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Binge eating and alcohol consumption: an integrative review. Eat Weight Disord 2021; 26:759-769. [PMID: 32424561 DOI: 10.1007/s40519-020-00923-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 05/06/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To identify the relationship between binge eating and alcohol consumption. METHODS This is an integrative literature review of publications from 2015 to 2019, using the Pubmed, Cinhahl, Psynet, Lilacs, Embase and Web of Science virtual databases and the descriptors ("Binge-Eating" OR "Bulimia") AND Alcohol* in English, Spanish and Portuguese. RESULTS A total of 964 articles were found. After reading the titles and abstracts and excluding duplicates, 36 articles were included in the final sample (35 in English and one in Portuguese). They were grouped into three thematic categories: "sample profile and characterization", "genetic and environmental factors", and "emotions and behavior". CONCLUSIONS The data indicate the existence of a relationship between binge eating and alcohol use, and some factors were associated with this comorbidity. Still, there were few publications on the theme at the national level, indicating the need for developing more research. These findings may support therapeutic actions and strategies for identification of cases, embracing approaches and more effective treatments to meet the individual's biopsychosocial demands. LEVEL OF EVIDENCE Level V, narrative review.
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de Souza ALG, de Almeida AA, Noll PRES, Noll M. Unhealthy life habits associated with self-induced vomiting and laxative misuse in Brazilian adolescents. Sci Rep 2021; 11:2482. [PMID: 33510267 PMCID: PMC7843628 DOI: 10.1038/s41598-021-81942-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 01/04/2021] [Indexed: 02/07/2023] Open
Abstract
Adolescence is a stage in life characterized by important social, cognitive, and physical changes. Adolescents are vulnerable to various psychosocial disorders, including eating disorders. We aimed to investigate the association between unhealthy habits, sociodemographic characteristics, and the practice of self-induced vomiting or laxative misuse in a representative sample of Brazilian adolescent girls and boys. Data from 102,072 students who participated in the National Adolescent School-based Health Survey were analyzed using the dependent variable: presence or absence of self-induced vomiting and/or laxative misuse; independent variables: consumption of unhealthy and high-calorie food items, age during first sexual intercourse, and the use of tobacco, alcohol, and/or illicit drugs. Associations between exposure and outcome were estimated using Poisson's regression models stratified by sex, and including region, school, age group, and mother's educational history as adjustment variables. Eating ultra-processed foods and age during first sexual intercourse were associated with self-induced vomiting and laxative misuse only for girls; all other variables (consuming unhealthy foods and using legal or illicit substances) were associated with these behaviors for both sexes after applying adjustment variables. Early interventions focusing on changing unhealthy behaviors may prevent development of eating disorders in adolescents. Our findings demonstrate a strong association of many unhealthy habits with laxative misuse and self-induced vomiting practices in Brazilian adolescents.
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Affiliation(s)
| | | | - Priscilla Rayanne E Silva Noll
- Instituto Federal de Educação, Ciência e Tecnologia Goiano, Campus Ceres, Ceres, GO, Brazil
- Department of Obstetrics and Gynecology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Matias Noll
- Instituto Federal de Educação, Ciência e Tecnologia Goiano, Campus Ceres, Ceres, GO, Brazil.
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Van Alsten SC, Duncan AE. Lifetime patterns of comorbidity in eating disorders: An approach using sequence analysis. EUROPEAN EATING DISORDERS REVIEW 2020; 28:709-723. [PMID: 32748537 DOI: 10.1002/erv.2767] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/05/2020] [Accepted: 06/29/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Eating disorders (EDs) have high rates of psychiatric comorbidity. This study aimed to characterize longitudinal patterns of comorbidities in adults with EDs. METHODS Sequence analysis and hierarchical clustering were applied to ages of onset and recency for select eating, substance, mood, and anxiety disorders from the 479 participants in the Collaborative Psychiatric Epidemiology Surveys with lifetime DSM-IV bulimia nervosa, binge eating disorder, or anorexia nervosa. External validators were compared across clusters using chi-square tests. RESULTS Five clusters were identified among individuals with any lifetime ED based on longitudinal sequence of psychiatric disorder onset and remission, characterized as: (1) multi-comorbid with early onset of comorbid disorder (46%); (2) moderate preeminent anxiety with moderate comorbidity and low ED persistence (20%); (3) late ED onset with low comorbidity (15%); (4) early onset, persistent ED with low comorbidity (14%); and (5) chronic, early onset depression (5%). Clusters were well differentiated by significant differences in age, body mass index, race, and psychiatric indicators. CONCLUSIONS This study demonstrates a new method to assess clustering of comorbidity among individuals with lifetime EDs. Having a psychiatric diagnosis prior to an ED was associated with greater psychopathology and illness duration. Information on timing of diagnoses may allow for more refined comorbidity classification.
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Affiliation(s)
- Sarah C Van Alsten
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Alexis E Duncan
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
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Kirkpatrick R, Booij L, Vance A, Marshall B, Kanellos-Sutton M, Marchand P, Khalid-Khan S. Eating disorders and substance use in adolescents: How substance users differ from nonsubstance users in an outpatient eating disorders treatment clinic. Int J Eat Disord 2019; 52:175-182. [PMID: 30638270 DOI: 10.1002/eat.23017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/16/2018] [Accepted: 12/20/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The relationship between eating disorders (EDs) and substance use (SU) has only been briefly described in literature using mainly adult populations. This study examined the prevalence and characteristics of SU among patients of an adolescent ED outpatient treatment program. METHOD A retrospective chart analysis was conducted to determine and subsequently compare medical status, psychosocial factors, treatment course and outcome between patients with and without SU. RESULTS Over 60% of patients with SU status (n = 203) reported regularly consuming substances. 33.4% of substance users received a diagnosis involving purging behaviors compared to 5.9% of nonusers. Females composed 96.4% and 81.7% of users and nonusers, respectively. Users reported significantly more self-harm (57.7% of users vs. 38.6% of nonusers) but did not differ significantly in terms of trauma (abuse or victimization; 48.3% of users vs. 44.9% of nonusers). The percentage of ideal body weight significantly improved throughout treatment and did not differ by SU with a mean increase of 5.29% (SD = 13.6) among nonusers compared to 5.45% (SD = 7.5) of users. While users and nonusers did not differ before and after treatment in ED severity, users were more likely than nonusers to drop-out of treatment (41.5% of users vs. 25.2% of nonusers). DISCUSSION Adolescents with SU benefit from ED outpatient treatment as much as those without SU, however, users are more likely to drop-out. Therefore, treatment should target these adolescents' emotional dysregulation to improve treatment compliance. Further research is necessary to determine the efficacy of such an approach.
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Affiliation(s)
- Ryan Kirkpatrick
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.,Centre for Neuroscience Studies, Queen's University, Botterell Hall, Kingston, Ontario, Canada
| | - Linda Booij
- Department of Psychology, Queen's University, Kingston, Ontario, Canada.,Department of Psychology, Concordia University, Montréal, Québec, Canada.,Sainte-Justine Hospital Research Centre, University of Montréal, Montréal, Québec, Canada
| | - Ashleigh Vance
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada
| | - Brittany Marshall
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada
| | - Marina Kanellos-Sutton
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Patricia Marchand
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Sarosh Khalid-Khan
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.,Centre for Neuroscience Studies, Queen's University, Botterell Hall, Kingston, Ontario, Canada.,Department of Psychology, Queen's University, Kingston, Ontario, Canada
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Flores-Fresco MJ, Blanco-Gandía MDC, Rodríguez-Arias M. Alteraciones de la Conducta Alimentaria en Pacientes con Trastorno por Abuso de Sustancias. CLINICA Y SALUD 2018. [DOI: 10.5093/clysa2018a18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Baker JH, Brosof LC, Munn-Chernoff MA, Lichtenstein P, Larsson H, Maes HH, Kendler KS. Associations Between Alcohol Involvement and Drive for Thinness and Body Dissatisfaction in Adolescent Twins: A Bivariate Twin Study. Alcohol Clin Exp Res 2018; 42:2214-2223. [PMID: 30252141 DOI: 10.1111/acer.13868] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/07/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Alcohol involvement has familial associations with bulimic symptoms (i.e., binge eating, inappropriate compensatory behaviors), with several studies indicating a genetic overlap between the two. It is unclear whether overlapping familial risk with alcohol involvement extends to other eating disorder symptoms. Understanding the genetic overlap between alcohol involvement and other eating disorder symptoms may aid in more targeted interventions for comorbid alcohol use-eating disorder symptoms. Thus, we investigated associations between alcohol involvement and 2 core eating disorder symptoms: drive for thinness and body dissatisfaction in adolescent female and male twins. METHODS We assessed 3 levels of alcohol involvement: alcohol use in the last month, having ever been intoxicated, and alcohol intoxication frequency via self-report. The Eating Disorder Inventory-II assessed drive for thinness and body dissatisfaction. Sex-specific biometrical twin modeling examined the genetic overlap between alcohol involvement and eating disorder symptoms. RESULTS Phenotypic associations between alcohol involvement, drive for thinness, and body dissatisfaction were significantly greater in girls compared with boys. A majority of the associations between alcohol involvement, drive for thinness, and body dissatisfaction in girls, but not boys, met our threshold for twin modeling (phenotypic r > 0.20). Moderate genetic correlations were observed between the 3 aspects of alcohol involvement and drive for thinness. Moderate genetic correlations were observed between alcohol use and intoxication frequency and body dissatisfaction. CONCLUSIONS Together with the literature on alcohol involvement and bulimic symptoms, these findings suggest a generalized association between alcohol involvement and eating disorder symptoms in girls, whereas this association may be symptom specific in boys. Genetic correlations indicate that the amount and direction of this genetic overlap differs across specific symptoms. When intervening on comorbid alcohol involvement and eating disorder symptoms, it may be important to target-specific eating disorder symptoms.
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Affiliation(s)
- Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Leigh C Brosof
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky
| | - Melissa A Munn-Chernoff
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Medical Science, Örebro University, Örebro, Sweden
| | - Hermine H Maes
- Department of Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
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Cuesto G, Everaerts C, León LG, Acebes A. Molecular bases of anorexia nervosa, bulimia nervosa and binge eating disorder: shedding light on the darkness. J Neurogenet 2017; 31:266-287. [PMID: 28762842 DOI: 10.1080/01677063.2017.1353092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Eating-disorders (EDs) consequences to human health are devastating, involving social, mental, emotional, physical and life-threatening aspects, concluding on impairment and death in cases of extreme anorexia nervosa. It also implies that people suffering an ED need to find psychiatric and psychological help as soon as possible to achieve a fully physical and emotional recovery. Unfortunately, to date, there is a crucial lack of efficient clinical treatment to these disorders. In this review, we present an overview concerning the actual pharmacological and psychological treatments, the knowledge of cells, circuits, neuropeptides, neuromodulators and hormones in the human brain- and other organs- underlying these disorders, the studies in animal models and, finally, the genetic approaches devoted to face this challenge. We will also discuss the need for new perspectives, avenues and strategies to be developed in order to pave the way to novel and more efficient therapeutics.
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Affiliation(s)
- Germán Cuesto
- a Centre for Biomedical Research of the Canary Islands , Institute of Biomedical Technologies, University of La Laguna , Tenerife , Spain
| | - Claude Everaerts
- b Centre des Sciences du Goût et de l'Alimentation , UMR 6265 CNRS, UMR 1324 INRA, Université de Bourgogne Franche-Comté , Dijon , France
| | - Leticia G León
- c Cancer Pharmacology Lab , AIRC Start Up Unit, University of Pisa , Pisa , Italy
| | - Angel Acebes
- a Centre for Biomedical Research of the Canary Islands , Institute of Biomedical Technologies, University of La Laguna , Tenerife , Spain
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Abstract
PURPOSE OF REVIEW We capture recent findings in the field of genetic epidemiology of eating disorders. As analytic techniques evolve for twin, population, and molecular genetic studies, new findings emerge at an accelerated pace. We present the current status of knowledge regarding the role of genetic and environmental factors that influence risk for eating disorders. RECENT FINDINGS We focus on novel findings from twin studies, population studies using genetically informative designs, and molecular genetic studies. Over the past 2 years, research in this area has yielded insights into: comorbidity with other psychiatric and medical disorders and with metabolic traits; developmental factors associated with the emergence of eating disorders; and the molecular genetics of anorexia nervosa. SUMMARY Insights from genetic epidemiology provide an important explanatory model for patients with eating disorders, family members, and clinicians. Understanding core biological determinants that explain the severity and persistence of the illnesses, their frequent co-occurrence with other conditions, and their familial patterns raises awareness and increases compassion for individuals living with these disorders. Large-scale genomic studies are currently underway. Ultimately, this domain of research may pave the way to greater understanding of the underlying neurobiology and inform the development of novel and effective interventions.
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Mustelin L, Latvala A, Raevuori A, Rose RJ, Kaprio J, Keski-Rahkonen A. Risky drinking behaviors among women with eating disorders-A longitudinal community-based study. Int J Eat Disord 2016; 49:563-71. [PMID: 27038220 DOI: 10.1002/eat.22526] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/06/2016] [Accepted: 02/07/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Eating disorders and alcohol use disorders often co-occur, but few prospective studies have examined their relationship. Using a large population-based twin sample, we investigated how the drinking behaviors of women with lifetime eating disorders unfold from adolescence to adulthood. METHOD We identified 182 women with a lifetime eating disorder assessed at mean age 24, including 92 women with DSM-5 anorexia nervosa and 58 women with DSM-5 bulimia nervosa, from the 1975-1979 birth cohorts of Finnish twins (N = 2,825 women). Frequency of drinking and intoxicating were assessed at ages 16, 24, and 34. Drinking problems were assessed at ages 24 and 34 by the Malmö-modified Michigan Alcohol Screening Test (Mm-Mast) and the Rutgers Alcohol Problem Index (RAPI). RESULTS At age 16, proportionately more women with eating disorders reported being severely intoxicated when they last drank (25% vs.16%, P = 0.001), and at both surveys in adulthood, they reported more frequent intoxication and more alcohol-related problems than their unaffected peers. Those who had recovered from their eating disorder at age 24 still reported more alcohol-related problems in their 30s than did other women. The age of drinking onset, number of monthly drinking days, or frequency of intoxication in adolescence did not differ between women with lifetime eating disorders and unaffected women. DISCUSSION Women with eating disorders scored higher than their unaffected peers on scales measuring alcohol dependence, alcohol-related problems, and intoxication. These differences persisted from mid-adolescence into young adulthood. Women with eating disorders should be assessed routinely for drinking behaviors. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:563-571).
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Affiliation(s)
- Linda Mustelin
- Department of Public Health, University of Helsinki, Finland.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Antti Latvala
- Department of Public Health, University of Helsinki, Finland
| | - Anu Raevuori
- Department of Public Health, University of Helsinki, Finland.,Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.,Institute of Clinical Medicine, Child Psychiatry, University of Turku, Finland.,National Institute for Health and Welfare, Helsinki, Finland
| | - Richard J Rose
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, Indiana
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Finland.,Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland.,National Institute for Health and Welfare, Helsinki, Finland
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Munn-Chernoff MA, Baker JH. A Primer on the Genetics of Comorbid Eating Disorders and Substance Use Disorders. EUROPEAN EATING DISORDERS REVIEW 2015; 24:91-100. [PMID: 26663753 DOI: 10.1002/erv.2424] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 11/12/2015] [Accepted: 11/13/2015] [Indexed: 01/05/2023]
Abstract
Eating disorders (EDs) and substance use disorders (SUDs) frequently co-occur; however, the reasons for this are unclear. We review the current literature on genetic risk for EDs and SUDs, as well as preliminary findings exploring whether these classes of disorders have overlapping genetic risk. Overall, genetic factors contribute to individual differences in liability to multiple EDs and SUDs. Although initial family studies concluded that no shared familial (which includes genetic) risk between EDs and SUDs exists, twin studies suggest a moderate proportion of shared variance is attributable to overlapping genetic factors, particularly for those EDs characterized by binge eating and/or inappropriate compensatory behaviours. No adoption or molecular genetic studies have examined shared genetic risk between these classes of disorders. Research investigating binge eating and inappropriate compensatory behaviours using emerging statistical genetic methods, as well as examining gene-environment interplay, will provide important clues into the aetiology of comorbid EDs and SUDs.
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Affiliation(s)
| | - Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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