Differences in daily stress, mood, coping, and eating behavior in binge eating and nonbinge eating college women

Stress-induced overeating behaviors explained from a (transitory) relief-learning perspective

People use various behaviors to cope with stressful events. These behaviors are mostly adaptive, as they allow a successful release of stress without impacting other aspects of life: How nice is it to have a break with a few spoons of that favorite ice cream during a hectic working day? However, when excessive consumption of high-sugar/salt ultra-processed food becomes the gateway to find relief from stress, eating loses this adaptive function and may escalate to binge eating, lead to obesity, and other medical conditions linked to overweight. Several etiological models attempt to explain stress-induced eating and excessive overeating behaviors characterizing these clinical conditions. The popular Emotional Eating Theory proposes that stress-related (over-)eating, a major predictor of obesity and diagnosed binge eating disorders, develops based on negative reinforcement learning since food consumption regulates the negative affective state associated with stressful circumstances. Differently, the prominent Incentive Sensitization Theory explains overeating, binge eating disorders (including bulimia), and obesity in terms of excessive amplification of reward 'wanting', which is thought to emerge from overexposure to obesogenic (food)cues. The several studies oriented by these theories have paved the way to better understand stress-related (over-)eating and its clinical excesses. However, a deep mechanistic understanding of how and why stress-induced (over-)eating can escalate till clinical forms of overeating remain elusive. A well-funded connection of the mechanisms proposed by the Emotional Eating Theory and the Incentive Sensitization Theory might address this etiological open question. To avoid erroneous arguments, it is however essential to first address the internal theoretical and methodological shortcomings of each theory and connected studies. These shortcomings stem from conceptual fallacies and poorly implemented designs, which might partially explain the 'high variability and low replicability' problem of empirical findings. Next, the formulation of a new integrative model could provide fresh insight into the deep learning and biological mechanisms of this escalation. A successful formalization of this model could then create the much-needed impact in clinical and preventive research since excessive overeating is a behavior hard to change once established. In this opinion paper, I propose to apply recent insights we gathered on the role of relief from the field of safety learning to stress (over-)eating. I will present a new relief-based model that, as a starting point, has the potential to connect the Emotional Eating Theory with the Incentive Sensitization Theory, setting the base for more integrative science.

Between- and within-person effects of stress on emotional eating in women: a longitudinal study over 49 days

BACKGROUND

Stress is associated with binge eating and emotional eating (EE) cross-sectionally. However, few studies have examined stress longitudinally, limiting understanding of how within-person fluctuations in stress influence EE over time and whether stress is a risk factor or consequence of EE. Additionally, little is known regarding how the biological stress response relates to EE.

METHODS

We used an intensive, longitudinal design to examine between-person and within-person effects of major life stress, daily stress, and cortisol on EE in a population-based sample of women (N = 477; ages 15-30; M = 21.8; s.d. = 3.0) from the Michigan State University Twin Registry. Participants reported past year major life stress, then provided daily ratings of EE and stress for 49 consecutive days. Hair cortisol concentration (HCC) was collected as a longitudinal biological stress measure.

RESULTS

Women reported greater EE when they experienced greater mean stress across days (between-person effects) or greater stress relative to their own average on a given day (within-person effects). Daily stress was more strongly associated with EE than major life stress. However, the impact of daily stress on EE was amplified in women with greater past year major life stress. Finally, participants with lower HCC had increased EE.

CONCLUSIONS

Findings confirm longitudinal associations between stress and EE in women, and highlight the importance of within-person shifts in stress in EE risk. Results also highlight HCC as a novel biological stress measure that is significantly associated with EE and may overcome limitations of prior physiological stress response indicators.

The role of eating expectancies and eating motives in the association between mood and loss-of-control eating: A national sample daily diary study

Loss-of-control eating (LOCE, the subjective inability to refrain from eating or cease eating), is highly mood-driven. Mood-related eating motives and eating expectancies have been identified as contributors to binge eating. However, little is known about how these factors relate to LOCE, much less their relationship with daily-level LOCE. This study assessed the impact of trait eating expectancies and daily eating motives on the relationship between daily affective states and LOCE. United States adults (n = 109) reporting recent LOCE participated in a ten-day diary study, completing two surveys per day regarding eating behaviors, mood, and motives. Data were analyzed at the within- and between-subject levels utilizing a Bayesian approach to examine pathways from mood to LOCE, mediated by eating motives and accounting for a moderating impact of baseline eating expectancies on the path leg between mood and motives. Negative mood was associated with LOCE at both the within- and between-subjects level by way of coping motives, and directly at the within-subjects level. Negative affect (NA) reduction expectancies did not moderate the indirect pathway. Positive mood was only associated with LOCE at the within-subjects level, via pleasure motives. This relationship was potentiated via reward expectancies. Therefore, although negative mood appears be a robust predictor of LOCE regardless of trait NA reduction expectancies, positive mood appears to have a specific set of conditions under which individuals are at increased likelihood of LOCE at the within-subjects level. These findings suggest that eating expectancies and motives for eating may be meaningful targets in LOCE interventions.

Humor and Hunger Affect the Response Toward Food Cues

The omnipresence of food cues in everyday life has been linked to troubled eating behavior and rising rates of obesity. While extended research has been conducted on the effects of negative emotions and stress on food consumption, very little is known about how positive emotions affect eating and particularly attention toward food cues. In the present study, we investigated whether humor impacts attentional bias toward food and whether it will affect preferences for healthy and unhealthy food items, depending on the hunger state. To do so, a group of randomly assigned participants watched funny video clips (humor group, N = 46) or neutral ones (control group, N = 49). Afterwards, they performed a modified Posner cueing task with low or high caloric food images serving as cues. We found a significant group × hunger interaction. Compared to the control group, the humor group responded more slowly to food cues when hungry, whereas the opposite was true when participants were satiated. Additionally, our results suggest that hunger possibly directs attention away from healthy food cues and toward unhealthy ones. No group differences were found with respect to food preferences and engagement and disengagement of attention. We discuss the potential of humor in counteracting aversive consequences of hunger on attention allocation toward food. We propose an underlying mechanism involving a combined reduction in cortisol levels and a decrease in activation of the reward system. However, given the novelty of the findings, further research is warranted, both to replicate the results as well as to investigate the suggested underlying processes.

Mediating effect of intolerance of uncertainty in the relationship between coping styles with stress during pandemic (COVID-19) process and compulsive buying behavior

Novel CoronaVirus Disease (COVID-19) has begun to expand swiftly beyond all borders and turned into a global source of infection for humans in that all media corporations began to repeatedly share breaking news to release the latest data of all countries. The consequence of that has been a heightened level of anxiety among humans and opting for unorthodox consumption behaviors as consumers. In this study the attempt was to analyze human behaviors during the ongoing pandemic process from the perspective of psychology and marketing fields of science. In so doing, interrelation among anxiety, which surfaced because of Covid-19 pandemic, coping style with stress of individuals and compulsive purchase behavior has been explored. Based on these interrelations, a structural model was suggested. Findings of the research indicated that anxiety has high effect on the helpless approach dimension, which is one of the coping styles with stress; and that helpless approach alone has an effect on compulsive buying behavior. Besides, another objective of the study was to evaluate the mediating effect of intolerance of uncertainty between coping style with stress and compulsive buying behavior. That analysis evidenced that intolerance of uncertainty in such an interrelation had a partial mediating effect.

Trait negative affect interacts with ovarian hormones to predict risk for emotional eating

Ovarian hormones significantly influence dysregulated eating in females. However, most women do not develop appreciable disordered eating, suggesting that ovarian hormones may not affect all women equally. We examined whether individual differences in trait negative affect (NA) moderate ovarian hormone-dysregulated eating associations in 446 women who provided saliva samples for hormone measurements and ratings of NA and emotional eating daily for 45 consecutive days. Women were at greatest risk for emotional eating when they had high trait NA and experienced a hormonal milieu characterized by low estradiol or high progesterone. While effects were evident in all women, the combination of high trait NA and high progesterone was particularly risky for women with a history of clinically significant binge eating episodes. These findings provide initial evidence that affective and hormonal risk interact to promote emotional eating, and that effects may be amplified in women with clinically significant binge eating.

A rational emotive behavior therapy-based intervention for binge eating behavior management among female students: a quasi-experimental study

BACKGROUND

Binge eating behavior is highly likely to progress to an eating disorder, with female students particularly at risk.

OBJECTIVE

This study aimed to verify the effect of a binge eating behavior management program, based on rational emotive behavior therapy (REBT), on binge eating behavior and related cognitive and emotional factors among female college students.

METHOD

The study, conducted from November 1 to December 2, 2016, involved a pretest-posttest design and nonequivalent control group. The sample included 24 and 22 first- to third-year students, from a college in South Korea, in the experimental and control groups, respectively. Data were collected using self-esteem, covert narcissism, perfectionism, body dissatisfaction, anxiety, depression, and binge eating scales and analyzed via frequency analysis, χ² tests, t tests, and analysis of covariance.

RESULTS

The results indicated that the REBT-based binge eating behavior management program exerted positive effects on participants' self-esteem, reducing covert narcissism, body dissatisfaction, anxiety, depression, and binge eating. However, there was no significant difference in perfectionism, although the experimental group's mean score decreased from pretest to posttest.

CONCLUSIONS

Based on the results, the program was considered to be effective, and is expected to be useful in preventing the development of eating disorders among female college students by treating binge eating behavior and related cognitive and emotional factors. This intervention could ultimately contribute to the improvement of female college students' health and quality of life.

Differential Expression of DeltaFosB in Reward Processing Regions Between Binge Eating Prone and Resistant Female Rats

Binge eating (BE) is characterized by the consumption of large amounts of palatable food in a discrete period and compulsivity. Even though BE is a common symptom in bulimia nervosa (BN), binge eating disorder (BED), and some cases of other specified feeding or eating disorders, little is known about its pathophysiology. We aimed to identify brain regions and neuron subtypes implicated in the development of binge-like eating in a female rat model. We separated rats into binge eating prone (BEP) and binge eating resistant (BER) phenotypes based on the amount of sucrose they consumed following foot-shock stress. We quantified deltaFosB (ΔFosB) expression, a stably expressed Fos family member, in different brain regions involved in reward, taste, or stress processing, to assess their involvement in the development of the phenotype. The number of ΔFosB-expressing neurons was: (1) higher in BEP than BER rats in reward processing areas [medial prefrontal cortex (mPFC), nucleus accumbens (Acb), and ventral tegmental area (VTA)]; (2) similar in taste processing areas [insular cortex, IC and parabrachial nucleus (PBN)]; and (3) higher in the paraventricular nucleus of BEP than BER rats, but not different in the locus coeruleus (LC), which are stress processing structures. To study subtypes of ΔFosB-expressing neurons in the reward system, we performed in situ hybridization for glutamate decarboxylase 65 and tyrosine hydroxylase (TH) mRNA after ΔFosB immunohistochemistry. In the mPFC and Acb, the proportions of γ-aminobutyric acidergic (GABAergic) and non-GABAergic ΔFosB-expressing neurons were similar in BER and BEP rats. In the VTA, while the proportion of dopaminergic ΔFosB-expressing neurons was similar in both phenotypes, the proportion of GABAergic ΔFosB-expressing neurons was higher in BER than BEP rats. Our results suggest that reward processing brain regions, particularly the VTA, are important for the development of binge-like eating.

Mid-adolescent stress differentially affects binge-like intake of sucrose across estrous cycles in female rats✰

Binge eating disorder (BED), characterized by excessive food consumption within a discrete period of time, is the most prevalent of all eating disorders, with higher rates in women than men. Chronic stress, particularly during adolescence, is a significant risk factor for BED in women, but the mechanism underlying this relationship remains elusive. We investigated the phenomenon by testing the impact of mid-adolescent intermittent physical stress (IPS) on binge-like intake of sucrose in adult female rats, assessing how the behavior changed across reproductive cycles. One hundred and nineteen Long-Evans rats were exposed to IPS (n = 59) or no stress (NS; n = 60) for 12 days during mid-adolescence (PD35-46). Binge-like eating was induced in adult animals using an intermittent access protocol: animals were provided with 12 h or 24 h access to sucrose, 12 h access to saccharin, or 12 h access to food over 28 days. After 1- or 28-day abstinence, compulsive responding for sucrose was measured using a conditioned suppression paradigm. Rats given 12 h access to sucrose developed binge-like intake, measured as increased consumption during the first hour; the effect was magnified in IPS animals and most pronounced during proestrous. Solution intake in IPS rats was predicted by open arm entries in the elevated plus maze, suggesting that increased risk-taking behavior is associated with greater binge-like eating. IPS blocked conditioned suppression after 28 days of abstinence, pointing to a role of mid-adolescent stress in compulsivity. Collectively, these findings emphasize the impact of stress on the emergence of binge eating in females and suggest that intervention programs for women with a history of adolescent adversity should be investigated as a means to reduce risk for BED.

Associations Between Approach and Avoidance Coping, Psychological Distress, and Disordered Eating Among Candidates for Bariatric Surgery

BACKGROUND

Individuals seeking bariatric surgery evidence risk for binge and disordered eating behaviors, which can lead to poorer post-surgical weight loss outcomes. Use of avoidant coping strategies to manage stress, along with symptoms of depression, are associated with disordered eating in the general population. However, the role of coping has not been examined among candidates for bariatric surgery, and coping and depression have rarely been considered in combination. Given the emerging standard that psychologists are involved in evaluations and treatment before and after surgery, consideration of these variables is clinically relevant.

METHODS

Participants were 399 patients undergoing pre-surgical bariatric psychological assessment. Hierarchical linear regression analyses tested whether gender, age, and BMI; approach and avoidance coping; and depression and anxiety were associated with disordered eating (binge eating, restraint, eating concerns, shape concerns, weight concerns) in a cross-sectional study design.

RESULTS

In initial steps of the model controlling demographic variables, approach coping predicted less and avoidance coping predicted more disordered eating across most outcomes examined. In models including depression and anxiety, avoidance (but not approach) coping remained a relevant predictor. The effects of depression were also quite robust, such that participants who were more depressed reported more disordered eating. More anxious participants reported more restrained eating.

CONCLUSIONS

Avoidance coping and depressive symptoms emerged as key variables in understanding recent disordered eating among patients considering bariatric surgery. Pre-surgical psychological evaluations and treatment approaches could be enhanced with consideration of patient coping strategies, particularly avoidant coping responses to stress, independent of psychological distress.

Regulation of adenosine A2A receptor gene expression in a model of binge eating in the amygdaloid complex of female rats

BACKGROUND

Pharmacological treatment approaches for eating disorders, such as binge eating disorder and bulimia nervosa, are currently limited.

METHODS AND AIMS

Using a well-characterized animal model of binge eating, we investigated the epigenetic regulation of the A_2A Adenosine Receptor (A_2AAR) and dopaminergic D2 receptor (D2R) genes.

RESULTS

Gene expression analysis revealed a selective increase of both receptor mRNAs in the amygdaloid complex of stressed and restricted rats, which exhibited binge-like eating, when compared to non-stressed and non-restricted rats. Consistently, pyrosequencing analysis revealed a significant reduction of the percentage of DNA methylation but only at the A_2AAR promoter region in rats showing binge-like behaviour compared to the control animals. Focusing thus on A_2AAR agonist (VT 7) administration (which inhibited the episode of binge systemically at 0.1 mg/kg or intra-central amygdala (CeA) injection at 900 ng/side) induced a significant increase of A_2AAR mRNA levels in restricted and stressed rats when compared to the control group. In addition, we observed a significant decrease in A_2AAR mRNA levels in rats treated with the A_2AAR antagonist (ANR 94) at 1 mg/kg. Consistent changes in the DNA methylation status of the A_2AAR promoter were found in restricted and stressed rats after administration of VT 7 or ANR 94.

CONCLUSION

We confirm the role of A_2AAR in binge eating behaviours, and we underline the importance of epigenetic regulation of the A_2AAR gene, possibly due to a compensatory mechanism to counteract the effect of binge eating. We suggest that A_2AAR activation, inducing receptor gene up-regulation, could be relevant to reduction of food consumption.

The Mindfulness App Trial for Weight, Weight-Related Behaviors, and Stress in University Students: Randomized Controlled Trial

Background

University students are at risk of weight gain during their studies. Key factors related to weight gain in this population include unhealthy weight-related behaviors because of stress. Mindfulness holds promise for weight management. However, there has not been any previous trial that has explored the effectiveness of a student-tailored mindfulness app for stress, weight-related behaviors, and weight. There is limited evidence that current mindfulness apps use evidence-based mindfulness techniques. A novel app was developed that combined evidence-based, mindfulness-based stress reduction and mindful eating (ME) techniques that were tailored to university students, with student-relevant themes for targeting weight behaviors, weight, and stress.

Objectives

The aim of this study was to test the effectiveness, acceptability, and feasibility of a student-tailored mindfulness app for weight, weight-related behaviors, and stress. Testing this app in a rigorous randomized controlled trial (RCT) for these outcomes is a novelty and contribution to this emerging field.

Methods

A 2-arm RCT of an 11-week duration was undertaken at the University of Queensland. Students were either randomized to the mindfulness app (n=45) or to a behavioral self-monitoring electronic diary (e-diary; n=45) for diet and exercise. Analysis of covariance was used to compare differences in weight, stress, mindfulness, ME, physical activity, and eating behaviors between both groups.

Results

Neither the mindfulness app group nor the e-diary group lost weight and there were no differences between the groups at follow-up. The mindfulness app group had significantly lower stress levels (P=.02) (adherers only), lower emotional eating (P=.02), and uncontrolled eating (P=.02) as well as higher mindfulness (P≤.001) and ME levels overall (P≤.001). The e-diary group had higher metabolic equivalents of moderate activity levels (P≤.01). However, the effect sizes were small. Regular adherence to mindfulness exercises in the app was low in the group. The majority of students (94%) liked the app and found it to be acceptable. Compared with other exercises, the most helpful reported meditation was the short breathing exercise observing the breath (39.4% [13/33] preferred it).

This was the first RCT that tested a mindfulness app for weight and weight-related behaviors in students. The modest level of user adherence likely contributes to the lack of effect on weight loss. However, there was a small, albeit promising, effect on weight-related eating behavior and stress.

Conclusions

A mindfulness app demonstrated effectiveness for stress, eating behaviors, mindfulness, and ME, but the effect sizes were small. Future studies should be conducted over longer periods of time and with greater participant compliance.

Trial Registration

Australian New Zealand Trial Registry ACTRN12616001349437; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371370 (Archived by WebCite at http://www.webcitation.org/761cc2K6ft)

Sex differences in the relationships among weight stigma, depression, and binge eating

Weight stigma and weight discrimination are prevalent in the United States and binge eating has been found to be associated with these experiences in numerous studies. One issue with the current literature on weight stigma and binge eating, however, is that study samples are primarily female, resulting in a lack of understanding of this relationship among males. To address this gap, we examined potential sex differences in the association between weight stigma and binge eating, as well as mediators of this relationship. Specifically, we examined experiences of weight discrimination and weight stigma consciousness as predictors of binge eating, and we assessed whether these relationships were mediated by depression, perceived stress, and/or perceived control. Results showed that, among females and males, experiences of weight discrimination significantly predicted binge eating and depression mediated this relationship; perceived stress also mediated this association, but only among males, and perceived control did not mediate for either sex. Results also showed that, among males, the relationship between weight stigma consciousness and binge eating was mediated by depression and perceived control, but not perceived stress. Weight stigma consciousness was unrelated to binge eating among females. Together, these findings suggest that weight stigma constructs differentially impact females and males, thereby illuminating the possible need for consideration of sex as an important component of efforts to reduce weight stigma.

"Not just right" experiences account for unique variance in eating pathology

"Not just right" experiences (NJREs) are uncomfortable sensations of incompleteness linked to obsessive-compulsive disorder; however, NJREs may be transdiagnostic and play a role in eating pathology. The current study examined relations between NJREs and eating pathology in undergraduate students. Participants (n = 248) completed self-report and behavioral assessments. Controlling for obsessive-compulsive symptoms, negative affect, and perfectionism, NJRE frequency was associated with greater drive for thinness, body dissatisfaction, and bulimic symptoms. Discomfort in response to a visual in vivo NJRE task was positively associated with drive for thinness and body dissatisfaction. The present study provides initial evidence for NJREs in eating pathology. Theoretical implications are discussed.

The Association among Emotions and Food Choices in First-Year College Students Using mobile-Ecological Momentary Assessments

Background

Studies have examined the associations between emotions and overeating but have only rarely considered associations between emotions and specific food choices. The purpose of this secondary data analysis was to use mobile ecological momentary assessments (mEMAs) to examine associations between emotions and food choices among first-year college students living in residence halls.

Methods

Using an intensive repeated-measures design, mEMAs were used to assess concurrent emotions and food choices in a racially/ethnically diverse sample of first-year college students (n = 663). Emotions were categorized as negative (sad, stressed, tired), positive (happy, energized, relaxed), and apathetic (bored, meh). Assessments were completed multiple times per day on four quasi-randomly selected days (three random weekdays and one random weekend day) during a 7-day period using random prompt times. Generalized estimating equations (GEE) were used to examine between- and within-person associations of emotional status with a variety of healthy and unhealthy food choices (sweets, salty snacks/fried foods, fruits/vegetables, pizza/fast food, sandwiches/wraps, meats/proteins, pasta/rice, cereals), adjusting for gender, day of week, and time of day, accounting for within-person dependencies among repeated measurements of eating behavior.

Results

At the between-person level, participants who reported positive emotions more frequently compared to others consumed meats/proteins more often (OR = 1.8; 99% CI = 1.2, 2.8). At the within-person level, on occasions when any negative emotion was reported (versus no negative emotion reported) participants were more likely to consume meats/proteins (OR = 1.5, 99% CI = 1.0, 2.1); on occasions when any positive emotion was reported as compared to occasions with no positive emotions, participants were more likely to consume sweets (OR = 1.7, 99% CI = 1.1, 2.6), but less likely to consume pizza/fast food (OR = 0.6, 99% CI = 0.4, 1.0).

Conclusions

Negative and positive emotions were significantly associated with food choices. mEMA methodology provides a unique opportunity to examine these associations within and between people, providing insights for individual and population-level interventions. These findings can be used to guide future longitudinal studies and to develop and test interventions that encourage healthy food choices among first-year college students and ultimately reduce the risk of weight gain.

The moderating role of resilience on the relationship between perceived stress and binge eating symptoms among young adult women

OBJECTIVE

Adolescence and young adulthood are developmental periods during the life course that are sometimes associated with heightened stress and engagement in binge eating. Binge eating has been linked to psychiatric comorbidity, poorer physical health, and lower quality of life. However, less is known about protective factors that could buffer against binge eating behaviors. The current study examined the moderating role of resilience on the relationship between perceived stress and binge eating symptoms among emerging adult female college students.

METHOD

Participants were 297 young adult women aged 18-25 years (M_age = 19.22, SD = 1.51; 52% self-identifying as a racial/ethnic minority) with Body Mass Index ranging from 15 to 66 (M_BMI = 25.01, SD = 6.18). Women completed this cross-sectional study while they were attending universities in the Western or Southern United States. Participants provided demographic and height/weight information, and completed the following measures: Perceived Stress Scale, Binge Eating Scale, and Brief Resilience Scale.

RESULTS

Higher perceived stress was significantly associated with more severe binge eating symptoms (b = 0.31; p < .01). In addition, higher resilience was associated with lower binge eating pathology (b = -0.20; p < .01). Moderation was supported as the relationship between perceived stress and binge eating symptoms varied by resilience level (b = -0.16; p < .01).

CONCLUSIONS

Women who perceived higher stress were more likely to engage in binge eating relative to women experiencing low stress; however, resilience attenuated this association. Resilience could be targeted to reduce the negative effects of perceived stress on eating behaviors in young women.

Associations of borderline personality disorder traits with stressful events and emotional reactivity in women with bulimia nervosa

Borderline personality disorder (BPD) traits are common among those with bulimia nervosa (BN). However, how these traits impact the state experience of precipitants of BN behavior, such as stressful events and emotional reactivity, has not been determined. Thus, the purpose of this naturalistic study was to examine this trait-state association in BN. Women with DSM-IV BN (N = 133) completed a baseline measure of personality pathology traits, and subsequently recorded their affective state and the frequency and perception of 3 types of stressful events (interpersonal, work/environment, and daily hassles) several times per day for 2 weeks using ecological momentary assessment (EMA). Pearson correlations assessed the associations between BPD traits (affective lability, identity problems, insecure attachment, and cognitive dysregulation) and (a) frequency of stressful events and (b) perception of stressful events. Generalized linear models (GLM) were used to evaluate the relationship between BPD traits and changes in negative affect following stressful events. Results revealed that while all traits were significantly associated with perceived stressfulness, certain BPD traits were significantly associated with the frequency of stressful events. Individuals with higher trait insecure attachment experienced larger increases in negative affect following interpersonal stressful events. These findings suggest that interventions focused on addressing stressful events and enhancing adaptive emotional responses to interpersonal events may be particularly useful for a subset of individuals with BN with BPD-related personality characteristics, including insecure attachment, affective lability, and identity problems. (PsycINFO Database Record

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

OBJECTIVE

Stress is associated with the maintenance of eating disorders and exercise behaviors. However, it is unclear how stress is associated with exercise and vice-versa among individuals with higher levels of eating disorder symptoms in daily life. The current study tested the moderating effect of eating disorder symptoms on the relationships between (1) daily stress and later exercise behavior and (2) daily exercise behavior and later stress.

METHOD

Female college students [N = 129, mean age = 19.19 (SD = 1.40)] completed the Eating Disorder Inventory-2. Participants then completed measures of stress and exercise four times daily across seven days using an automated telephone ecological momentary assessment system. Data were analyzed using multilevel models.

RESULTS

Drive for thinness, bulimic symptoms, and body dissatisfaction significantly moderated the relationship between daily stress and later exercise (ps = .01-.05), such that higher daily stress predicted higher later exercise only in individuals who were low (but not average or high) in drive for thinness, bulimic symptoms, and body dissatisfaction symptoms.

DISCUSSION

Stress is associated with exercise differentially depending on individuals' eating disorder symptoms. Our findings suggest that only individuals with lower levels of eating disorder symptoms exercise when stressed.

A Systematic Review of Electronic Mindfulness-Based Therapeutic Interventions for Weight, Weight-Related Behaviors, and Psychological Stress

INTRODUCTION

Recent research indicates that mindfulness-based interventions are effective for stress, maladaptive weight-related behaviors, and weight loss. Little is presently known about their applicability and effectiveness when delivered electronically, including through Web-based and mobile device media. The primary aims of this review were to identify what types of electronic mindfulness-based interventions have been undertaken for stress, maladaptive weight-related behaviors, and weight loss, and to assess their overall effectiveness.

METHODS

A systematic search of PubMed (MEDLINE), Embase, CINAHL, and Web of Science databases was undertaken in June 2016.

RESULTS

A total of 21 studies were identified that met inclusion criteria and were selected in the final review. Of these, 19 were mindfulness-based interventions for stress reduction. Two were Web-based mindful eating/intuitive eating interventions for weight. Only one electronic mindfulness-based study was identified that targeted both stress and maladaptive weight-related behaviors. Most electronic interventions were effective for stress reduction N = 14/19 (74%). There were insufficient electronic mindfulness-based interventions for weight to determine if they were effective or not. Additionally, no mobile mindfulness-based intervention was identified for weight or weight-related behaviors.

CONCLUSION

Electronic mindfulness-based interventions through diverse media appear to be effective for stress reduction. More studies are needed that target weight and weight-related behaviors as well as studies that target both stress and weight. More randomized controlled trials (RCTs) that assess mobile mindfulness-based apps are needed as we only identified four app trials for stress. Mobile mindfulness-based interventions for weight and weight-related behaviors are a future area of research novelty.

Socioeconomic Correlates of Eating Disorder Symptoms in an Australian Population-Based Sample

BACKGROUND

Recent research has challenged the stereotype that eating disorders are largely limited to young, White, upper-class females. This study investigated the association between indicators of socioeconomic status and eating disorder features.

METHODS AND FINDINGS

Data were merged from cross-sectional general population surveys of adults in South Australia in 2008 (n = 3034) and 2009 (n = 3007) to give a total sample of 6041 participants. Multivariate logistic regressions were employed to test associations between indicators of socioeconomic status (household income, educational level, employment status, indigenous status and urbanicity) and current eating disorder features (objective binge eating, subjective binge eating, purging, strict dieting and overvaluation of weight/shape). Eating disorder features occurred at similar rates across all levels of income, education, indigenous status, and urbanicity (p > 0.05). However, compared to working full-time, not working due to disability was associated with an increased risk of objective binge eating (odds ratio (OR) = 2.30, p < 0.01) and purging (OR = 4.13, p < 0.05), engagement in home-duties with an increased risk of overvaluation of weight/shape (OR = 1.39, p < 0.05), and unemployment with an increased risk of objective binge eating (OR = 2.02, p < 0.05) and subjective binge eating (OR = 2.80, p < 0.05). Furthermore, participants with a trade or certificate qualification were at a significantly increased risk of reporting strict dieting compared to participants without a tertiary qualification (OR = 1.58, p <0.01). Limitations included the small numbers of indigenous participants (n = 115) and participants who reported purging (n = 54), exclusion of excessive exercise (which is associated with eating disorders, particularly in males), and the conduct of interviews by laypersons.

CONCLUSIONS

Overall, symptoms of eating disorders are distributed equally across levels of socioeconomic status. This study highlights the need for universal access to specialised services, to train healthcare workers in the detection and diagnosis of eating disorders in diverse subgroups, and to combat barriers to help-seeking experienced by people who do not conform to the demographic stereotype of an eating disorder. The increased prevalence of various eating disorder features in those who are not working could be addressed by providing support to help sufferers join the workforce, or engage in meaningful social or community activities to improve resilience against the development of eating disorders.

Stress-induced eating in women with binge-eating disorder and obesity

The purpose of the current study was to investigate stress-induced eating in women with binge-eating disorder (BED) and obesity. Three groups of women [obese with BED (n=9); obese non-BED (n=11); and normal weight (NW) non-BED (n=12)], rated their levels of hunger and psychological distress before and after completing the Trier Social Stress Test, followed by food anticipation and then consumption of their preferred snack food. We differentiated between the motivational and hedonic components of eating by measuring the amount of food participants poured into a serving bowl compared to the amount consumed. Stress did not affect poured and consumed calories differently between groups. Across all subjects, calories poured and consumed were positively correlated with post-stress hunger, but calories poured was positively correlated with post-stress anxiety and negative affect. These results indicate that stress-related psychological factors may be more strongly associated with the motivational drive to eat (i.e. amount poured) rather than the hedonic aspects of eating (i.e. amount consumed) for women in general. Exploratory correlation analyses per subgroup suggest that post-stress hunger was positively associated with calories poured and consumed in both non-BED groups. In the obese BED group, calories consumed was negatively associated with dietary restraint and, although not significantly, positively associated with stress-induced changes in anxiety.These findings suggest that stress-induced snacking in obese BED women may be influenced by psychological factors more so than homeostatic hunger mechanisms. After controlling for dietary restraint and negative affect, the NW non-BED women ate a greater percentage of the food they poured than both obese groups, suggesting that obesity may be associated with a heightened motivational drive to eat coupled with a reduction in hedonic pleasure from eating post-stress. Further studies that incorporate novel approaches to measuring the motivational versus hedonic aspects of stress-induced eating may expose nuanced eating behaviors that differentiate BED and obesity. If confirmed, our findings would support prevention and treatment strategies that target subsets of women based on obesity and BED status.

Epigenetic regulation of nociceptin/orphanin FQ and corticotropin-releasing factor system genes in frustration stress-induced binge-like palatable food consumption

Evidence suggests that binge eating may be caused by a unique interaction between dieting and stress. We developed a binge-eating model in which female rats with a history of intermittent food restriction show binge-like palatable food consumption after a 15-minute exposure to the sight of the palatable food (frustration stress). The aim of the present study was to investigate the regulation of the stress neurohormone corticotropin-releasing factor (CRF) system and of the nociceptin/orphanin FQ (N/OFQ) system genes in selective rat brain regions, using our animal model. Food restriction by itself seems to be responsible in the hypothalamus for the downregulation on messenger RNA levels of CRF-1 receptor, N/OFQ and its receptor (NOP). For the latter, this alteration might be due to selective histone modification changes. Instead, CRF gene appears to be upregulated in the hypothalamus as well as in the ventral tegmental area only when rats are food restricted and exposed to frustration stress, and, of relevance, these changes appear to be due to a reduction in DNA methylation at gene promoters. Moreover, also CRF-1 receptor gene resulted to be differentially regulated in these two brain regions. Epigenetic changes may be viewed as adaptive mechanisms to environmental perturbations concurring to facilitate food consumption in adverse conditions, that is, in this study, under food restriction and stressful conditions. Our data on N/OFQ and CRF signaling provide insight on the use of this binge-eating model for the study of epigenetic modifications in controlled genetic and environmental backgrounds.

The Development of a Novel Measure to Assess Motives for Compensatory Eating in Response to Exercise: The CEMQ

Compensatory eating in response to exercise may be an obstacle to achieving weight-loss and fitness goals. In this study we develop and conduct a preliminary examination of the psychometric properties of the Compensatory Eating Motives Questionnaire (CEMQ), a self-report questionnaire of motives for compensatory eating. Development and testing of the CEMQ was conducted in two student samples. Of respondents, 75% reported engaging in compensatory eating. Factor analysis yielded factors representing three domains of motives for compensatory eating: Eating for Reward, Eating for Recovery, and Eating for Relief. Internal consistency of the factors was adequate, and the factor structure was replicated. Correlations between the CEMQ subscales and trait questionnaires supported hypotheses for convergent and divergent validity. These results encourage further investigation of compensatory eating as a potential obstacle to weight loss, and support the continued assessment of the CEMQ as a tool to measure three conceptually distinct motives for compensatory eating.

Acute Stressors Reduce Neural Inhibition to Food Cues and Increase Eating Among Binge Eating Disorder Symptomatic Women

Stressors can trigger binge-eating but researchers have yet to consider their effects on both neural responses to food cues and food consumption among those at risk. In this experiment, we examined the impact of acute stressors on neural activation to food images and subsequent food consumption within binge-eating disorder (BED) and non-eating disordered control groups. Eighteen women meeting DSM-IV BED criteria and 26 women serving as non-eating disordered controls were randomly assigned to unpleasant stressor (painful cold pressor test (CPT) followed by negative performance feedback) or less unpleasant stressor (non-painful sensory discrimination task followed by positive performance feedback) conditions. Subsequently, they were scanned with functional magnetic resonance imaging (fMRI) while viewing food and neutral images. After the scans, participants completed a self-report battery in an environment conducive to snacking. During exposure to food images, BED-symptomatic women in the unpleasant stressor condition reported more liking of high calorie food images and showed less activation in one inhibitory area, the hippocampus, compared to controls in this condition. BED-symptomatic women exposed to unpleasant stressors also consumed more chocolate than any other group during the post-scan questionnaire completion. Crucially, reduced hippocampal activation to high calorie food images predicted more chocolate consumption following fMRI scans within the entire sample. This experiment provides initial evidence suggesting unpleasant acute stressors contribute to reduced inhibitory region responsiveness in relation to external food cues and later food consumption among BED-symptomatic women.

Life Event Stress and Binge Eating Among Adolescents: The Roles of Early Maladaptive Schemas and Impulsivity

This study examined the relationships between life event stress, early maladaptive schemas, impulsivity and binge eating among adolescents and investigated the effects of early maladaptive schemas and impulsivity on the relationship between life event stress and binge eating. Specifically, we examined a moderated mediation model in which early maladaptive schemas mediated this relationship and impulsivity moderated the mediation effect. Life event stress, early maladaptive schemas, impulsivity and binge eating were investigated in a sample of 2172 seventh-, eighth- and tenth-grade middle and high school students (mean age = 14.55 years, standard deviation = 1.29). The results indicated that adolescents with greater life event stress, more early maladaptive schemas and higher levels of impulsivity displayed more severe binge eating. In addition, early maladaptive schemas mediated the relationship between life event stress and binge eating, while impulsivity moderated this relationship. Furthermore, impulsivity also moderated the mediation effect of early maladaptive schemas; as impulsivity levels increased, the strength of the association between life event stress and early maladaptive schemas increased. This study illustrates the importance of understanding individual differences and their effects on the relationship between life event stress and binge eating. Copyright © 2015 John Wiley & Sons, Ltd.

Academic burnout and eating disorder among students in Monash University Malaysia

This study examined the prevalence of academic burnout and the relationship between academic burnout and eating disorder among Monash university students for a period of one year. One hundred and thirty-two participants were recruited for the study via advertisement. They were invited to complete three instruments, namely Demographic Questionnaire, Maslach Burnout Inventory - Student Survey (MBI-SS) and Three Factor Eating Questionnaire-Revised 18-item (TFEQ-18). In addition, anthropometric measurements such as weight, height, body mass index (BMI), body fat percentage and waist circumference were taken. All data were collected at baseline and after 6-8weeks. Analysis of Variance (ANOVA), Kruskal-Wallis and Bonferroni pairwise comparison tests were performed using Stata version 13. The prevalence of academic burnout after 6-8weeks was revealed to be 17.4% and 73.5% respectively for moderate and high level of academic burnout respectively. Emotional eating (EEat) scores were significantly different over levels of academic burnout after 6-8weeks (p=0.0103) while no significant differences was observed in other subscales such as cognitive restraint (CR) and uncontrolled eating (UE). These findings evidenced partial associations between academic burnout and eating disorder.

Associations of neuroticism-impulsivity and coping with binge eating in a nationally representative sample of adolescents in the United States

OBJECTIVE

Binge eating behavior is a public health concern due to its negative physical and mental health consequences. Little is known about the interplay of personality traits, coping styles, and binge eating in the general adolescent population. We examined the associations among the combination of neuroticism and impulsivity (NI), maladaptive coping styles (poor problem solving, distraction, and escape-avoidance), and lifetime prevalence of binge eating in a nationally representative sample of U.S. adolescents. We also explored coping as a moderator of the NI-lifetime binge eating association and gender as a moderator of the NI-coping associations and coping-lifetime binge eating associations.

METHODS

We used data from the National Comorbidity Survey: Adolescent Supplement (NCS-A: 2001-2004), a cross-sectional nationally representative study of adolescents aged 13 to 18years (n=10,028). We studied the associations of NI and coping with lifetime binge eating using multivariate regression models.

RESULTS

High NI was significantly associated with all three coping styles, especially escape-avoidance (β=3.96, confidence interval [CI]=3.62, 4.29, p<0.001). Gender was a significant moderator of the NI-distraction coping association (β=-0.68, CI=-1.33, -0.03, p=0.041), indicating a stronger association in males (β=1.20, CI=0.81, 1.58, p<0.001) than females (β=0.53, CI=0.02, 1.03, p=0.042). Lifetime prevalence of binge eating was 1.13 times higher with increased escape-avoidance coping (CI=1.10, 1.18, p<0.001).

DISCUSSION

Our findings indicate significant associations among high NI, increased escape-avoidance coping, and higher lifetime prevalence of binge eating in adolescents. Findings of our study have potential to inform development of interventions that target modification of maladaptive personality traits and coping styles to reduce problematic eating.

Negative affect, interpersonal perception, and binge eating behavior: An experience sampling study

OBJECTIVE

Etiological and maintenance models for disordered eating highlight the salience of negative affect and interpersonal dysfunction. This study employed a 14-day experience sampling procedure to assess the impact of negative affect and interpersonal perceptions on binge eating behavior.

METHOD

Young adult women (N = 40) with recurrent binge eating and significant clinical impairment recorded their mood, interpersonal behavior, and eating behaviors at six stratified semirandom intervals daily through the use of personal digital assistants.

RESULTS

Although momentary negative affect was associated with binge eating behavior, average levels of negative affect over the experience sampling period were not, and interpersonal problems moderated the relationship between negative affect and binge eating. Interpersonal problems also intensified the association between momentary interpersonal perceptions and binge eating behavior. Lagged analyses indicated that previous levels of negative affect and interpersonal style also influence binge eating.

DISCUSSION

The study findings suggest there may be important differences in how dispositional versus momentary experiences of negative affect are associated with binge eating. Results also highlight the importance of interpersonal problems for understanding relationships among negative affect, interpersonal perception, and binge eating behavior. These results offer several possibilities for attending to affective and interpersonal functioning in clinical practice.

Examining the Relationship between Binge Eating and Coping Strategies and the Definition of Binge Eating in a Sample of Spanish Adolescents

The present study had two major goals: to explore the relationship between binge eating and coping strategies in a sample of Spanish adolescents and to examine the adolescents' concept of binge eating. Two hundred and fifty-nine adolescents from a secondary school completed the Adolescent Coping Scale (ACS; Frydenberg & Lewis, 1993) and the Bulimic Investigatory Test, Edinburgh (BITE; Henderson & Freeman, 1987), as well as additional questions regarding the binge-eating episodes. The results show that the adolescents who reported binge eating used more avoidance coping strategies than those who did not engage in this behavior. Adolescents took into account mainly the amount of food eaten when defining a binge with few of them mentioning loss of control in their descriptions. The results of the study have implications for the prevention of this behavior. The development of constructive ways for solving daily problems and coping with stressors may be a possible prevention strategy for this behaviour in adolescence.

Exploring relationships over time between psychological distress, perceived stress, life events and immature defense style on disordered eating pathology

Background

Perceived stress, immature defense style, depression and anxiety and negative life events all are known to be associated with eating disorders. The present study aimed to investigate the relationships between these factors and their relative strength of association with eating disorder symptoms over time.

Methods

This research was embedded in a longitudinal study of adult women with varying levels of eating disorder symptoms and who were initially recruited from tertiary educational institutions in two Australian states. Four years from initial recruitment, 371 participants completed the Eating Disorder Examination- Questionnaire (EDE-Q) for eating disorder symptoms.

Kessler-10 Psychological Distress Scale (K-10) as a measure of depression and anxiety, a Life Events Checklist as a measure of previous exposure to potentially traumatic events, the Defense Style Questionnaire (DSQ) and the Perceived Stress Scale (PSS) to determine perceived stress. One year later, in year 5, 295 (878.7%) completed follow-up assessments including the EDE-Q. The questionnaires were completed online or returned via reply paid post.

Results

All four independent factors were found to correlate significantly with the global EDE-Q score in cross-sectional analyses (all Spearman rho (r_s) >0.18, p < 0.01) and at one year follow-up (all r_s > 0.15, all p < 0.05). In multivariate linear regression modeling adjusted for age and year 4 global EDE-Q scores, perceived stress and psychological distress scores were significantly associated with year 5 global EDE-Q scores (p = 0.046 and <0.001 respectively).

Conclusions

Psychological distress, and to a lesser degree perceived stress had the strongest association with eating disorder symptoms over time The findings support further investigation of interventions to reduce distress and perceived stress in adult females with disordered eating.

Ecological momentary assessment of stressful events and negative affect in bulimia nervosa

OBJECTIVE

Negative affect precedes binge eating and purging in bulimia nervosa (BN), but little is known about factors that precipitate negative affect in relation to these behaviors. We aimed to assess the temporal relation among stressful events, negative affect, and bulimic events in the natural environment using ecological momentary assessment.

METHOD

A total of 133 women with current BN recorded their mood, eating behavior, and the occurrence of stressful events every day for 2 weeks. Multilevel structural equation mediation models evaluated the relations among Time 1 stress measures (i.e., interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal), Time 2 negative affect, and Time 2 binge eating and purging, controlling for Time 1 negative affect.

RESULTS

Increases in negative affect from Time 1 to Time 2 significantly mediated the relations between Time 1 interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal and Time 2 binge eating and purging. When modeled simultaneously, confidence intervals for interpersonal stressors, general daily hassles, and stress appraisal did not overlap, suggesting that each had a distinct impact on negative affect in relation to binge eating and purging.

CONCLUSIONS

Our findings indicate that stress precedes the occurrence of bulimic behaviors and that increases in negative affect following stressful events mediate this relation. Results suggest that stress and subsequent negative affect may function as maintenance factors for bulimic behaviors and should be targeted in treatment.

Depression, stress and body fat are associated with binge eating in a community sample of African American and Hispanic women

OBJECTIVE

The purpose of this study was to examine the relationships among depressive symptoms, stress and severity of binge eating symptoms in a community sample of African American and Hispanic or Latina women.

METHOD

Women (African American, n = 127; Hispanic or Latina, n = 44) completed measures of body composition, stress, depression, and binge eating.

RESULTS

Scores on a depressive symptom scale indicated that 24.0 % of participants exhibited clinically significant levels of depressive symptoms. Mean binge eating scores were below the threshold for clinically diagnosed binge eating (12.99 ± 7.90). Mean stressful event scores were 25.86 ± 14.26 and the average stress impact score was 78.36 ± 55.43. Linear regression models found that body composition, stress impact score, and being classified as having clinically significant levels of depression were associated with severity of binge eating symptoms.

CONCLUSION

Higher levels of percent body fat, a CES-D score ≥16 and higher WSI-Impact scores were associated with greater severity of binge eating symptoms.

Sleep disturbances and binge eating disorder symptoms during and after pregnancy

STUDY OBJECTIVE

We compared sleep problems during pregnancy and sleep dissatisfaction 18 months after pregnancy in pregnant women with binge eating disorder (BED) symptoms and pregnant women without an eating disorder.

DESIGN

Norwegian Mother and Child Cohort Study (MoBa).

PATIENTS OR PARTICIPANTS

Data were gathered from 72,435 women. A total of 1,495 (2.1%) women reported having BED symptoms both before and during pregnancy; 921 (1.3%) reported pre-pregnancy BED symptoms that remitted during pregnancy; 1,235 (1.7%) reported incident BED symptoms during pregnancy; and 68,784 (95.0%) reported no eating disorder symptoms before or during pregnancy (referent).

MEASUREMENTS AND RESULTS

Questionnaires were collected at 3 time points, with a median completion time of 17.1 weeks gestation, 30.1 weeks gestation, and 18.7 months after childbirth. We collected information on demographics, eating disorder status before and during pregnancy, sleep problems during the first 18 weeks of pregnancy, hours of sleep during the third trimester, and sleep satisfaction 18 months after childbirth. All BED symptom groups were significantly more likely to report sleep problems during the first 18 weeks of pregnancy than the referent (adjusted odds ratio [OR] = 1.26-1.42, false discovery rate [FDR] P < 0.05). In the third trimester, women with incident BED symptoms during pregnancy were more likely to report more hours of sleep than the referent (adjusted OR = 1.49, FDR P < 0.01). All BED symptom groups had higher odds of reporting more dissatisfaction with sleep 18 months after childbirth (adjusted ORs = 1.28-1.47, FDR P < 0.01).

CONCLUSIONS

BED before or during pregnancy is associated with sleeping problems during pregnancy and dissatisfaction with sleep 18 months after childbirth. Health care professionals should inquire about BED during pregnancy as it may be associated with sleep disturbances, in addition to the hallmark eating concerns.

Role of orexin-1 receptor mechanisms on compulsive food consumption in a model of binge eating in female rats

Orexins (OX) and their receptors (OXR) modulate feeding, arousal, stress, and drug abuse. Neural systems that motivate and reinforce drug abuse may also underlie compulsive food seeking and intake. Therefore, the effects of GSK1059865 (5-bromo-N-[(2S,5S)-1-(3-fluoro-2-methoxybenzoyl)-5-methylpiperidin-2-yl]methyl-pyridin-2-amine), a selective OX(1)R antagonist, JNJ-10397049 (N-(2,4-dibromophenyl)-N'-[(4S,5S)-2,2-dimethyl-4-phenyl-1,3-dioxan-5-yl]urea), a selective OX(2)R antagonist, and SB-649868 (N-[((2S)-1-{[5-(4-fluorophenyl)-2-methyl-1,3-thiazol-4-yl]carbonyl}-2-piperidinyl)methyl]-1-benzofuran-4-carboxamide), a dual OX(1)/OX(2)R antagonist were evaluated in a binge eating (BE) model in female rats. BE of highly palatable food (HPF) was evoked by three cycles of food restriction followed by stress, elicited by exposing rats to HPF, but preventing them from having access to it for 15 min. Pharmacokinetic assessments of all compounds were obtained under the same experimental conditions used for the behavioral experiments. Topiramate was used as the reference compound as it selectively blocks BE in rats and humans. Dose-related thresholds for sleep-inducing effects of the OXR antagonists were measured using polysomnography in parallel experiments. SB-649868 and GSK1059865, but not JNJ-10397049, selectively reduced BE for HPF without affecting standard food pellet intake, at doses that did not induce sleep. These results indicate, for the first time, a major role of OX(1)R mechanisms in BE, suggesting that selective antagonism at OX(1)R could represent a novel pharmacological treatment for BE and possibly other eating disorders with a compulsive component.

Sleep problems are associated with binge eating in women

OBJECTIVE

We examined the association among current self-reported sleep problems, lifetime binge eating (BE), and current obesity in women from the Swedish Twin study of Adults: Genes and Environment.

METHOD

Logistic regression analyses were used to evaluate these associations in 3,790 women aged 20-47 years.

RESULTS

BE was reported by 244 (6.4%) women and was positively associated with not getting enough sleep (p < .015), sleeping poorly (p < .001), problems falling asleep (p < .001), feeling sleepy during work or free time (p < .001), and disturbed sleep (p < .001). These same sleep variables, as well as napping and being a night person, were also significantly associated with obesity. The associations between BE and sleep remained after accounting for obesity.

DISCUSSION

This investigation offers empirical support for an independent association between sleep problems and BE, which is likely due to complex psychological, biological, neuroendocrine, and metabolic factors.

The relationships between fat talk, body dissatisfaction, and drive for thinness: perceived stress as a moderator

Although body dissatisfaction and drive for thinness are commonplace in college-aged women, their relationships with fat talk and stress are understudied. This study examined (a) whether fat talk predicts body dissatisfaction and drive for thinness and (b) whether stress moderates these relationships. Results from self-report questionnaires completed by 121 female college students revealed that fat talk and perceived stress were significantly positively correlated with body dissatisfaction and drive for thinness. Although fat talk was a significant independent predictor of body dissatisfaction and drive for thinness, stress moderated these relationships such that they were stronger at lower stress levels. Although contrary to predictions, these results are logical when means are considered. Results suggest that fat talk positively predicts body dissatisfaction and drive for thinness in students with relatively lower stress levels, but does not for students under high stress because mean levels of these constructs are all already high.

Prevalence of stress references on college freshmen Facebook profiles

Stress is common among college students and associated with adverse health outcomes. This study used the social networking Web site Facebook to identify self-reported stress and associated conditions among college students. Public Facebook profiles of undergraduate freshman at a large Midwestern State University (n = 300) were identified using a Facebook search. Content analysis of Facebook profiles included demographic information and displayed references to stress, weight concerns, depressive symptoms, and alcohol. The mean reported age was 18.4 years, and the majority of profile owners were female (62%). Stress references were displayed on 37% of the profiles, weight concerns on 6%, depressive symptoms on 24%, and alcohol on 73%. The display of stress references was associated with female sex (odds ratio [OR], 2.81; confidence interval [CI], 1.7-4.7), weight concerns (OR, 5.36; CI, 1.87-15.34), and depressive symptoms (OR, 2.7; CI, 1.57-4.63). No associations were found between stress and alcohol references. College freshmen frequently display references to stress on Facebook profiles with prevalence rates similar to self-reported national survey data. Findings suggest a positive association between referencing stress and both weight concerns and depressive symptoms. Facebook may be a useful venue to identify students at risk for stress-related conditions and to disseminate information about campus resources to these students.

Effect of Hypericum perforatum Extract in an Experimental Model of Binge Eating in Female Rats

Purpose. The present study evaluated the effect of Hypericum perforatum dry extract in an experimental model of binge eating (BE). Methods. BE for highly palatable food (HPF) was evoked in female rats by three 8-day cycles of food restriction/re-feeding and acute stress on the test day (day 25). Stress was induced by preventing access to HPF for 15 min, while rats were able to see and smell it. Hypericum perforatum dry extract was given by gavage. Results. Only rats exposed to both food restrictions and stress exhibited BE. The doses of 250 and 500 mg/kg of Hypericum perforatum extract significantly reduced the BE episode, while 125 mg/kg was ineffective. The same doses did not affect HPF intake in the absence of BE. The dose of 250 mg/kg did not significantly modify stress-induced increase in serum corticosterone levels, suggesting that the effect on BE is not due to suppression of the stress response The combined administration of 125 mg/kg of Hypericum perforatum together with Salidroside, active principle of Rhodiola rosea, produced a synergic effect on BE. Conclusions. The present results indicate for the first time that Hypericum perforatum extracts may have therapeutic properties in bingeing-related eating disorders.

Comparison of physical and psychological status in younger and older overweight-obese women

BACKGROUND AND AIM

Obesity prevalence is noticeably growing, even in the elderly. Most of the studies concerning the impact of obesity in the elderly evaluated physical co-morbidities, whilst very few data are available on psychological co-morbidities in people ≥ 60 years of age. The present study aimed to compare anthropometrical measures, physical co-morbidities and psychosocial factors correlated with overweight and obesity in younger and elderly people.

METHODS AND RESULTS

In 456 women in the age range of 18-59 years and 128 women in the age range of 60-80 years with body mass index (BMI) ≥ 25/kg m², body weight, height and waist and hip circumferences were measured. The presence of co-morbidities such as osteoarthritis, hypertension, type 2 diabetes and hypercholesterolaemia was assessed. The Obesity Related Well Being 97 Questionnaire (ORWELL 97), Body Uneasiness Test (BUT), Symptom Check List 90 (SCL 90) and Binge Eating Scale (BES) tests were used to evaluate psychometric variables. BMI was not significantly different between younger overweight-obese subjects and older overweight-obese subjects, whereas waist circumference and waist-to-hip ratio (WHR) were significantly higher in the elderly. Osteoarthritis, hypertension and hypercholesterolaemia were significantly more frequent in the elderly. Older overweight-obese subjects had better scores in most of the psychometric questionnaires.

CONCLUSIONS

Our results show that older overweight-obese subjects have generally more physical co-morbidities but a better psychological status than younger adults, despite similar BMI. These data may contribute to a better understanding of obesity consequences in the elderly and may help clinicians to differentiate obesity treatments in relation to patients' age.

The 'freshman 15': trends and predictors in a sample of multiethnic men and women

This study focused on predictors of the 'freshman 15' phenomenon among university students. Participants (N=390) included men and women who identified as African American (32%), Latino American (27%), and European American (41%). Students gained on average 3.2 lbs and 0.5 in BMI from their first through third semesters. Changes in weight and BMI did not differ by gender or racial/ethnic group. Students with lower Scholastic Aptitude Test (SAT) scores were more likely to experience the 'freshman 15'. Results suggest that universities should work with students who may be underprepared for college in order to minimize weight gain.

Revisiting the affect regulation model of binge eating: a meta-analysis of studies using ecological momentary assessment

The affect regulation model of binge eating, which posits that patients binge eat to reduce negative affect (NA), has received support from cross-sectional and laboratory-based studies. Ecological momentary assessment (EMA) involves momentary ratings and repeated assessments over time and is ideally suited to identify temporal antecedents and consequences of binge eating. This meta-analytic review includes EMA studies of affect and binge eating. Electronic database and manual searches produced 36 EMA studies with N = 968 participants (89% Caucasian women). Meta-analyses examined changes in affect before and after binge eating using within-subjects standardized mean gain effect sizes (ESs). Results supported greater NA preceding binge eating relative to average affect (ES = 0.63) and affect before regular eating (ES = 0.68). However, NA increased further following binge episodes (ES = 0.50). Preliminary findings suggested that NA decreased following purging in bulimia nervosa (ES = -0.46). Moderators included diagnosis (with significantly greater elevations of NA prior to bingeing in binge eating disorder compared to bulimia nervosa) and binge definition (with significantly smaller elevations of NA before binge vs. regular eating episodes for the Diagnostic and Statistical Manual of Mental Disorders definition compared to lay definitions of binge eating). Overall, results fail to support the affect regulation model of binge eating and challenge reductions in NA as a maintenance factor for binge eating. However, limitations of this literature include unidimensional analyses of NA and inadequate examination of affect during binge eating, as binge eating may regulate only specific facets of affect or may reduce NA only during the episode.

Mood-as-input hypothesis and perseverative psychopathologies

Mood-as-input hypothesis is a theory of task perseveration that has been applied to the understanding of perseveration across psychopathologies such as pathological worrying, compulsive checking, depressive rumination, and chronic pain. We review 10 years of published evidence from laboratory-based analogue studies and describe their relevance for perseveration in clinical populations. In particular, mood-as-input hypothesis predicts that perseveration at a task will be influenced by interactions between the individual's stop rules for the task and their concurrent mood, and that the valency of an individual's concurrent mood is used as information about whether the stop rule-defined goals for the task have been met. The majority of the published research is consistent with this hypothesis, and we provide evidence that clinical populations possess characteristics that would facilitate perseveration through mood-as-input processes. We argue that mood-as-input research on clinical populations is long overdue because (1) it has potential as a transdiagnostic mechanism helping to explain the development of perseveration and its comorbidity across a range of different psychopathologies, (2) it is potentially applicable to any psychopathology where perseveration is a defining feature of the symptoms, and (3) it has treatment implications for dealing with clinical perseveration.