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Gutierrez-Colina AM, Aichele S, Lavender JM, Sanchez N, Thorstad I, Gulley LD, Emerick JE, Schrag R, Thomas V, Spinner H, Arnold T, Heroy A, Haigney MC, Tanofsky-Kraff M, Shomaker LB. Associations of social and cognitive-behavioral variables with disinhibited eating and anxiety: An ecological momentary assessment study. Int J Eat Disord 2024; 57:1213-1223. [PMID: 38415929 DOI: 10.1002/eat.24177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE Among adolescents, disinhibited eating and anxiety commonly co-occur. Precision intervention approaches targeting unique mechanistic vulnerabilities that contribute to disinhibited eating and anxiety may therefore be helpful. However, the effectiveness of such interventions hinges on knowledge of between- and within-person associations related to disinhibited eating, anxiety, and related processes. METHOD A sample of 39 adolescent females (12-17 years) with elevated anxiety and above-average weight (BMI %ile ≥ 75th) completed measures of theoretically driven social and cognitive-behavioral variables, disinhibited eating, and anxiety via ecological momentary assessment over 7 days. Data were analyzed using mixed-effects models. RESULTS Between-person differences in social stressors were linked to emotional eating, eating in the absence of hunger, and anxiety, whereas between-person differences in negative thoughts were associated with all disinhibited eating variables and anxiety. Between-person differences in avoidance were not related to any outcome. Additionally, between-person differences in social stressors and negative thoughts-as well as within-person deviations (from person-average levels) of social stressors, negative thoughts, and avoidance-were associated with anxiety. In turn, between-person differences in anxiety predicted eating in the absence of hunger and emotional eating, and within-person deviations in anxiety were associated with emotional eating at any given time point. DISCUSSION Findings support elements of both the interpersonal and cognitive-behavioral models of disinhibited eating. Differential trigger effects on anxiety, both at the between- and within-person levels, and significant associations between anxiety and all eating-related outcomes, highlight the potential utility of interventions targeting individual differences in sensitivity to anxiety triggers. PUBLIC SIGNIFICANCE Findings provide support for the interpersonal and cognitive-behavioral models of disinhibited eating, highlighting anxiety as a salient vulnerability and potential mechanistic factor underlying disinhibited eating. Social, cognitive, and behavioral variables were differentially related to anxiety across participants, suggesting potential for future intervention tailoring and intervention selection based on adolescents' sensitivity to anxiety as a trigger for disinhibited eating behavior.
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Affiliation(s)
- Ana M Gutierrez-Colina
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Stephen Aichele
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Colorado School of Public Health, Aurora, Colorado, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Natalia Sanchez
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Isabel Thorstad
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Lauren D Gulley
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Jill E Emerick
- Department of Pediatrics, Uniformed Services University, Bethesda, Maryland, USA
| | - Ruby Schrag
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Victoria Thomas
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Holly Spinner
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Thomas Arnold
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Andrew Heroy
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Mark C Haigney
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Marian Tanofsky-Kraff
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, Maryland, USA
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado, USA
- Colorado School of Public Health, Aurora, Colorado, USA
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Parker MN, LeMay-Russell S, Loch LK, Bloomer BF, Te-Vazquez J, Moursi NA, Nwosu EE, Lazareva J, Schvey NA, Brady SM, Yang SB, Turner SA, Tanofsky-Kraff M, Yanovski JA. Associated features of pediatric loss-of-control eating severity during a laboratory-based feeding paradigm. Eat Behav 2023; 50:101790. [PMID: 37536224 PMCID: PMC10529390 DOI: 10.1016/j.eatbeh.2023.101790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023]
Abstract
Laboratory-based loss-of-control eating (LOC-eating; i.e., feeling like one cannot stop eating) paradigms have provided inconsistent evidence that the features of pediatric LOC-eating are consistent with those of DSM-5-TR binge-eating episodes. Thus, this study investigated whether recent LOC-eating (in the prior month) and/or greater LOC-eating severity during a meal are positively associated with faster eating rate, energy intake when adjusting for hunger, post-meal stomachache and sickness (a proxy for eating until uncomfortably full), depression, and guilt. Recent LOC-eating was assessed via interview. Participants were presented with a buffet-type meal and instructed to "Let yourself go and eat as much as you want." Immediately following, youth reported on their experience of LOC-eating during the meal (LOC-eating severity). Eating rate (kcal/min) was computed by dividing total energy intake by the duration of the meal. Prior to and following the meal, youth reported hunger, sickness, and stomachache via sliding Visual Analog Scales, depression via the Brunel Mood Scale and guilt via the PANAS-X. Three-hundred-ten youth participated (61.2 % Female; 46.3 % non-Hispanic White, 12.96 ± 2.72 y). Recent LOC-eating was not significantly associated with any DSM-5-TR binge-eating feature during the laboratory meal (ps = 0.07-0.85). However, LOC-eating severity during the meal was positively associated with eating rate, eating adjusted for hunger, post-meal sickness and stomachache, and guilt (ps < 0.045). LOC-eating severity during a laboratory-based feeding paradigm meal, but not recent LOC-eating, was associated with several features of DSM-5-TR binge-eating episodes. Future studies should assess multiple components of LOC-eating to further characterize the phenomenology of pediatric LOC-eating.
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Affiliation(s)
- Megan N Parker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA
| | - Sarah LeMay-Russell
- Department of Psychiatry and Behavioral Health, Duke University School of Medicine, 2608 Erwin Rd, Suite 300, Durham, NC 27705, USA
| | - Lucy K Loch
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA
| | - Bess F Bloomer
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA
| | - Jennifer Te-Vazquez
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA
| | - Nasreen A Moursi
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA
| | - Ejike E Nwosu
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA
| | - Julia Lazareva
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA
| | - Sheila M Brady
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA
| | - Shanna B Yang
- Nutrition Department, Clinical Center, NIH, 10 Center Drive, Bethesda, MD 20892, USA
| | - Sara A Turner
- Nutrition Department, Clinical Center, NIH, 10 Center Drive, Bethesda, MD 20892, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA; Military Outcomes Cardiovascular Research (MiCOR) Program, Department of Medicine, USU, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA
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3
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D'Adamo L, Sonnenblick RM, Juarascio AS, Manasse SM. Relations between forms of dietary restraint, restriction, and loss-of-control eating among adolescents seeking weight control: An ecological momentary assessment study. Eat Behav 2023; 50:101791. [PMID: 37544108 PMCID: PMC10528310 DOI: 10.1016/j.eatbeh.2023.101791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE This study aimed to: 1) compare rates of dietary restraint and restriction between adolescents with and without loss-of-control (LOC) eating who were seeking weight control and 2) examine temporal relations between restraint/restriction and LOC eating. METHOD 37 adolescents seeking weight control (mean age: 15.4 ± 1.5; 62 % White; 57 % female; mean BMI percentile = 97.3 ± 3.1) completed a one-week ecological momentary assessment protocol and reported on dietary restraint/restriction and eating behavior prior to beginning a weight control intervention. Chi-square tests examined differences in frequency of restraint/restriction between participants with and without LOC eating. Multilevel models examined associations between dietary restraint/restriction and LOC eating at the next survey and on the next day. RESULTS Of 37 participants, 15 (41 %) reported engaging in LOC eating. Participants with LOC eating more frequently endorsed several forms of restraint and restriction versus participants without LOC eating. Attempting to avoid enjoyable foods and attempting to limit eating at one survey predicted greater likelihood of LOC eating at the next survey. CONCLUSIONS Findings suggest that attempted restraint, but not actual restriction, was associated with LOC eating. Research should explore additional factors that may influence these relationships, which could inform weight control treatments that address restraint/restriction.
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Affiliation(s)
- Laura D'Adamo
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA; Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
| | - Ross M Sonnenblick
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
| | - Adrienne S Juarascio
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
| | - Stephanie M Manasse
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
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Bauman V, Sanchez N, Repke HE, Spinner H, Thorstad I, Gulley LD, Mains AM, Lavender JM, Thompson KA, Emerick JE, Thomas V, Arnold TB, Heroy A, Gutierrez-Colina AM, Haigney MC, Shomaker LB, Tanofsky-Kraff M. Loss of control eating in relation to blood pressure among adolescent girls with elevated anxiety at-risk for excess weight gain. Eat Behav 2023; 50:101773. [PMID: 37343482 DOI: 10.1016/j.eatbeh.2023.101773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
Loss of control (LOC)-eating, excess weight, and anxiety are robustly linked, and are independently associated with markers of poorer cardiometabolic health, including hypertension. However, no study has examined whether frequency of LOC-eating episodes among youth with anxiety symptoms and elevated weight status may confer increased risk for hypertension. We examined the relationship between LOC-eating frequency and blood pressure among 39 adolescent girls (14.9 ± 1.8 years; body mass index [BMI] = 29.9 ± 5.6; 61.5 % White; 20.5 % African American/Black; 5 % Multiple Races; 2.5 % Asian; 12.8 % Hispanic/Latino; 30.8 % with reported LOC-eating) with elevated anxiety and above average BMI who enrolled in a clinical trial aimed at preventing excess weight gain. LOC-eating over the past three months was assessed via clinical interview, and blood pressure (systolic and diastolic) was measured with an automatic blood pressure monitor. Adjusting for age, fat mass, and height, LOC-eating episode frequency was significantly, positively associated with diastolic blood pressure (β = 0.38, p = 0.02), but not with systolic blood pressure (β = 0.13, p = 0.41). Replication studies, with larger sample sizes, participants of varying weight-strata, and prospective data are required to elucidate the relationship between LOC-eating and cardiovascular functioning in youth with elevated anxiety.
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Affiliation(s)
- Viviana Bauman
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Natalia Sanchez
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523, USA
| | - Hannah E Repke
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Holly Spinner
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Isabel Thorstad
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Lauren D Gulley
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523, USA; Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, CO 80045, USA
| | - Autumn M Mains
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Katherine A Thompson
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Jill E Emerick
- Department of Pediatrics, Uniformed Services University, Bethesda, MD 20814, USA
| | - Victoria Thomas
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Thomas B Arnold
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Andrew Heroy
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; The Metis Foundation, San Antonio, TX 78216, USA
| | - Ana M Gutierrez-Colina
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523, USA; Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, CO 80045, USA
| | - Mark C Haigney
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523, USA; Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, CO 80045, USA; Colorado School of Public Health, Aurora, CO 80045, USA
| | - Marian Tanofsky-Kraff
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA; Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD 20814, USA.
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Parker MN, Faulkner LM, Shank LM, Schvey NA, Loch LK, Haynes HE, Bloomer BF, Moursi NA, Fatima S, Te-Vazquez JA, Brady SM, Yang SB, Turner SA, Tanofsky-Kraff M, Yanovski JA. Heart Rate Variability and Laboratory-Based Loss-of-Control Eating in Children and Adolescents. Nutrients 2022; 14:nu14194027. [PMID: 36235684 PMCID: PMC9570996 DOI: 10.3390/nu14194027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/24/2022] Open
Abstract
Among youth, greater heart rate (HR) and lesser HR variability (HRV) are precursors to loss-of-control (LOC) eating episodes in the natural environment. However, there are limited data examining whether pre-meal HR and HRV are associated with greater LOC-eating in the laboratory setting. We therefore examined temporal relationships between pre-meal HR, frequency- and time-based metrics of pre-meal HRV, perceived LOC-eating, and energy intake during a meal designed to simulate a LOC-eating episode. Among 209 participants (54.5% female, 12.58 ± 2.72 years, 0.52 ± 1.02 BMIz), 19 reported LOC-eating in the prior month. Perceived LOC-eating during the laboratory meal was not significantly linked to pre-meal HR (p = 0.37), but was positively related to pre-meal HRV (ps = 0.02–0.04). This finding was driven by youth with recent LOC-eating, as these associations were not significant when analyses were run only among participants without recent reported LOC-eating (p = 0.15–0.99). Pre-meal HR and HRV were not significantly related to total energy intake (ps = 0.27–0.81). Additional research is required to determine whether early-stage pediatric LOC-eating is preceded by a healthy pre-meal stress response. Longitudinal studies could help clarify whether this pattern becomes less functional over time among youth who develop recurrent LOC-eating episodes.
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Affiliation(s)
- Megan N. Parker
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
| | - Loie M. Faulkner
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Lisa M. Shank
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
| | - Natasha A. Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
| | - Lucy K. Loch
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Hannah E. Haynes
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Bess F. Bloomer
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Nasreen A. Moursi
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
| | - Syeda Fatima
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Jennifer A. Te-Vazquez
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Shanna B. Yang
- Nutrition Department, NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA
| | - Sara A. Turner
- Nutrition Department, NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
- Correspondence: ; Tel.: +1-301-496-0858
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Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD). Int J Mol Sci 2022; 23:ijms231810814. [PMID: 36142725 PMCID: PMC9504787 DOI: 10.3390/ijms231810814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.
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Zhou JC, Rifas-Shiman SL, Haines J, Jones K, Oken E. Adolescent overeating and binge eating behavior in relation to subsequent cardiometabolic risk outcomes: a prospective cohort study. J Eat Disord 2022; 10:140. [PMID: 36100924 PMCID: PMC9472357 DOI: 10.1186/s40337-022-00660-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Binge eating disorder is bidirectionally associated with obesity and with metabolic syndrome. It is less clear whether overeating and binge eating, or overeating with loss of control, also predicts metabolic risk, and if so, whether these associations are solely attributable to greater weight. The goal of this study was to examine longitudinal associations of overeating and binge eating behavior with cardiometabolic risk markers in adolescence. METHODS Adolescents (n = 619) in the Project Viva research study self-reported overeating and binge eating behavior in early adolescence (median 12.9 years, "baseline"). In late adolescence (median 17.4 years, "follow-up"), we assessed outcomes of adiposity and blood pressure, and in a subset of participants (n = 270-424), biomarkers of dyslipidemia, insulin resistance, liver dysfunction, inflammation, and adipokine homeostasis. We conducted multivariable linear regression analyses adjusted for socio-demographics and prenatal obesogenic exposures, and additionally for baseline body mass index (BMI) z-score. RESULTS At baseline, 58 (9%) participants reported overeating behavior, and of those, 24 (41%) had binge eating behavior (e.g., overeating accompanied by loss of control). In adjusted models, adolescents with overeating had higher adiposity at follow-up ~ 5 years later (e.g., % body fat 4.03; 95% confidence interval (CI) 1.76, 6.31) than those not reporting overeating behavior; additional adjustment for baseline BMI z-score attenuated associations generally except for % body fat (2.95; 95% CI 1.03, 4.87). Overeating behavior was also associated with higher inflammation and greater adipokine dysfunction, remaining positively associated with interleukin-6 (IL-6) (log-transformed β = 0.42 pg/mL; 95% CI 0.12, 0.73) and negatively with adiponectin (log-transformed β = -0.28 ug/mL; 95% CI - 0.47, - 0.08) even after adjusting for baseline BMI z-score. Overeating behavior was not consistently associated with other outcomes. Adolescents reporting binge eating behavior generally had the greatest adiposity, (e.g., % body fat 5.00; 95% CI 1.74, 8.25) as compared to those without overeating. CONCLUSIONS Adolescents reporting overeating and binge eating behavior had higher adiposity and poorer inflammatory and adipokine profiles, but no difference in other outcomes, than adolescents who did not endorse these behaviors. These associations were only partially accounted for by higher baseline BMI z-score. These differences may signal increased risk for future cardiovascular disease.
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Affiliation(s)
- Joyce C Zhou
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.,Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA, 02215, USA
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Kathryn Jones
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA, 02215, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA, 02215, USA. .,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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8
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Ralph AF, Brennan L, Byrne S, Caldwell B, Farmer J, Hart LM, Heruc GA, Maguire S, Piya MK, Quin J, Trobe SK, Wallis A, Williams-Tchen AJ, Hay P. Management of eating disorders for people with higher weight: clinical practice guideline. J Eat Disord 2022; 10:121. [PMID: 35978344 PMCID: PMC9386978 DOI: 10.1186/s40337-022-00622-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The prevalence of eating disorders is high in people with higher weight. However, despite this, eating disorders experienced by people with higher weight have been consistently under-recognised and under-treated, and there is little to guide clinicians in the management of eating disorders in this population. AIM The aim of this guideline is to synthesise the current best practice approaches to the management of eating disorders in people with higher weight and make evidence-based clinical practice recommendations. METHODS The National Eating Disorders Collaboration Steering Committee auspiced a Development Group for a Clinical Practice Guideline for the treatment of eating disorders for people with higher weight. The Development Group followed the 'Guidelines for Guidelines' process outlined by the National Health and Medical Research Council and aim to meet their Standards to be: 1. relevant and useful for decision making; 2. transparent; 3. overseen by a guideline development group; 4. identifying and managing conflicts of interest; 5. focused on health and related outcomes; 6. evidence informed; 7. making actionable recommendations; 8. up-to-date; and, 9. accessible. The development group included people with clinical and/or academic expertise and/or lived experience. The guideline has undergone extensive peer review and consultation over an 18-month period involving reviews by key stakeholders, including experts and organisations with clinical academic and/or lived experience. RECOMMENDATIONS Twenty-one clinical recommendations are made and graded according to the National Health and Medical Research Council evidence levels. Strong recommendations were supported for psychological treatment as a first-line treatment approach adults (with bulimia nervosa or binge-eating disorder), adolescents and children. Clinical considerations such as weight stigma, interprofessional collaborative practice and cultural considerations are also discussed. CONCLUSIONS This guideline will fill an important gap in the need to better understand and care for people experiencing eating disorders who also have higher weight. This guideline acknowledges deficits in knowledge and consequently the reliance on consensus and lower levels of evidence for many recommendations, and the need for research particularly evaluating weight-neutral and other more recent approaches in this field.
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Affiliation(s)
| | - Leah Brennan
- School of Psychology and Public Health, La Trobe University, Wodonga, Australia
| | - Sue Byrne
- Department of Psychology, University of Western Australia, Perth, Australia
| | | | - Jo Farmer
- Lived Experience Advocate, Melbourne, Australia
| | - Laura M. Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Gabriella A. Heruc
- Eating Disorders and Nutrition Research Group (ENRG), School of Medicine, Western Sydney University, Sydney, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia
- Sydney Local Health District, NSW Health, Sydney, Australia
| | - Milan K. Piya
- School of Medicine, Western Sydney University, Macarthur Clinical School, Sydney, Australia
- Camden and Campbelltown Hospitals, Sydney, Australia
| | - Julia Quin
- Lived Experience Advocate, Melbourne, Australia
| | - Sarah K. Trobe
- National Eating Disorders Collaboration, Sydney, Australia
| | - Andrew Wallis
- Sydney Children’s Hospitals Network, The Children’s Hospital Westmead, Sydney, Australia
| | | | - Phillipa Hay
- Eating Disorders and Body Image (EDBI), Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- South Western Sydney Local Health District, Sydney, Australia
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9
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Shank LM, Moursi NA, Tanofsky-Kraff M. Loss-of-Control Eating and Cardiometabolic Health in Relation to Overweight and Obesity. Curr Diab Rep 2022; 22:257-266. [PMID: 35403985 DOI: 10.1007/s11892-022-01466-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Loss-of-control (LOC) eating, the subjective feeling of being unable to control what or how much is being consumed, is common. The purpose of this review was to examine the relationships among LOC eating, cardiometabolic health, and weight management intervention outcomes. RECENT FINDINGS In youth and adults, LOC eating is associated with and predictive of psychological symptoms, high weight, and worsened cardiometabolic health. While LOC eating pre-intervention does not appear to impact outcomes, LOC eating during or following is associated with worsened outcomes from behavioral and surgical weight management interventions. When individuals are undergoing weight management interventions, it may be important to regularly assess for LOC eating. There is limited research on the examined relationships in diverse populations (e.g., males, individuals of a lower socio-economic status, racial/ethnic minority groups). Future research should examine these relationships across the lifespan in diverse populations, with a focus on how these relationships can be impacted through targeted interventions.
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Affiliation(s)
- Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Nasreen A Moursi
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA.
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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10
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Yu Y, Fernandez ID, Meng Y, Zhao W, Groth SW. Gut hormones, adipokines, and pro- and anti-inflammatory cytokines/markers in loss of control eating: A scoping review. Appetite 2021; 166:105442. [PMID: 34111480 PMCID: PMC10683926 DOI: 10.1016/j.appet.2021.105442] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/31/2022]
Abstract
Loss of control (LOC) eating is the defining feature of binge-eating disorder, and it has particular relevance for bariatric patients. The biomarkers of LOC eating are unclear; however, gut hormones (i.e., ghrelin, cholecystokinin [CCK], peptide YY [PYY], glucagon-like peptide 1 [GLP-1], and pancreatic polypeptide [PP]), adipokines (i.e., leptin, adiponectin), and pro- and anti-inflammatory cytokines/markers (e.g., high-sensitivity C-reactive protein [hsCRP]) are candidates due to their involvement in the psychophysiological mechanisms of LOC eating. This review aimed to synthesize research that has investigated these biomarkers with LOC eating. Because LOC eating is commonly examined within the context of binge-eating disorder, is sometimes used interchangeably with subclinical binge-eating, and is the latent construct underlying disinhibition, uncontrolled eating, and food addiction, these eating behaviors were included in the search. Only studies among individuals with overweight or obesity were included. Among the identified 31 studies, 2 studies directly examined LOC eating and 4 studies were conducted among bariatric patients. Most studies were case-control in design (n = 16) and comprised female-dominant (n = 13) or female-only (n = 13) samples. Studies generally excluded fasting total ghrelin, fasting CCK, fasting PYY, and fasting PP as correlates of the examined eating behaviors. However, there was evidence that the examined eating behaviors were associated with lower levels of fasting acyl ghrelin (the active form of ghrelin) and adiponectin, higher levels of leptin and hsCRP, and altered responses of postprandial ghrelin, CCK, and PYY. The use of GLP-1 analog was able to decrease binge-eating. In conclusion, this review identified potential biomarkers of LOC eating. Future studies would benefit from a direct focus on LOC eating (especially in the bariatric population), using longitudinal designs, exploring potential mediators and moderators, and increased inclusion of the male population.
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Affiliation(s)
- Yang Yu
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
| | - I Diana Fernandez
- School of Public Health, University of Rochester, 265 Crittenden Blvd, Rochester, NY, 14642, USA.
| | - Ying Meng
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
| | - Wenjuan Zhao
- Department of Oncology, Shanghai Medical College, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, 200032, China.
| | - Susan W Groth
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
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11
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Prevalence of binge-eating disorder among children and adolescents: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2021; 32:549-574. [PMID: 34318368 DOI: 10.1007/s00787-021-01850-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/18/2021] [Indexed: 12/16/2022]
Abstract
The objective is to estimate the prevalence of binge-eating disorder (BED) and subclinical BED in children and adolescents. Relevant articles were searched in the databases of PubMED and PsycINFO. Articles were included if they measured BED, subclinical BED, binge eating and/or loss of control (LOC) eating in samples of up to 20 years of age or with a mean age below 20 years. Subclinical BED covers participants with < 4 OBEs but ≥ 1 OBE pr. month and studies measuring subclinical DSM-IV/DSM-5 BED, but where all criteria were not met. All study types and measuring methods were accepted, but studies were excluded if they did not assess and exclude cases of recurrent compensatory behaviors. Meta-analyses were used to obtain an overall estimate of the prevalence of BED and subclinical BED, while stratified meta-analyses were used to assess sources of heterogeneity. 39 studies measuring BED, subclinical BED and/or a low frequency of binge eating were included. Two meta-analyses resulted in an overall estimated prevalence of 1.32% BED and 3.0% subclinical BED in children and adolescents. The results were influenced by high heterogeneity. Potential sources to heterogeneity in the BED result were weight of participants and sample types as well as level of risk of bias in the included studies. BED seems to be as frequent in children and adolescents as anorexia nervosa and bulimia nervosa. Hence, treatment of BED and BED symptoms in younger populations should be prioritized on the same terms as anorexia and bulimia nervosa.
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12
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Cella S, Cipriano A, Aprea C, Cotrufo P. Self-Esteem and Binge Eating among Adolescent Boys and Girls: The Role of Body Disinvestment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147496. [PMID: 34299947 PMCID: PMC8304970 DOI: 10.3390/ijerph18147496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/04/2021] [Accepted: 07/10/2021] [Indexed: 12/14/2022]
Abstract
Although low self-esteem and body disinvestment have been recognized as potential risk factors for disordered eating, no studies have explored how these factors may work together to predict binge eating in adolescents. Therefore, we hypothesized a path model for girls and boys separately to investigate whether the body’s investment dimensions (feelings towards the body, physical touch, body care, body protection) mediate the relationship between self-esteem and binge eating, and age moderate such relationships. Participants were 1046 Italian students aged between 11 and 19 years (472 girls, Mage = 14.17; 574 boys, Mage = 14.60) screened through self-report measures. Both models showed an acceptable fit (males: χ2(22) = 30.441; RMSEA = 0.026; CFI = 0.99; TLI = 0.97; SRMR = 0.023; females: χ2(22) = 34.723; RMSEA = 0.35; CFI = 0.98; TLI = 0.95; SRMR = 0.029). Negative body feelings and reduced body protection fully mediated the relationship between self-esteem and binge eating, regardless of gender. Our findings highlight the importance of interventions promoting body emotional investment to reduce adolescents’ vulnerability to binge eating.
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13
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Jebeile H, Lister NB, Baur LA, Garnett SP, Paxton SJ. Eating disorder risk in adolescents with obesity. Obes Rev 2021; 22:e13173. [PMID: 33410207 DOI: 10.1111/obr.13173] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/22/2020] [Accepted: 10/27/2020] [Indexed: 01/13/2023]
Abstract
The intersection between adolescent obesity and eating disorder risk is one that requires urgent attention. This review aimed to synthesize the literature on the risk of clinical eating disorders in adolescents with obesity, discuss challenges with assessing risk, and examine implications for clinical practice and future research. Obesity and eating disorders can coexist resulting in exacerbated physical and psychological health issues. Recognized eating disorder risk factors, including body dissatisfaction, poor self-esteem, depression, and engaging in dieting behaviors, are elevated and frequently reported in adolescents with obesity, highlighting a vulnerability to the development of eating disorders. Unsupervised dieting to manage weight may exacerbate eating disorder risk, while structured and supervised weight management is likely to reduce eating disorder risk for most adolescents. However, some adolescents may present to an obesity service with an undiagnosed eating disorder or may develop an eating disorder during or following treatment. We conclude that a risk management approach, with screening or monitoring for eating disorder-related risk factors and behaviors, should be utilized to identify those at risk. Future research to identify eating disorder risk factors specific to adolescents with obesity is required to inform screening and monitoring protocols, patient care, and address current knowledge gaps.
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Affiliation(s)
- Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia.,Kids Research, The Children's Hospital at Westmead, Westmead, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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14
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Goldschmidt AB, Khoury JC, Mitchell JE, Jenkins TM, Bond DS, Zeller MH, Michalsky MP, Inge TH. Loss of Control Eating and Health Indicators Over 6 Years in Adolescents Undergoing Metabolic and Bariatric Surgery. Obesity (Silver Spring) 2021; 29:740-747. [PMID: 33759383 PMCID: PMC8474017 DOI: 10.1002/oby.23126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/22/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of this study was to assess associations between loss of control (LOC) eating and health outcomes among adolescents undergoing metabolic and bariatric surgery. METHODS A total of 234 adolescents were studied before and up to 6 years after surgery in a prospective, observational cohort design. Adolescents provided self-reports of LOC eating, pain severity, sleep quality, polycystic ovary syndrome, gastroesophageal reflux disease, and medication usage and objective measures of fasting glucose, serum insulin, glycohemoglobin A1c , cholesterol, triglycerides, and blood pressure. χ2 tests, Wilcoxon rank sums, and generalized linear mixed models were used to assess concurrent and prospective associations between LOC eating and health indicators. RESULTS LOC eating presented in 32.5% of adolescents before surgery and was positively associated with sleep disturbances and psychiatric medication usage. After surgery, LOC eating presented in 7.9% to 14.6% of participants and was correlated with improved low- and high-density lipoprotein cholesterol levels and greater back pain. LOC eating was inversely associated with low-density lipoprotein cholesterol at the next consecutive time point. CONCLUSIONS LOC eating was unexpectedly associated with improved low- and high-density lipoprotein cholesterol in adolescents undergoing metabolic and bariatric surgery. Deleterious effects of LOC eating on obesity-related health conditions, aside from back pain, were not detected. Metabolic and other weight-independent health benefits of surgery may persist postoperatively despite LOC eating and associated weight regain.
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Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Jane C. Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - James E. Mitchell
- Department of Psychiatry and Behavioral Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Todd M. Jenkins
- Department of Surgery, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Dale S. Bond
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Meg H. Zeller
- Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Marc P. Michalsky
- Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA
| | - Thomas H. Inge
- Department of Surgery, University of Colorado, Denver and Children’s Hospital Colorado, Aurora, CO, USA
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15
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Prevalence and Correlates of Disinhibited Eating in Youth from Marginalized Racial/Ethnic Groups. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-020-00347-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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16
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Byrne ME, Tanofsky-Kraff M, Kelly NM, Grammer AC, Jaramillo M, Mi SJ, Stojek MM, Shank LM, Burke NL, Cassidy O, Schvey NA, Brady SM, Demidowich AP, Broadney MM, Yanovski SZ, Yanovski JA. Pediatric Loss-of-Control Eating and Anxiety in Relation to Components of Metabolic Syndrome. J Pediatr Psychol 2020; 44:220-228. [PMID: 30339233 DOI: 10.1093/jpepsy/jsy077] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 09/01/2018] [Indexed: 01/17/2023] Open
Abstract
Objective Pediatric loss-of-control (LOC) eating is associated with, and predictive of, gains in adiposity and adverse metabolic outcomes. In addition, some preliminary data suggest that anxiety may exacerbate the relationship of LOC eating with weight and metabolic syndrome (MetS)-related measures. We therefore examined whether anxiety moderated the relationship between LOC eating and body mass index z (BMIz), adiposity, and MetS-related measures in youth. Methods A convenience sample of non-treatment-seeking boys and girls of varying weight strata were interviewed to determine the presence of LOC eating and completed a questionnaire assessing trait anxiety. BMIz and MetS-related measures (blood pressure, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, glucose, and insulin) were measured after an overnight fast. Adiposity was assessed by air displacement plethysmography or dual-energy x-ray absorptiometry. Analyses adjusted for age, sex, race, height, fat mass, and depressive symptoms, as appropriate. Results In all, 379 youths (13.0 ± 2.8 years; 53% female; BMIz = 0.8 ± 1.1; 22% with LOC eating) were studied. Anxiety was not significantly related to BMIz, adiposity, or MetS-related measures. However, anxiety and LOC eating interacted such that only among youth with LOC eating, anxiety was positively associated with fasting insulin (p = .02) and insulin resistance (p = .01). The interaction of anxiety and LOC eating was not significantly related to BMIz, adiposity, or any other MetS-related measure (ps = ns). Conclusions Only among non-treatment-seeking youth with LOC eating, anxiety may be associated with increased insulin secretion and insulin resistance. Longitudinal studies are required to confirm these findings and explore mechanisms for these relationships.
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Affiliation(s)
- Meghan E Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Nichole M Kelly
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Anne Claire Grammer
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Manuela Jaramillo
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Sarah J Mi
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Monika M Stojek
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS.,Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF)
| | - Natasha L Burke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Omni Cassidy
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS).,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Sheila M Brady
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Andrew P Demidowich
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Miranda M Broadney
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
| | - Susan Z Yanovski
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, DHHS
| | - Jack A Yanovski
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
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17
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Williamson G, Guidinger C, Kelly NR. Low body mass and ethnic identity exploration exacerbate the association between body image concerns and loss of control eating in Hispanic/Latino men. Int J Eat Disord 2020; 53:180-190. [PMID: 31490573 DOI: 10.1002/eat.23168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Although Hispanic/Latino populations have some of the highest rates of obesity in the United States, little is known about their loss of control (LOC) eating, a robust predictor of excess weight gain. This study examined the association between body image concerns and LOC eating frequency in a sample of young Hispanic/Latino men. Body mass index (BMI), ethnic identity, and acculturation were examined as potential moderators. METHOD The sample included 271 Hispanic/Latino men between the ages of 18 and 30 years (Mage = 23.89 ± 3.54; MBMI = 26.46 ± 5.82). Participants completed an online survey and reported on height, weight, and demographic characteristics; concerns with muscularity and body fat; LOC eating frequency in the last 28 days; ethnic identity; and perceived acculturation. RESULTS Negative binomial regression models were conducted, adjusting for BMI, income, education, and presence of a psychiatric diagnosis. Concerns with muscularity and body fat were positively associated with LOC eating frequency (ps < .001). Low BMI exacerbated the link between concerns with body fat and LOC eating frequency (p = .03). The positive association between concerns with muscularity and LOC eating frequency was exacerbated among those who reported low ethnic identity exploration (p = .01). While acculturation did not function as a moderator (ps = .14-.27), it was inversely associated with LOC eating frequency (p < .001). DISCUSSION BMI and ethnic identity are important individual factors to consider in the link between body image concerns and LOC eating among young Hispanic/Latino men.
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Affiliation(s)
- Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon.,The Prevention Science Institute, University of Oregon, Eugene, Oregon
| | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon.,The Prevention Science Institute, University of Oregon, Eugene, Oregon
| | - Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon.,The Prevention Science Institute, University of Oregon, Eugene, Oregon
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18
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Tanofsky-Kraff M, Schvey NA, Grilo CM. A developmental framework of binge-eating disorder based on pediatric loss of control eating. AMERICAN PSYCHOLOGIST 2020; 75:189-203. [PMID: 32052994 PMCID: PMC7027731 DOI: 10.1037/amp0000592] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although binge-eating disorder may manifest in childhood, a significantly larger proportion of youth report episodes involving a loss of control while eating, the hallmark feature of binge eating that predicts excess weight gain and obesity. Adults with binge-eating disorder often report that symptoms emerged during childhood or adolescence, suggesting that a developmental perspective of binge eating may be warranted. Thus, loss of control eating may be a marker of prodromal binge-eating disorder among certain susceptible youth. The present article offers a broad developmental framework of binge-eating disorder and proposes areas of future research to determine which youths with loss of control eating are at risk for persistent and exacerbated behavior that may develop into binge-eating disorder and adult obesity. To this end, this article provides an overview of loss of control eating in childhood and adolescence, including its characterization, etiology, and clinical significance, with a particular focus on associations with metabolic risk, weight gain, and obesity. A conceptual model is proposed to further elucidate the mechanisms that may play a role in determining which youths with loss of control are at greatest risk for binge-eating disorder and obesity. Ways in which treatments for adult binge-eating disorder may inform approaches to reduce loss of control eating and prevent excess weight gain in youth are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine
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19
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Byrne ME, Tanofsky-Kraff M, Jaramillo M, Shank LM, LeMay-Russell S, Rubin SG, Ramirez S, Altman DR, Schvey NA, Brady SM, Shomaker LB, Courville AB, Yang SB, Kozlosky M, Broadney MM, Yanovski SZ, Yanovski JA. Relationships of Trait Anxiety and Loss of Control Eating with Serum Leptin Concentrations among Youth. Nutrients 2019; 11:nu11092198. [PMID: 31547319 PMCID: PMC6771081 DOI: 10.3390/nu11092198] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 01/13/2023] Open
Abstract
Loss of control (LOC) eating in youth is associated with elevated fasting serum leptin, even after accounting for adiposity. Anxiety is closely linked to, and may exacerbate, LOC eating. Yet, it remains unclear how anxiety relates to leptin, or if the relationship is moderated by the presence of LOC eating. We examined whether self-reported trait anxiety interacted with LOC eating in relation to leptin in a convenience sample of youths (n = 592; 13.1 ± 2.7 years; body mass index z-score (BMIz) = 0.9 ± 1.1; 61.8% girls; 53.5% non-Hispanic White; 36.6% with LOC eating). LOC eating was assessed by interview. Leptin was measured after an overnight fast. Exploratory analyses were conducted to examine anxiety and LOC eating in relation to laboratory intake patterns in three sub-samples. In a generalized linear model adjusting for relevant covariates, anxiety significantly interacted with LOC eating in relation to leptin (p = 0.02), such that greater trait anxiety related to higher concentrations of leptin only among youth with LOC eating. Trait anxiety was not significantly related to fasting serum leptin independently in a generalized linear model adjusting for age, race, height, sex, study type, and fat mass (kg). Exploratory mechanistic analyses of food intake patterns did not identify consistent results for participants with both anxiety and LOC eating. Among youth with LOC eating, anxiety may be associated with higher serum leptin. Prospective data are required to elucidate the directionality and mechanisms of these relationships.
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Affiliation(s)
- Meghan E. Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
- Correspondence: ; Tel.: +1-301-295-1482
| | - Manuela Jaramillo
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Lisa M. Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Sarah LeMay-Russell
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Sarah G. Rubin
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Sophie Ramirez
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Deborah R. Altman
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Natasha A. Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
| | - Sheila M. Brady
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Lauren B. Shomaker
- Department of Human Development and Family Studies, College of Health and Human Sciences, Colorado State University, Fort Collins, CO 80523, USA;
| | - Amber B. Courville
- Nutrition Department, Clinical Center, NIH, 10 Center Drive, Bethesda, MD 20892, USA; (A.B.C.); (S.B.Y.); (M.K.)
| | - Shanna B. Yang
- Nutrition Department, Clinical Center, NIH, 10 Center Drive, Bethesda, MD 20892, USA; (A.B.C.); (S.B.Y.); (M.K.)
| | - Merel Kozlosky
- Nutrition Department, Clinical Center, NIH, 10 Center Drive, Bethesda, MD 20892, USA; (A.B.C.); (S.B.Y.); (M.K.)
| | - Miranda M. Broadney
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Susan Z. Yanovski
- Division of Digestive Diseases & Nutrition, National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), NIH, 6707 Democracy Blvd, Rm 6025, Bethesda, MD 20892, USA;
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
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20
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Abstract
PURPOSE OF REVIEW This review summarizes findings on pediatric loss-of-control (LOC) eating and obesity published since 2013 in relation to physiological, socioenvironmental, and psychological factors. RECENT FINDINGS LOC eating and obesity are highly comorbid in youth. Genetic and physiological risk factors are associated with the development of LOC eating. Adverse physiological outcomes of LOC eating include increased risk for overweight and obesity and greater dysfunction in components of metabolic syndrome. Socioenvironmental, psychological, and behavioral factors, such as weight-based teasing, dieting, negative affect, emotion dysregulation, and aspects of cognitive functioning, are consistently related to LOC eating in youth, independent of weight. Prospectively, LOC eating may predict the onset of anxiety disorders, depression, and more severe eating psychopathology later in life. Updates on interventions and future directions are discussed. LOC eating may be a key symptom to target adverse physiological and psychological outcomes; however, treatments are limited and require further examination.
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Affiliation(s)
- Meghan E Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814-4799, USA
| | - Sarah LeMay-Russell
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814-4799, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814-4799, USA.
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21
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Shank LM, Tanofsky-Kraff M, Radin RM, Shomaker LB, Wilfley DE, Young JF, Brady S, Olsen CH, Reynolds JC, Yanovski JA. Remission of loss of control eating and changes in components of the metabolic syndrome. Int J Eat Disord 2018; 51:565-573. [PMID: 29607525 PMCID: PMC6002918 DOI: 10.1002/eat.22866] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Pediatric loss of control (LOC) eating prospectively predicts the worsening of metabolic syndrome components. However, it is unknown if remission of LOC eating is associated with improvements in metabolic health. Therefore, we conducted a secondary analysis of a trial that enrolled adolescent girls with LOC eating, examining whether LOC remission (vs. persistence) at end-of-treatment was associated with changes in metabolic syndrome components at 6-month follow-up. METHOD One hundred three adolescent girls (age 14.5 ± 1.7 years; BMI-z 1.5 ± 0.3; 56.3% non-Hispanic White, 24.3% non-Hispanic Black) with elevated weight (75th-97th BMI %ile) and reported LOC eating were assessed for metabolic syndrome components at baseline and again six months following the interventions. The main effects of LOC status at end-of-treatment (persistence vs. remission) on metabolic syndrome components (waist circumference, lipids, glucose, and blood pressure) at 6-month follow-up were examined, adjusting for baseline age, depressive symptoms, LOC frequency, fat mass, and height, as well as race, change in height, change in fat mass, and the baseline value of each respective component. RESULTS Youth with LOC remission at end-of-treatment had lower glucose (83.9 ± 6.4 vs. 86.5 ± 5.8 mg/dL; p = .02), higher high-density lipoprotein cholesterol (50.3 ± 11.8 vs. 44.8 ± 11.9 mg/dL; p = .01), and lower triglycerides (84.4 ± 46.2 vs. 96.9 ± 53.7 mg/dL; p = .02) at 6-month follow-up when compared with youth with persistent LOC, despite no baseline differences in these components. No other component significantly differed by LOC eating status (ps > .05). DISCUSSION Reducing LOC eating in adolescent girls may have a beneficial impact on some components of the metabolic syndrome.
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Affiliation(s)
- Lisa M Shank
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland.,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland.,Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, Maryland
| | - Marian Tanofsky-Kraff
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland.,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland
| | - Rachel M Radin
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland.,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland
| | - Lauren B Shomaker
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland.,Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Penninsylvania
| | - Sheila Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland
| | - Cara H Olsen
- Preventive Medicine and Biostatistics Department, USUHS, Bethesda, Maryland
| | - James C Reynolds
- Radiology and Imaging Sciences Department, Clinical Center, NIH, Bethesda, Maryland
| | - Jack A Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland
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22
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Hilbert A, Kurz S, Dremmel D, Weihrauch Blüher S, Munsch S, Schmidt R. Cue reactivity, habituation, and eating in the absence of hunger in children with loss of control eating and attention-deficit/hyperactivity disorder. Int J Eat Disord 2018; 51:223-232. [PMID: 29341214 DOI: 10.1002/eat.22821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Childhood loss of control (LOC) eating and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid conditions and present with disordered eating behaviors, such as overeating. This study sought to delineate shared and specific abnormalities in physiological, cognitive-motivational, and behavioral components of food-specific impulsivity in children with LOC eating and ADHD. Specifically, children's reactivity and habituation to food and eating in the absence of hunger were examined. METHODS Within this community-based study, four groups of 8-13-year-old children with LOC eating (n = 24), ADHD (n = 32), comorbid LOC eating/ADHD (n = 9), and matched controls (n = 34) received a standard laboratory test meal to establish satiety and were then exposed to their favorite snack food in a cue exposure/reactivity trial, while salivation and desire to eat were repeatedly assessed. Subsequently, they were offered a variety of snack foods ad libitum. RESULTS Children with LOC eating, ADHD, and LOC/ADHD did not differ from controls in salivary reactivity and habituation to food cues. Children with LOC eating and ADHD showed greater cue reactivity of the desire to eat than controls, but groups did not differ in its longer-term increments. At free access, only children with LOC/ADHD consumed significantly more energy than controls. Longer-term increments of desire to eat predicted greater energy intake beyond LOC/ADHD group status. DISCUSSION Desire to eat among children with comorbid LOC eating and ADHD was associated with overeating in the absence of hunger, which may contribute to excess weight gain. Delineation of the specific features of childhood LOC eating versus ADHD warrants further study.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Susanne Kurz
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.,Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Daniela Dremmel
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Susann Weihrauch Blüher
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.,Pediatric Endocrinology, Department of Pediatrics I, Martin Luther University of Halle, Halle, Germany
| | - Simone Munsch
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Ricarda Schmidt
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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23
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Burke NL, Shomaker LB, Brady S, Reynolds JC, Young JF, Wilfley DE, Sbrocco T, Stephens M, Olsen CH, Yanovski JA, Tanofsky-Kraff M. Impact of Age and Race on Outcomes of a Program to Prevent Excess Weight Gain and Disordered Eating in Adolescent Girls. Nutrients 2017; 9:nu9090947. [PMID: 28846646 PMCID: PMC5622707 DOI: 10.3390/nu9090947] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 08/23/2017] [Accepted: 08/23/2017] [Indexed: 01/23/2023] Open
Abstract
Interpersonal psychotherapy (IPT) prevents weight gain and reduces loss-of-control (LOC)-eating in adults. However, IPT was not superior to health-education (HE) for preventing excess weight gain and reducing LOC-eating over 1-year in adolescent girls at risk for excess weight gain and eating disorders. Limited data suggest that older and non-White youth may be especially responsive to IPT. In secondary analyses, we examined if age or race moderated weight and LOC-eating outcomes. The 113 participants (12–17 years; 56.6% White) from the original trial were re-contacted 3 years later for assessment. At baseline and follow-up visits through 3 years, we assessed BMI, adiposity by dual energy X-ray absorptiometry, and LOC-eating presence. In linear mixed models, baseline age moderated 3-year BMI outcome; older girls in IPT had the lowest 3-year BMI gain compared to younger girls in IPT and all girls in HE, p = 0.04. A similar pattern was observed for adiposity. Race moderated 3-year LOC-eating; non-White girls in IPT were most likely to abstain from LOC-eating at 3 years compared to all other girls, p = 0.04. This hypothesis-generating analysis suggests future studies should determine if IPT is especially efficacious at reducing LOC-eating in older, non-White adolescents.
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Affiliation(s)
- Natasha L Burke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), US Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA.
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, 303 Behavioral Sciences Building, 1570 Campus Delivery, Fort Collins, CO 80523, USA.
| | - Sheila Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), US Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA.
| | - James C Reynolds
- Radiology and Imaging Sciences Department, Warren Grant Magnuson Clinical Center, National Institutes of Health (NIH), US Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA.
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA.
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, Campus Box 8134, St. Louis, MO 63110, USA.
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
| | - Mark Stephens
- Department of Family and Community Medicine, Pennsylvania State University, 1850 E. Park Avenue, Suite 207, State College, PA 16803, USA.
| | - Cara H Olsen
- Department of Preventative Medicine & Biometrics, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
| | - Jack A Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), US Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA.
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), US Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA.
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24
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Shank LM, Crosby RD, Grammer AC, Shomaker LB, Vannucci A, Burke NL, Stojek M, Brady SM, Kozlosky M, Reynolds JC, Yanovski JA, Tanofsky-Kraff M. Examination of the interpersonal model of loss of control eating in the laboratory. Compr Psychiatry 2017; 76:36-44. [PMID: 28410467 PMCID: PMC5478390 DOI: 10.1016/j.comppsych.2017.03.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/04/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The interpersonal model of loss of control (LOC) eating proposes that interpersonal problems lead to negative affect, which in turn contributes to the onset and/or persistence of LOC eating. Despite preliminary support, there are no data examining the construct validity of the interpersonal model of LOC eating using temporally sensitive reports of social stress, distinct negative affective states, and laboratory energy intake. METHOD 117 healthy adolescent girls (BMI: 75th-97th %ile) were recruited for a prevention trial targeting excess weight gain in adolescent girls who reported LOC eating. Prior to the intervention, participants completed questionnaires of recent social stress and consumed lunch from a multi-item laboratory test meal. Immediately before the test meal, participants completed a questionnaire of five negative affective states (anger, confusion, depression, fatigue, anxiety). Bootstrapping mediation models were conducted to evaluate pre-meal negative affect states as explanatory mediators of the association between recent social stress and palatable (desserts and snack-type) food intake. All analyses adjusted for age, race, pubertal stage, height, fat mass percentage, and lean mass. RESULTS Pre-meal state anxiety was a significant mediator for recent social stress and palatable food intake (ps<.05). By contrast, pre-meal state anger, confusion, depression, and fatigue did not mediate the relationship between social stress and palatable food intake (ps>.05). DISCUSSION Pre-meal anxiety appears to be the salient mood state for the interpersonal model among adolescent girls with LOC eating. Interventions that focus on improving both social functioning and anxiety may prove most effective at preventing and/or ameliorating disordered eating and obesity in these adolescents.
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Affiliation(s)
- Lisa M. Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA
| | - Ross D. Crosby
- Department of Biomedical Statistics & Methodology, Neuropsychiatric Research Institute, 120 Eighth Street South, Fargo, ND, 58107, USA
| | - Anne Claire Grammer
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Lauren B. Shomaker
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Department of Human Development and Family Studies and Colorado School of Public Health, Colorado State University, Fort Collins, CO 80523-1570, USA
| | - Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Natasha L. Burke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Monika Stojek
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Merel Kozlosky
- Nutrition Department, Clinical Center, NIH, DHHS, 10 Center Drive, Bethesda. MD 20892, USA
| | - James C. Reynolds
- Radiology and Imaging Sciences Department, Warren Grant Magnuson Clinical Center, NIH, DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA.
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Goldschmidt AB. Are loss of control while eating and overeating valid constructs? A critical review of the literature. Obes Rev 2017; 18:412-449. [PMID: 28165655 PMCID: PMC5502406 DOI: 10.1111/obr.12491] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/22/2016] [Accepted: 11/22/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND Binge eating is a marker of weight gain and obesity, and a hallmark feature of eating disorders. Yet its component constructs - overeating and loss of control (LOC) while eating - are poorly understood and difficult to measure. OBJECTIVE The objective of this study is to critically review the human literature concerning the validity of LOC and overeating across the age and weight spectrum. DATA SOURCES English-language articles addressing the face, convergent, discriminant and predictive validity of LOC and overeating were included. RESULTS Loss of control and overeating appear to have adequate face validity. Emerging evidence supports the convergent and predictive validity of the LOC construct, given its unique cross-sectional and prospective associations with numerous anthropometric, psychosocial and eating behaviour-related factors. Overeating may be best conceptualized as a marker of excess weight status. LIMITATIONS Binge eating constructs, particularly in the context of subjectively large episodes, are challenging to measure reliably. Few studies addressed overeating in the absence of LOC, thereby limiting conclusions about the validity of the overeating construct independent of LOC. Additional studies addressing the discriminant validity of both constructs are warranted. DISCUSSION Suggestions for future weight-related research and for appropriately defining binge eating in the eating disorders diagnostic scheme are presented.
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Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
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Shank LM, Tanofsky-Kraff M, Kelly NR, Schvey NA, Marwitz SE, Mehari RD, Brady SM, Demidowich AP, Broadney MM, Galescu OA, Pickworth CK, Yanovski SZ, Yanovski JA. Pediatric Loss of Control Eating and High-Sensitivity C-Reactive Protein Concentrations. Child Obes 2017; 13:1-8. [PMID: 27732055 PMCID: PMC5278829 DOI: 10.1089/chi.2016.0199] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Loss of control (LOC) eating in youth is associated with excess body weight and adiposity. After adjusting for fat mass, youth with LOC eating have higher blood pressure and higher low-density lipoprotein cholesterol compared to youth without LOC eating. Increased inflammation may account for this relationship, although few data have examined this hypothesis. Therefore, this study explored the association between LOC eating and high-sensitivity C-reactive protein (hsCRP), a marker of inflammation. METHODS We investigated hsCRP concentrations in relation to LOC eating in a convenience sample of 194 youth (age 14.3 ± 2.1 years; 63.9% female; BMI-z 1.64 ± 1.06). The presence of LOC eating in the past month was assessed by the Eating Disorder Examination interview. Serum hsCRP was measured by enzyme-linked immunosorbent assay. Adiposity was measured by air displacement plethysmography or dual-energy x-ray absorptiometry. We compared hsCRP in those with and without LOC eating in analyses accounting for sex, adiposity, height, depressive symptoms, and eating psychopathology. RESULTS Youth with LOC eating had significantly greater hsCRP than youth without LOC eating (p = 0.02), after accounting for all covariates. The number of LOC eating episodes in the past month was positively associated with hsCRP (p = 0.01). The relationship between LOC eating and hsCRP was not mediated by depressive symptoms or eating psychopathology (ps > 0.05). CONCLUSIONS Youth with disinhibited eating may manifest increased chronic inflammation. Those with LOC eating may be an important subgroup at risk for adverse health outcomes associated with both chronic inflammation and obesity. Future research should examine whether hsCRP concentrations mediate the relationship between LOC eating and its association with cardiometabolic risk.
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Affiliation(s)
- Lisa M. Shank
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Nichole R. Kelly
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Natasha A. Schvey
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Shannon E. Marwitz
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Rim D. Mehari
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Miranda M. Broadney
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Ovidiu A. Galescu
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Courtney K. Pickworth
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Office of Obesity Research, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
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Axon E, Atkinson G, Richter B, Metzendorf M, Baur L, Finer N, Corpeleijn E, O'Malley C, Ells LJ. Drug interventions for the treatment of obesity in children and adolescents. Cochrane Database Syst Rev 2016; 11:CD012436. [PMID: 27899001 PMCID: PMC6472619 DOI: 10.1002/14651858.cd012436] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Child and adolescent obesity has increased globally, and can be associated with significant short- and long-term health consequences. OBJECTIVES To assess the efficacy of drug interventions for the treatment of obesity in children and adolescents. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PubMed (subsets not available on Ovid), LILACS as well as the trial registers ICTRP (WHO) and ClinicalTrials.gov. Searches were undertaken from inception to March 2016. We checked references and applied no language restrictions. SELECTION CRITERIA We selected randomised controlled trials (RCTs) of pharmacological interventions for treating obesity (licensed and unlicensed for this indication) in children and adolescents (mean age under 18 years) with or without support of family members, with a minimum of three months' pharmacological intervention and six months' follow-up from baseline. We excluded interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included participants with a secondary or syndromic cause of obesity. In addition, we excluded trials which included growth hormone therapies and pregnant participants. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality and extracted data following standard Cochrane methodology. Where necessary we contacted authors for additional information. MAIN RESULTS We included 21 trials and identified eight ongoing trials. The included trials evaluated metformin (11 trials), sibutramine (six trials), orlistat (four trials), and one trial arm investigated the combination of metformin and fluoxetine. The ongoing trials evaluated metformin (four trials), topiramate (two trials) and exenatide (two trials). A total of 2484 people participated in the included trials, 1478 participants were randomised to drug intervention and 904 to comparator groups (91 participants took part in two cross-over trials; 11 participants not specified). Eighteen trials used a placebo in the comparator group. Two trials had a cross-over design while the remaining 19 trials were parallel RCTs. The length of the intervention period ranged from 12 weeks to 48 weeks, and the length of follow-up from baseline ranged from six months to 100 weeks.Trials generally had a low risk of bias for random sequence generation, allocation concealment and blinding (participants, personnel and assessors) for subjective and objective outcomes. We judged approximately half of the trials as having a high risk of bias in one or more domain such as selective reporting.The primary outcomes of this review were change in body mass index (BMI), change in weight and adverse events. All 21 trials measured these outcomes. The secondary outcomes were health-related quality of life (only one trial reported results showing no marked differences; very low certainty evidence), body fat distribution (measured in 18 trials), behaviour change (measured in six trials), participants' views of the intervention (not reported), morbidity associated with the intervention (measured in one orlistat trial only reporting more new gallstones following the intervention; very low certainty evidence), all-cause mortality (one suicide in the orlistat intervention group; low certainty evidence) and socioeconomic effects (not reported).Intervention versus comparator for mean difference (MD) in BMI change was -1.3 kg/m2 (95% confidence interval (CI) -1.9 to -0.8; P < 0.00001; 16 trials; 1884 participants; low certainty evidence). When split by drug type, sibutramine, metformin and orlistat all showed reductions in BMI in favour of the intervention.Intervention versus comparator for change in weight showed a MD of -3.9 kg (95% CI -5.9 to -1.9; P < 0.00001; 11 trials; 1180 participants; low certainty evidence). As with BMI, when the trials were split by drug type, sibutramine, metformin and orlistat all showed reductions in weight in favour of the intervention.Five trials reported serious adverse events: 24/878 (2.7%) participants in the intervention groups versus 8/469 (1.7%) participants in the comparator groups (risk ratio (RR) 1.43, 95% CI 0.63 to 3.25; 1347 participants; low certainty evidence). A total 52/1043 (5.0%) participants in the intervention groups versus 17/621 (2.7%) in the comparator groups discontinued the trial because of adverse events (RR 1.45, 95% CI 0.83 to 2.52; 10 trials; 1664 participants; low certainty evidence). The most common adverse events in orlistat and metformin trials were gastrointestinal (such as diarrhoea, mild abdominal pain or discomfort, fatty stools). The most frequent adverse events in sibutramine trials included tachycardia, constipation and hypertension. The single fluoxetine trial reported dry mouth and loose stools. No trial investigated drug treatment for overweight children. AUTHORS' CONCLUSIONS This systematic review is part of a series of associated Cochrane reviews on interventions for obese children and adolescents and has shown that pharmacological interventions (metformin, sibutramine, orlistat and fluoxetine) may have small effects in reduction in BMI and bodyweight in obese children and adolescents. However, many of these drugs are not licensed for the treatment of obesity in children and adolescents, or have been withdrawn. Trials were generally of low quality with many having a short or no post-intervention follow-up period and high dropout rates (overall dropout of 25%). Future research should focus on conducting trials with sufficient power and long-term follow-up, to ensure the long-term effects of any pharmacological intervention are comprehensively assessed. Adverse events should be reported in a more standardised manner specifying amongst other things the number of participants experiencing at least one adverse event. The requirement of regulatory authorities (US Food and Drug Administration and European Medicines Agency) for trials of all new medications to be used in children and adolescents should drive an increase in the number of high quality trials.
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Affiliation(s)
- Emma Axon
- University of NottinghamCochrane Skin GroupNottinghamUKNG7 2NR
| | - Greg Atkinson
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Bernd Richter
- Institute of General Practice, Medical Faculty of the Heinrich‐Heine‐University DüsseldorfCochrane Metabolic and Endocrine Disorders GroupPO Box 101007DüsseldorfGermany40001
| | - Maria‐Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich‐Heine‐University DüsseldorfCochrane Metabolic and Endocrine Disorders GroupPO Box 101007DüsseldorfGermany40001
| | - Louise Baur
- The University of SydneyDepartment of Paediatrics and Child HealthLocked Bag 4001WestmeadAustraliaNSW 2145
| | - Nicholas Finer
- UCL Institute of Cardiovascular ScienceNational Centre for Cardiovascular Prevention and Outcomes170 Tottenham Court RoadLondonUKW1T 7HA
- Novo Nordisk A/SGlobal Medical Affairs ManagementCopenhagenDenmark
| | - Eva Corpeleijn
- University Medical Centre GroningenDepartment of EpidemiologyHanzeplein 1GroningenNetherlands9713 GZ
| | - Claire O'Malley
- Durham UniversityDepartment of Sport and Exercise SciencesDurhamUKDH1 3HN
| | - Louisa J Ells
- Teesside UniversitySchool of Health and Social CareParkside West OfficesMiddlesbroughUKTS1 3BA
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Abstract
PURPOSE OF REVIEW This review provides an update on the new Diagnostic and Statistical Manual (DSM) diagnosis of binge-eating disorder (BED) by presenting diagnostic criteria, associated risk factors and co-morbidities, and tools for assessment. An update on the currently available evidence-based treatments for adolescent BED is provided to help with the coordination of treatment planning for identified patients with this condition. RECENT FINDINGS BED is now officially included in the DSM. Research with youth has begun to show improvement from treatments such as cognitive behavioral therapy, previously shown to be useful in adults. SUMMARY BED is common and often begins during youth. The availability of diagnostic criteria, along with increasing knowledge about the condition and available treatments, is expected to result in improved identification and management in younger patients.
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