influence on eating disturbances and to new targets for therapy of aberrant eating behaviors. PMID:20141625

A multidimensional approach to understanding the potential risk factors and covariates of adult picky eating.

PubMed

Ellis, Jordan M; Schenk, Rebecca R; Galloway, Amy T; Zickgraf, Hana F; Webb, Rose Mary; Martz, Denise M

2018-06-01

Adult picky eating (PE) has received increased attention in the eating behavior literature due to its important association with adult avoidant-restrictive food intake disorder (ARFID). The current study tested a model of potential risk factors of adult PE behavior, including perceived early parental feeding practices. An exploratory model was also utilized to understand associations with different aspects of adult PE behaviors. A sample of 1339 US adults recruited through Amazon's MTurk completed an online survey that included the recently developed Adult Picky Eating Questionnaire (APEQ), retrospective reports of parental feeding practices, and other measures of eating behavior and demographic variables. A structural equation modeling procedure tested a series of regression models that included BMI and disordered eating behaviors as covariates. SEM modeling indicated that retrospective reports of greater parental pressure to eat, higher disgust sensitivity, lower PE age of onset, and experiencing an aversive food event were associated with general adult PE behavior. Results also indicated parental encouragement of healthy eating may be a protective factor, and that men endorsed higher levels of adult PE. Exploratory analyses indicated that cross-sectional predictors and covariates were differentially related to specific aspects of PE as measured by the APEQ subscales. Early experiences, including parental approaches to feeding, appear to be potential risk factors of PE behavior in adults. A nuanced understanding of adult PE is important for the prevention and treatment of severe PE behaviors, related psychosocial impairment, and ARFID. Copyright © 2018 Elsevier Ltd. All rights reserved.

Body checking and eating cognitions in Brazilian outpatients with eating disorders and non psychiatric controls.

PubMed

Kachani, Adriana Trejger; Barroso, Lucia Pereira; Brasiliano, Silvia; Cordás, Táki Athanássios; Hochgraf, Patrícia Brunfentrinker

2015-12-01

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.

Characterization of Binge-Eating Behavior in Individuals With Binge-Eating Disorder in an Adult Population in the United States.

PubMed

Pawaskar, Manjiri; Solo, Kirk; Valant, Jason; Schmitt, Emily; Nwankwo, Millicent; Herman, Barry K

2016-10-27

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.

A 10-session cognitive-behavioral therapy (CBT-T) for eating disorders: Outcomes from a case series of nonunderweight adult patients.

PubMed

Waller, Glenn; Tatham, Madeleine; Turner, Hannah; Mountford, Victoria A; Bennetts, Alison; Bramwell, Kate; Dodd, Julie; Ingram, Lauren

2018-03-01

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.

Childhood Anxiety Trajectories and Adolescent Disordered Eating: Findings from the NICHD Study of Early Child Care and Youth Development

PubMed Central

Zerwas, Stephanie; Von Holle, Ann; Watson, Hunna; Gottfredson, Nisha; Bulik, Cynthia M.

2015-01-01

Objective The goal of the present paper was to examine whether childhood anxiety trajectories predict eating psychopathology. We predicted that girls with trajectories of increasing anxiety across childhood would have significantly greater risk of disordered eating in adolescence in comparison to girls with stable or decreasing trajectories of anxiety over childhood. Method Data were collected as part of the prospective longitudinal NICHD Study of Early Child Care and Youth Development (N=450 girls). Childhood anxiety was assessed yearly (54 months through 6th grade) via maternal report on the Child Behavior Checklist. Disordered eating behaviors were assessed at age 15 via adolescent self-report on the Eating Attitudes Test (EAT-26). We conducted latent growth mixture modeling to define girls’ childhood anxiety trajectories. Maternal sensitivity, maternal postpartum depression, maternal anxiety, and child temperament were included as predictors of trajectory membership. Results The best fitting model included three trajectories of childhood anxiety, the low-decreasing class (22.9% of girls), the high-increasing class (35.4%), and the high-decreasing class (41.6%). Mothers with more symptoms of depression and separation anxiety had girls who were significantly more likely to belong to the high-increasing anxiety trajectory. There were no significant differences in adolescent disordered eating for girls across the three childhood anxiety trajectories. Conclusions Childhood anxiety, as captured by maternal report, may not be the most robust predictor of adolescent disordered eating and may be of limited utility for prevention programs that aim to identify children in the community at greatest risk for disordered eating. PMID:24938214

Does Internalizing Society and Media Messages Cause Body Dissatisfaction, in Turn Causing Disordered Eating?

PubMed

Dye, Heather

2016-01-01

The purpose of this study was to examine the predictive influence that internalization of society and media messages has on body dissatisfaction, as well as the prediction influence that body dissatisfaction has on disordered eating behaviors, such as preoccupation with weight, dieting, and eating restraint. A total of 324 participants completed the demographic questionnaire, the Multidimensional Body Self Relations Questionnaire (Cash, 2001 ), the Sociocultural Attitudes Towards Appearance Questionnaire (Heinberg, Thompson, & Stormer, 1995 ) for women, and the Sociocultural Attitudes Towards Appearance Questionnaire-Revised-Male-Version (Cusumano & Thompson, 1997 ) for men, and the locus of control (Rotter, 1966 ). The results of this study found that high internalization leads to body dissatisfaction, in turn, leading to disordered eating behaviors, such as preoccupation with weight, dieting, and eating restraint. This study proposes the implementation of media literacy and education programs that teach college women and men, girls and boys, to think more critically about the media.

Obese Patients With a Binge Eating Disorder Have an Unfavorable Metabolic and Inflammatory Profile.

PubMed

Succurro, Elena; Segura-Garcia, Cristina; Ruffo, Mariafrancesca; Caroleo, Mariarita; Rania, Marianna; Aloi, Matteo; De Fazio, Pasquale; Sesti, Giorgio; Arturi, Franco

2015-12-01

To evaluate whether obese patients with a binge eating disorder (BED) have an altered metabolic and inflammatory profile related to their eating behaviors compared with non-BED obese.A total of 115 White obese patients consecutively recruited underwent biochemical, anthropometrical evaluation, and a 75-g oral glucose tolerance test. Patients answered the Binge Eating Scale and were interviewed by a psychiatrist. The patients were subsequently divided into 2 groups according to diagnosis: non-BED obese (n = 85) and BED obese (n = 30). Structural equation modeling analysis was performed to elucidate the relation between eating behaviors and metabolic and inflammatory profile.BED obese exhibited significantly higher percentages of altered eating behaviors, body mass index (P < 0.001), waist circumference (P < 0.01), fat mass (P < 0.001), and a lower lean mass (P < 0.001) when compared with non-BED obese. Binge eating disorder obese also had a worse metabolic and inflammatory profile, exhibiting significantly lower high-density lipoprotein cholesterol levels (P < 0.05), and higher levels of glycated hemoglobin (P < 0.01), uric acid (P < 0.05), erythrocyte sedimentation rate (P < 0.001), high-sensitive C-reactive protein (P < 0.01), and white blood cell counts (P < 0.01). Higher fasting insulin (P < 0.01) and higher insulin resistance (P < 0.01), assessed by homeostasis model assessment index and visceral adiposity index (P < 0.001), were observed among BED obese. All differences remained significant after adjusting for body mass index. No significant differences in fasting plasma glucose or 2-hour postchallenge plasma glucose were found. Structural equation modeling analysis confirmed the relation between the altered eating behaviors of BED and the metabolic and inflammatory profile.Binge eating disorder obese exhibited an unfavorable metabolic and inflammatory profile, which is related to their characteristic eating habits.

Obese Patients With a Binge Eating Disorder Have an Unfavorable Metabolic and Inflammatory Profile

PubMed Central

Succurro, Elena; Segura-Garcia, Cristina; Ruffo, Mariafrancesca; Caroleo, Mariarita; Rania, Marianna; Aloi, Matteo; De Fazio, Pasquale; Sesti, Giorgio; Arturi, Franco

2015-01-01

Abstract To evaluate whether obese patients with a binge eating disorder (BED) have an altered metabolic and inflammatory profile related to their eating behaviors compared with non-BED obese. A total of 115 White obese patients consecutively recruited underwent biochemical, anthropometrical evaluation, and a 75-g oral glucose tolerance test. Patients answered the Binge Eating Scale and were interviewed by a psychiatrist. The patients were subsequently divided into 2 groups according to diagnosis: non-BED obese (n = 85) and BED obese (n = 30). Structural equation modeling analysis was performed to elucidate the relation between eating behaviors and metabolic and inflammatory profile. BED obese exhibited significantly higher percentages of altered eating behaviors, body mass index (P < 0.001), waist circumference (P < 0.01), fat mass (P < 0.001), and a lower lean mass (P < 0.001) when compared with non-BED obese. Binge eating disorder obese also had a worse metabolic and inflammatory profile, exhibiting significantly lower high-density lipoprotein cholesterol levels (P < 0.05), and higher levels of glycated hemoglobin (P < 0.01), uric acid (P < 0.05), erythrocyte sedimentation rate (P < 0.001), high-sensitive C-reactive protein (P < 0.01), and white blood cell counts (P < 0.01). Higher fasting insulin (P < 0.01) and higher insulin resistance (P < 0.01), assessed by homeostasis model assessment index and visceral adiposity index (P < 0.001), were observed among BED obese. All differences remained significant after adjusting for body mass index. No significant differences in fasting plasma glucose or 2-hour postchallenge plasma glucose were found. Structural equation modeling analysis confirmed the relation between the altered eating behaviors of BED and the metabolic and inflammatory profile. Binge eating disorder obese exhibited an unfavorable metabolic and inflammatory profile, which is related to their characteristic eating habits. PMID:26717356

Experiences of recovery in binge-eating disorder: a qualitative approach using online message boards.

PubMed

Lord, Vanessa M; Reiboldt, Wendy; Gonitzke, Dariella; Parker, Emily; Peterson, Caitlin

2018-02-01

In this study, qualitative methods were employed to analyze secondary data from the anonymous postings of a pro-recovery website in an effort to investigate the changes in thinking of binge-eating disorder (BED) sufferers who were able to recover from the disorder, understand more fully how guilt and self-blame affect recovery, and explore the perceived motivators and challenges to recovery. 681 messages from 65 participants pertaining to BED were analyzed from January 1, 2014-January 1, 2015 through thematic analysis. Coding strategies were employed to reveal patterns within the experiences of the participants. The researchers identified three themes surrounding "changes in thinking" from analysis of the message board postings: admitting the disorder, recognizing unhealthy coping behaviors, and seeing recovery. Further analysis of postings suggested that guilt and self-blame hinder recovery by promoting a feedback cycle of binging, which leads to further guilt and self-blame. The data ultimately identified experiences that resulted in or hindered recovery. The experience of validation appeared to result in recovery; those who experienced validation were less inclined to engage in disordered eating behaviors. Conversely, weight loss or attempts at weight loss hindered recovery by ultimately promoting more disordered eating behaviors. This qualitative analysis of message board postings offers authentic, credible data with a unique perspective. Practitioners working in the field of eating disorders such as registered dietitian nutritionists or therapists might use evidence from the data to guide their practice.

An exploratory investigation of purging disorder.

PubMed

Smith, Kathryn E; Crowther, Janis H

2013-01-01

Purging Disorder (PD) is an understudied pattern of behaviors within the Eating Disorder Not Otherwise Specified (EDNOS) category. Such categorization may suggest that PD is not clinically significant as other eating disorders. However, evidence has suggested that PD is associated with significant impairments in psychosocial functioning and well-being. Despite the apparent clinical significance of PD, it remains to be determined if PD is distinct from other clinically significant eating disorders. The present study sought to assess the phenomenology, clinical significance, and distinctiveness of PD. Group scores on measures of eating pathology, body image disturbance, and psychological correlates were compared using MANOVA among a female undergraduate sample (N=94) meeting diagnostic criteria for PD (n=20), Bulimia Nervosa (BN; n=35), restrained eating (n=18), and healthy controls (n=21). Overall, results indicated the PD group reported less severe symptoms than BN but more severe symptoms than controls. The PD and restraint groups were similar on most variables (including subjective binge behavior), with the exception of perfectionism and hunger. Findings support the conceptualization of PD as existing along a spectrum of bulimic spectrum disorders rather than as a distinct diagnostic category. Copyright © 2012 Elsevier Ltd. All rights reserved.

Eating Disorders: National Institute of Mental Health's Perspective

ERIC Educational Resources Information Center

Chavez, Mark; Insel, Thomas R.

2007-01-01

The mission of the National Institute of Mental Health (NIMH) is to reduce the burden of mental and behavioral disorders through research, and eating disorders embody an important fraction of this burden. Although past and current research has provided important knowledge regarding the etiology, classification, pathophysiology, and treatment of…

Psychometric properties of the Compulsive Exercise Test in an adolescent eating disorder population.

PubMed

Formby, Pam; Watson, Hunna J; Hilyard, Anna; Martin, Kate; Egan, Sarah J

2014-12-01

The objective of this study was to evaluate the factor structure, validity, and reliability of the Compulsive Exercise Test (CET) in an adolescent clinical eating disorder population. The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project, a prospective ongoing registry study comprising consecutive pediatric tertiary eating disorder referrals. Adolescents (N=104; 12-17years) with eating disorders completed the CET and other measures. Factor structure, convergent validity, and internal consistency were evaluated. Despite failing to identify a factor structure, the study provided clear evidence of the multidimensionality of the measure. The total score correlated significantly with measures of eating pathology, perfectionism, and frequency of exercise for shape and weight control (r=0.32-0.70, ps<0.05). More research into the multidimensional nature of compulsive exercise in clinical populations is needed. Further, research into compulsive exercise offers promise as an addition to existing cognitive behavioral models and treatments for eating disorders. Copyright © 2014 Elsevier Ltd. All rights reserved.

Convergent dysregulation of frontal cortical cognitive and reward systems in eating disorders.

PubMed

Stefano, George B; Ptáček, Radek; Kuželová, Hana; Mantione, Kirk J; Raboch, Jiří; Papezova, Hana; Kream, Richard M

2013-05-10

A substantive literature has drawn a compelling case for the functional involvement of mesolimbic/prefrontal cortical neural reward systems in normative control of eating and in the etiology and persistence of severe eating disorders that affect diverse human populations. Presently, we provide a short review that develops an equally compelling case for the importance of dysregulated frontal cortical cognitive neural networks acting in concert with regional reward systems in the regulation of complex eating behaviors and in the presentation of complex pathophysiological symptoms associated with major eating disorders. Our goal is to highlight working models of major eating disorders that incorporate complementary approaches to elucidate functionally interactive neural circuits defined by their regulatory neurochemical phenotypes. Importantly, we also review evidence-based linkages between widely studied psychiatric and neurodegenerative syndromes (e.g., autism spectrum disorders and Parkinson's disease) and co-morbid eating disorders to elucidate basic mechanisms involving dopaminergic transmission and its regulation by endogenously expressed morphine in these same cortical regions.

Protective Behavioral Strategies and Alcohol Use Outcomes among College Women Drinkers: Does Disordered Eating and Race Moderate This Association?

ERIC Educational Resources Information Center

Landry, Alicia S.; Moorer, Kayla D.; Madson, Michael B.; Zeigler-Hill, Virgil

2014-01-01

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.…

Mental Health Literacy and Eating-Disordered Behavior: Beliefs of Adolescent Girls Concerning the Treatment of and Treatment-Seeking for Bulimia Nervosa

ERIC Educational Resources Information Center

Mond, J. M.; Marks, P.; Hay, P. J.; Rodgers, B.; Kelly, C.; Owen, C.; Paxton, S. J.

2007-01-01

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…

Evaluation of a Theory-Driven E-Learning Intervention for Future Oral Healthcare Providers on Secondary Prevention of Disordered Eating Behaviors

ERIC Educational Resources Information Center

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.; Brown, Kelli R. McCormack; Tedesco, Lisa A.; Hendricson, William

2013-01-01

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…

Cultural Adaptation of a Cognitive Behavior Therapy Guided Self-Help Program for Mexican American Women with Binge Eating Disorders

ERIC Educational Resources Information Center

Shea, Munyi; Cachelin, Fary; Uribe, Luz; Striegel, Ruth H.; Thompson, Douglas; Wilson, G. Terence

2012-01-01

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…

Screening High School Students for Eating Disorders: Validity of Brief Behavioral and Attitudinal Measures

ERIC Educational Resources Information Center

Haines, Jess; Ziyadeh, Najat J.; Franko, Debra L.; McDonald, Julia; Mond, Jonathan M.; Austin, S. Bryn

2011-01-01

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…

Self-Reported Eating Disorders of Black, Low-Income Adolescents: Behavior, Body Weight Perceptions, and Methods of Dieting.

ERIC Educational Resources Information Center

Balentine, Margaret; And Others

1991-01-01

Study identified African-American low-income adolescents who thought they had bulimia or anorexia nervosa, identified common behaviors, and compared actual and perceived body weight and dieting methods. About 12 percent suspected an eating disorder and perceived themselves as heavier more often than their peers. Fasting was the most common dieting…

Body Satisfaction and Eating Disorder Behaviors among Immigrant Adolescents in North America

ERIC Educational Resources Information Center

Magtoto, Joanne; Cox, David; Saewyc, Elizabeth

2013-01-01

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.…

Weight-related abuse: Perceived emotional impact and the effect on disordered eating.

PubMed

Salwen, Jessica K; Hymowitz, Genna F; Bannon, Sarah M; O'Leary, K Daniel

2015-07-01

The purpose of this article was to evaluate theories that (1) weight-related abuse (WRA) plays a unique role in the development of disordered eating, above and beyond general childhood verbal abuse and weight-related teasing, and (2) the perceived emotional impact of WRA mediates the relationship between WRA and current disordered eating. Self-report questionnaires on childhood trauma, weight-related teasing, WRA, and current eating behaviors were administered to a total of 383 undergraduate students. In initial regressions, WRA significantly predicted binge eating, emotional eating, night eating, and unhealthy weight control. WRA continued to significantly predict all 4 forms of disordered eating following the introduction of measures of weight-related teasing and childhood verbal abuse into the regression. Latent variable analysis confirmed that perceived emotional impact of WRA mediated the relationship between WRA and disordered eating, and tests for indirect effects yielded a significant indirect effect of WRA on disordered eating through perceived emotional impact. In sum, WRA is a unique construct and the content of childhood or adolescent maltreatment is important in determining eventual psychopathology outcomes. These findings support the necessity of incorporating information on developmental history and cognitive factors into assessment and treatment of individuals with disordered eating. Copyright © 2015 Elsevier Ltd. All rights reserved.

Initial validation of the Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS): A measure of three restrictive eating patterns.

PubMed

Zickgraf, Hana F; Ellis, Jordan M

2018-04-01

Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating or feeding disorder characterized by inadequate nutritional or caloric intake leading to weight loss, nutritional deficiency, supplement dependence, and/or significant psychosocial impairment. DSM-5 lists three different eating patterns that can lead to symptoms of ARFID: avoidance of foods due to their sensory properties (e.g., picky eating), poor appetite or limited interest in eating, or fear of negative consequences from eating. Research on the prevalence and psychopathology of ARFID is limited by the lack of validated instruments to measure these eating behaviors. The present study describes the development and validation of the nine-item ARFID screen (NIAS), a brief multidimensional instrument to measure ARFID-associated eating behaviors. Participants were 455 adults recruited on Amazon's Mechanical Turk, 505 adults recruited from a nationally-representative subject pool, and 311 undergraduates participating in research for course credit. Exploratory and confirmatory factor analyses provided evidence for three factors. The NIAS subscales demonstrated high internal consistency, test-retest reliability, invariant item loadings between two samples, and convergent/discriminant validity with other measures of picky eating, appetite, fear of negative consequences, and psychopathology. The scales were also correlated with measures of ARFID-like symptoms (e.g., low BMI, low fruit/vegetable variety and intake, and eating-related psychosocial interference/distress), although the picky eating, appetite, and fear scales had distinct independent relationships with these constructs. The NIAS is a brief, reliable instrument that may be used to further investigate ARFID-related eating behaviors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Preferred Psychological Internet Resources for Addressing Anxiety Disorders, Parenting Problems, Eating Disorders, and Chemical Dependency.

ERIC Educational Resources Information Center

Morse, Laura; Doran, Matt; Simonin, Danielle; Smith, Allyson; Maloney, Colleen; Wright, Cara; Underwood, Michelle; Hoppel, Andrea; O'Donnell, Shannon; Chambliss, Catherine

Although the Internet offers information about psychological problems and support resources for behavioral health problems, the quality of this information varies widely. So as to offer guidance in this area, preferred sites pertaining to anxiety disorders, parenting problems, eating disorders, and chemical dependency were analyzed. A total of 365…

[Risk factors related with eating disorders in a community of adolescents].

PubMed

Díaz Benavente, M; Rodríguez Morilla, F; Martín Leal, C; Hiruela Benjumea, M V

2003-10-31

To detect risk factors related with eating disorders. Descriptive, cross-sectional study. 5 secondary schools in the Virgen de Rocío health area in Seville, Spain. 789 students enrolled in the first and second years of compulsory secondary school, and their families. MAIN MEASURES. Body mass index, risk behaviors related with food and exercise, influence of the mass media on models of desirable body types, and family climate. Data were obtained with three validated questionnaires: the Eating Attitudes Test (EAT-40), the CIMEC-26, and the Family Environment Scale (FES). In 6.9% of the participants, BMI was between 15 and 17, reflecting slight malnutrition. On the EAT scale, 68 participants (8.8%) had scores that were indicative of illness or risk of illness, and 25 (3.3%) could be diagnosed as having eating behavior disorder according to DSM-IV criteria. According to the CIMEC questionnaire, 104 participants (13.5%) were found to be significantly vulnerable to media pressures, and 85 (11.1%) were considered highly vulnerable. Parents' comments on eating behavior were related with the results on the EAT-40 CIMEC questionnaires (P=.01). No statistically significant relationship was found between family climate scores and the scores on the EAT-40 or CIMEC questionnaires. Students in rural or suburban area schools scored higher on the EAT-40 (P=.04) and CIMEC (P=.01) than students in urban or city center schools. The identification of persons considered at risk will allow us to use primary prevention programs more efficiently.

Eating disorder-specific risk factors moderate the relationship between negative urgency and binge eating: A behavioral genetic investigation.

PubMed

Racine, Sarah E; VanHuysse, Jessica L; Keel, Pamela K; Burt, S Alexandra; Neale, Michael C; Boker, Steven; Klump, Kelly L

2017-07-01

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).

Enhanced cognitive behavioral therapy for eating disorders adapted for a group setting.

PubMed

Wade, Stephanie; Byrne, Sue; Allen, Karina

2017-08-01

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.

Disordered Eating in College Students: Links with Childhood Abuse and Maternal Eating Behavior.

ERIC Educational Resources Information Center

Feilke, Kim; Chambliss, Catherine

The prevalence of sexual conflicts in many patients with eating disorders has been well documented. A parallel has been found between psychological problems experienced by victims of childhood sexual abuse and patients with anorexia nervosa and/or bulimia. Past studies have used inpatient clinical samples; however, this study extended this area of…

An Analysis of Specific Life Satisfaction Domains and Disordered Eating among College Students

ERIC Educational Resources Information Center

Matthews, Molly; Zullig, Keith J.; Ward, Rose Marie; Horn, Thelma; Huebner, E. Scott

2012-01-01

Research has revealed that overall life satisfaction (LS) is negatively related to disordered eating. This study examined whether specific LS domains (e.g., family, friends, etc.) were more strongly associated with eating behaviors/weight perceptions (e.g., exercising to lose weight, using laxatives to lose weight, etc.) in 723 randomly selected…

A randomized controlled trial of family therapy and cognitive behavior therapy guided self-care for adolescents with bulimia nervosa and related disorders.

PubMed

Schmidt, Ulrike; Lee, Sally; Beecham, Jennifer; Perkins, Sarah; Treasure, Janet; Yi, Irene; Winn, Suzanne; Robinson, Paul; Murphy, Rebecca; Keville, Saskia; Johnson-Sabine, Eric; Jenkins, Mari; Frost, Susie; Dodge, Liz; Berelowitz, Mark; Eisler, Ivan

2007-04-01

To date no trial has focused on the treatment of adolescents with bulimia nervosa. The aim of this study was to compare the efficacy and cost-effectiveness of family therapy and cognitive behavior therapy (CBT) guided self-care in adolescents with bulimia nervosa or eating disorder not otherwise specified. Eighty-five adolescents with bulimia nervosa or eating disorder not otherwise specified were recruited from eating disorder services in the United Kingdom. Participants were randomly assigned to family therapy for bulimia nervosa or individual CBT guided self-care supported by a health professional. The primary outcome measures were abstinence from binge-eating and vomiting, as assessed by interview at end of treatment (6 months) and again at 12 months. Secondary outcome measures included other bulimic symptoms and cost of care. Of the 85 study participants, 41 were assigned to family therapy and 44 to CBT guided self-care. At 6 months, bingeing had undergone a significantly greater reduction in the guided self-care group than in the family therapy group; however, this difference disappeared at 12 months. There were no other differences between groups in behavioral or attitudinal eating disorder symptoms. The direct cost of treatment was lower for guided self-care than for family therapy. The two treatments did not differ in other cost categories. Compared with family therapy, CBT guided self-care has the slight advantage of offering a more rapid reduction of bingeing, lower cost, and greater acceptability for adolescents with bulimia or eating disorder not otherwise specified.

Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane systematic reviews

PubMed Central

Costa, Marcelle Barrueco; Melnik, Tamara

2016-01-01

ABSTRACT Eating disorders are psychiatric conditions originated from and perpetuated by individual, family and sociocultural factors. The psychosocial approach to treatment and prevention of relapse is crucial. To present an overview of the scientific evidence on effectiveness of psychosocial interventions in treatment of eating disorders. All systematic reviews published by the Cochrane Database of Systematic Reviews - Cochrane Library on the topic were included. Afterwards, as from the least recent date of these reviews (2001), an additional search was conducted at PubMed with sensitive search strategy and with the same keywords used. A total of 101 primary studies and 30 systematic reviews (5 Cochrane systematic reviews), meta-analysis, guidelines or narrative reviews of literature were included. The main outcomes were: symptomatic remission, body image, cognitive distortion, psychiatric comorbidity, psychosocial functioning and patient satisfaction. The cognitive behavioral approach was the most effective treatment, especially for bulimia nervosa, binge eating disorder and the night eating syndrome. For anorexia nervosa, the family approach showed greater effectiveness. Other effective approaches were interpersonal psychotherapy, dialectic behavioral therapy, support therapy and self-help manuals. Moreover, there was an increasing number of preventive and promotional approaches that addressed individual, family and social risk factors, being promising for the development of positive self-image and self-efficacy. Further studies are required to evaluate the impact of multidisciplinary approaches on all eating disorders, as well as the cost-effectiveness of some effective modalities, such as the cognitive behavioral therapy. PMID:27462898

Overestimation of body size in eating disorders and its association to body-related avoidance behavior.

PubMed

Vossbeck-Elsebusch, Anna N; Waldorf, Manuel; Legenbauer, Tanja; Bauer, Anika; Cordes, Martin; Vocks, Silja

2015-06-01

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.

Impaired prefrontal cognitive control over interference by food images in binge-eating disorder and bulimia nervosa.

PubMed

Lee, Jung Eun; Namkoong, Kee; Jung, Young-Chul

2017-06-09

Binge-eating disorder (BED)characterized by recurrent episodes of binge-eating without inappropriate compensatory behaviors is classified as an official diagnosis in DSM-5. However, the neural bases that differentiate BED from other eating disorders such as bulimia nervosa (BN), are still under debate. Thirty-nine participants (HC, n=14; BN, n=13; BED, n=12) underwent functional MRI while performing a Stroop-Match-to-Sample task. This pilot study investigated how food images interfered with the behavioral performances and blood-oxygenation-level-dependent neuronal activity. Compared to healthy controls, participants with BN showed lower accuracy indicating impaired cognitive control over interference. Compared to healthy controls, participants with BED demonstrated stronger activations in the ventral striatum in response to food images. By contrast, participants with BN exhibited stronger activations in the premotor cortex and dorsal striatum. These aberrant ventral and dorsal frontostriatal activations in response to food images are associated with increased reward sensitivity and habitual binge-eating/purging behaviors in BED and BN. Copyright © 2017 Elsevier B.V. All rights reserved.

Eating Disorder Symptomatology and Identity Formation in Adolescence: A Cross-Lagged Longitudinal Approach.

PubMed

Verschueren, Margaux; Claes, Laurence; Bogaerts, Annabel; Palmeroni, Nina; Gandhi, Amarendra; Moons, Philip; Luyckx, Koen

2018-01-01

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.

Eating Disorder Symptomatology and Identity Formation in Adolescence: A Cross-Lagged Longitudinal Approach

PubMed Central

Verschueren, Margaux; Claes, Laurence; Bogaerts, Annabel; Palmeroni, Nina; Gandhi, Amarendra; Moons, Philip; Luyckx, Koen

2018-01-01

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. PMID:29915548

The Role of Ghrelin, Salivary Secretions, and Dental Care in Eating Disorders

PubMed Central

Yagi, Takakazu; Ueda, Hirotaka; Amitani, Haruka; Asakawa, Akihiro; Miyawaki, Shouichi; Inui, Akio

2012-01-01

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. PMID:23016127

The role of maternal anorexia nervosa and bulimia nervosa before and during pregnancy in early childhood wheezing: Findings from the NINFEA birth cohort study.

PubMed

Popovic, Maja; Pizzi, Costanza; Rusconi, Franca; Gagliardi, Luigi; Galassi, Claudia; Trevisan, Morena; Merletti, Franco; Richiardi, Lorenzo

2018-05-02

This study evaluates associations of maternal eating disorders (bulimia nervosa, anorexia nervosa, and purging behaviors) with infant wheezing and examines the effects of eating disorders on several wheezing determinants. We studied 5,150 singletons from the NINFEA birth cohort. Maternal bulimia nervosa and anorexia nervosa diagnoses were ascertained from the questionnaires completed in pregnancy and 6 months after delivery, and were analyzed as: ever diagnosis, only before pregnancy, and during pregnancy. Purging behaviors were assessed for 12 months before or during pregnancy. The associations with wheezing between 6 and 18 months of age were assessed in models adjusted for a priori selected confounders. Children born to mothers with lifetime eating disorders were at an increased risk of developing wheezing (adjusted OR 1.68; [95% CI: 1.08, 2.60]), and this risk further increased when the disorders were active during pregnancy (2.52 [1.23, 5.19]). Increased risk of offspring wheezing was observed also for purging behaviors without history of eating disorder diagnosis (1.50 [1.10, 2.04]). The observed associations were not explained by comorbid depression and/or anxiety. Bulimia nervosa and/or anorexia nervosa during pregnancy were also associated with several risk factors for wheezing, including maternal smoking, adverse pregnancy outcomes, shorter breastfeeding duration, and day-care attendance. The associations of maternal eating disorders with offspring wheezing suggest long-term adverse respiratory outcomes in children of mothers with eating disorders. A better understanding of mechanisms implicated is necessary to help reduce the respiratory disease burden in these children. © 2018 Wiley Periodicals, Inc.

Impulse Control Disorders and Related Complications of Parkinson’s Disease Therapy

PubMed Central

Lopez, Alexander M.; Weintraub, Daniel; Claassen, Daniel O.

2017-01-01

Impulsive and compulsive behaviors in Parkinson’s disease (PD) patients are most often attributed to dopamine agonist therapy; dysregulation of the mesocorticolimbic system accounts for this behavioral phenotype. The clinical presentation is commonly termed impulse control disorder (ICD): Behaviors include hypersexuality, compulsive eating, shopping, pathological gambling, and compulsive hobby participation. However, not all PD individuals taking dopamine agonists develop these behavioral changes. In this review, the authors focus on the similarities between the phenotypic presentation of ICDs with that of other reward-based behavioral disorders, including binge eating disorder, pathological gambling, and substance use disorders. With this comparison, we emphasize that the transition from an impulsive to compulsive behavior likely follows a ventral to dorsal striatal pattern, where an altered dopaminergic reward system underlies the emergence of these problematic behaviors. The authors discuss the neurobiological similarities between these latter disorders and ICDs, emphasizing similar pathophysiological processes and discussing treatment options that have potential for translation to PD patients. PMID:28511259

The experience of women with an eating disorder in the perinatal period: a meta-ethnographic study.

PubMed

Fogarty, Sarah; Elmir, Rakime; Hay, Phillipa; Schmied, Virginia

2018-05-02

Pregnancy is a time of enormous body transformation. For those with an eating disorder during pregnancy this time of transformation can be distressing and damaging to both the mother and the child. In this meta-ethnographic study, we aimed to examine the experiences of women with an Eating Disorder in the perinatal period; that is during pregnancy and two years following birth. A meta-ethnographic framework was used in this review. After a systematic online search of the literature using the keywords such as pregnancy, eating disorders, anorexia, bulimia, binge eating disorder, perinatal, postnatal and post-partum, 11 papers, involving 94 women, were included in the review. A qualitative synthesis of the papers identified 2 key themes. The key theme that emerged during pregnancy was: navigating a 'new' eating disorder. The key that emerged in the perinatal period was return to the 'old' eating disorder. Following a tumultuous pregnancy experience, many described returning to their pre-pregnancy eating behaviors and thoughts. These experiences highlight the emotional difficulty experienced having an eating disorder whilst pregnant but they also point to opportunities for intervention and a continued acceptance of body image changes. More research is needed on the experiences of targeted treatment interventions specific for pregnant and postpartum women with an eating disorder and the effectiveness of putative treatment interventions during this period.

Disentangling body image: The relative associations of overvaluation, dissatisfaction, and preoccupation with psychological distress and eating disorder behaviors in male and female adolescents.

PubMed

Mitchison, Deborah; Hay, Phillipa; Griffiths, Scott; Murray, Stuart B; Bentley, Caroline; Gratwick-Sarll, Kassandra; Harrison, Carmel; Mond, Jonathan

2017-02-01

The distinctiveness and relative clinical significance of overvaluation, dissatisfaction, and preoccupation with body weight/shape remains inconclusive. This study sought to add to the evidence by testing associations between these three body image constructs and indicators of clinical significance. Male and female secondary students (N = 1,666) aged 12-18 years completed a survey that included measures of dissatisfaction with, overvaluation of, and preoccupation with weight/shape, psychological distress, eating disorder behaviors, and basic demographic information. Conditional process analysis was employed to test the independent and mediating effects of overvaluation, dissatisfaction, and preoccupation on distress, dietary restraint, and objective binge eating. Overvaluation, dissatisfaction, and preoccupation were highly correlated (r = 0.47-0.84). In girls, preoccupation demonstrated the strongest independent and mediating effects on distress, dietary restraint, and binge eating; whereas neither the direct or indirect effects of dissatisfaction on distress and overvaluation on binge eating were significant. Among boys however, the direct and indirect effects of overvaluation, dissatisfaction, and preoccupation on distress and eating disorder behaviors were relatively equal. Preoccupation with weight/shape may be particularly clinically significant in girls, whereas all constructs of body image disturbance may be equally clinically significant in boys. The findings are consistent with the view that these constructs, while closely related, are distinct. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:118-126). © 2016 Wiley Periodicals, Inc.

Covariation bias for food-related control is associated with eating disorders symptoms in normal adolescents.

PubMed

Mayer, Birgit; Muris, Peter; Kramer Freher, Nancy; Stout, Janne; Polak, Marike

2012-12-01

Covariation bias refers to the phenomenon of overestimating the contingency between certain stimuli and negative outcomes, which is considered as a heuristic playing a role in the maintenance of certain types of psychopathology. In the present study, covariation bias was investigated within the context of eating pathology. In a sample of 148 adolescents (101 girls, 47 boys; mean age 15.3 years), a priori and a posteriori contingencies were measured between words referring to control and loss of control over eating behavior, on the one hand, and fear, disgust, positive and neutral outcomes, on the other hand. Results indicated that all adolescents displayed an a priori covariation bias reflecting an overestimation of the contingency of words referring to loss of control over eating behavior and fear- and disgust-relevant outcomes, while words referring to control over eating behavior were more often associated with positive and neutral outcomes. This bias was unrelated to level of eating disorder symptoms. In the case of a posteriori contingency estimates no overall bias could be observed, but some evidence was found indicating that girls with higher levels of eating disorder symptoms displayed a stronger covariation bias. These findings provide further support for the notion that covariation bias is involved in eating pathology, and also demonstrate that this type of cognitive distortion is already present in adolescents. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effects of a food-specific inhibition training in individuals with binge eating disorder-findings from a randomized controlled proof-of-concept study.

PubMed

Giel, Katrin Elisabeth; Speer, Eva; Schag, Kathrin; Leehr, Elisabeth Johanna; Zipfel, Stephan

2017-06-01

Impulsivity might contribute to the development and maintenance of obesity and eating disorders. Patients suffering from binge eating disorder (BED) show an impulsive eating pattern characterized by regular binge eating episodes. Novel behavioral interventions increasing inhibitory control could improve eating behavior in BED. We piloted a novel food-specific inhibition training in individuals with BED. N = 22 BED patients according to SCID-I were randomly assigned to three sessions of a training or control condition. In both conditions, pictures of high-caloric food items were presented in peripheral vision on a computer screen while assessing gaze behavior. The training group had to suppress the urge to turn their gaze towards these pictures (i.e., to perform antisaccades). The control group was allowed to freely explore the pictures. We assessed self-reported food craving, food addiction, and wanting/liking of food pictures pre- and post-intervention. Twenty participants completed the study. The training proved to be feasible and acceptable. Patients of the training group significantly improved inhibitory control towards high-caloric food stimuli. Both groups reported a significantly lower number of binge eating episodes in the last four weeks after termination of the study. No changes were found in food craving, food addiction, liking, and wanting ratings. A food-specific inhibition training could be a useful element in the treatment of BED and other eating disorders; however, larger efficacy studies in patient samples are needed to investigate the efficacy of this and similar training approaches.

Treatment of obsessive-compulsive disorder complicated by comorbid eating disorders.

PubMed

Simpson, H Blair; Wetterneck, Chad T; Cahill, Shawn P; Steinglass, Joanna E; Franklin, Martin E; Leonard, Rachel C; Weltzin, Theodore E; Riemann, Bradley C

2013-01-01

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.

Neuropsychology of eating disorders: 1995–2012

PubMed Central

Jáuregui-Lobera, Ignacio

2013-01-01

Eating disorders are considered psychiatric pathologies that are characterized by pathological worry related to body shape and weight. The lack of progress in treatment development, at least in part, reflects the fact that little is known about the pathophysiologic mechanisms that account for the development and persistence of eating disorders. The possibility that patients with eating disorders have a dysfunction of the central nervous system has been previously explored; several studies assessing the relationship between cognitive processing and certain eating behaviors have been conducted. These studies aim to achieve a better understanding of the pathophysiology of such diseases. The aim of this study was to review the current state of neuropsychological studies focused on eating disorders. This was done by means of a search process covering three relevant electronic databases, as well as an additional search on references included in the analyzed papers; we also mention other published reviews obtained by handsearching. PMID:23580091

Eating disorders and body image concerns in Asian American women: assessment and treatment from a multicultural and feminist perspective.

PubMed

Cummins, Lillian Huang; Lehman, Janice

2007-01-01

Eating disorders are one of the most lethal psychiatric illnesses and affect millions of individuals worldwide. While they have been more typically attributed to middle class, Caucasian, adolescent females, current research suggests that there is a similar prevalence of eating disorders and their symptoms, especially body dissatisfaction, among Asian American girls and women. Despite this, very little research has investigated how culture and gender may impact the assessment and treatment of eating disorders for Asian American women. This review examines the literature on the prevalence of eating disorders and negative body image in Asian American women and describes current research on the efficacy of a variety of theoretical approaches for treatment, including psychodynamic, cognitive-behavioral, and feminist perspectives. Recommendations for considering culture and gender when working clinically with Asian American women who experience eating concerns as well as suggestions for future research directions are provided.

Functional hypothalamic amenorrhea is associated with elevated ghrelin and disordered eating.

PubMed

Schneider, Lisa F; Warren, Michelle P

2006-12-01

To determine whether ghrelin, an orexigen released by the stomach, is elevated in women with hypothalamic amenorrhea who are of normal weight and whether this is associated with abnormal eating behaviors. Controlled clinical study. Healthy volunteers in an academic research environment. Twenty-seven women with functional hypothalamic amenorrhea (FHA) and 42 normally menstruating women. None. Ghrelin and eating behavior. Ghrelin was significantly elevated in FHA (648.4 +/- 92.0 pg/mL vs. controls 596.7 +/- 79.0 pg/mL), while leptin, although lower, was not significantly so (FHA 5.4 +/- 2.8 ng/mL vs. controls 6.4 +/- 3 ng/mL). Eating Attitudes Test (EAT) scores were also significantly elevated in FHA (15.3 +/- 10.6 vs. controls 10.3 +/- 8.4), particularly on the subscale that measured bulimic behaviors. However, FHA patients consumed significantly more kilocalories (1,930 kcal/day vs. 1,588 kcal/day). High ghrelin in women with FHA may be linked to abnormal dietary behaviors, as reflected in high EAT scores yet characterized by normal caloric intake. Ghrelin may act as a restraining metabolic signal preventing a return to cyclicity in women with both disordered eating and FHA, prolonging amenorrhea when leptin has returned to normal.

Eating disorders among fashion models: a systematic review of the literature.

PubMed

Zancu, Simona Alexandra; Enea, Violeta

2017-09-01

In the light of recent concerns regarding the eating disorders among fashion models and professional regulations of fashion model occupation, an examination of the scientific evidence on this issue is necessary. The article reviews findings on the prevalence of eating disorders and body image concerns among professional fashion models. A systematic literature search was conducted using ProQUEST, EBSCO, PsycINFO, SCOPUS, and Gale Canage electronic databases. A very low number of studies conducted on fashion models and eating disorders resulted between 1980 and 2015, with seven articles included in this review. Overall, results of these studies do not indicate a higher prevalence of eating disorders among fashion models compared to non-models. Fashion models have a positive body image and generally do not report more dysfunctional eating behaviors than controls. However, fashion models are on average slightly underweight with significantly lower BMI than controls, and give higher importance to appearance and thin body shape, and thus have a higher prevalence of partial-syndrome eating disorders than controls. Despite public concerns, research on eating disorders among professional fashion models is extremely scarce and results cannot be generalized to all models. The existing research fails to clarify the matter of eating disorders among fashion models and given the small number of studies, further research is needed.

Should ovulation be induced in women recovering from an eating disorder or who are compulsive exercisers?

PubMed

Abraham, S; Mira, M; Llewellyn-Jones, D

1990-03-01

The eating and exercise history of women with secondary amenorrhea and failure of ovulation using CC was studied in 14 consecutive women on a GnRH-a program. All had a history of an eating or exercise disorder. At the time of the interview, 7 women continued to have an eating or exercise disorder. There were 15 pregnancies (12 women) with 12 live births, of which 4 weighed less than 2,500 g. Infertility specialists should inquire routinely about a woman's body weight and eating and exercise behaviors, and consider treatment for these before prescribing drugs to induce ovulation.

Parenting styles and weight-related symptoms and behaviors with recommendations for practice.

PubMed

Enten, Roni S; Golan, Moria

2008-02-01

With the incidence of eating disorders increasing in recent years, the role of parents in the pathology of these illnesses is of great interest, particularly the impact of their parenting style. Few studies have investigated the connection between parenting styles and adolescent eating disorders. Reviewed here are key studies on parenting style categorized into the following four broad areas related to eating disorder pathology: food-related symptoms, feeding style, research on ethnic populations, and populations with eating disorders. The results reflect previous findings on the benefits of the authoritative parenting style. Suggestions for parenting programs and further research are included.

Interpreting genetics in the context of eating disorders: Evidence of disease, not diversity

PubMed Central

Easter, Michele

2013-01-01

How is genetic involvement interpreted for disorders whose medicalisation is contested? Framing psychiatric and behavioral disorders in terms of genetics is expected to make them seem “more medical.” Yet, genetic etiology can also be used to frame behavior as acceptable human variation, rather than a medical problem (e.g., sexual orientation). I analyze responses to the idea of a genetic component in anorexia and bulimia nervosa (AN/BN) via semi-structured interviews with a sample of 50 women diagnosed with an eating disorder (25 recovered). All but three volunteered that genetics would medicalise AN/BN, by (1) making eating disorders seem more like “real” diseases; (2) implying a need for professional treatment; or (3) for biologically-based treatment. Results also indicate several “counter-logics,” by which genetic framing could support non-medical definitions of AN/BN. I argue that genetic framing reduces perceived individual responsibility, which can support definitions of behavior as either a reflection of disease (which entails intervention) or a reflection of normal human diversity (which does not). In the context of public skepticism as to the “reality” of AN/BN, genetic involvement was taken as evidence of disease in ongoing negotiations about the medical and moral status of people with eating disorders. PMID:24286479

Restrained eating and self-esteem in premenopausal and postmenopausal women.

PubMed

Drobnjak, Suzana; Atsiz, Semra; Ditzen, Beate; Tuschen-Caffier, Brunna; Ehlert, Ulrike

2014-01-01

There has been limited research about disordered eating in middle-aged women, and to date, few data exist about restrained eating behavior in postmenopausal women. Therefore, the aim of this study was to examine eating behavior with a specific focus on menopause as an associated factor in restrained eating. Beyond this, we were interested in how postmenopausal status and self-esteem would interact to determine eating patterns in women in middle age. We conducted an online survey in women aged between 40 and 66. Eating behavior was assessed with the Eating Disorder Examination-Questionnaire (EDE-Q) in premenopausal (N = 318) and postmenopausal women (N = 250). All participants rated their self-esteem using the Rosenberg Self-Esteem Scale (RSE) and reported their weight, height, waist circumference, and hip circumference. 15.7% of all participants showed clinically meaningful scores on restrained eating. Postmenopausal women showed significantly higher scores on the EDE-Q subscale of restrained eating as compared to premenopausal women, but when controlling for body mass index, however, this finding was no longer significant. Further exploratory analyses suggest that particularly low or high self-esteem levels are associated with restrained eating. Self-esteem might serve as a mediator between menopausal status and restrained eating, however results of these additional analyses were inconsistent. Restrained eating may appear in middle-aged women. Particularly in postmenopausal women, restrained eating might be associated with lower and higher self-esteem.

Associations of Adolescent Emotional and Loss of Control Eating with 1-year Changes in Disordered Eating, Weight and Adiposity

PubMed Central

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.

2016-01-01

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

Pathways for Disordered Eating Behaviors in Minority Girls: The Role of Adiposity, Peer Weight-Related Teasing, and Desire to Be Thinner

ERIC Educational Resources Information Center

Olvera, Norma; McCarley, Kendall; Matthews-Ewald, Molly R.; Fisher, Felicia; Jones, Martinque; Flynn, Erika G.

2017-01-01

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…

Integrating Motivational Interviewing and Cognitive Behavioral Therapy in the Treatment of Eating Disorders: Tailoring Interventions to Patient Readiness for Change

ERIC Educational Resources Information Center

Geller, Josie; Dunn, Erin C.

2011-01-01

This paper focuses on the integration of Motivational Interviewing (MI) and cognitive behavioral therapy (CBT) in the treatment of eating disorders. Although CBT is regarded as the treatment of choice in this population, it nevertheless has limitations: some patients fail to engage, drop out from treatment prematurely, or simply do not improve.…

Cognitive behavioral approaches in adolescent anorexia and bulimia nervosa.

PubMed

Schmidt, U

2009-01-01

This article starts with what is known about cognitive behavior therapy (CBT) in adults with eating disorders and with some developmental considerations about CBT in children and adolescents. It then considers how CBT might be adapted for adolescents with eating disorders and reviews the current knowledge base on CBT in adolescents. The article finishes with some thoughts on future developments in this area.

Eating Disorders: Prevention through Education.

ERIC Educational Resources Information Center

Nagel, K. L.; Jones, Karen H.

1993-01-01

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…

Adolescent Eating Disorders: Anorexia and Bulimia. Publication 352-004.

ERIC Educational Resources Information Center

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…

Comorbidity of mood and substance use disorders in patients with binge-eating disorder: Associations with personality disorder and eating disorder pathology.

PubMed

Becker, Daniel F; Grilo, Carlos M

2015-08-01

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.

The Relationship between Binge Eating Disorder and Suicidality: A Systematic Review

PubMed Central

Conti, Chiara; Lanzara, Roberta; Scipioni, Mattia; Iasenza, Marzia; Guagnano, Maria T.; Fulcheri, Mario

2017-01-01

Background: We carried out a systematic review analyzing the relation between binge eating disorder (BED), a recent addition to the eating disorders in DSM-5, and suicidality (i.e., suicidal ideation or attempted and/or committed suicide) by synthesizing the relevant studies' qualitative data. Methods: We conducted, according to PRISMA guidelines, a systematic search of the literature on PubMed, Scopus, ISI Web of Science, PsycINFO, Google Scholar, and ScienceDirect. Search terms were “binge eating disorder” combined with the “AND” Boolean operator and “suicid*.” Results: The initial search identified 4,014 records, of which 17 research reports met the predefined inclusion criteria and were analyzed. BED was found to be significantly associated with a marked increase in suicidal behaviors and suicidal ideation (SI). The presence and severity of BED were found to be relevant predictive factors for suicidality, notably in association with mood disorders and specific psychological features, while a high body mass index (BMI) did not always affect suicidality. BED has usually been associated with suicide risk, particularly when occurring with another psychiatric disorder and/or in an adolescent population. Conclusion: Pursuant to these findings, it is necessary to consider both dysfunctional eating behavior and related psychopathological factors that may induce SI and suicidal behavior in BED, aiming to identify patients and subgroups of patients needing greater clinical psychological attention to most effectively prevent and treat suicidality. PMID:29259574

Risk factors for eating disorders in Greek- and Anglo-Australian adolescent girls.

PubMed

Mildred, H; Paxton, S J; Wertheim, E H

1995-01-01

Past research indicates ethnicity may be related to eating disorder and related risk factors. The present study examines risk factors for eating disorders in 50 Anglo- and 50 Greek-Australian girls (mean age = 13.5 years). The variables assessed included bulimic tendencies, body dissatisfaction, use of extreme weight loss behaviors (EWLBs), self-esteem, depression and family cohesion and adaptability. Cultural eating patterns were also explored. A stepwise discriminant function analysis to examine whether the two groups could be discriminated on these variables was significant and correctly classified 73.9% of the sample, the chief discriminating variables being Pressure to Eat, EWLBs, and Family Adaptability. Univariate analyses indicated differences between the groups on Pressure to Eat, Family Adaptability, and Mother's Shape. Although the groups were discriminable, a number of variables generally associated with eating disorder did not contribute to the function. These data are discussed in terms of cultural assimilation.

Gender Difference in the Prevalence of Eating Disorder Symptoms

PubMed Central

Striegel-Moore, Ruth H.; Rosselli, Francine; Perrin, Nancy; DeBar, Lynn; Wilson, G. Terence; May, Alexis; Kraemer, Helena C.

2009-01-01

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

Eating disorders in the context of preconception care: fertility specialists' knowledge, attitudes, and clinical practices.

PubMed

Rodino, Iolanda S; Byrne, Susan M; Sanders, Katherine A

2017-02-01

To gauge fertility specialists' knowledge, clinical practices, and training needs in regard to eating disorders. Cross-sectional study. Fertility clinics. Eighty Australian and New Zealand fertility specialists who were members of the Fertility Society of Australia. None. Responses to an anonymously completed online questionnaire. Approximately 54% of doctors correctly identified the body mass index relevant to anorexia nervosa, and 30% identified menstrual disturbances for anorexia, while 63.8% of doctors incorrectly nominated maladaptive weight control behaviors as a characteristic of binge eating disorder. While clinicians (83.7%) agreed it was important to screen for eating disorders during preconception assessments, 35% routinely screened for eating disorders and 8.8% indicated that their clinics had clinical practice guidelines for management of eating disorders. A minority of participants (13.8%) felt satisfied with their level of university training in eating disorders, 37.5% of doctors felt confident in their ability to recognize symptoms of an eating disorder, and 96.2% indicated a need for further education and clinical guidelines. On most items examined, knowledge and clinical practices regarding eating disorders did not differ according to doctor gender or years of clinical experience working as a fertility specialist. Knowledge about eating disorders in the context of fertility treatment is important. This study highlights the uncertainty among fertility specialists in detecting features of eating disorders. The findings point to the importance of further education and training, including the development of clinical guidelines specific to fertility health care providers. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Molecular-genetic correlates of self-harming behaviors in eating-disordered women: findings from a combined Canadian-German sample.

PubMed

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

2011-01-15

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.

Predictors and moderators of response to cognitive behavioral therapy and medication for the treatment of binge eating disorder.

PubMed

Grilo, Carlos M; Masheb, Robin M; Crosby, Ross D

2012-10-01

To examine predictors and moderators of response to cognitive behavioral therapy (CBT) and medication treatments for binge-eating disorder (BED). 108 BED patients in a randomized double-blind placebo-controlled trial testing CBT and fluoxetine treatments were assessed prior, throughout, and posttreatment. Demographic factors, psychiatric and personality disorder comorbidity, eating disorder psychopathology, psychological features, and 2 subtyping methods (negative affect, overvaluation of shape/weight) were tested as predictors and moderators for the primary outcome of remission from binge eating and 4 secondary dimensional outcomes (binge-eating frequency, eating disorder psychopathology, depression, and body mass index). Mixed-effects models analyzed all available data for each outcome variable. In each model, effects for baseline value and treatment were included with tests of both prediction and moderator effects. Several demographic and clinical variables significantly predicted and/or moderated outcomes. One demographic variable signaled a statistical advantage for medication only (younger participants had greater binge-eating reductions), whereas several demographic and clinical variables (lower self-esteem, negative affect, and overvaluation of shape/weight) signaled better improvements if receiving CBT. Overvaluation was the most salient predictor/moderator of outcomes. Overvaluation significantly predicted binge-eating remission (29% of participants with vs. 57% of participants without overvaluation remitted). Overvaluation was especially associated with lower remission rates if receiving medication only (10% vs. 42% for participants without overvaluation). Overvaluation moderated dimensional outcomes: Participants with overvaluation had significantly greater reductions in eating disorder psychopathology and depression levels if receiving CBT. Overvaluation predictor/moderator findings persisted after controlling for negative affect. Our findings have clinical utility for prescription of CBT and medication and implications for refinement of the BED diagnosis. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Disordered eating in college sorority women: A social network analysis of a subset of members from a single sorority chapter.

PubMed

Becker, Kendra R; Stojek, Monika M; Clifton, Allan; Miller, Joshua D

2018-06-07

Disordered eating attitudes and behaviors are prevalent among college women, and peers appear to influence current and future eating pathology. Social network analysis (SNA) is an innovative quantitative method to examine relationships (i.e., ties) among people based on their various attributes. In this study, the social network of one sorority was modeled using exponential random graph model (ERGM) to explore if homophily, or the tendency for relationship ties to exist based on shared attributes, was present according to sorority members' disordered eating behaviors/attitudes and their body mass index (BMI). Participants included members of one sorority at a large Southeastern university. All members were included on a roster unless they elected to opt out during the consent process, and 41 (19%) of the members completed the study measures. Participants completed the Social Network Questionnaire developed for this study (degree of "liking" of every member on the roster), the Eating Disorder Examination-Questionnaire (EDE-Q), and a demographics questionnaire in exchange for 1 h of community service credit. The final sample consisted of mostly White women with an average age of 20. Homophily across liking ties was examined based on the EDE-Q Global scale, episodes of binge eating, and BMI. The greater the difference in EDE-Q scores, the more likely the participants were to like one another. The greater the difference in BMI, the less likely the participants were to like one another. Binge eating was unrelated to homophily. College sorority women appear to prefer other women with dissimilar levels of disordered eating attitudes, suggesting complex interactions between stigmatized or valued disordered eating attributes. Women with similar BMI were more likely to like one another, confirming past findings. Copyright © 2018. Published by Elsevier Ltd.

Predictors and Moderators of Response to Cognitive Behavioral Therapy and Medication for the Treatment of Binge Eating Disorder

PubMed Central

Grilo, Carlos. M.; Masheb, Robin M.; Crosby, Ross D.

2012-01-01

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 post-treatment. Demographic factors, psychiatric and personality-disorder co-morbidity, eating-disorder psychopathology, psychological features, and two sub-typing methods (negative-affect, overvaluation of shape/weight) were tested as predictors and moderators for the primary outcome of remission from binge-eating and four secondary dimensional outcomes (binge-eating frequency, eating-disorder psychopathology, depression, and body mass index). Mixed-effects-models analyzed all available data for each outcome variable. In each model, effects for baseline value and treatment were included with tests of both prediction and moderator effects. Results Several demographic and clinical variables significantly predicted and/or moderated outcomes. One demographic variable signaled a statistical advantage for medication-only (younger participants had greater binge-eating reductions) whereas several demographic and clinical variables (lower self-esteem, negative-affect, and overvaluation of shape/weight) signaled better improvements if receiving CBT. Overvaluation was the most salient predictor/moderator of outcomes. Overvaluation significantly predicted binge-eating remission (29% of participants with versus 57% of participants without overvaluation remitted). Overvaluation was especially associated with lower remission rates if receiving medication-only (10% versus 42% for participants without overvaluation). Overvaluation moderated dimensional outcomes: participants with overvaluation had significantly greater reductions in eating-disorder psychopathology and depression levels if receiving CBT. Overvaluation predictor/moderator findings persisted after controlling for negative-affect. Conclusions Our findings have clinical utility for prescription of CBT and medication and implications for refinement of the BED diagnosis. PMID:22289130

Surfing for thinness: a pilot study of pro-eating disorder Web site usage in adolescents with eating disorders.

PubMed

Wilson, Jenny L; Peebles, Rebecka; Hardy, Kristina K; Litt, Iris F

2006-12-01

Pro-eating disorder Web sites are communities of individuals who engage in disordered eating and use the Internet to discuss their activities. Pro-recovery sites, which are less numerous, express a recovery-oriented perspective. This pilot study investigated the awareness and usage of pro-eating disorder Web sites among adolescents with eating disorders and their parents and explored associations with health and quality of life. This was a cross-sectional study of 698 families of patients (aged 10-22 years) diagnosed with an eating disorder at Stanford between 1997 and 2004. Anonymous surveys were mailed and offered in clinic. Survey content included questions about disease severity, health outcomes, Web site usage, and parental knowledge of eating disorder Web site usage. Surveys were returned by 182 individuals: 76 patients and 106 parents. Parents frequently (52.8%) were aware of pro-eating disorder sites, but an equal number did not know whether their child visited these sites, and only 27.6% had discussed them with their child. Most (62.5%) parents, however, did not know about pro-recovery sites. Forty-one percent of patients visited pro-recovery sites, 35.5% visited pro-eating disorder sites, 25.0% visited both, and 48.7% visited neither. While visiting pro-eating disorder sites, 96.0% reported learning new weight loss or purging techniques. However, 46.4% of pro-recovery site visitors also learned new techniques. Pro-eating disorder site users did not differ from nonusers in health outcomes but reported spending less time on school or schoolwork and had a longer duration of illness. Users of both pro-eating disorder and pro-recovery sites were hospitalized more than users of neither site. Pro-eating disorder site usage was prevalent among adolescents with eating disorders, yet parents had little knowledge of this. Although use of these sites was not associated with other health outcomes, usage may have a negative impact on quality of life and result in adolescents' learning about and adopting disordered eating behaviors.

The effects of cognitive-behavioral therapy for eating disorders on quality of life: A meta-analysis.

PubMed

Linardon, Jake; Brennan, Leah

2017-07-01

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.

Dropout from cognitive-behavioral therapy for eating disorders: A meta-analysis of randomized, controlled trials.

PubMed

Linardon, Jake; Hindle, Annemarie; Brennan, Leah

2018-05-01

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.

Reliability and Validity of the Diabetes Eating Problem Survey in Turkish Children and Adolescents with Type 1 Diabetes Mellitus.

PubMed

Atik Altınok, Yasemin; Özgür, Suriye; Meseri, Reci; Özen, Samim; Darcan, Şükran; Gökşen, Damla

2017-12-15

The aim of this study was to show the reliability and validity of a Turkish version of Diabetes Eating Problem Survey-Revised (DEPS-R) in children and adolescents with type 1 diabetes mellitus. A total of 200 children and adolescents with type 1 diabetes, ages 9-18 years, completed the DEPS-R Turkish version. In addition to tests of validity, confirmatory factor analysis was conducted to investigate the factor structure of the 16-item Turkish version of DEPS-R. The Turkish version of DEPS-R demonstrated satisfactory Cronbach's ∝ (0.847) and was significantly correlated with age (r=0.194; p<0.01), hemoglobin A1c levels (r=0.303; p<0.01), and body mass index-standard deviation score (r=0.412; p<0.01) indicating criterion validity. Median DEPS-R scores of Turkish version for the total samples, females, and males were 11.0, 11.5, and 10.5, respectively. Disturbed eating behaviors and insulin restriction were associated with poor metabolic control. A short, self-administered diabetes-specific screening tool for disordered eating behavior can be used routinely in the clinical care of adolescents with type 1 diabetes. The Turkish version of DEPS-R is a valid screening tool for disordered eating behaviors in type 1 diabetes and it is potentially important to early detect disordered eating behaviors.

HAPIFED: a Healthy APproach to weIght management and Food in Eating Disorders: a case series and manual development.

PubMed

da Luz, Felipe Q; Swinbourne, Jessica; Sainsbury, Amanda; Touyz, Stephen; Palavras, Marly; Claudino, Angelica; Hay, Phillipa

2017-01-01

There is a high prevalence of overweight or obesity in people with eating disorders. However, therapies for eating disorders, namely binge eating disorder and bulimia nervosa, do not address weight management. Conversely, weight loss treatments for people with overweight or obesity do not address psychological aspects related to eating disorders. Thus we developed a new treatment for overweight or obesity with comorbid binge eating disorder or bulimia nervosa, entitled HAPIFED (a H ealthy AP proach to we I ght management and F ood in E ating D isorders). This paper describes HAPIFED and reports a case series examining its feasibility and acceptability. Eleven participants with overweight or obesity and binge eating disorder or bulimia nervosa were treated with HAPIFED in two separate groups (with once or twice weekly meetings). Weight, body mass index (BMI) and eating disorder symptoms, as well as depression, anxiety and stress, were assessed at baseline and at the end of the 20-session HAPIFED intervention. Eight of the 11 participants completed the intervention, with diverse results. Six of the 8 participants who completed HAPIFED reduced their weight between baseline and the end of the intervention. Median scores on the Eating Disorder Examination Questionnaire for binge eating, restraint, and concerns about eating or weight and shape, were reduced in the group overall between baseline and the end of the intervention. One participant, who at baseline was inducing vomiting and misusing laxatives in an attempt to lose weight, reduced these behaviors by the end of the intervention. Three participants at baseline were undertaking episodes of compulsive exercise, and they reduced or stopped this behavior, but one participant commenced episodes of compulsive exercise by the end of the intervention. All participants who completed the intervention rated the suitability and success of HAPIFED as 7 or more out of 10 (0 = not at all suitable/successful; 10 = extremely suitable/successful). This case series supports the feasibility and acceptability of HAPIFED as a potential new treatment for overweight or obesity with comorbid binge eating disorder or bulimia nervosa. Clinical trials are necessary to examine the efficacy and effectiveness of HAPIFED. Australian and New Zealand Clinical Trials Registry (Universal Trial Number): U1111-1149-7766. Date of registration: 4th November 2013.

Defining Features of Unhealthy Exercise Associated with Disordered Eating and Eating Disorder Diagnoses

PubMed Central

Holland, Lauren A.; Brown, Tiffany A.; Keel, Pamela K.

2013-01-01

Objectives 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. Design Cross-sectional epidemiological study. Methods 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. Results 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. Conclusions 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. PMID:24391457

Electrolyte and acid-base abnormalities associated with purging behaviors.

PubMed

Mehler, Philip S; Walsh, Kristine

2016-03-01

Eating disorders that are associated with purging behaviors are complicated by frequent blood electrolyte and acid-base abnormalities. Herein, we review the major electrolyte and acid-base abnormalities and their treatment methods. The body of rigorous, eating disorder-specific literature on this topical area is not robust enough to perform a systematic review as defined by PRISMA guidelines. Therefore, a qualitative review of mostly medical literature was conducted. Hypokalemia, hyponatremia, and sodium chloride-responsive metabolic alkalosis are the most common serum changes that occur as a result of purging behaviors. They vary depending on the mode and frequency of purging behaviors. They can all potentially cause dangerous medical complications and are in need of definitive medical treatment. Eating disorders that are associated with purging behaviors are associated with a number of electrolyte and acid-base changes which are complex in their origin, documented to be medically dangerous and this definitive treatment is necessary to help achieve a successful treatment outcome, and in need of definitive treatment as described herein. © 2016 Wiley Periodicals, Inc.

Cognitive Behavioral Guided Self-Help for the Treatment of Recurrent Binge Eating

ERIC Educational Resources Information Center

Striegel-Moore, Ruth H.; Wilson, G. Terence; DeBar, Lynn; Perrin, Nancy; Lynch, Frances; Rosselli, Francine; Kraemer, Helena C.

2010-01-01

Objective: Despite proven efficacy of cognitive behavioral therapy (CBT) for treating eating disorders with binge eating as the core symptom, few patients receive CBT in clinical practice. Our blended efficacy-effectiveness study sought to evaluate whether a manual-based guided self-help form of CBT (CBT-GSH), delivered in 8 sessions in a health…

Update on Psychological Trauma, Other Severe Adverse Experiences and Eating Disorders: State of the Research and Future Research Directions.

PubMed

Trottier, Kathryn; MacDonald, Danielle E

2017-08-01

This paper provides an updated review of the literature on the relationship between psychological trauma exposure, other severe adverse experiences, and eating disorders. Trauma exposure and other severe adverse experiences (e.g., emotional abuse) in both childhood and adulthood are associated with eating disorders. The relationship between traumatic and other adverse experiences and eating disorders appears to be mediated by emotional and behavioral dysregulation, as well as by cognitive factors such as self-criticism. Biological vulnerabilities may also be relevant to this relationship. Overall, the literature is limited by predominantly cross-sectional designs. There is clear evidence of a correlational relationship between trauma exposure and other severe adverse events, and eating disorders. Both risk and maintenance factor hypotheses have been put forth; however, prospective research testing these hypotheses remains limited. Future research should use prospective designs and focus on trauma-related symptoms (rather than trauma exposure) in order to advance research on risk and maintaining factors for eating disorders and inform treatment directions.

The Latent Class Structure of Chinese Patients with Eating Disorders in Shanghai.

PubMed

Zheng, Yuchen; Kang, Qing; Huang, Jiabin; Jiang, Wenhui; Liu, Qiang; Chen, Han; Fan, Qing; Wang, Zhen; Chen, Jue; Xiao, Zeping

2017-08-25

Eating disorder is culture related, and the clinical symptoms are different between eastern and western patients. So the validity of feeding and eating disorders in the upcoming ICD-11 guide for Chinese patients is unclear. To explore the latent class structure of Chinese patients with eating disorder and the cross-cultural validity of the eating disorder section of the new ICD-11 guide in China. A total of 379 patients with eating disorders at Shanghai Mental Health Center were evaluated using the EDI questionnaire and a questionnaire developed by researchers from 2010 to 2016. SPSS 20.0 was used to enter data and analyze demographic data, and Latent GOLD was employed to conduct latent profile analysis. According to the results of latent profile analysis, patients with eating disorder were divided into five classes: low-weight fasting class (23.1%), non-fat-phobic binge/purge class (21.54%), low-fat-phobic binge class (19.27%), fat-phobic binge class (19.27%), and non-fat-phobic low-weight class (16.76%). Among the clinical symptoms extracted, there were significant differences in Body Mass Index (BMI), binge eating behavior, self-induced vomiting, laxative use and fat-phobic opinion; while there was no significant difference in restrictive food intake. Based on the clinical symptoms, there are five latent classes in Chinese patients with eating disorder, which is in accordance with the diagnostic categories of feeding and eating disorder in ICD-11. However, further work is needed in improving the fat-phobic opinion of patients with eating disorder and clarifying the BMI standard of thinness in the Chinese population.

Frontal behavioral syndromes in Prader-Willi syndrome.

PubMed

Ogura, Kaeko; Shinohara, Mayumi; Ohno, Kousaku; Mori, Etsuro

2008-08-01

Prader-Willi syndrome (PWS) is a genetically determined neurodevelopmental disorder presenting with behavioral problems including hyperphagia, emotional aberration, and compulsion-like behaviors. This combination of behavioral problems is likely to be caused by damage to the orbitofrontal cortices and anterior temporal lobes or to circuits involving them. To investigate the prevalence of eating and non-eating behavioral disturbances in PWS by using assessment tools developed originally for patients with frontotemporal dementia and with frontal lobe injury. The questionnaire consisted of 35 questions related to three categories of behavior: eating behaviors (including four domains: appetite, food preference, eating habits, and other oral behaviors), stereotypy (including four domains: roaming, speaking, movements, and daily rhythm), and collecting behaviors. It was administered in Japan to the parents of 250 individuals aged 1-42 years with a clinical diagnosis of PWS. The prevalence rates of symptoms in all categories were high. Each domain involved in eating behaviors was significantly correlated with stereotypy and collecting behaviors. The prevalence rates and severity scores of some eating and non-eating behaviors were higher in the older groups. Abnormal eating behaviors, stereotyped behaviors, and collecting behaviors were common in the PWS subjects. There was also a potential link between abnormal eating and non-eating behaviors related to frontal behavioral syndromes. It is likely that these behavioral abnormalities reflect dysfunction of the orbitofrontal cortices and anterior temporal lobes.

Rapid response in psychological treatments for binge eating disorder.

PubMed

Hilbert, Anja; Hildebrandt, Thomas; Agras, W Stewart; Wilfley, Denise E; Wilson, G Terence

2015-06-01

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).

Prevention programs for body image and eating disorders on University campuses: a review of large, controlled interventions.

PubMed

Yager, Zali; O'Dea, Jennifer A

2008-06-01

Body dissatisfaction, dieting, eating disorders and exercise disorders are prevalent among male and female university students worldwide. Male students are also increasingly adopting health-damaging, body-image-related behaviors such as excessive weight lifting, body building and steroid abuse. Given the severity and difficulty of treating eating disorders, prevention of these problems is a recognized public health goal. Health promotion and health education programs have been conducted in the university setting since the mid 1980s, but few have achieved significant improvements in target health attitudes and behaviors. In this paper, 27 large, randomized and controlled health promotion and health education programs to improve body dissatisfaction, dieting and disordered eating and exercise behaviors of male and female college students are reviewed. In general, health education programs to improve body image and prevent eating disorders in the university setting have been limited by small sample sizes and the exclusion of male students. The majority of studies were conducted among either female undergraduate psychology students or women that were recruited using on-campus advertising. The latter reduces the ability to generalize results to the whole university population, or the general community. In addition, there has been a paucity of longitudinal studies that are methodologically sound, as only 82% (22/27) of interventions included in the review used random assignment of groups, and only 52% (n = 14) included follow-up testing. Information-based, cognitive behavioral and psycho-educational approaches have been the least effective at improving body image and eating problems among university students. Successful elements for future initiatives are identified as taking a media literacy- and dissonance-based educational approach, incorporating health education activities that build self-esteem, and using computers and the internet as a delivery medium. A newly designed program for Australian university students is described.

Disordered eating in French high-level athletes: association with type of sport, doping behavior, and psychological features.

PubMed

Rousselet, M; Guérineau, B; Paruit, M C; Guinot, M; Lise, S; Destrube, B; Ruffio-Thery, S; Dominguez, N; Brisseau-Gimenez, S; Dubois, V; Mora, C; Trolonge, S; Lambert, S; Grall-Bronnec, M; Prétagut, S

2017-03-01

Over the last few years, disordered eating in athletes has received increasing attention. According to several studies, athletes could be more vulnerable to disordered eating and some characteristics specific to the athletic community could be in favour of an increased risk of poor body image and disturbed eating habits in athletes. However, the literature is sparse and some methodological issues in studies have been pointed out. In this context, we aimed at determining the prevalence of disordered eating in French high-level athletes using clinical interviews of three different clinicians and identifying what are the factors associated with disordered eating in athletes. In France, all athletes registered on the French high-level list have to undergo a yearly evaluation. Data collected during the somatic assessment, the dietary consultation, and the psychological of the yearly evaluation were used. Multivariate analysis was performed for identification of factors associated with disordered eating. Out of the 340 athletes included, 32.9% have been detected with a disordered eating. They were difficult to detect by clinicians, as usual criteria did not seem to be reliable for athletes. Competing in sports emphasizing leanness or low body weight was associated with disordered eating; however, gender was not. These results highlight the need for the development of specific screening tools for high-level athletes. Furthermore, the identification of factors associated with disordered eating could improve early detection and prevention program effectiveness.

The association of "food addiction" with disordered eating and body mass index.

PubMed

Gearhardt, Ashley N; Boswell, Rebecca G; White, Marney A

2014-08-01

The contribution of an addictive process to elevated body mass index (BMI) and disordered eating is an area of growing interest. Yet, little is known about how "food addiction" may be related to disordered eating and obesity. The ability of addictive-like eating to account for eating pathology not captured by traditional eating disorders is unknown. No prior research has examined the association of "food addiction" with bulimia nervosa (BN). Finally, little is understood about the association of "food addiction" with patterns of dieting and weight gain. The current study was conducted to address these gaps in the literature. Participants (N=815) were recruited from online advertisements nationwide and completed measures related to "food addiction", BMI, weight history, and disordered eating. Addictive-like eating was associated with elevated current and lifetime highest BMI, weight cycling, and eating pathology. The prevalence of "food addiction" was higher in participants with BN than in those with binge eating disorder (BED). "Food addiction" continued to be related to clinically relevant variables, especially elevated BMI, even when participants did not meet criteria for BED or BN. The co-occurrence of "food addiction" with eating disorders appears to be associated with a more severe variant of eating pathology. An addictive-type response to highly palatable food may be contributing to eating-related problems, including obesity and eating disorders. BN relative to BED appears to be more strongly associated with "food addiction." Additionally, the concept of "food addiction" appears to capture clinically relevant information in participants who do not meet criteria for either BN or BED. Further examination of "food addiction" may be important in understanding the mechanisms underlying certain types of problematic eating behavior. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Association of “Food Addiction” with Disordered Eating and Body Mass Index

PubMed Central

Gearhardt, Ashley N.; Boswell, Rebecca G.; White, Marney A.

2014-01-01

Introduction The contribution of an addictive process to elevated body mass index (BMI) and disordered eating is an area of growing interest. Yet, little is known about how “food addiction” may be related to disordered eating and obesity. The ability of addictive-like eating to account for eating pathology not captured by traditional eating disorders is unknown. No prior research has examined the association of “food addiction” with bulimia nervosa (BN). Finally, little is understood about the association of “food addiction” with patterns of dieting and weight gain. The current study was conducted to address these gaps in the literature. Material and Methods Participants (N = 815) were recruited from online advertisements nationwide and completed measures related to “food addiction”, BMI, weight history, and disordered eating. Results Addictive-like eating was associated with elevated current and lifetime highest BMI, weight cycling, and eating pathology. The prevalence of “food addiction” was higher in participants with BN than in those with binge eating disorder (BED). “Food addiction” continued to be related to clinically relevant variables, especially elevated BMI, even when participants did not meet criteria for BED or BN. The co-occurrence of “food addiction” with eating disorders appears to be associated with a more severe variant of eating pathology. Discussion An addictive-type response to highly palatable food may be contributing to eating-related problems, including obesity and eating disorders. BN relative to BED appears to be more strongly associated with “food addiction.” Additionally, the concept of “food addiction” appears to capture clinically relevant information in participants who do not meet criteria for either BN or BED. Further examination of “food addiction” may be important in understanding the mechanisms underlying certain types of problematic eating behavior. PMID:25064294

Nocturnal Eating: Association with Binge Eating, Obesity, and Psychological Distress

PubMed Central

Striegel-Moore, Ruth H.; Rosselli, Francine; Wilson, G. Terence; Perrin, Nancy; Harvey, Kate; DeBar, Lynn

2009-01-01

Objective To examine clinical correlates of nocturnal eating, a core behavioral symptom of night eating syndrome. Method Data from 285 women who had participated in a two-stage screening for binge eating were utilized. Women (n = 41) who reported one or more nocturnal eating episodes in the past 28 days on the Eating Disorder Examination and women who did not report nocturnal eating (n =244) were compared on eating disorder symptomatology, Body Mass Index (BMI), and on measures of psychosocial adjustment. Results Nocturnal eaters were significantly more likely to report binge eating and differed significantly from non-nocturnal eaters (with responses indicating greater disturbance) on weight and shape concern, eating concern, self-esteem, depression, and functional impairment, but not on BMI or dietary restraint. Group differences remained significant in analyses adjusting for binge eating. Conclusions This study confirms the association between nocturnal eating and binge eating previously found in treatment seeking samples yet also suggests that the elevated eating disorder symptoms and decreased psychosocial adjustment observed in nocturnal eaters is not simply a function of binge eating. PMID:19708071

A Biopsychosocial Model of Disordered Eating and the Pursuit of Muscularity in Adolescent Boys

ERIC Educational Resources Information Center

Ricciardelli, Lina A.; McCabe, Marita P.

2004-01-01

This review provides an evaluation of the correlates and/or risk factors associated with disordered eating and the pursuit of muscularity among adolescent boys. One of the main conclusions is that similar factors and processes are associated with both behavioral problems. Several factors found to be consistently associated with disordered eating…

Negative affect, interpersonal perception, and binge eating behavior: An experience sampling study.

PubMed

Ambwani, Suman; Roche, Michael J; Minnick, Alyssa M; Pincus, Aaron L

2015-09-01

Etiological and maintenance models for disordered eating highlight the salience of negative affect and interpersonal dysfunction. This study employed a 14-day experience sampling procedure to assess the impact of negative affect and interpersonal perceptions on binge eating behavior. Young adult women (N = 40) with recurrent binge eating and significant clinical impairment recorded their mood, interpersonal behavior, and eating behaviors at six stratified semirandom intervals daily through the use of personal digital assistants. Although momentary negative affect was associated with binge eating behavior, average levels of negative affect over the experience sampling period were not, and interpersonal problems moderated the relationship between negative affect and binge eating. Interpersonal problems also intensified the association between momentary interpersonal perceptions and binge eating behavior. Lagged analyses indicated that previous levels of negative affect and interpersonal style also influence binge eating. The study findings suggest there may be important differences in how dispositional versus momentary experiences of negative affect are associated with binge eating. Results also highlight the importance of interpersonal problems for understanding relationships among negative affect, interpersonal perception, and binge eating behavior. These results offer several possibilities for attending to affective and interpersonal functioning in clinical practice. © 2015 Wiley Periodicals, Inc.

Safety of alternate day fasting and effect on disordered eating behaviors.

PubMed

Hoddy, Kristin K; Kroeger, Cynthia M; Trepanowski, John F; Barnosky, Adrienne R; Bhutani, Surabhi; Varady, Krista A

2015-05-06

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 < 0.0001) by 4.2 ± 0.3%. Some subjects reported constipation (17%), water retention (2%), dizziness (<20%), and general weakness (<15%). Bad breath doubled from baseline (14%) to post-treatment (29%), though not significantly. Depression and binge eating decreased (P < 0.01) with ADF. Purgative behavior and fear of fatness remained unchanged. ADF helped subjects increase (P < 0.01) restrictive eating and improve (P < 0.01) body image perception. Therefore, ADF produces minimal adverse outcomes, and has either benign or beneficial effects on eating disorder symptoms.

Eating Competence of College Students in an Introductory Nutrition Course

ERIC Educational Resources Information Center

Brown, Lora Beth; Larsen, Katrina J.; Nyland, Nora K.; Eggett, Dennis L.

2013-01-01

Objective: Describe eating competence, a positive and flexible way of conceptualizing eating attitudes and behaviors, in students enrolled in an introductory nutrition course. Methods: Online completion of the Satter Eating Competence Inventory (ecSI) and self-assessment of eating disorder status by 557 students (343 ages 18-20 years and 180 ages…

Associated Factors for Self-Reported Binge Eating among Male and Female Adolescents.

ERIC Educational Resources Information Center

Ledoux, Sylvie; And Others

1993-01-01

Adolescents (n=3,287) completed questionnaire concerning eating behaviors. Found that binge eaters had disorderly eating habits (skipping meals, snacking, eating sweets, unbalanced diets), concern with body shape (feeling too fat), and depressive symptoms more often than nonbinge eaters did. Relationship between binging episodes and eating habits,…

Ghrelin in eating disorders.

PubMed

Yi, Chun-Xia; Heppner, Kristy; Tschöp, Matthias H

2011-06-20

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 disorders such as Prader-Willi syndrome, anorexia nervosa, bulimia nervosa and binge-eating. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The Continuity/Discontinuity Models of Eating Disorders: A Review of the Literature and Implications for Assessment, Treatment, and Prevention

ERIC Educational Resources Information Center

Gleaves, David H.; Brown, Joshua D.; Warren, Cortney S.

2004-01-01

Are the eating disorders discrete diagnostic entities or do they fall along one or more continua ranging from normal body weight, eating behavior, and weight concerns to severely disturbed patterns? Researchers have debated this question for at least 30 years and have used numerous creative strategies to examine this and related questions. This…

Innovative interventions for disordered eating: evaluating dissonance-based and yoga interventions.

PubMed

Mitchell, Karen S; Mazzeo, Suzanne E; Rausch, Sarah M; Cooke, Kathryn L

2007-03-01

Eating-disordered behavior is prevalent among college women. Few interventions have successfully reduced risk factors for these behaviors, however. The most promising interventions are both selective and interactive. This study compared two newer types of interventions that meet these criteria: cognitive dissonance and yoga programs. This study advertised programs for women who were dissatisfied with their bodies. Participants (N = 93) were randomly assigned to dissonance, yoga, or control groups. Hierarchical regression analyses revealed that there were no significant post-intervention differences between the yoga and control groups. Dissonance group participants had significantly lower scores than the scores of both other groups on measures of disordered eating, drive for thinness, body dissatisfaction, alexithymia, and anxiety. These findings have important implications for interventions on college campuses. In particular, dissonance interventions appear to be an efficient and inexpensive approach to reducing eating disorder risk factors. Additional research regarding the value of yoga interventions is needed. 2006 by Wiley Periodicals, Inc.

Negative affective experiences in relation to stages of eating disorder recovery.

PubMed

Harney, Megan B; Fitzsimmons-Craft, Ellen E; Maldonado, Christine R; Bardone-Cone, Anna M

2014-01-01

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, in turn, has salutatory effects on depression, anxiety, and perceived stress. © 2013.

Negative Affective Experiences in Relation to Stages of Eating Disorder Recovery

PubMed Central

Harney, Megan B.; Fitzsimmons-Crafr, Ellen E.; Maldonado, Christine R.; Bardone-Cone, Anna M.

2013-01-01

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 salutatory effects on depression, anxiety, and perceived stress. PMID:24411745

Severe avoidant/restrictive food intake disorder and coexisting stimulant treated attention deficit hyperactivity disorder.

PubMed

Pennell, Alexandra; Couturier, Jennifer; Grant, Christina; Johnson, Natasha

2016-11-01

There is a growing body of literature describing the development, clinical course, and treatment of avoidant/restrictive food intake disorder (ARFID), a diagnostic category introduced in the DSM-5. However, information surrounding complex cases of ARFID involving coexisting medical and/or psychiatric disorders remains scarce. Here we report on two cases of young patients diagnosed concurrently with ARFID and attention deficit hyperactivity disorder (ADHD) who both experienced significant growth restriction following initiation of stimulant medication. The appetite suppressant effect of stimulants exacerbated longstanding avoidant and restrictive eating behaviors resulting in growth restriction and admission to an inpatient eating disorders unit. The implications of ARFID exacerbated by stimulant-treated ADHD are explored, as well as the treatment delivered. These cases suggest that further research is needed to explore management options to counteract the appetite suppression effects of stimulants, while simultaneously addressing attention deficit symptoms and oppositional behavior. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1036-1039). © 2016 Wiley Periodicals, Inc.

Insidious: The relationship patients have with their eating disorders and its impact on symptoms, duration of illness, and self-image.

PubMed

Forsén Mantilla, Emma; Clinton, David; Birgegård, Andreas

2017-10-28

In published clinical and autobiographical accounts of eating disorders, patients often describe their disorder in personified ways, that is, relating to the disorder as if it were an entity, and treatment often involves techniques of externalization. By encouraging patients to think about their eating disorder as a relationship, this study aimed to examine how young female patients experience their eating disorder as acting towards them, how they react in response, and whether these interactions are associated with symptoms, illness duration, and self-image. Structural Analysis of Social Behavior (SASB) was used to operationalize how patients experience the actions of their eating disorder and their own reactions to the disorder. The relationship between patients (N = 150) and their eating disorders was examined with respect to symptoms, duration of illness, and self-image. Patients were also compared on their tendency to react with affiliation in relation to their disorder. Patients' responses on the SASB indicated that they tended to conceptualize their eating disorders as blaming and controlling, and they themselves as sulking and submitting in response. Greater experience of the eating disorder as being controlling was associated with higher levels of symptomatology. Patients reacting with more negative affiliation towards their disorder were less symptomatic. When encouraging patients to think about their eating disorder as a relationship, comprehensible relationship patterns between patients and their eating disorders emerged. The idea that this alleged relationship may resemble a real-life relationship could have theoretical implications, and its exploration may be of interest in treatment. Patients were able to conceptualize their eating disorder as a significant other to whom they relate when encouraged to do so. Patients tended to experience their disorder as controlling and domineering. Exploring the hypothetical patient-eating disorder relationship may prove helpful in understanding dysfunctional relational patterns. Helping patients to rebel against their eating disorder could potentially aid in symptom reduction. © 2017 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Mexican American Women’s Perspectives on a Culturally Adapted Cognitive-Behavioral Therapy Guided Self-Help Program for Binge Eating

PubMed Central

Shea, Munyi; Cachelin, Fary M.; Gutierrez, Guadalupe; Wang, Sherry; Phimphasone, Phoutdavone

2015-01-01

The prevalence of bulimia nervosa (BN) and binge eating disorder (BED) among Latinas is comparable to those of the general population; however, few interventions and treatment trial research have focused on this group. Cognitive-behavioral therapy (CBT) is the treatment of choice for binge eating related disorders. CBT-based guided self-help (CBTgsh)—a low-cost minimal intervention—has also been shown effective in improving binge eating related symptom, but the effectiveness of the CBTgsh among ethnic minority women is not well understood. Cultural adaptation of evidence-based treatments can be an important step for promoting treatment accessibility and engagement among underserved groups. This qualitative study was part of a larger investigation that examined the feasibility and efficacy of a culturally adapted CBTgsh program among Mexican American women with binge eating disorders. Post-treatment focus groups were conducted with 12 Mexican American women with BN or BED who participated in the intervention. Data were analyzed with the grounded theory methodology (Corbin & Strauss, 2008). Three themes emerged from the data: 1) eating behavior and body ideals are socially and culturally constructed, 2) multifaceted support system is crucial to Mexican American women’s treatment engagement and success, and 3) the culturally adapted CBTgsh program is feasible and relevant to Mexican American women’s experience, but it can be strengthened with increased family and peer support. The findings provide suggestions for further adaptation and refinement of the CBTgsh, and implications for future research as well as early intervention for disordered eating in organized care settings. PMID:26462112

Eating Disorders Among Female Students of Taif University, Saudi Arabia.

PubMed

Abd El-Azeem Taha, Azza Ali; Abu-Zaid, Hany Ahmed; El-Sayed Desouky, Dalia

2018-03-01

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.

The Microbiota, the Gut and the Brain in Eating and Alcohol Use Disorders: A ‘Ménage à Trois’?

PubMed Central

Temko, Jamie E.; Bouhlal, Sofia; Farokhnia, Mehdi; Lee, Mary R.; Cryan, John F.; Leggio, Lorenzo

2017-01-01

Abstract Aims Accumulating evidence for the influence of the gut microbiota on the bidirectional communication along the gut-brain axis suggests a role of the gut microbiota in eating disorders (EDs) and alcohol and substance use disorders. The potential influence of altered gut microbiota (dysbiosis) on behaviors associated with such disorders may have implications for developing therapeutic interventions. Methods A systematic review of preclinical and clinical studies evaluating the gut microbiota, EDs and alcohol and substance use disorders was conducted using MEDLINE, Embase and Web of Science databases with the objective being to examine the role of the gut microbiota in behavioral correlates of these disorders. Original papers focused on the gut microbiota and potential behavioral implications were deemed eligible for consideration. Results The resulting 12 publications were limited to gut microbiota studies related to EDs and alcohol and substance use disorders. Some studies suggest that dysbiosis and gut microbial byproducts may influence the pathophysiology of EDs via direct and indirect interference with peptide hormone signaling. Additionally, dysbiosis was shown to be correlated with alcohol use disorder-related symptoms, i.e. craving, depression and anxiety. Finally, a mouse study suggests that manipulations in the gut microbiota may affect cocaine-related behaviors. Conclusions Promising, albeit preliminary, findings suggest a potential role of the gut microbiota in behavioral correlates of EDs and alcohol and substance use disorders. Short summary Preliminary evidence exists supporting the role of the gut microbiota in eating disorders and alcohol and substance use disorders, although additional investigation is needed to determine what is causative versus epiphenomenological. PMID:28482009

[Written and pictorial content in magazines and their possible relationship to eating disorders].

PubMed

Szabó, Kornélia; Túry, Ferenc

2012-02-01

In the current study we reviewed the literature on studies exploring the magazine reading frequency, written and pictorial contents appearing in magazines and their connection to eating disorders. Reading different fashion and fitness magazines has effect on readers through several indirect and direct factors and through trustable and false information. They affect readers' body satisfaction, self-esteem, eating habits and more generally their health behavior. Different theories have been explained to account for these associations and several other studies examined empirically the connection between the frequency of magazine reading and eating disorders, as well as the symptoms leading to eating disorders. We analyzed and summarized articles between 1975 and 2009 from online databases. We used the following sources: Science Direct (http://www.sciencedirect.com/), Springer-Verlag GmbH (http://www.springerlink.com/) and SAGE Publications Ltd (http://online.sagepub. com/). The pictorial and written magazine contents were associated with the development and maintenance of eating disorders or with symptoms that might lead to eating disorders. The publications compared to previous years featured an increased number of advertisements for unhealthy foods, for unhealthy radical diet plans and exercise programs. Furthermore the magazines contained conflicting messages about nutrition, body functions and eating disorders. Written and pictorial magazine contents, messages might increase the risk for development of eating disorders, especially in vulnerable individuals.

The role of emotional dysregulation in concurrent eating disorders and substance use disorders.

PubMed

Spence, Sarah; Courbasson, Christine

2012-12-01

This study explored the role of emotional dysregulation in 178 participants with concurrent EDs and SUDs. We ran two path analyses: Model 1 predicted negative mood regulation from alexithymia, and Model 2 predicted emotional eating from negative mood regulation. For Model 1, difficulty identifying and describing feelings was related to poor coping expectancies, while externally-oriented thinking was related to greater coping expectancies. For Model 2, poor coping expectancies in general were related to emotional eating, while greater coping expectancies in relation to behavior (i.e., the belief that some behavior or action can alleviate one's negative affect) also resulted in increased emotional eating. This finding suggests that there may be differences in the purpose of emotional eating; some people may believe that emotional eating can be used as an effective coping strategy to deal with negative affect. Copyright © 2012 Elsevier Ltd. All rights reserved.

The fear of food measure: a novel measure for use in exposure therapy for eating disorders.

PubMed

Levinson, Cheri A; Byrne, Meghan

2015-04-01

Exposure therapy for mealtime anxiety has preliminarily been effective at increasing food intake and decreasing anxiety in individuals with anorexia nervosa (AN). To enhance our knowledge of exposure therapy for AN researchers and clinicians need a comprehensive measure that assesses outcomes relevant to exposure therapy for AN. In the current four studies we developed Fear of Food Measure (FOFM) that assesses three cognitive and behavioral outcomes: trait anxiety about eating, food avoidance behaviors, and feared concerns related to eating. In a community (N = 399) and undergraduate female sample (N = 203) the FOFM exhibited a good three-factor structure and convergent and divergent validity. In a sample of women (N = 72) we showed that the anxiety about eating subscale significantly predicted in vivo food intake over and above other established predictors of eating (e.g., restraint). In a clinical sample diagnosed with an eating disorder (N = 41) we showed that anxiety about eating was associated with food intake and anxiety during an exposure meal and that all subscales of the FOFM significantly decreased over the course of a four-session exposure intervention. Finally, we found that participants diagnosed with an eating disorder had higher levels of fear of food than did matched controls (N = 23). The FOFM is a psychometrically valid measure that can assess if patients are improving while undergoing exposure therapy and could be used to pinpoint problematic behaviors that can be addressed in exposure therapy. © 2014 Wiley Periodicals, Inc.

Eating Disorder Quality of Life Scale (EDQLS) in ethnically diverse college women: an exploratory factor analysis.

PubMed

Akoury, Liya M; Rozalski, Vincent; Barchard, Kimberly A; Warren, Cortney S

2018-03-01

Extant research suggests that disordered eating is common in college women and is associated with decreased quality of life. The Eating Disorder Quality of Life Scale (EDQLS) examines impairment to disordered eating-related quality of life, but has not been validated in college women. Accordingly, the purpose of this study was to examine the reliability, validity, and factor structure of the EDQLS in a diverse sample of 971 college women. Students from a large United States university completed questionnaires examining disordered eating and the EDQLS online. The EDQLS demonstrated excellent internal consistency and good convergent validity with the Eating Disorder Examination Questionnaire (EDEQ). Contrary to the original 12-domain design of the EDQLS, principal component analyses suggested five factors that mapped onto the following constructs: (1) Positive Emotionality; (2) Body/Weight Dissatisfaction; (3) Disordered Eating Behaviors; (4) Negative Emotionality; and (5) Social Engagement. However, 15 of the 40 items loaded onto multiple factors. Total scores on the EDQLS are reliable and valid when used with diverse samples of college women, but some revisions are needed to create subscales than can justifiably be used in clinical practice.

Co-occurrence of eating disorders and alcohol use disorders in women: a meta analysis.

PubMed

Gadalla, T; Piran, N

2007-01-01

This meta analysis involved 41 studies published between January of 1985 and May of 2006, which examined the co-occurrence of eating disorders (ED) and alcohol use disorders (AUD) in women. Studies were reviewed and a quantitative synthesis of their results was carried out via the calculation of standardised effect sizes. Direction and strength of the relationships between AUD and specific disordered eating patterns were examined. Heterogeneity of reported results was also assessed and examined. Only 4 out of 41 studies reported negative associations between ED and AUD. The magnitude of the associations between eating-disordered patterns and AUD ranged from small to medium size and were statistically significant for any ED, bulimia nervosa (BN)/bulimic behavior, purging, binge eating disorder (BED) and eating disorders not otherwise specified (EDNOS). No association was found between anorexia nervosa (AN) and AUD. The magnitude of the association between BN and AUD was the most divergent across studies and those between each of BED and dietary restriction and AUD were the most consistent across studies. Reported associations of different patterns of disordered eating and AUD were generally weakest and most divergent when participants were recruited from clinical settings and strongest and most homogeneous when participants were recruited from student populations.

Self-Mutilation and Eating Disorders.

ERIC Educational Resources Information Center

Favazza, Armando R.; And Others

1989-01-01

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…

Men, Muscles, and Eating Disorders: an Overview of Traditional and Muscularity-Oriented Disordered Eating.

PubMed

Lavender, Jason M; Brown, Tiffany A; Murray, Stuart B

2017-06-01

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.

The uncompetitive N-methyl-D-aspartate antagonist memantine reduces binge-like eating, food-seeking behavior, and compulsive eating: role of the nucleus accumbens shell.

PubMed

Smith, Karen L; Rao, Rahul R; Velázquez-Sánchez, Clara; Valenza, Marta; Giuliano, Chiara; Everitt, Barry J; Sabino, Valentina; Cottone, Pietro

2015-03-13

Binge-eating disorder is characterized by excessive, uncontrollable consumption of palatable food within brief periods of time. The role of the glutamatergic N-methyl-D-aspartate (NMDA) receptor system in hedonic feeding is poorly understood. The aim of this study was to characterize the effects of the uncompetitive NMDA receptor antagonist memantine on palatable food-induced behavioral adaptations using a rat model, which mimics the characteristic symptomatology observed in binge-eating disorder. For this purpose, we allowed male Wistar rats to respond to obtain a highly palatable, sugary diet (Palatable group) or a regular chow diet (Chow control group), for 1 h a day, under a fixed-ratio 1 (FR1) schedule of reinforcement. Upon stabilization of food responding, we tested the effects of memantine on the Chow and Palatable food groups' intake. Then, we tested the effects of memantine on food-seeking behavior, under a second-order schedule of reinforcement. Furthermore, we investigated the effects of memantine on the intake of food when it was offered in an aversive, bright compartment of a light/dark conflict test. Finally, we evaluated the effects of memantine on FR1 responding for food, when microinfused into the nucleus accumbens (NAcc) shell or core. Memantine dose-dependently decreased binge-like eating and fully blocked food-seeking behavior and compulsive eating, selectively in the Palatable food group. The drug treatment did not affect performance of the control Chow food group. Finally, intra-NAcc shell, but not core, microinfusion of memantine decreased binge-like eating. Together, these findings substantiate a role of memantine as a potential pharmacological treatment for binge-eating disorder.

The Uncompetitive N-methyl-D-Aspartate Antagonist Memantine Reduces Binge-Like Eating, Food-Seeking Behavior, and Compulsive Eating: Role of the Nucleus Accumbens Shell

PubMed Central

Smith, Karen L; Rao, Rahul R; Velázquez-Sánchez, Clara; Valenza, Marta; Giuliano, Chiara; Everitt, Barry J; Sabino, Valentina; Cottone, Pietro

2015-01-01

Binge-eating disorder is characterized by excessive, uncontrollable consumption of palatable food within brief periods of time. The role of the glutamatergic N-methyl-D-aspartate (NMDA) receptor system in hedonic feeding is poorly understood. The aim of this study was to characterize the effects of the uncompetitive NMDA receptor antagonist memantine on palatable food-induced behavioral adaptations using a rat model, which mimics the characteristic symptomatology observed in binge-eating disorder. For this purpose, we allowed male Wistar rats to respond to obtain a highly palatable, sugary diet (Palatable group) or a regular chow diet (Chow control group), for 1 h a day, under a fixed-ratio 1 (FR1) schedule of reinforcement. Upon stabilization of food responding, we tested the effects of memantine on the Chow and Palatable food groups' intake. Then, we tested the effects of memantine on food-seeking behavior, under a second-order schedule of reinforcement. Furthermore, we investigated the effects of memantine on the intake of food when it was offered in an aversive, bright compartment of a light/dark conflict test. Finally, we evaluated the effects of memantine on FR1 responding for food, when microinfused into the nucleus accumbens (NAcc) shell or core. Memantine dose-dependently decreased binge-like eating and fully blocked food-seeking behavior and compulsive eating, selectively in the Palatable food group. The drug treatment did not affect performance of the control Chow food group. Finally, intra-NAcc shell, but not core, microinfusion of memantine decreased binge-like eating. Together, these findings substantiate a role of memantine as a potential pharmacological treatment for binge-eating disorder. PMID:25381776

Interpersonal interactions on online forums addressing eating concerns.

PubMed

Ransom, Danielle C; La Guardia, Jennifer G; Woody, Erik Z; Boyd, Jennifer L

2010-03-01

Although some research suggests that online eating disorder forums promote "pro-eating-disorder" lifestyles and discourage recovery, other research suggests that such forums are an important source of interpersonal support. The current study extends this research by exploring the positive and negative behaviors encouraged on these forums and by comparing forum members' perceptions of support received from online and offline relationships to support received in relationships of age-matched controls. In a survey of 60 forum members, we assessed information exchanged and support provided on eating disorder forums. Further, we assessed perceptions of social support for general and specific life concerns in this group of forum members as well as 64 age-matched university controls. Results show that both adaptive and maladaptive behaviors are encouraged on the forums, and that this encouragement has some influence on forum members trying out these behaviors. Overall, forum members reported receiving less support for their eating concerns as compared to their general life stressors, and they perceived less support for both their general concerns and eating concerns in their offline relationships as compared to their online forum relationships. Moreover, forum members reported receiving less support from their offline relationships as compared to support received in relationships by age-matched controls. Forum members perceive less support in their important relationships than other peers do, and they seek out and participate in forums as a means of attaining greater social support. However, our research suggests that these forums also encourage dysregulated eating behaviors. Implications of online forum support and its impact on recovery are discussed further.

The effects of repetitive transcranial magnetic stimulation in obese females with binge eating disorder: a protocol for a double-blinded, randomized, sham-controlled trial.

PubMed

Maranhão, Mara Fernandes; Estella, Nara Mendes; Cury, Maria Elisa Gisbert; Amigo, Veruska Lastoria; Picasso, Clarissa Mollinero; Berberian, Arthur; Campbell, Iain; Schmidt, Ulrike; Claudino, Angélica Medeiros

2015-08-12

Binge eating disorder is a new category in DSM-5 and highly associated with higher body mass index. The neural mechanisms that underlie binge eating are of great interest in order to improve treatment interventions. Brain mechanisms underlying drug and food craving are suggested to be similar: for example, both are reported to be associated with increased neural activity in the orbitofrontal and anterior cingulate cortex, and a diminished regulatory influence from lateral prefrontal circuits. Several studies have begun to assess the potential benefits of brain stimulation in reducing craving and addictive behaviors. Data from a study of a one-off session of transcranial magnetic stimulation in healthy women identified as strong cravers and of individuals with bulimic-type eating disorders, reported a reduction in food craving and binge eating episodes. This provides support for a more extensive investigation of the potential therapeutic benefits of transcranial magnetic stimulation. Lastly, brain imaging studies and a dimensional approach, will improve understanding of the neural correlates of the disorders and of the mode of action of transcranial magnetic stimulation. Sixty eligible obese females, with binge eating disorder, will be randomly allocated to receive 20 sessions of transcranial magnetic stimulation intervention (n = 30) or the sham transcranial magnetic stimulation intervention (n = 30) scattered 3 days/week. Thirty eligible controls will complete the baseline assessment. The primary outcome (number of binge eating episodes) will be assed at each treatment sessions, and 8 weeks after intervention completion (follow-up). It is hypothesized that mean weekly binge-eating episodes will be reduced in the intervention group, compared to the sham group, and that the effect will be maintained at follow-up. Despite the severity associated with Binge Eating Disorder, there are limited treatment options. This study is an important step in the development of more effective treatments. Importantly, the study is the first to investigating binge eating disorder using a dimensional approach, by looking at the different aspects of the disorder, such as behavioral factors, biological factors, brain circuits and chemistry. Clinical Trials NCT02180984 . Registered in July 2014.

Prevalence and treatment of eating disorders among Hispanics/Latino Americans in the United States.

PubMed

Perez, Marisol; Ohrt, Tara K; Hoek, Hans W

2016-11-01

We reviewed the recent literature on prevalence rates, and application of evidence-based treatments for eating disorders among Hispanics/Latinos residing in the United States. Lifetime prevalence rates of anorexia nervosa are lower among Hispanic/Latinos than non-Hispanic Whites. There are comparable rates of bulimia nervosa and binge eating disorder (BED) among Hispanic/Latinos and non-Hispanic Whites. BED is the most common eating disorder among Hispanic/Latinos. Evidence-based treatments have begun to be implemented with Hispanics/Latinos. The core concepts of cognitive behavioral therapy for bulimia nervosa and BED apply to this population. Culture-specific adaptations include strengthening the collectivistic framework within an individualistic treatment, psychoeducation of immediate and extended family, and adjustment of meal plans that incorporated cultural foods. There are more similarities than differences in the prevalence of eating disorders across Hispanics/Latinos and non-Hispanic Whites. However, the social context such as immigration status and acculturation is important to consider in the development of eating disorders. In addition, the Westernization of Latin America may change the future relationship of immigration status and development of eating disorder within the United States. Overall, cultural adaptations of evidence-based treatments involved the inclusion of family within treatment, acculturation-related issues, and managing family conflicts that arise because of the changes in eating patterns.

Empowerment, feminism, and self-efficacy: relationships to body image and disordered eating.

PubMed

Kinsaul, Jessica A E; Curtin, Lisa; Bazzini, Doris; Martz, Denise

2014-01-01

Sociocultural norms pertaining to an ideal of thinness for women likely play a role in the development and maintenance of disturbance in body image, and by extension, disordered eating. However, competing norms associated with feminism may buffer women from pressures associated with achieving the thin ideal. The present study explored the relationship between feminist ideology, empowerment, and self-efficacy relative to body image and eating behavior with a sample of U.S. undergraduate women (N=318) attending a southeastern U.S. mid-sized university. In planned hierarchical multiple regression analyses, endorsement of feminist ideology predicted perceptions of positive body image, but did not appear to predict disordered eating. Self-efficacy emerged as a robust predictor of positive body image and lower disordered eating even after controlling for perceptions of personal empowerment and feminism. Results, although limited by correlational data, suggest that self-efficacy may protect college-aged women from disordered eating and negative body image. Copyright © 2013 Elsevier Ltd. All rights reserved.

Prader-Willi Syndrome

ERIC Educational Resources Information Center

Kundert, Deborah King

2008-01-01

Although known for its distinctive food-related behaviors, Prader-Willi syndrome is a multisystem disorder with genetic, developmental, and behavioral features. Two separate and distinct eating disorders are noted: initial feeding difficulties and failure to thrive, and later overeating. Additional outcomes observed with this disorder include…

A Cognitive- Behavioral Therapeutic Program for Patients with Obesity and Binge Eating Disorder: Short- and Long- Term Follow-Up Data of a Prospective Study

ERIC Educational Resources Information Center

Vanderlinden, Johan; Adriaensen, An; Vancampfort, Davy; Pieters, Guido; Probst, Michel; Vansteelandt, Kristof

2012-01-01

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…

Evaluate, Assess, Treat: Development and evaluation of the EAT framework to increase effective communication regarding sensitive oral-systemic health issues

PubMed Central

DeBate, Rita D.; Cragun, Deborah; Gallentine, Ashley A.; Severson, Herbert H.; Shaw, Tracey; Cantwell, Carley; Christiansen, Steve; Koerber, Anne; Hendricson, William; Tomar, Scott L.; Brown, Kelli McCormack; Tedesco, Lisa A.

2012-01-01

Oral healthcare providers are likely to encounter a number of sensitive oral/systemic health issues while interacting with patients. The purpose of the current study was to develop and evaluate a framework aimed at oral healthcare providers to engage in active secondary prevention of eating disorders (i.e., early detection of oral manifestations of disordered eating behaviors, patient approach and communication, patient-specific oral treatment, and referral to care) for patients presenting with signs of disordered eating behaviors. The EAT Framework was developed based on the Brief Motivational Interviewing (B-MI) conceptual framework and comprises three continuous steps: Evaluating, Assessing, and Treating. Using a group-randomized control design, 11 dental hygiene (DH) and 7 dental (D) classes from 8 institutions were randomized to either the intervention or control conditions. Both groups completed preand post-intervention assessments. Hierarchical linear models were conducted to measure the effects of the intervention while controlling for baseline levels. Statistically significant improvements from pre-to post-intervention were observed in the Intervention group compared with the Control group on knowledge of eating disorders and oral findings, skills-based knowledge, and self-efficacy (all p < .01). Effect sizes ranged from .57–.95. No statistically significant differences in outcomes were observed by type of student. Although the EAT Framework was developed as part of a larger study on secondary prevention of eating disorders, the procedures and skills presented can be applied to other sensitive oral/systemic health issues. Because the EAT Framework was developed by translating B-MI principles and procedures, the framework can be easily adopted as a non-confrontational method for patient communication. PMID:23050505

Family dinner and disordered eating behaviors in a large cohort of adolescents

PubMed Central

Haines, Jess; Gillman, Matthew W.; Rifas-Shiman, Sheryl; Field, Alison E.; Austin, S. Bryn

2009-01-01

We aimed to examine longitudinal associations between family dinner and disordered eating behaviors among adolescents. We studied 7535 females and 5913 males, 9 to 14 years of age in 1996. We performed multivariable logistic regression to assess the associations of previous year family dinner with 1-year incidence of each of 3 outcomes: purging, binge eating, and frequent dieting. Compared to those who ate family dinner “never or some days,” female adolescents who ate family dinner at least most days were less likely to initiate purging, binge eating, and frequent dieting. Estimates of association among males were similar in direction and magnitude, although lower frequency of the outcomes resulted in less precise estimates and fewer statistically significant results. PMID:20390605

Outcomes of Cognitive Behavioral Therapy (CBT) Interventions Provided by Unlicensed Professionals

ClinicalTrials.gov

2018-05-04

Obsessive Compulsive Disorder; Body Dysmorphic Disorder; Tourette Syndrome; Trichotillomania; Panic Disorder; Social Phobia; Generalized Anxiety Disorder; Depression; Post-Traumatic Stress Disorder; Attention Deficit Hyperactivity Disorder; Eating Disorder; Specific Phobia; General Medical Condition

Associations among eating regulation and body mass index, weight, and body fat in college students: the moderating role of gender.

PubMed

Gropper, Sareen S; Arsiwalla, Dilbur D; Lord, Denali C; Huggins, Kevin W; Simmons, Karla P; Ulrich, Pamela V

2014-04-01

This study investigated associations between eating regulation behaviors and body mass index (BMI), weight, and percent body fat in male and female students over the first two years of college. Subjects included 328 college students (215 females and 113 males). Height and weight (via standard techniques), body composition (via bioelectrical impedance analysis), and eating regulation behaviors (using the Regulation of Eating Behavior Scale) were conducted two to three times during both the freshman and sophomore years. Significant associations between eating regulation and BMI, weight, and/or percent body fat were shown mostly in females. In females, higher BMI, weight, and/or percent body fat at the end of the second year of college were found in those with low levels of autonomous, intrinsic motivation, and identified regulation, and high levels of amotivation, while lower BMI, weight, and/or percent body fat were associated with high levels of autonomous, intrinsic motivation, and identified regulation, and low levels of amotivation. The findings that specific eating behaviors in females during the first two years of college influence BMI, weight, and/or percent body fat may be useful for inclusion in university programs focused on college student health to help decrease the risk of obesity and disordered eating/eating disorders in female college students. Copyright © 2014 Elsevier Ltd. All rights reserved.

Examining the Relationship Between Soda Consumption and Eating Disorder Pathology

PubMed Central

Bragg, M.A.; White, M. A.

2013-01-01

Objective This study aimed to compare diet soda drinkers, regular soda drinkers, and individuals who do not regularly consume soda on clinically significant eating disorder psychopathology, including binge eating, overeating, and purging. Method Participants (n=2077) were adult community volunteers who completed an online survey that included the Eating Disorder Examination Questionnaire and questions regarding binge eating behaviors, purging, current weight status, and the type and frequency of soda beverages consumed. Results Diet soda drinkers (34%, n=706) reported significantly higher levels of eating, shape, and weight concerns than regular soda drinkers (22%, n=465), who in turn reported higher levels on these variables than non-soda drinkers (44%, n=906). Diet soda drinkers were more likely to report binge eating and purging than regular soda drinkers, who were more likely to report these behaviors than non-soda drinkers. Consumption of any soda was positively associated with higher BMI, though individuals who consumed regular soda reported significantly higher BMI than diet soda drinkers, who in turn reported higher weight than those who do not consume soda regularly. Conclusions Individuals who consume soda regularly reported higher BMI and more eating psychopathology than those who do not consume soda. These findings extend previous research demonstrating positive associations between soda consumption and weight. PMID:24167775

Exploring gender differences in the link between weight suppression and eating pathology.

PubMed

Burnette, C Blair; Simpson, Courtney C; Mazzeo, Suzanne E

2017-12-01

Weight suppression (WS), the difference in one's highest weight (excluding pregnancy) and current weight at current height, is associated with the onset of eating disorders. Previous research has explored the influence of WS in predominantly clinical, female samples. However, the transition to college is a particularly high-risk time for weight gain and the development of eating pathology and men with eating disorders often have higher premorbid weights. This study investigated the associations of WS and dimensions of eating pathology in an undergraduate sample (N=859) and examined the effect of gender. Results demonstrated that higher levels of WS were associated with more dietary restraint (p=0.004) and more frequent purging behaviors (p<0.001); WS was indirectly related to loss-of-control eating through dietary restraint for both men and women (p<0.001). Additionally, men with higher WS were more likely to engage in extreme weight control behaviors, such as vomiting and laxative abuse (p=0.036). Findings suggest that weight history might be especially important to assess in men at risk for disordered eating. This approach might be particularly beneficial with college students due to their heightened risk of eating and weight disturbances. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Relationship of Disordered Eating Attitudes With Body Composition and Anthropometric Indices in Physical Education Students.

PubMed

Rouzitalab, Tohid; Pourghassem Gargari, Bahram; Amirsasan, Ramin; Asghari Jafarabadi, Mohammad; Farsad Naeimi, Alireza; Sanoobar, Meisam

2015-11-01

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 < 0.05). In males, the EAT-26 score was positively correlated with weist perimeter (WP) (r = 0.21, P < 0.05) and the waist-to-hip ratio (r = 0.26, P < 0.01). In females, the EAT-26 score was positively correlated with weight (r = 0.19, P < 0.05) and the WP (r = 0.28, P < 0.01). In females, weight (P < 0.05), body mass index (BMI) (P < 0.05), WP (P < 0.01), and waist-to-hip ratio (P < 0.05) were significantly different between disordered 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.

Two sides of the same coin? A new instrument to assess body checking and avoidance behaviors in eating disorders.

PubMed

Legenbauer, Tanja; Martin, Franziska; Blaschke, Ariane; Schwenzfeier, Anne; Blechert, Jens; Schnicker, Katja

2017-06-01

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.

A body image and disordered eating intervention for women in midlife: a randomized controlled trial.

PubMed

McLean, Siân A; Paxton, Susan J; Wertheim, Eleanor H

2011-12-01

This study examined the outcome of a body image and disordered eating intervention for midlife women. The intervention was specifically designed to address risk factors that are pertinent in midlife. Participants were 61 women aged 30 to 60 years (M = 43.92, SD = 8.22) randomly assigned to intervention (n = 32) or (delayed treatment) control (n = 29) groups. Following an 8-session facilitated group cognitive behavioral therapy-based intervention, outcomes from the Body Shape Questionnaire; Eating Disorder Examination Questionnaire; Body Image Avoidance Questionnaire; Physical Appearance Comparison Scale; Sociocultural Attitudes Towards Appearance Scale, Internalization subscale; measures of appearance importance, cognitive reappraisal, and self-care; Dutch Eating Behavior Questionnaire; and Kessler Psychological Distress Scale were compared for statistical and clinical significance from baseline to posttest and 6-month follow-up. Following the intent-to-treat principle, mixed-model analyses with a mixed within-between design demonstrated that the intervention group had large improvements that were statistically significantly different from the control group in body image, disordered eating, and risk factor variables and that were maintained at 6-month follow-up. Furthermore, the improvements were also of clinical importance. This study provides support for the efficacy of an intervention to reduce body image and eating concerns in midlife women. Further research into interventions tailored for this population is warranted.

Treatment preferences of patients with binge eating disorder.

PubMed

Brody, Michelle L; Masheb, Robin M; Grilo, Carlos M

2005-05-01

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

Latent Profile Analysis to Determine the Typology of Disinhibited Eating Behaviors in Children and Adolescents

PubMed Central

Vannucci, Anna; Tanofsky-Kraff, Marian; Crosby, Ross D.; Ranzenhofer, Lisa M.; Shomaker, Lauren B.; Field, Sara E.; Mooreville, Mira; Reina, Samantha A.; Kozlosky, Merel; Yanovski, Susan Z.; Yanovski, Jack A.

2012-01-01

Objective We used latent profile analysis (LPA) to classify children and adolescents into subtypes based on the overlap of disinhibited eating behaviors—eating in the absence of hunger, emotional eating, and subjective and objective binge eating. Method Participants were 411 youth (8–18y) from the community who reported on their disinhibited eating patterns. A subset (n=223) ate ad libitum from two test meals. Results LPA produced five subtypes that were most prominently distinguished by objective binge eating (OBE; n=53), subjective binge eating (SBE; n=59), emotional eating (EE; n=62), a mix of emotional eating and eating in the absence of hunger (EE-EAH; n=172), and no disinhibited eating (No-DE; n=64). Accounting for age, sex, race, BMI-z, the four disinhibited eating groups had more problem behaviors than no disinhibited eating (p=.001). OBE and SBE subtypes had greater BMI-z, percent fat mass, disordered eating attitudes, and trait anxiety than EE, EAH-EE, and No-DE subtypes (ps<.01). However, the OBE subtype reported the highest eating concern (p<.001) and the OBE, SBE, and EE subtypes reported higher depressive symptoms than EE-EAH and No-DE subtypes. Across both test meals, OBE and SBE consumed less percent protein and higher percent carbohydrate than the other subtypes (ps<.02), adjusting for age, sex, race, height, lean mass, percent fat mass, and total intake. EE also consumed greater percent carbohydrate and lower percent fat compared than EE-EAH and No-DE (ps<.03). The SBE subtype consumed the least total calories (p=.01). Discussion We conclude that behavioral subtypes of disinhibited eating may be distinguished by psychological characteristics and objective eating behavior. Prospective data are required to determine whether subtypes predict the onset of eating disorders and obesity. PMID:23276121

When chocolate seeking becomes compulsion: gene-environment interplay.

PubMed

Patrono, Enrico; Di Segni, Matteo; Patella, Loris; Andolina, Diego; Valzania, Alessandro; Latagliata, Emanuele Claudio; Felsani, Armando; Pompili, Assunta; Gasbarri, Antonella; Puglisi-Allegra, Stefano; Ventura, Rossella

2015-01-01

Eating disorders appear to be caused by a complex interaction between environmental and genetic factors, and compulsive eating in response to adverse circumstances characterizes many eating disorders. We compared compulsion-like eating in the form of conditioned suppression of palatable food-seeking in adverse situations in stressed C57BL/6J and DBA/2J mice, two well-characterized inbred strains, to determine the influence of gene-environment interplay on this behavioral phenotype. Moreover, we tested the hypothesis that low accumbal D2 receptor (R) availability is a genetic risk factor of food compulsion-like behavior and that environmental conditions that induce compulsive eating alter D2R expression in the striatum. To this end, we measured D1R and D2R expression in the striatum and D1R, D2R and α1R levels in the medial prefrontal cortex, respectively, by western blot. Exposure to environmental conditions induces compulsion-like eating behavior, depending on genetic background. This behavioral pattern is linked to decreased availability of accumbal D2R. Moreover, exposure to certain environmental conditions upregulates D2R and downregulates α1R in the striatum and medial prefrontal cortex, respectively, of compulsive animals. These findings confirm the function of gene-environment interplay in the manifestation of compulsive eating and support the hypothesis that low accumbal D2R availability is a "constitutive" genetic risk factor for compulsion-like eating behavior. Finally, D2R upregulation and α1R downregulation in the striatum and medial prefrontal cortex, respectively, are potential neuroadaptive responses that parallel the shift from motivated to compulsive eating.

Feminist identity, body image, and disordered eating

PubMed Central

Borowsky, Hannah M.; Eisenberg, Marla E.; Bucchianeri, Michaela M.; Piran, Niva; Neumark-Sztainer, Dianne

2016-01-01

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

Feminist identity, body image, and disordered eating.

PubMed

Borowsky, Hannah M; Eisenberg, Marla E; Bucchianeri, Michaela M; Piran, Niva; Neumark-Sztainer, Dianne

2016-01-01

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.

Eating Disorders: Explanatory Variables in Caucasian and Hispanic College Women

ERIC Educational Resources Information Center

Aviña, Vanessa; Day, Susan X.

2016-01-01

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…

Group Treatment of Eating Disorders in a University Counseling Center.

ERIC Educational Resources Information Center

Snodgrass, Gregory; And Others

Sociocultural pressures to pursue an unrealistic ideal of thinness have contributed to an increasing number of students seeking help at a university counseling center for the eating disorders of anorexia nervosa and bulimia. To help these students, a group treatment technique was developed using a cognitive-behavioral approach. Treatment…

Treatment and Counseling Approaches for Eating Disorders.

ERIC Educational Resources Information Center

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…

Heterogeneity Moderates Treatment Response among Patients with Binge Eating Disorder

ERIC Educational Resources Information Center

Sysko, Robyn; Hildebrandt, Tom; Wilson, G. Terence; Wilfley, Denise E.; Agras, W. Stewart

2010-01-01

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…

Starving for Support: How Women with Anorexia Receive "Thinspiration" on the Internet

ERIC Educational Resources Information Center

Curry, Jennifer; Ray, Shannon

2010-01-01

This article provides the definition of anorexia, prevalence of the disorder, and treatment prognosis. Further, although the Internet provides many helpful resources for identifying problematic eating behavior and resources for persons suffering with eating disorders, Web sites exist that are meant to encourage, promote, and sustain anorexic…

Factors affecting the dental erosion severity of patients with eating disorders.

PubMed

Otsu, Mitsuhiro; Hamura, Akira; Ishikawa, Yuiko; Karibe, Hiroyuki; Ichijyo, Tomoyasu; Yoshinaga, Yoko

2014-01-01

Intraoral disease is a common occurrence in patients with eating disorders, particularly dental erosion, which frequently becomes severe and may hinder daily life. The severity varies from patient to patient. Understanding the underlying mechanisms may help prevent dental erosion in these patients. Accordingly, we investigated the relationship between the severity of erosion and the behavior of patients with eating disorders, with a focus on daily diet and vomiting behavior. A total 71 female eating disorder outpatients from the Clinical Center of Psychosomatic Dentistry of Nippon Dental University Hospital and the Psychosomatic Internal Medicine Department of Kudanzaka Hospital or who were hospitalized at Hasegawa Hospital were enrolled. Dental erosion severity and location were determined by oral examination. Patients who induced vomiting were queried on their behavior during vomiting and on routine diet habits. Patients with dental erosion were further divided into mild and severe groups based on the lesion severity and the groups compared. Dental erosion was observed in 43 of 50 subjects who induced vomiting. Dental erosion was most frequent on the palatal side of the anterior maxillary teeth, occurring in 81.3% of the subjects. There were significant differences observed between the mild and severe groups according to post-vomiting oral hygiene. Significantly more subjects in the mild group consumed large amounts of water before vomiting, and significantly more subjects in the severe group routinely consumed carbonated beverages or sweetened food. While self-induced vomiting is the main cause of dental erosion in eating disorder patients, the erosion severity may be affected by behavior when inducing vomiting or by routine consumption of certain foods and beverages. Addressing these factors may help prevent severe dental erosion in patients who chronically induce vomiting.

The urgent matter of online pro-eating disorder content and children: clinical practice.

PubMed

Custers, Kathleen

2015-04-01

During the last decade, much concern has been expressed about online pro-eating disorder communities (e.g., pro-anorexia websites and blogs) which encourage their users to engage in disordered eating behavior. The aim of the current paper is to reemphasize the importance of pro-eating disorder communities in light of the recent changes in the media landscape. With the increase of social networking sites, pro-anorexia messages have transplanted to more volatile and constantly changing media, such as Snapchat, Twitter, Facebook, Instagram, Pinterest, and many others. Most parents, educators, and health professionals are unaware of the sheer scope and nature of such pro-anorexia messages in these new contexts. The current paper will provide a review of pro-eating disorder websites, overview the effects of such websites on young people's health, examine the emergence of these messages on social media platforms, and highlight a number of guidelines for clinicians and parents. The dissemination of online pro-eating disorder content to different types of social networking sites is becoming an urgent issue. • Existing research on pro-eating disorder websites examines the prevalence and the content of these websites, and the effects of pro-eating disorder content on both clinical (eating disordered individuals) and non-clinical samples (non-eating disordered individuals). • The scope and nature of such anorexia messages is unknown to most adults, and many people (including parents and medical professionals) are insufficiently aware of the ease with which young people access, navigate, and use a wide range of online platforms. • Pro-anorexia messages are no longer limited to websites that can be easily monitored, but instead have been transplanted to more volatile and constantly changing media such as Snapchat, Twitter, Facebook, Pinterest, and Tumblr which makes pro-eating disorder content much more easily accessible. • This paper wants to emphasize the implications of the presence of pro-eating disorder content on websites and social media. A number of guidelines for parents and clinicians are provided.

Depression and treatment outcome in anorexia nervosa.

PubMed

Calugi, Simona; El Ghoch, Marwan; Conti, Maddalena; Dalle Grave, Riccardo

2014-08-15

The aim of this study was to compare the immediate and long-term effect of a cognitive-behavior therapy program for anorexia nervosa inpatients with and without concomitant Major Depressive Episodes (MDE). The program has been adapted from the "enhanced" form of Cognitive Behavior Therapy (CBT) for eating disorders. Sixty-three consecutive underweight adult patients with severe eating disorder were treated with inpatient CBT. MDE was assessed with the structured clinical interview for DSM-IV. The Eating Disorder Examination, and the Brief Symptom Inventory were recorded at entry, at the end of treatment, and 6 and 12 months later. MDE was present in 60.3% of participants. No significant differences were observed in the demographic and baseline clinical variables between patients with and without MDE. Significant improvements in weight, and in eating disorder and general psychopathology were showed. There were no differences between participants with and without MDE in terms of treatment outcome, and the severity of depression was not associated with changes in global Eating Disorder Examination score. These findings suggest that a diagnosis of MDE does not influence the outcome of inpatient treatment for anorexia nervosa patients, and that the severity of depression cannot be used to predict the success or failure of such treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Are we really delivering evidence-based treatments for eating disorders? How eating-disordered patients describe their experience of cognitive behavioral therapy.

PubMed

Cowdrey, Natasha D; Waller, Glenn

2015-12-01

Psychotherapists report routinely not practising evidence-based treatments. However, there is little research examining the content of therapy from the patient perspective. This study examined the self-reported treatment experiences of individuals who had been told that they had received cognitive-behavior therapy (CBT) for their eating disorder. One hundred and fifty-seven such sufferers (mean age = 25.69 years) were recruited from self-help organisations. Participants completed an online survey assessing demographics, clinical characteristics, and therapy components. The use of evidence-based CBT techniques varied widely, with core elements for the eating disorders (e.g., weighing and food monitoring) used at well below the optimum level, while a number of unevidenced techniques were reported as being used commonly. Cluster analysis showed that participants received different patterns of intervention under the therapist label of 'CBT', with evidence-based CBT being the least common. Therapist age and patient diagnosis were related to the pattern of intervention delivered. It appears that clinicians are not subscribing to a transdiagnostic approach to the treatment of eating disorders. Patient recollections in this study support the conclusion that evidence-based practice is not routinely undertaken with this client group, even when the therapy offered is described as such. Copyright © 2015 Elsevier Ltd. All rights reserved.

Group Schema Therapy for Eating Disorders: A Pilot Study

PubMed Central

Simpson, Susan G.; Morrow, Emma; van Vreeswijk, Michiel; Reid, Caroline

2010-01-01

This paper describes the use of Group Schema Therapy for Eating Disorders (ST-E-g) in a case series of eight participants with chronic eating disorders and high levels of co-morbidity. Treatment was comprised of 20 sessions which included cognitive, experiential, and interpersonal strategies, with an emphasis on behavioral change. Specific schema-based strategies focused on bodily felt-sense and body-image, as well as emotional regulation skills. Six attended until end of treatment, two dropped-out at mid-treatment. Eating disorder severity, global schema severity, shame, and anxiety levels were reduced between pre- and post-therapy, with a large effect size at follow-up. Clinically significant improvement in eating severity was found in four out of six completers. Group completers showed a mean reduction in schema severity of 43% at post-treatment, and 59% at follow-up. By follow-up, all completers had achieved over 60% improvement in schema severity. Self-report feedback suggests that group factors may catalyze the change process in schema therapy by increasing perceptions of support and encouragement to take risks and try out new behaviors, whilst providing a de-stigmatizing and de-shaming therapeutic experience. PMID:21833243

Subclinical eating disorders in female medical students in Anhui, China: a cross-sectional study.

PubMed

Chang, Wei-Wei; Nie, Miao; Kang, Yao-Wen; He, Lian-Ping; Jin, Yue-Long; Yao, Ying-Shui

2015-04-01

This cross-sectional study explored the prevalence of eating disorders (EDs) and possible associated factors (depressive symptoms, anxiety and BMI, etc) on EDs in female medical students in China. A total of 1,135 students in Wuhu, Anhui Province were sampled to participate in this survey. The survey collected sociodemographic data, depressive symptoms, anxiety and eating behaviors of students. The students at risk for eating disorders were 2.17%. Eating disorder risk was more frequent in students with poor parent's relationship, students with poor relationship with parents, students with high body mass index, students who were excessive focus on slimming propaganda, and students whose relatives have a diet. Also, the mean scores for the psychological factors of depression and anxiety were higher in students with eating disorder risk. A multiple linear regression model was produced depicting that depression, anxiety, high level of BMI, focusing on slimming propaganda, and dieting status among relatives were risk factors of having an eating disorder risk. A significant fraction of female medical students in Anhui are at high risk of development of eating disorders. A comprehensive intervention focusing on family environment and emotion management should be designed to prevent occurrence of such disorders among medical students that would undoubtedly hamper the availability of dependable medical services in future. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Adolescent Girls and Their Mothers Talk About Experiences of Binge and Loss of Control Eating

PubMed Central

Palmberg, Allison A.; Stern, Marilyn; Kelly, Nichole R.; Bulik, Cynthia; Belgrave, Faye Z.; Trapp, Stephen K.

2013-01-01

Evidence suggests that adolescents’ experience of binge eating (BE) might differ in important ways from that of adults. Moreover, although BE appears more common in African American women than other disordered eating behaviors, little is known about the influence of cultural factors on this behavior in adolescents. The current investigation used qualitative methodology to examine the perceptions of White and African American adolescent girls and their mothers regarding experiences of binge and loss of control eating. Five focus groups were completed with 19 adolescent girls (aged 13–17, 58 % African American, 41 % White) who endorsed loss of control eating behaviors. Their mothers (N = 19) also completed separate, concurrent focus groups addressing food and eating behaviors. Responses to focus group questions were analyzed using thematic qualitative analysis. Adolescents’ awareness of their eating behaviors varied greatly. Girls reported some awareness of how emotions influence their eating behaviors, and described using food to achieve autonomy. Mothers evidenced awareness of their daughters’ problematic eating behaviors, the effects of emotions on eating for both their daughters and themselves, and sociocultural factors influencing diet. Data from these focus groups can inform the development of innovative interventions for adolescent girls engaging in loss of control eating. PMID:25400491

Less symptomatic, but equally impaired: Clinical impairment in restricting versus binge-eating/purging subtype of anorexia nervosa.

PubMed

Reas, Deborah Lynn; Rø, Øyvind

2018-01-01

This study investigated subtype differences in eating disorder-specific impairment in a treatment-seeking sample of individuals with anorexia nervosa (AN). The Clinical Impairment Assessment (CIA) and the Eating Disorder Examination-Questionnaire (EDE-Q) were administered to 142 patients. Of these, 54.9% were classified as restricting type (AN-R) and 45.1% were classified as binge-eating/purging type (AN-B/P) based on an average weekly occurrence of binge eating and/or purging episodes (≥4 episodes/28days). Individuals with AN-B/P exhibited higher levels of core ED psychopathology (dietary restraint, eating concern, shape/weight concerns) in addition to the expected higher frequency of binge/purge episodes. No significant differences existed between AN subtypes in the severity of ED-related impairment. Weight/shape concerns and binge eating frequency significantly predicted level of impairment. Differential associations were observed between the type of ED pathology that significantly contributed to impairment according to AN subtype. Although those with AN-B/P displayed higher levels of core attitudinal and behavioral ED pathology than AN-R, no significant differences in ED-specific impairment were found between AN subtypes. Eating disorder-related impairment in AN was not related to the severity of underweight or purging behaviors, but was uniquely and positively associated with weight/shape concerns and binge eating frequency. Copyright © 2018 Elsevier Ltd. All rights reserved.

Pharmacological management of binge eating disorder: current and emerging treatment options

PubMed Central

McElroy, Susan L; Guerdjikova, Anna I; Mori, Nicole; O’Melia, Anne M

2012-01-01

Growing evidence suggests that pharmacotherapy may be beneficial for some patients with binge eating disorder (BED), an eating disorder characterized by repetitive episodes of uncontrollable consumption of abnormally large amounts of food without inappropriate weight loss behaviors. In this paper, we provide a brief overview of BED and review the rationales and data supporting the effectiveness of specific medications or medication classes in treating patients with BED. We conclude by summarizing these data, discussing the role of pharmacotherapy in the BED treatment armamentarium, and suggesting future areas for research. PMID:22654518

Celiac Disease Is Associated with Childhood Psychiatric Disorders: A Population-Based Study.

PubMed

Butwicka, Agnieszka; Lichtenstein, Paul; Frisén, Louise; Almqvist, Catarina; Larsson, Henrik; Ludvigsson, Jonas F

2017-05-01

To determine the risk of future childhood psychiatric disorders in celiac disease, assess the association between previous psychiatric disorders and celiac disease in children, and investigate the risk of childhood psychiatric disorders in siblings of celiac disease probands. This was a nationwide registry-based matched cohort study in Sweden with 10 903 children (aged <18 years) with celiac disease and 12 710 of their siblings. We assessed the risk of childhood psychiatric disorders (any psychiatric disorder, psychotic disorder, mood disorder, anxiety disorder, eating disorder, psychoactive substance misuse, behavioral disorder, attention-deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and intellectual disability). HRs of future psychiatric disorders in children with celiac disease and their siblings was estimated by Cox regression. The association between previous diagnosis of a psychiatric disorder and current celiac disease was assessed using logistic regression. Compared with the general population, children with celiac disease had a 1.4-fold greater risk of future psychiatric disorders. Childhood celiac disease was identified as a risk factor for mood disorders, anxiety disorders, eating disorders, behavioral disorders, ADHD, ASD, and intellectual disability. In addition, a previous diagnosis of a mood, eating, or behavioral disorder was more common before the diagnosis of celiac disease. In contrast, siblings of celiac disease probands were at no increased risk of any of the investigated psychiatric disorders. Children with celiac disease are at increased risk for most psychiatric disorders, apparently owing to the biological and/or psychological effects of celiac disease. Copyright © 2017 Elsevier Inc. All rights reserved.

The role of depression and anxiety in impulsive and obsessive-compulsive behaviors among anorexic and bulimic patients.

PubMed

Finzi-Dottan, Ricky; Zubery, Eynat

2009-01-01

Eating disorders are believed to range across a spectrum of varying degrees of obsessive-compulsive and impulsive behavior. Sixty anorexic (mean age = 19.8; sd = 5.9) and 109 bulimic (mean age = 26.9; sd = 11.3) female patients completed self-report questionnaires assessing obsessive-compulsiveness, impulsivity, depression and anxiety, as well as two eating disorder scales. Results yielded significantly higher levels of impulsivity and negative body image in the bulimic compared to the anorexic group. Regression analysis predicting impulsivity showed that bulimia and negative body image were the main contributors. Regression analysis for predicting obsessive-compulsive behavior suggested that depression and anxiety obscure the link between anorexia and obsessive-compulsive behavior, and a high BMI intensifies the association between anxiety and obsessive-compulsive behavior. The high rates of both impulsivity and obsessive-compulsiveness found in both groups, and their association with the severity of the eating disorder, may suggest that impulsivity and obsessive-compulsiveness are not mutually exclusive and can both be found among anorexic and bulimic patients.

Does short-term fasting promote pathological eating patterns?

PubMed

Schaumberg, Katherine; Anderson, Drew A; Reilly, Erin E; Anderson, Lisa M

2015-12-01

Fasting, or going a significant amount of time without eating, has been identified as a risk factor for the development of pathological eating patterns. Findings from several studies examining the impact of fasting on subsequent eating behaviors have been mixed. The current study recruited college students to record food intake, episodes of binge eating, and use of compensatory behaviors before, throughout, and following a 24-hour fast. Participants attended an initial appointment in which they completed measures of dietary restraint and disinhibition and received instructions on self-monitoring and fasting. Participants (N=122) self-monitored their eating behaviors for 96 h, including a 24-hour fasting period. Participants did not demonstrate significant increases in disordered eating behaviors following the fast (e.g., objective binge episodes, self-defined excessive eating or compensatory behavior use). Baseline disinhibition predicted excessive eating as well as objective binge episodes both before and after fasting. Altogether, findings have implications for research seeking to further understand how fasting may contribute to the development of pathological eating patterns; specifically, it seems that the ED risk associated with fasting is derived from the behavior's interaction with other individual difference variables. Copyright © 2015 Elsevier Ltd. All rights reserved.

Respiratory sinus arrhythmia as a predictor of eating disorder symptoms in college students: Moderation by responses to stress and parent psychological control.

PubMed

Abaied, Jamie L; Wagner, Caitlin; Breslend, Nicole Lafko; Flynn, Megan

2016-04-01

This longitudinal study examined the prospective contribution of respiratory sinus arrhythmia (RSA), a key physiological indicator of self-regulation, to eating disorder symptoms in college students, and whether this link was moderated by maladaptive responses to stress and parent psychological control. At Wave 1, college students' RSA was measured at rest. At Waves 1 and 2 (six-month follow-up), students reported on their eating disorder symptoms, coping and involuntary responses to stress, and perceptions of their parents' use of psychological control. Significant three-way interactions indicated that the link between RSA and subsequent eating disorder symptoms was contingent on responses to stress and parent psychological control. In the context of maladaptive responses to stress and high psychological control, RSA predicted increased eating disorder symptoms over time. In the absence of parent psychological control, high RSA was beneficial in most cases, even when individuals reported maladaptive responses to stress. This study presents novel evidence that high RSA contributes to risk for or resilience to eating disorder symptoms over time. RSA can be protective against eating disorder symptoms, but in some contexts, the self-regulation resources that high RSA provides may be inappropriately applied to eating cognitions and behaviors. This research highlights the importance of examining physiological functioning conjointly with other risk factors as precursors to eating disorder symptoms over time. Copyright © 2016. Published by Elsevier Ltd.

Early childhood sleep and eating problems as predictors of adolescent and adult mood and anxiety disorders.

PubMed

Ong, Say How; Wickramaratne, Priya; Tang, Min; Weissman, Myrna M

2006-11-01

Recent studies have suggested that eating and sleep problems during early childhood may pose as risk factors for mood and anxiety disorders in later life. We aim to study the associations between early childhood sleep and eating problems, specifically high motor activity during sleep and irregularities in sleep/eating schedules, and lifetime history of mood and anxiety disorders. We followed up 164 offspring, who were at high and low risk for major depression by virtue of their parental history (at least one parent had Major Depressive Disorder). Target sleep and eating problems were measured using Dimensions of Temperament Survey (DOTS). The offspring were blindly assessed at 3 times over 20 years using a structured diagnostic interview. Irregularities in sleeping and eating schedules in childhood (low rhythmicity) was associated with adolescent-onset major depression and anxiety disorder, as well as childhood-onset anxiety disorder. High motor activity level during sleep was associated with both childhood-onset and adolescent-onset dysthymic disorder. Neither childhood sleep nor eating irregularities were associated with adult onset psychopathology. Retrospective reports of childhood sleep and eating patterns were derived from parent-reports. Reported problems may overlap with clinical diagnoses. Clinicians should be alerted to parental reports of children's sleep and eating problems suggesting low rhythmicity, as well as high motor activity levels during sleep. These early behaviors may be predictive of subsequent mood and anxiety disorders in childhood and adolescence.

Binge-Eating Disorder in Adults: A Systematic Review and Meta-analysis.

PubMed

Brownley, Kimberly A; Berkman, Nancy D; Peat, Christine M; Lohr, Kathleen N; Cullen, Katherine E; Bann, Carla M; Bulik, Cynthia M

2016-09-20

The best treatment options for binge-eating disorder are unclear. To summarize evidence about the benefits and harms of psychological and pharmacologic therapies for adults with binge-eating disorder. 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. 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. 2 reviewers independently extracted trial data, assessed risk of bias, and graded strength of evidence. 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. 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 assessed beyond end of treatment. Cognitive behavioral therapy, lisdexamfetamine, SGAs, and topiramate reduced binge eating and related psychopathology, and lisdexamfetamine and topiramate reduced weight in adults with binge-eating disorder. Agency for Healthcare Research and Quality.

Evaluation of Extinction as a Functional Treatment for Binge Eating

ERIC Educational Resources Information Center

Bosch, Amanda; Miltenberger, Raymond G.; Gross, Amy; Knudson, Peter; Breitwieser, Carrie Brower

2008-01-01

Binge eating is a serious behavior problem exhibited by individuals diagnosed with binge eating disorder and bulimia nervosa. Binge eating is thought to be maintained by automatic negative reinforcement in the form of relief from negative emotional responding. Current treatments produce only moderate abstinence, perhaps because they do not attempt…

Culturally Adapted Cognitive Behavioral Guided Self-Help for Binge Eating: A Feasibility Study with Mexican Americans

PubMed Central

Cachelin, Fary M.; Shea, Munyi; Phimphasone, Phoutdavone; Wilson, G. Terence; Thompson, Douglas R.; Striegel, Ruth H.

2014-01-01

Objective was to test feasibility and preliminary efficacy of a culturally adapted cognitive-behavioral self-help program to treat binge eating and related problems in Mexican Americans. Participants were 31 women recruited from the Los Angeles area and diagnosed with binge eating disorder, recurrent binge eating or bulimia nervosa. Participants completed a culturally adapted version of a CBT-based self-help program with 8 guidance sessions over a 3-month period. Treatment efficacy was evaluated in terms of binge eating, psychological functioning, and weight loss. Intent-to-treat analyses revealed 35.5% abstinence from binge eating at post-treatment and 38.7% diagnostic remission. Results indicated significant pre-treatment to post-treatment improvement on distress level, BMI, eating disorder psychopathology, and self-esteem. Satisfaction with the program was high. Findings demonstrate that the program is acceptable, feasible, and efficacious in reducing binge eating and associated symptoms for Mexican American women. Study provides “proof of concept” for implementation of culturally adapted forms of evidence-based programs. PMID:25045955

Appearance-based rejection sensitivity as a mediator of the relationship between symptoms of social anxiety and disordered eating cognitions and behaviors.

PubMed

Linardon, Jake; Braithwaite, Rachel; Cousins, Rachel; Brennan, Leah

2017-12-01

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.

Associations between friends' disordered eating and muscle-enhancing behaviors

PubMed Central

Eisenberg, Marla E.; Wall, Melanie; Shim, Jin Joo; Bruening, Meg; Loth, Katie; Neumark-Sztainer, Dianne

2012-01-01

Dieting, unhealthy weight control and muscle-enhancing behaviors are common among adolescents: friends are a probable source of influence on these behaviors. The present study uses data provided by nominated friends to examine associations between friends' disordered eating and muscle-enhancing behaviors and participants' own behaviors in a diverse sample of American youth. Male and female adolescents (mean age = 14.4) completed surveys and identified their friends from a class roster; friends' survey data were then linked to each participant. Participants (N = 2126) who had at least one nominated friend were included in the analytic sample. Independent variables were created using the same weight control and muscle-enhancing behaviors reported by nominated friends, and were used in logistic regression models to test associations between participants' and their friends' behaviors, stratified by gender. Results indicated that dieting, disordered eating and muscle-enhancing behaviors were common in this sample, and selected friends' behaviors were associated with the same behaviors in participants. For example, girls whose friends reported extreme weight control behaviors had significantly greater odds of using these behaviors than girls whose friends did not report these same behaviors (OR = 2.39). This research suggests that friends' weight- and shape-related behaviors are a feature of social relationships, and is the first report demonstrating these associations for muscle-enhancing behaviors. Capitalizing on the social element may be important to the development of increasingly effective intervention and prevention programs. PMID:23010337

Effectiveness of reducing the risk of eating-related problems using the German school-based intervention program, "Torera", for preadolescent boys and girls.

PubMed

Berger, U; Schaefer, J-M; Wick, K; Brix, C; Bormann, B; Sowa, M; Schwartze, D; Strauss, B

2014-08-01

Representative surveys indicate that eating disorders are an increasing problem, especially among (pre)adolescents. We assessed the effects of a German school-based primary prevention program ("Torera") for seventh graders. Torera especially relates to pathological eating behavior in the realm of bulimia nervosa or binge eating disorder. The program is built upon two previously evaluated modules for sixth graders with a gender-specific adaption. The coeducational intervention involves nine manual-guided lessons touching a wide range of eating-related problems. Twenty-two Thuringian secondary schools (n = 256 boys and 277 girls, aged 11-13 years at baseline) participated in a trial with 2 control groups (untreated and pretreated) with pre-post assessment. Primary outcomes were conspicuous eating behavior and body self-esteem, measured by standardized questionnaires (SCOFF, EAT-26D, and FBeK). Girls and students at risk showed significant improvement with small (d = 0.35) to medium (d = 0.66) effect sizes on eating behavior, significantly mediated by body self-esteem. Boys only improved with respect to eating attitudes, revealing a small effect size (d = 0.35). With relatively low implementation costs (about 2.50 per student), Torera provides an efficient model for reducing risky eating behavior and strengthening body self-esteem without negative side effects. To improve the effectiveness of the intervention, further research efforts focusing on at-risk groups (secondary prevention) and structural actions for prevention (e.g., offering healthy school catering) are needed.

A comprehensive model of food addiction in patients with binge-eating symptomatology: The essential role of negative urgency.

PubMed

Wolz, Ines; Granero, Roser; Fernández-Aranda, Fernando

2017-04-01

Food addiction has been widely researched in past years. However, there is a debate on the mechanisms underlying addictive eating and a better understanding of the processes associated to these behaviors is needed. Previous studies have found characteristic psychological correlates of food addiction, such as high negative urgency, emotion regulation difficulties and low self-directedness, in different samples of adults with addictive eating patterns. Still, it seems difficult to disentangle effects independent from general eating disorder psychopathology. Therefore, this study aimed to test a comprehensive model under control of eating disorder severity, in order to find independent predictors of food addiction. 315 patients with eating disorder diagnoses on the binge-eating spectrum were assessed in personality, emotion regulation, negative urgency, eating disorder symptomatology, and food addiction by self-report. Hypothesis-driven structural equation modeling was conducted to test the comprehensive model. The only independent predictor found for food addiction was negative urgency, while self-directedness and emotion regulation predicted negative urgency and were highly related to eating disorder symptomatology, but not to food addiction. Altogether the model suggests that low self-directedness and difficulties in emotion regulation are related to higher eating disorder symptomatology in general. Those patients who, in addition to these traits, tend to act impulsively when in negative mood states, are at risk for developing addictive eating patterns. Urgency-based treatments are therefore recommended for this subgroup of patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Rapid Response in Psychological Treatments for Binge-Eating Disorder

PubMed Central

Hilbert, Anja; Hildebrandt, Thomas; Agras, W. Stewart; Wilfley, Denise E.; Wilson, G. Terence

2015-01-01

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

Acceptance and commitment therapy as a novel treatment for eating disorders: an initial test of efficacy and mediation.

PubMed

Juarascio, Adrienne; Shaw, Jena; Forman, Evan; Timko, C Alix; Herbert, James; Butryn, Meghan; Bunnell, Douglas; Matteucci, Alyssa; Lowe, Michael

2013-07-01

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 experiential avoidance, poor experiential awareness, and lack of motivation. These variables are explicit targets of Acceptance and Commitment Therapy (ACT). The current study examined the efficacy of an ACT-based group treatment for eating disorders by examining whether the addition of ACT groups to treatment-as-usual (TAU) at a residential treatment facility for eating disorders would improve treatment outcomes. TAU patients received an intensive residential treatment, while ACT patients received these services but additionally attended, depending on diagnosis, either ACT for anorexia nervosa groups or ACT for bulimia nervosa groups. Although individuals in both treatment conditions demonstrated large decreases in eating pathology, there were trends toward larger decreases among those receiving ACT. ACT patients also showed lower rates of rehospitalization during the 6 months after discharge. Overall, results suggest that ACT is a viable treatment option for individuals with eating pathology and further outcome research is warranted.

Family Meal Frequency among Children and Adolescents with Eating Disorders

PubMed Central

Elran-Barak, Roni; Sztainer, Maya; Goldschmidt, Andrea B.; Le Grange, Daniel

2014-01-01

Purpose: 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 if family meal frequency is associated with eating disorder psychopathology. Methods: 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 (EDE) and the Family Meal Questionnaire (FMQ) prior to treatment at the University of Chicago Eating Disorders Program. Results: AN and BN participants significantly differed in terms of family meal frequency. A majority of participants with AN (71.7%), compared to 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<.05) and FED-NEC (r=-.340, r=-.276, p<.05). Conclusions: AN patients' higher family meal frequency may beexplained bytheir 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. PMID:24529833

The relationship between Internet addiction and bulimia in a sample of Chinese college students: depression as partial mediator between Internet addiction and bulimia.

PubMed

Tao, ZhuoLi

2013-09-01

It has been reported that Internet addiction is associated with substance dependence. Eating disorders have high rates of co-morbidity with substance use disorders. The relationship between Internet addiction and eating disorders was reported in a previous study. To examine the hypothesis that Internet addiction is closely associated with bulimia. The hypothesis that depression mediates the relationship between Internet addiction and bulimia symptoms was also tested. 2,036 Chinese college students were assessed on Internet addiction, eating behaviors and depression. Binge eating, compensatory behaviors, weight concern, menarche and weight change were also reported. Multiple regression analysis was used to test the mediating effect of depression. Internet addicts showed significantly higher scores on most subscales on EDI-1 than the controls. They reported significantly more binge eating, weight concern and weight change than the controls. Among all of the participants, depression was found to be a partial mediator in the relationship between Internet addiction and bulimia. This survey provides evidence of the co-morbidity of Internet addiction and bulimia.

Internet-delivered eating disorder prevention: A randomized controlled trial of dissonance-based and cognitive-behavioral interventions.

PubMed

Chithambo, Taona P; Huey, Stanley J

2017-10-01

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.

Efficacy trial of a selective prevention program targeting both eating disorders and obesity among female college students: 1- and 2-year follow-up effects.

PubMed

Stice, Eric; Rohde, Paul; Shaw, Heather; Marti, C Nathan

2013-02-01

Evaluate the effects of a prevention program targeting both eating disorders and obesity at 1- and 2-year follow-ups. Female college students at risk for these outcomes because of body image concerns (N = 398) were randomized to the Healthy Weight 2 group-based 4-hr prevention program, which promotes lasting healthy improvements to dietary intake and physical activity and nutrition science health behavior change principles, or an educational brochure control condition. Intervention participants showed significantly less body dissatisfaction and eating disorder symptoms and lower eating disorder onset through 2-year follow-up versus controls, but the former 2 effects were small. There were no main effects for body mass index (BMI), depressive symptoms, dieting, caloric intake, physical activity, or obesity onset. Moderator analyses revealed stronger eating disorder symptom effects for youths with initially elevated symptoms and lower pressure to be thin, stronger BMI effects for youths with initially elevated symptoms and BMI scores, and weaker eating disorder symptom effects for youths with initially elevated pressure to be thin. The 60% reduction in eating disorder onset over the 2-year follow-up was clinically significant and a novel effect for a prevention program, but the main effects on continuous outcomes were small, suggesting that adding nutrition science principles weakened the intervention efficacy. Effects on both eating disorder symptoms and BMI were greater for those with elevated eating disorder symptoms and BMI at pretest, implying that it might be useful to target these individuals in future trials.

The Effects of Ovarian Hormones and Emotional Eating on Changes in Weight Preoccupation Across the Menstrual Cycle

PubMed Central

Hildebrandt, Britny A.; Racine, Sarah E.; Keel, Pamela K.; Burt, S. Alexandra; Neale, Michael; Boker, Steven; Sisk, Cheryl L.; Klump, Kelly L.

2014-01-01

Objective Previous research has shown that fluctuations in ovarian hormones (i.e., estradiol and progesterone) predict changes in binge eating and emotional eating across the menstrual cycle. However, the extent to which other eating disorder symptoms fluctuate across the menstrual cycle and are influenced by ovarian hormones remains largely unknown. The current study sought to examine whether levels of weight preoccupation vary across the menstrual cycle and whether changes in ovarian hormones and/or other factors (i.e., emotional eating, negative affect) account for menstrual-cycle fluctuations in this eating disorder phenotype. Method For 45 consecutive days, 352 women ages 15–25 provided daily ratings of weight preoccupation, negative affect, and emotional eating. Daily saliva samples also were collected and assayed for estradiol and progesterone levels using enzyme-immunoassay techniques. Results Weight preoccupation varied significantly across the menstrual cycle, with the highest levels in the pre-menstrual and menstrual phases. However, ovarian hormones did not account for within-person changes in weight preoccupation across the menstrual cycle. Instead, the most significant predictor of menstrual-cycle changes in weight preoccupation was changes in emotional eating. Discussion Fluctuations in weight preoccupation across the menstrual cycle appear to be influenced primarily by emotional eating rather than ovarian hormones. Future research should continue to examine relationships among ovarian hormones, weight preoccupation, emotional eating, and other core eating disorder symptoms (e.g., body dissatisfaction, compensatory behaviors) in an effort to more fully understand the role of these biological and behavioral factors for the full spectrum of eating pathology. PMID:24965609

The diagnosis and treatment of eating disorders.

PubMed

Herpertz, Stephan; Hagenah, Ulrich; Vocks, Silja; von Wietersheim, Jörn; Cuntz, Ulrich; Zeeck, Almut

2011-10-01

Eating disorders are of major significance both in clinical medicine and in society at large. Anorexia and bulimia nervosa almost exclusively afflict young persons, severely impairing their physical and mental health. The peak ages for these diseases are in late adolescence and young adulthood; patients therefore suffer setbacks both in school and/or in their occupational careers. This scientifically based S3 guideline was developed with the intention of improving the treatment of eating disorders and motivating future research in this area. The existing national and international guidelines on the three types of eating disorders were synoptically compared, the literature on the subject was systematically searched, and meta-analyses on bulimia nervosa and binge-eating disorder were carried out. 15 consensus conferences were held, as a result of which 44 evidence-based recommendations were issued. Anorexia and bulimia nervosa are diagnosed according to the ICD-10 criteria (International Classification of Diseases), binge-eating disorder according to those of the DSM (Diagnostic and Statistical Manual of Mental Disorders). Psychotherapy is the mainstay of treatment for all three disorders, and cognitive behavioral therapy is the form of psychotherapy best supported by the available evidence. The administration of selective serotonin reuptake inhibitors (SSRI) can be recommended as a flanking measure in the treatment of bulimia nervosa only. The evidence does not support any type of pharmacotherapy for anorexia nervosa or binge-eating disorder. Bulimia nervosa and binge-eating disorder can usually be treated on an outpatient basis, as long as they are no more than moderately severe; full-fledged anorexia nervosa is generally an indication for in-hospital treatment. This guideline contains evidence- and consensus-based recommendations for the diagnosis and treatment of eating disorders. If strictly implemented, it should result in improved care for the affected patients.

An integrative model of risk for high school disordered eating.

PubMed

Davis, Heather A; Smith, Gregory T

2018-06-21

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).

Attitudes toward Seeking Professional Help for an Eating Disorder: The Role of Stigma and Anticipated Outcomes

ERIC Educational Resources Information Center

Hackler, Ashley H.; Vogel, David L.; Wade, Nathaniel G.

2010-01-01

This study examined the relationship between self-stigma, anticipated risks and benefits associated with seeking counseling, and attitudes toward seeking counseling among college students with disordered eating attitudes and behaviors. The results of hierarchical regression analyses demonstrated that self-stigma and the anticipated risks and…

A Mediational Model of Autonomy, Self-Esteem, and Eating Disordered Attitudes and Behaviors.

ERIC Educational Resources Information Center

Frederick, Christina M.; Grow, Virginia M.

1996-01-01

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)

Sexual Orientation, Weight Concerns, and Eating-Disordered Behaviors in Adolescent Girls and Boys.

ERIC Educational Resources Information Center

Austin, S. Bryn; Ziyadeh, Najat; Kahn, Jessica A.; Camargo, Carlos A.; Colditz, Graham A.; Field, Alison E.

2004-01-01

Objective: To examine sexual orientation group differences in eating disorder symptoms in adolescent girls and boys. Method: Cross-sectional associations were examined using multivariate regression techniques using data gathered in 1999 from 10,583 adolescents in the Growing Up Today Study, a cohort of children of women participating in the…