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Boutelle KN, Afari N, Obayashi S, Eichen DM, Strong DR, Peterson CB. Design of the CHARGE study: A randomized control trial evaluating a novel treatment for Veterans with binge eating disorder and overweight and obesity. Contemp Clin Trials 2023; 130:107234. [PMID: 37210072 PMCID: PMC10409628 DOI: 10.1016/j.cct.2023.107234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/14/2023] [Accepted: 05/16/2023] [Indexed: 05/22/2023]
Abstract
A large number of Veterans experience binge eating and overweight or obesity, which are associated with significant health and psychological consequences. The gold-standard program for the treatment of binge eating, Cognitive Behavioral Therapy (CBT), results in decreases in binge eating frequency but does not result in significant weight loss. We developed the Regulation of Cues (ROC) program to reduce overeating and binge eating through improvement in sensitivity to appetitive cues and decreased responsivity to external cues, an approach that has never been tested among Veterans. In this study, we combined ROC with energy restriction recommendations from behavioral weight loss (ROC+). This study is a 2-arm randomized controlled trial designed to evaluate the feasibility and acceptability of ROC+, and to compare the efficacy of ROC+ and CBT on reduction of binge eating, weight, and energy intake over 5-months of treatment and 6-month follow-up. Study recruitment completed in March 2022. One hundred and twenty-nine Veterans were randomized (mean age = 47.10 (sd = 11.3) years; 41% female, mean BMI = 34.8 (sd = 4.7); 33% Hispanic) and assessments were conducted at baseline, during treatment and at post-treatment. The final 6-month follow-ups will be completed in April 2023. Targeting novel mechanisms including sensitivity to internal cures and responsivity to external cues is critically important to improve binge eating and weight-loss programs among Veterans. Clinicaltrials.govNCT03678766.
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Affiliation(s)
- Kerri N Boutelle
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - Niloofar Afari
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; VA San Diego Healthcare System, 3350 La Jolla Village Dr, San Diego, CA 92161, USA
| | - Saori Obayashi
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Dawn M Eichen
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West 2450 Riverside Ave, Minneapolis, MN 55454, USA
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Moraes CEFD, Antunes MML, Mourilhe C, Sichieri R, Hay P, Appolinario JC. Food Consumption during Binge Eating Episodes in Binge Eating Spectrum Conditions from a Representative Sample of a Brazilian Metropolitan City. Nutrients 2023; 15:nu15071573. [PMID: 37049413 PMCID: PMC10096673 DOI: 10.3390/nu15071573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/11/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
The prevalence of binge eating spectrum conditions (BESC) are increasing globally. However, there is a lack of data from general population samples in low- and middle-income countries. Thus, this study described the food consumption during objective binge eating episodes (OBE) in people with BESC from a metropolitan city in Brazil. Participants comprised 136 adults (18 years old-60 years old) with Binge Eating Disorder (BED), Bulimia Nervosa (BN), or recurrent binge eating (RBE) from a two-phase epidemiological survey. They were interviewed in their homes by trained lay interviewers using the Questionnaire on Eating and Weight Patterns updated for the DSM-5 to assess BESC diagnosis and food consumption during a typical OBE. Overall, participants consumed a mean of 1067 kcal during the episodes. For the most part, these calories were derived from carbohydrates (58%) and lipids (30%), irrespective of the diagnosis. Regarding food item consumption, individuals with BED and RBE consumed staple foods (mainly rice and beans) more frequently than those with BN. Conversely, participants with BN ingested sugar-sweetened beverages more frequently than the BED group. In conclusion, there were differences in the eating patterns of individuals with BESC in Brazil. BED and RBE participants consumed more typical foods, whereas those with BN preferred foods with a high content of energy during their OBE.
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Affiliation(s)
- Carlos Eduardo Ferreira de Moraes
- Group of Obesity and Eating Disorders (GOTA), Psychiatry Institute (IPUB), Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2750, Australia
| | - Marina Maria Leite Antunes
- Group of Obesity and Eating Disorders (GOTA), Psychiatry Institute (IPUB), Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | - Carla Mourilhe
- Group of Obesity and Eating Disorders (GOTA), Psychiatry Institute (IPUB), Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Social Medicine Institute (IMS), State University of Rio de Janeiro (UERJ), Rio de Janeiro 28625-570, Brazil
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2750, Australia
- Mental Health Services, South West Sydney Local Health District (SWSLHD), Campbelltown, NSW 2560, Australia
| | - Jose Carlos Appolinario
- Group of Obesity and Eating Disorders (GOTA), Psychiatry Institute (IPUB), Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
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da Luz FQ, Sainsbury A, Salis Z, Hay P, Cordás T, Morin CM, Paulos-Guarnieri L, Pascoareli L, El Rafihi-Ferreira R. A systematic review with meta-analyses of the relationship between recurrent binge eating and sleep parameters. Int J Obes (Lond) 2023; 47:145-164. [PMID: 36581669 DOI: 10.1038/s41366-022-01250-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Sleep problems are known to compound the negative effects of other health issues, such as eating disorders and the associated behavior of binge eating. Previous studies suggested associations between binge eating and sleep problems, but the strength of the relationship is unknown. METHODS We conducted a systematic review with meta-analyses examining the relationship between binge eating and sleep parameters. We searched for studies in Scopus, PubMed, and PsycInfo. The quality of evidence, including risk of bias, was assessed with adaptations of the Newcastle-Ottawa Scale and the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies, depending on study design. Data was synthesized as the difference in sleep between people who did or did not have binge eating. RESULTS Thirty-one reports of studies met our eligibility criteria. Results are presented in 12 meta-analyses. In the 7 reports of studies (with 4448 participants) that assessed poor overall sleep quality, we found poorer overall sleep quality in people with binge eating compared to people without binge eating, with a standardized mean difference of 0.77 (95% confidence interval [CI] 0.61-0.92; P < 0.001), which is a large effect size. In addition, we found evidence that people with binge eating had significantly greater hypersomnia/daytime sleepiness (7 reports of studies with 4370 participants), insomnia (5 reports of studies with 12,733 participants), and difficulty falling asleep (3 reports of studies with 4089 participants) compared to people without binge eating, with moderate effect sizes (standardized mean differences of 0.57-0.66). CONCLUSIONS People with binge eating exhibit poorer overall sleep quality compared to people without binge eating, and may also exhibit greater hypersomnia/daytime sleepiness, insomnia, and difficulty falling asleep. It is recommended that healthcare professionals routinely screen for poor overall sleep quality when treating people with binge eating-and address sleep difficulties when present.
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Affiliation(s)
- Felipe Q da Luz
- The University of Sydney, Faculty of Medicine and Health, Sydney Medical School, Sydney, NSW, Australia.
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), São Paulo, SP, Brazil.
| | - Amanda Sainsbury
- The University of Western Australia, School of Human Sciences, Perth, WA, Australia
| | - Zubeyir Salis
- University of New South Wales, Faculty of Medicine, School of Public Health, Centre for Big Data Research in Health, Kensington, NSW, Australia
| | - Phillipa Hay
- Western Sydney University, School of Medicine, Translational Health Research Institute, Sydney, NSW, Australia
| | - Táki Cordás
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), São Paulo, SP, Brazil
| | - Charles M Morin
- Université Laval, École de Psychologie, Sainte-Foy, Québec, QC, Canada
| | - Léo Paulos-Guarnieri
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Sleep Ambulatory (ASONO), São Paulo, SP, Brazil
| | - Luisa Pascoareli
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), São Paulo, SP, Brazil
| | - Renatha El Rafihi-Ferreira
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Sleep Ambulatory (ASONO), São Paulo, SP, Brazil
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Cleland L, Kennedy HL, Pettie MA, Kennedy MA, Bulik CM, Jordan J. Eating disorders, disordered eating, and body image research in New Zealand: a scoping review. J Eat Disord 2023; 11:7. [PMID: 36650575 PMCID: PMC9847028 DOI: 10.1186/s40337-022-00728-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/25/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The prevention and treatment of eating disorders relies on an extensive body of research that includes various foci and methodologies. This scoping review identified relevant studies of eating disorders, body image, and disordered eating with New Zealand samples; charted the methodologies, sample characteristics, and findings reported; and identified several gaps that should be addressed by further research. METHODS Using scoping review methodology, two databases were searched for studies examining eating disorders, disordered eating, or body image with New Zealand samples. Snowball methods were further used to identify additional relevant articles that did not appear in initial searches. Two independent reviewers screened the titles and abstracts of 473 records. Full text assessment of the remaining 251 records resulted in 148 peer-reviewed articles being identified as eligible for the final review. A search of institutional databases yielded 106 Masters and Doctoral theses for assessment, with a total of 47 theses being identified as eligible for the final review. The included studies were classified by methodology, and the extracted information included the study foci, data collected, sample size, demographic information, and key findings. RESULTS The eligible studies examined a variety of eating disorder categories including binge-eating disorder, bulimia nervosa, and anorexia nervosa, in addition to disordered eating behaviours and body image in nonclinical or community samples. Methodologies included treatment trials, secondary analysis of existing datasets, non-treatment experimental interventions, cross-sectional observation, case-control studies, qualitative and mixed-methods studies, and case studies or series. Across all of the studies, questionnaire and interview data were most commonly utilised. A wide range of sample sizes were evident, and studies often reported all-female or mostly-female participants, with minimal inclusion of males and gender minorities. There was also an underrepresentation of minority ethnicities in many studies, highlighting the need for future research to increase diversity within samples. CONCLUSION This study provides a comprehensive and detailed overview of research into eating disorders and body image in New Zealand, while highlighting important considerations for both local and international research.
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Affiliation(s)
- Lana Cleland
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand
| | - Hannah L Kennedy
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand
| | - Michaela A Pettie
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Martin A Kennedy
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand. .,Mental Health Clinical Research Unit, Te Whatu Ora, Waitaha, Christchurch, New Zealand.
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Davis HA, Keel PK, Tangney JP, Smith GT. Increases in shame following binge eating among women: Laboratory and longitudinal findings. Appetite 2022; 178:106276. [PMID: 35973455 DOI: 10.1016/j.appet.2022.106276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022]
Abstract
This multi-method, two-study investigation tested the hypothesis that, controlling for guilt and negative affect, shame increases following binge eating. Support for this hypothesis constitutes the first step in testing the theory that shame mediates the link between binge eating and comorbid psychopathology. Study 1 employed a laboratory binge-eating paradigm in n = 51 women [21 with bulimia nervosa, 30 controls]. Study 2 employed a naturalistic test of prospective relationships among binge eating, shame, guilt, and negative affect in n = 302 college women over three months. In Study 1, women with bulimia nervosa reported increases in shame that were not explained by changes in guilt or negative affect, following laboratory binge eating, compared with controls. In Study 2, baseline binge eating predicted increased shame at follow-up independently of guilt and negative affect. Should shame prove to mediate the link between binge eating and comorbid disorders, interventions to reduce shame may be useful for those who binge.
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Affiliation(s)
| | - Pamela K Keel
- Department of Psychology, Florida State University, United States
| | - June P Tangney
- Department of Psychology, George Mason University, United States
| | - Gregory T Smith
- Department of Psychology, University of Kentucky, United States
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Appolinario JC, Sichieri R, Lopes CS, Moraes CE, da Veiga GV, Freitas S, Nunes MAA, Wang YP, Hay P. Correlates and impact of DSM-5 binge eating disorder, bulimia nervosa and recurrent binge eating: a representative population survey in a middle-income country. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1491-1503. [PMID: 35044479 PMCID: PMC9246799 DOI: 10.1007/s00127-022-02223-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 01/06/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE Binge eating disorder (BED), bulimia nervosa (BN) and recurrent binge eating (RBE) are binge eating spectrum conditions causing a significant impact in individual's health and functioning. Information regarding those conditions came mostly from high-income countries. The objective of this study was to assess the prevalence of DSM-5 BED, BN and RBE and correlates in a representative sample from a metropolitan area of a middle-income country. METHODS The data were obtained from a cross-sectional population-based household survey in two stages in Rio de Janeiro, Brazil. Noninstitutionalized residents aged 18-60 years were assessed by lay interviewers using the Questionnaire of Eating and Weight Patterns-5 (QEWP-5). Positive cases and a paired sample screen-negative cases were reassessed by phone with the Eating Disorders Section of SCID-I-P (adapted for DSM-5). The data were collected from September 2019 to February 2020. RESULTS Overall, 2297 individuals were interviewed. Prevalence of BED was 1.4%, BN 0.7%, RBE 6.2%. Psychiatric comorbidities, such as depression, anxiety and ADHD were significantly more prevalent in people with BED, BN and RBE than in people without these eating problems. Several medical conditions, when controlling for body mass index, were significantly more prevalent in people with BED, BN and RBE. People with BED and BN had marked impairments in work/school, social and family life, reduced mental and physical HRQoL and under half had sought treatment. CONCLUSION As in high income countries, in Rio de Janeiro, Brazil, BED, BN and RBE are prevalent conditions and are associated with elevated BMI, functional impairment, psychiatric and medical comorbidity and poorer HRQoL.
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Affiliation(s)
- Jose C. Appolinario
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Av. Professor Gastão Bahiana, 496 ap1809, Rio de Janeiro, 22071-030 Brazil
| | - Rosely Sichieri
- Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Claudia S. Lopes
- Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos E. Moraes
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Av. Professor Gastão Bahiana, 496 ap1809, Rio de Janeiro, 22071-030 Brazil
| | - Gloria V. da Veiga
- Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Silvia Freitas
- State Institute of Diabetes and Endocrinology, Rio de Janeiro, Brazil
| | | | - Yuan-Pang Wang
- Instituto de Psiquiatria (LIM-23), Universidade de São Paulo, São Paulo, Brazil
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Penrith, Australia ,Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, Australia
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Moraes CEFD, Mourilhe C, Veiga GVD, de Freitas SR, Luiz RR, Hay P, Appolinario JC. Concurrent validity of the Brazilian Portuguese version of the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) in the general population. Eat Behav 2021; 43:101571. [PMID: 34562857 DOI: 10.1016/j.eatbeh.2021.101571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/01/2021] [Accepted: 09/15/2021] [Indexed: 11/18/2022]
Abstract
The Questionnaire on Eating and Weight Patterns-5 is a self-report instrument developed for the screening of Binge Eating Disorder (BED) and Bulimia Nervosa (BN) according to DSM-5. The present study aimed to examine the concurrent validity of the Brazilian version of QEWP-5 to assess BED and BN in the general population. The Brazilian version of QEWP-5 was administered to 2297 subjects, aged from 18 to 60 years. All screen-positive and a subset of screen-negative participants were also interviewed by telephone using the eating disorders (ED) module of Structured Clinical Interview for DSM-IV - Patients Version (SCID-I-P) for the assessment of BED, BN, and their subthreshold forms. For the assessment of BED, the sensitivity of QEWP-5 was 0.41 and its specificity was 0.90. The positive and negative predictive values were 0.48 and 0.87, respectively. Regarding the assessment of BN, QEWP-5 showed a sensitivity of 0.56, a specificity of 0.90, a positive predictive value of 0.35, and a negative predictive value of 0.95. For the global screening of ED (BED, BN, and subthreshold forms), QEWP-5 showed a sensitivity of 0.71, a specificity of 0.83, a positive predictive value of 0.64 and a negative predictive value of 0.87. QEWP-5 can be a useful instrument for the initial screening of diagnostic threshold ED psychopathology in general population samples. However, it has less utility in identifying cases of BED and BN independently.
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Affiliation(s)
- Carlos Eduardo Ferreira de Moraes
- Federal University of Rio de Janeiro, Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Rio de Janeiro (RJ), Brazil.
| | - Carla Mourilhe
- Federal University of Rio de Janeiro, Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Rio de Janeiro (RJ), Brazil; Federal University of Rio de Janeiro (UFRJ), Josué de Castro Nutrition Institute (INJC), Department of Social and Applied Nutrition (DNSA), Rio de Janeiro (RJ), Brazil.
| | - Glória Valéria da Veiga
- Federal University of Rio de Janeiro (UFRJ), Josué de Castro Nutrition Institute (INJC), Department of Social and Applied Nutrition (DNSA), Rio de Janeiro (RJ), Brazil.
| | - Sílvia Regina de Freitas
- Federal University of Rio de Janeiro, Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Rio de Janeiro (RJ), Brazil; State Institute of Diabetes e Endocrinology (IEDE), Rio de Janeiro (RJ), Brazil.
| | - Ronir Raggio Luiz
- Federal University of Rio de Janeiro, Institute of Collective Health Studies (IESC), Rio de Janeiro (RJ), Brazil.
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
| | - Jose Carlos Appolinario
- Federal University of Rio de Janeiro, Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Rio de Janeiro (RJ), Brazil.
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Huryk KM, Drury CR, Loeb KL. Diseases of affluence? A systematic review of the literature on socioeconomic diversity in eating disorders. Eat Behav 2021; 43:101548. [PMID: 34425457 DOI: 10.1016/j.eatbeh.2021.101548] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 06/01/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
The stereotype that eating disorders (ED) primarily present among individuals of higher socioeconomic status (SES) has long persisted in popular and professional perception. This belief has likely contributed to disparities in ED identification and treatment, particularly among those of lower SES backgrounds. The objective of this article was to systematically review the literature investigating socioeconomic diversity in distinct ED diagnoses. A PRISMA search was conducted to identify studies that empirically assessed the association between ED pathology and indicators of SES via PubMed and PsycINFO. This search generated 13,538 articles, of which 62 articles published between 1973 and August 2020 met criteria for inclusion in the review. Included studies were primarily cross-sectional and covered diagnoses of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), with quality ratings of poor, fair, and good. Results are examined in the context of studies' sampling methods, operationalization of SES, and statistical analyses. There is no consistent pattern of evidence to suggest a relationship between high SES and ED. Instead, all ED present across a wide range of socioeconomic backgrounds. Limitations included the predominance of cross-sectional study designs and poor to fair quality ratings. Future research should include adequately powered, community-based longitudinal studies that examine how sociocultural factors, including SES, intersect to influence ED risk and treatment outcome. The existing data suggest an urgent need to prioritize affordable and accessible ED treatment.
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Affiliation(s)
- Kathryn M Huryk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Catherine R Drury
- School of Psychology, Fairleigh Dickinson University, 1000 River Road, T-WH1-01, Teaneck, NJ 07666, USA.
| | - Katharine L Loeb
- Chicago Center for Evidence-Based Treatment, 25 E Washington St, Suite 1015, Chicago, IL 60602, USA.
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Sienkiewicz ME, Iverson KM, Smith BN, Mitchell KS. Associations between eating disorder symptoms, employment status, and occupational functioning among female veterans. Eat Behav 2021; 42:101536. [PMID: 34182295 DOI: 10.1016/j.eatbeh.2021.101536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 06/07/2021] [Accepted: 06/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Eating disorders (EDs) have been shown to negatively impact occupational functioning and may be associated with employment status. Findings have been inconsistent, and depression may mediate this relation. Further, prior research focuses mainly on binge eating disorder's (BED) impact on occupational functioning. We assessed the association between transdiagnostic ED symptoms and occupational functioning and employment status among female veterans, who tend to have high rates of EDs and unemployment but who remain understudied. METHOD Participants were 198 female veterans (Mage = 54.09) in the New England region who participated in a larger study. They completed a mailed survey including the Eating Disorder Diagnostic Scale, Center for Epidemiologic Studies-Depression Scale, employment status (employed vs. unemployed and out of the workforce), and the Inventory of Psychosocial Functioning to assess occupational functioning. RESULTS ED symptoms were not significantly related to employment status but were negatively associated with occupational functioning when controlling for body mass index. Depressive symptoms mediated the associations between ED symptoms and both being out of the workforce and occupational functioning, respectively. DISCUSSION Higher levels of ED symptoms were associated with worse occupational functioning in a female veteran sample. Further, comorbid depressive symptoms may be an important treatment target when addressing occupational health in women experiencing ED symptoms.
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Affiliation(s)
- Megan E Sienkiewicz
- National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130, USA
| | - Katherine M Iverson
- National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130, USA; Department of Psychiatry, Boston University School of Medicine, 715 Albany St, Boston, MA 02118, USA
| | - Brian N Smith
- National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130, USA; Department of Psychiatry, Boston University School of Medicine, 715 Albany St, Boston, MA 02118, USA
| | - Karen S Mitchell
- National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130, USA; Department of Psychiatry, Boston University School of Medicine, 715 Albany St, Boston, MA 02118, USA.
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Abstract
The WHOunderlined the importance of a healthy diet for the psychophysical well-being of the person. Self Determination Theory highlighted how the interaction between contextual, such as peer pressure, and motivational factors play a fundamental role in promoting healthy eating habits. The present study aims to assess if peer pressure affects eating habits and binge eating through the mediation of motivation. Questionnaires were administered to 588 young-adults aged between 18 and 24 years (M = 20.56, DS = 1.78) in the Italian context. Results suggest that Peer Pressure predicted Controlled Motivation and Autonomous Motivation, and that motivation predicted Eating Behaviors and Binge Eating. In addition, Peer Pressure also has a direct effect on Binge Eating. The results confirm the importance of investigating contextual and motivational factors in the area of prevention and intervention in eating habits.
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Affiliation(s)
- Nadia Barberis
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, Messina, Italy
| | - Maria Cristina Gugliandolo
- Dipartimento di Scienze Umane, Sociali e della Salute, Università degli Studi di Cassino e del Lazio Meridionale, Cassino, Italy
| | - Sebastiano Costa
- Dipartimento di Psicologia, Università degli Studi della Campania Luigi Vanvitelli, Caserta, Italy
| | - Marco Cannavò
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, Messina, Italy
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Boswell RG, Potenza MN, Grilo CM. The Neurobiology of Binge-eating Disorder Compared with Obesity: Implications for Differential Therapeutics. Clin Ther 2021; 43:50-69. [PMID: 33257092 PMCID: PMC7902428 DOI: 10.1016/j.clinthera.2020.10.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 10/30/2020] [Accepted: 10/30/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Emerging work indicates divergence in the neurobiologies of binge-eating disorder (BED) and obesity despite their frequent co-occurrence. This review highlights specific distinguishing aspects of BED, including elevated impulsivity and compulsivity possibly involving the mesocorticolimbic dopamine system, and discusses implications for differential therapeutics for BED. METHODS This narrative review describes epidemiologic, clinical, genetic, and preclinical differences between BED and obesity. Subsequently, this review discusses human neuroimaging work reporting differences in executive functioning, reward processing, and emotion reactivity in BED compared with obesity. Finally, on the basis of the neurobiology of BED, this review identifies existing and new therapeutic agents that may be most promising given their specific targets based on putative mechanisms of action relevant specifically to BED. FINDINGS BED is characterized by elevated impulsivity and compulsivity compared with obesity, which is reflected in divergent neurobiological characteristics and effective pharmacotherapies. Therapeutic agents that influence both reward and executive function systems may be especially effective for BED. IMPLICATIONS Greater attention to impulsivity/compulsivity-related, reward-related, and emotion reactivity-related processes may enhance conceptualization and treatment approaches for patients with BED. Consideration of these distinguishing characteristics and processes could have implications for more targeted pharmacologic treatment research and interventions.
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Affiliation(s)
- Rebecca G Boswell
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA.
| | - Marc N Potenza
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Yale School of Medicine, Child Study Center, New Haven, CT, USA; Yale University, Department of Neuroscience, New Haven, CT, USA
| | - Carlos M Grilo
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA; Yale University, Department of Psychology, New Haven, CT, USA
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da Luz FQ, Hay P, Wisniewski L, Cordás T, Sainsbury A. The treatment of binge eating disorder with cognitive behavior therapy and other therapies: An overview and clinical considerations. Obes Rev 2020; 22. [PMID: 33350574 DOI: 10.1111/obr.13180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 11/29/2022]
Abstract
Binge eating disorder (BED) is a public health problem in several countries. BED is commonly associated with comorbidities such as obesity, diabetes, and depression. Notwithstanding the health problems associated with BED, evidence-based treatments for BED are not widely used by healthcare professionals worldwide. Thus, we provide an overview of the leading evidence-based psychological therapies for BED, with the intention of informing healthcare professionals and the general community and facilitating greater provision of treatment. Cognitive behavior therapy (CBT) for BED is briefly presented, focusing mainly on adaptations and stages of the cognitive behavior therapy-enhanced (CBT-E) transdiagnostic model for eating disorders. We also succinctly discuss the use of CBT in combination with weight management interventions or pharmacotherapy, as well as the use of interpersonal therapy and dialectical behavior therapy for BED. We conclude that there is a variety of evidence-based psychological therapies that can be used by a variety of healthcare professionals (not only by psychologists) to help reduce binge eating and associated psychopathology in people with BED. Given the high and increasing prevalence of BED, as well as the availability of effective evidence-based treatments, we encourage more healthcare professionals to explore up-skilling to assist people with BED.
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Affiliation(s)
- Felipe Q da Luz
- Eating Disorders Program (AMBULIM), Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Charles Perkins Centre, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Lucene Wisniewski
- Center for Evidence Based Treatment, Shaker Heights, OH, USA
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Táki Cordás
- Eating Disorders Program (AMBULIM), Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Amanda Sainsbury
- School of Human Sciences, Faculty of Science, The University of Western Australia, Perth, WA, Australia
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Wong MNT, Hay P. Exploring associations between age of onset and quality of life of people with eating disorder behaviours and weight/shape overvaluation: a general population study. Australas Psychiatry 2020; 28:660-663. [PMID: 32484736 DOI: 10.1177/1039856220928873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To identify the age of onset of eating disorder behaviours (EDBs) and weight/shape overvaluation in a community sample and to evaluate the association between the age of onset and duration of EDBs with health related quality of life (HRQoL). METHOD Data were extracted from the 2008/2009 Health Omnibus Survey (HOS). In 2008, 3034 and in 2009, 3007 participants from a randomly selected sample of households in the Australian population were interviewed for current and age of onset of EDBs. In 2008, mental and physical HRQoL was assessed with the Short Form 12-item instrument (SF-36-2). In 2009, role impairment was assessed with reported days out of role in the past month. RESULTS There were no significant associations between ages of onset of EDBs with the overall summary measures of physical or mental HRQoL. There was a significant positive association between the duration of EDBs with role impairment. The age of onset of EDBs had a significant negative association with physical HRQoL subscales of SF-36-2 but effect sizes were small. CONCLUSIONS The age of onset of EDBs did not appear to have a significant impact on overall HRQoL measures but duration of symptoms impacted on current role function.
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Affiliation(s)
| | - Phillipa Hay
- Translational Health Research Institute Western Sydney University, and Camden and Campbell town Hospitals, Australia
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Carrard I, Rothen S, Rodgers RF. Body image and disordered eating in older women: A Tripartite Sociocultural model. Eat Behav 2020; 38:101412. [PMID: 32683276 DOI: 10.1016/j.eatbeh.2020.101412] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
Evidence suggests that body image concerns and disordered eating exist in women even at older ages. Few studies have examined the factors that are related with body image and eating concerns in this age group. In particular, the roles of sociocultural influences and thin-ideal internalization remain unclear. In the present study, we tested a modified tripartite sociocultural model of body image and disordered eating behaviors in a sample of 222 women aged 60 to 75 years, using structural equation modeling. After adjustment, a model similar to that observed in young women was a good fit to the data. Perceived pressure from the media revealed a direct relationship with body image concerns, as well as an indirect relationship mediated by thin-ideal internalization. Peer pressure was directly associated with body image concerns, and thin-ideal internalization was associated with dieting. In older women, pressure to conform to appearance ideals, in particular from the media, may impact the internalization of appearance ideals and body image concerns that might, in turn, increase disordered eating. The usefulness of sociocultural models for framing body image and eating concerns in older women implies that similar prevention interventions to those used in younger women could be adapted to fill a gap in available resources for this group.
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Affiliation(s)
- Isabelle Carrard
- Department of Nutrition and dietetics, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland.
| | | | - Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA, United States; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France
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Christensen KA, French MN, Chen EY. Multi-method assessment of palatable food exposure in women with and without eating disorders. Eur Eat Disord Rev 2020; 28:594-602. [PMID: 32627915 DOI: 10.1002/erv.2746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 04/30/2020] [Accepted: 05/03/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Eating disorders (EDs) are characterized by dysregulated responses to palatable food. Using a multi-method approach, this study examined responses to palatable food exposure and subsequent ad libitum eating in women with binge-eating disorder (BED: n = 64), anorexia nervosa (AN: n = 16), and bulimia nervosa (BN: n = 35) and 26 healthy controls (HCs). METHOD Participants were exposed to palatable food followed by an ad libitum eating opportunity. Affective and psychophysiological responses were measured before and during the task. RESULTS Participants with EDs reported greater negative affect, particularly fear, following the food cue exposure, whereas HCs reported no change. BN and BED groups reported greater urge to binge after the food cue exposure, whereas AN and HC groups reported no change. Respiratory sinus arrhythmia levels, skin conductance and tonic skin conductance levels increased during food exposure for all groups. Across baseline and during the food exposure, the BED group had lower respiratory sinus arrhythmia levels relative to the BN and HC groups. The BED group consumed significantly more palatable food than the AN group. CONCLUSIONS 'Palatable' food stimuli elicited more negative affect, particularly fear, in individuals with EDs; and this, rather than psychophysiological responses, distinguishes individuals with EDs from those without.
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Affiliation(s)
- Kara A Christensen
- Cognition and Emotion Lab, Ohio State University, 1835 Neil Avenue, Columbus, Ohio, 43210, USA.,Department of Psychology, University of Kansas, 1415 Jayhawk Blvd, Lawrence, KS, 66045, USA
| | - Melanie N French
- TEDp (Temple Eating Disorders Program), Temple University, 1701 North 13th Street, Philadelphia, Pennsylvania, 19122, USA
| | - Eunice Y Chen
- TEDp (Temple Eating Disorders Program), Temple University, 1701 North 13th Street, Philadelphia, Pennsylvania, 19122, USA
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Waszczuk MA, Waaktaar T, Eley TC, Torgersen S. Etiological influences on continuity and co-occurrence of eating disorders symptoms across adolescence and emerging adulthood. Int J Eat Disord 2019; 52:554-563. [PMID: 30729562 DOI: 10.1002/eat.23040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 01/23/2019] [Accepted: 01/23/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The role of common and symptom-specific genetic and environmental influences in maintaining eating disorder symptoms across development remains unclear. This study investigates the continuity and change of etiological influences on drive for thinness, bulimia, and body dissatisfaction symptoms and their co-occurrence, across adolescence and emerging adulthood. METHOD In total, 2,629 adolescent twins (mean age = 15.20, SD = 1.95) reported eating disorders symptoms across three waves of data collection. Biometric common pathways model was fitted to estimate genetic and environmental contributions to the continuity of each symptom over time, as well as time- and symptom-specific influences. RESULTS Drive for thinness and body dissatisfaction symptoms showed a pattern of high continuity across development and high correlations with each other, whereas bulimia symptoms were moderately stable and less associated with the other two symptoms. Latent factors reflecting continuity of each symptom were largely under genetic influence (Al = 0.60-0.82). New genetic influences contributing to change in the developmental course of symptoms were observed in emerging adulthood. Genetic influences correlated considerably between the three symptoms. Non-shared environmental influences were largely time-and symptom-specific, but some contributed moderately to the continuity across development (El = 0.18-0.40). The etiological overlap was larger between drive for thinness and body dissatisfaction symptoms than with bulimia symptoms. DISCUSSION The results provide preliminary evidence that stable as well as newly emerging genetic influences contribute to the co-occurrence of drive for thinness, bulimia, and body dissatisfaction symptoms across adolescence and emerging adulthood. Conversely, environmental influences were less stable and contributed to change in symptoms over time.
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Affiliation(s)
- Monika A Waszczuk
- Department of Psychiatry, Stony Brook University, Stony Brook, New York
| | - Trine Waaktaar
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Thalia C Eley
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
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Kim YR, Hwang BI, Lee GY, Kim KH, Kim M, Kim KK, Treasure J. Determinants of binge eating disorder among normal weight and overweight female college students in Korea. Eat Weight Disord 2018; 23:849-60. [PMID: 30196529 DOI: 10.1007/s40519-018-0574-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE The aim of the present study was to describe the clinical features of binge eating disorder (BED) in normal weight and overweight undergraduate Korean women. METHODS 117 overweight (BMI ≥ 25 kg/m2) and 346 normal weight (18 kg/m2 ≤ BMI < 25 kg/m2) undergraduate Korean women completed questionnaires to assess for BED. Their emotional eating behaviors, binge eating-related behaviors, a spectrum of compulsive behaviors such as substance abuse and obsessive-compulsive disorder, and psychological profiles were evaluated through personal interviews and questionnaires. The features of those with BED were compared to those without BED in the overweight and normal weight groups. RESULTS Both normal weight and overweight BED women had higher levels of functional impairment, eating disorder psychopathology including emotional and external eating behaviors, and neuroticism than their non-BED counterparts. In the normal weight group, BED women had more frequent alcohol consumption and obsessive-compulsive symptoms than non-BED women. In the overweight group, BED women had higher levels of depression and lower extraversion than non-BED women. CONCLUSIONS BED is associated with global functional impairment and mental health problems. Thus, the association with high functional impairments and psychiatric comorbidities suggest that people with BED may benefit from treatment. LEVEL III Evidence obtained from well-designed case-control analytic studies, from more than one center.
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Trindade AP, Appolinario JC, Mattos P, Treasure J, Nazar BP. Eating disorder symptoms in Brazilian university students: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2018; 41:179-187. [PMID: 30328965 PMCID: PMC6781688 DOI: 10.1590/1516-4446-2018-0014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/19/2018] [Indexed: 12/14/2022]
Abstract
Objective: To synthesize the risk of eating disorder (ED) symptoms in Brazilian university students through a systematic review and meta-analysis. Secondary goals were to analyze whether any specific majors were related to higher ED risk and whether any regions of Brazil had higher proportions of college students at risk of ED. Methods: The procedures followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, and a search was conducted in three electronic databases (MEDLINE, LILACS, and SciELO). Results: Thirty-three studies were included in the analysis, of which 14 were included in the meta-analysis. All included studies used self-report questionnaires, the most frequent of which was the Eating Attitudes Test (EAT-26). None of the studies used a structured interview to diagnose ED. A meta-analysis of studies with a cutoff ≥ 20 for the EAT-26 (n=5) found 14.9% (95%CI 12.8-17.2%) positive screenings, while those with a cutoff of t ≥ 21 (n=9) found 13.3% (95%CI 11.3-15.6%) positive screenings. There was a significantly higher proportion of positive screenings among nutrition majors than all other majors combined (26.5 and 20.5%, respectively). Conclusion: Nutrition students seem to be at higher risk of ED. Further research should investigate whether positive screenings translate to actual ED diagnoses.
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Affiliation(s)
- Amanda P Trindade
- Grupo de Obesidade e Transtornos Alimentares, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, RJ, Brazil
| | - Jose C Appolinario
- Grupo de Obesidade e Transtornos Alimentares, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, RJ, Brazil
| | - Paulo Mattos
- Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Bruno P Nazar
- Grupo de Obesidade e Transtornos Alimentares, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, RJ, Brazil.,Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil
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Sheehan DV, Gasior M, McElroy SL, Radewonuk J, Herman BK, Hudson J. Effects of Lisdexamfetamine Dimesylate on Functional Impairment Measured on the Sheehan Disability Scale in Adults With Moderate-to-severe Binge Eating Disorder: Results from Two Randomized, Placebo-controlled Trials. Innov Clin Neurosci 2018; 15:22-29. [PMID: 30013816 PMCID: PMC6040726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: In two Phase III, randomized, placebo-controlled trials (NCT01718483 and NCT01718509 at ClinicalTrials.gov), lisdexamfetamine dimesylate (LDX) reduced binge eating days/week in adults with moderate-to-severe binge eating disorder (BED). We describe the effects of LDX (50mg and 70mg) on the Sheehan Disability Scale (SDS; exploratory endpoint) from both studies. Design: The SDS was assessed at baseline, Week 6, and Week 12/early termination. Analyses included mixed-effects models for repeated measures for the examination of SDS total and domain score changes and a generalized estimating equation model to assess dichotomized remission status (remission [total score ≤6] versus nonremission [total score >6]). Results: Least squares (95% confidence interval [CI]) mean treatment differences for SDS total score change from baseline at Week 12 were -2.80 (-3.98, -1.61) in Study 1 and -3.70 (-4.81, -2.58) in Study 2 (both p<0.001). Least squares (95% CI) mean treatment differences across SDS domains favored LDX over placebo in both studies for the change from baseline at Week 12 (work/school: -0.8 [-1.2, -0.4] and -1.1 [-1.5, -0.7], both p<0.001; social life/leisure activities: -1.0 [-1.4, -0.5] and -1.4 [-1.8, -1.0], both p<0.001; and family life/home responsibilities: -1.0 [-1.4, -0.5] and -1.3 [-1.7, -0.9], both p<0.001). Odds ratios (95% CI) for SDS remission versus nonremission favored LDX over placebo at Week 12 (Study 1: 2.39 [1.44, 3.96]; p<0.001 and Study 2: 5.12 [2.80, 9.33]; p<0.001). Conclusion: These findings indicate that LDX treatment is associated with improvement on the SDS in adults with moderate-to-severe BED.
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Affiliation(s)
- David V Sheehan
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Drs. Herman and Gasior and Ms. Radewonuk are formerly affiliated with Shire Pharmaceuticals in Lexington, Massachusetts
- Dr. McElroy is with the Lindner Center of HOPE and the University of Cincinnati College of Medicine in Mason, Ohio
- Dr. Hudson is with McLean Hospital/Harvard Medical School in Belmont, Massachusetts
| | - Maria Gasior
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Drs. Herman and Gasior and Ms. Radewonuk are formerly affiliated with Shire Pharmaceuticals in Lexington, Massachusetts
- Dr. McElroy is with the Lindner Center of HOPE and the University of Cincinnati College of Medicine in Mason, Ohio
- Dr. Hudson is with McLean Hospital/Harvard Medical School in Belmont, Massachusetts
| | - Susan L McElroy
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Drs. Herman and Gasior and Ms. Radewonuk are formerly affiliated with Shire Pharmaceuticals in Lexington, Massachusetts
- Dr. McElroy is with the Lindner Center of HOPE and the University of Cincinnati College of Medicine in Mason, Ohio
- Dr. Hudson is with McLean Hospital/Harvard Medical School in Belmont, Massachusetts
| | - Jana Radewonuk
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Drs. Herman and Gasior and Ms. Radewonuk are formerly affiliated with Shire Pharmaceuticals in Lexington, Massachusetts
- Dr. McElroy is with the Lindner Center of HOPE and the University of Cincinnati College of Medicine in Mason, Ohio
- Dr. Hudson is with McLean Hospital/Harvard Medical School in Belmont, Massachusetts
| | - Barry K Herman
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Drs. Herman and Gasior and Ms. Radewonuk are formerly affiliated with Shire Pharmaceuticals in Lexington, Massachusetts
- Dr. McElroy is with the Lindner Center of HOPE and the University of Cincinnati College of Medicine in Mason, Ohio
- Dr. Hudson is with McLean Hospital/Harvard Medical School in Belmont, Massachusetts
| | - James Hudson
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Drs. Herman and Gasior and Ms. Radewonuk are formerly affiliated with Shire Pharmaceuticals in Lexington, Massachusetts
- Dr. McElroy is with the Lindner Center of HOPE and the University of Cincinnati College of Medicine in Mason, Ohio
- Dr. Hudson is with McLean Hospital/Harvard Medical School in Belmont, Massachusetts
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Cimino S, Simonelli A, Parolin M, Ballarotto G, Carbone P, Cerniglia L. A Theoretical and Empirical Linkage between Road Accidents and Binge Eating Behaviors in Adolescence. Int J Environ Res Public Health 2018; 15:ijerph15020355. [PMID: 29462976 PMCID: PMC5858424 DOI: 10.3390/ijerph15020355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 01/13/2023]
Abstract
This study aimed at identifying specific clusters of maladaptive emotional–behavioral symptoms in adolescent victims of motorbike collisions considering their scores on alexithymia and impulsivity in addition to examining the prevalence of clinical binge eating behaviors (respectively through the Youth Self-Report (YSR), Toronto Alexithymia Scale-20 (TAS-20), Barratt Impulsiveness Scale-11 (BIS-11), and Binge Eating Scale (BES)). Emotional–behavioral profiles, difficulties in identifying and describing feelings, impulsivity, and binge eating behaviors have been assessed in 159 adolescents addressing emergency departments following motorbike collisions. Our results showed a cluster of adolescents with clinical binge eating behaviors, high rates of motorbike accidents, and high levels of internalizing and externalizing problems, alexithymia, and impulsivity (23.3% of the sample); a second cluster of adolescents with clinical binge eating behaviors, a moderate number of collisions, and moderate levels of emotional and behavioral problems on the above four dimensions (25.8% of the sample); and a third cluster of youth without clinical binge eating behaviors, with a moderate number of accidents, and with low scores on the four dimensions (50.9% of the sample). Adolescents of Cluster 1 showed a higher likelihood to be involved in motorbike collisions than the youth in Clusters 2 and 3 (p < 0.0001). We suggest that adolescents’ motor collisions could be associated with their difficulties in emotion regulation and with their impaired psychological profiles, which could also underpin their disordered eating. The identification of specific clusters of psychopathological symptoms among this population could be useful for the construction of prevention and intervention programs aimed at reducing motor collision recidivism and alleviating co-occurring psychopathologies.
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Affiliation(s)
- Silvia Cimino
- Department of Dynamic and Clinical Psychology, University of Rome "Sapienza", Rome 00100, Italy.
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padua, Padua 35100, Italy.
| | - Micol Parolin
- Department of Developmental and Social Psychology, University of Padua, Padua 35100, Italy.
| | - Giulia Ballarotto
- Department of Dynamic and Clinical Psychology, University of Rome "Sapienza", Rome 00100, Italy.
| | - Paola Carbone
- Department of Dynamic and Clinical Psychology, University of Rome "Sapienza", Rome 00100, Italy.
| | - Luca Cerniglia
- Department of Psychology, International Telematic University, Rome 00100, Italy.
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Marzilli E, Cerniglia L, Cimino S. A narrative review of binge eating disorder in adolescence: prevalence, impact, and psychological treatment strategies. Adolesc Health Med Ther 2018; 9:17-30. [PMID: 29379325 PMCID: PMC5759856 DOI: 10.2147/ahmt.s148050] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Binge eating disorder (BED) represents one of the most problematic clinical conditions among youths. Research has shown that the developmental stage of adolescence is a critical stage for the onset of eating disorders (EDs), with a peak prevalence of BED at the age of 16–17 years. Several studies among adults with BED have underlined that it is associated with a broad spectrum of negative consequences, including higher concern about shape and weight, difficulties in social functioning, and emotional-behavioral problems. This review aimed to examine studies focused on the prevalence of BED in the adolescent population, its impact in terms of physical, social, and psychological outcomes, and possible strategies of psychological intervention. The review of international literature was made on paper material and electronic databases ProQuest, PsycArticles, and PsycInfo, and the Scopus index were used to verify the scientific relevance of the papers. Epidemiological research that examined the prevalence of BED in adolescent samples in accordance with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition showed a prevalence ranging from 1% to 4%. More recently, only a few studies have investigated the prevalence of BED, in accordance with the Diagnostic and Statistical Manual of Disorders, Fifth Edition criteria, reporting a prevalence of ~1%–5%. Studies that focused on the possible impact that BED may have on physical, psychological, and social functioning showed that adolescents with BED have an increased risk of developing various adverse consequences, including obesity, social problems, substance use, suicidality, and other psychological difficulties, especially in the internalizing area. Despite the evidence, to date, reviews on possible and effective psychological treatment for BED among young population are rare and focused primarily on adolescent females.
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Affiliation(s)
- Eleonora Marzilli
- Department of Dynamic and Clinical Psychology, Psychology and Medicine Faculty, Sapienza - University of Rome
| | - Luca Cerniglia
- Department of Psychology, Psychology Faculty, International Telematic University Uninettuno, Rome, Italy
| | - Silvia Cimino
- Department of Dynamic and Clinical Psychology, Psychology and Medicine Faculty, Sapienza - University of Rome
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Davidsen AH, Hoyt WT, Poulsen S, Waaddegaard M, Lau M. Eating disorder severity and functional impairment: moderating effects of illness duration in a clinical sample. Eat Weight Disord 2017; 22:499-507. [PMID: 27659175 DOI: 10.1007/s40519-016-0319-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 09/07/2016] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. METHODS The study included 159 patients diagnosed with bulimia nervosa, binge eating disorder or eating disorder not otherwise specified. Regression analysis was applied to assess the effect of the hypothesized moderators and mediators. Eating disorder severity was measured with the Eating Disorder Examination Questionnaire, functional impairment was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically. RESULTS Duration of illness significantly moderated the relationship between eating disorder severity and functional impairment; the relationship was strongest for patients with a shorter duration of illness. Psychological distress partly mediated the relationship between eating disorder severity and functional impairment. Duration of illness significantly moderated the relationship between psychological distress and functional impairment; the strongest relationship was seen for patients with a shorter duration of illness. Body mass index was not a significant moderator of the relationship between ED severity and functional impairment. CONCLUSIONS Overall, this study established a link between ED severity, psychological distress and functional impairment indicating that both eating disorder severity and psychological distress are more strongly related to impaired role functioning for patients with more recent onset of an eating disorder. More research in the complex relationship between ED severity and functional impairment is needed.
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Affiliation(s)
- Annika Helgadóttir Davidsen
- Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark, Stolpegaardsvej 20, 2820, Gentofte, Denmark.
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K., Denmark.
| | - William T Hoyt
- Department of Counseling Psychology, School of Education, UW-Madison, Madison, USA
| | - Stig Poulsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Mette Waaddegaard
- Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark, Stolpegaardsvej 20, 2820, Gentofte, Denmark
| | - Marianne Lau
- Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark, Stolpegaardsvej 20, 2820, Gentofte, Denmark
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Boutelle KN, Knatz S, Carlson J, Bergmann K, Peterson CB. An Open Trial Targeting Food Cue Reactivity and Satiety Sensitivity in Overweight and Obese Binge Eaters. Cogn Behav Pract 2017; 24:363-373. [PMID: 29269997 PMCID: PMC5734111 DOI: 10.1016/j.cbpra.2016.08.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Data suggests that individuals who binge eat are more responsive to food cues in the environment and less sensitive to satiety cues. The aim of this open trial was to evaluate the feasibility, acceptability, and initial effectiveness of a novel treatment grounded in Schachter's externality theory targeting food cue reactivity and satiety responsiveness with obese adults who binge eat. Treatment was provided in groups, and utilized appetite monitoring, cue-exposure treatment, in vivo exercises, self-monitoring, and coping skills. Twenty-eight overweight and obese adults who binge eat (82% female; mean age = 47.5 years [SD = 12.8]; BMI = 38.9 [SD = 10.3]; 79% White non-Hispanic) participated in a 4-month group-based treatment program. Assessments were conducted at baseline, posttreatment, and 3-month follow-up time points. Results indicated that this treatment was well accepted and had high retention at posttreatment. Initial effectiveness showed significant decreases in BMI, and improvements in loss of control and overeating episodes, food responsiveness, and power of food. The majority of results were maintained at the 3-month follow-up time point. This open trial provides preliminary evidence for the feasibility, acceptability, and initial effectiveness of this treatment on both eating disorder symptoms and weight in obese adults who binge eat. Because these data are preliminary, further treatment development and randomized controlled studies are needed.
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Pawaskar M, Witt EA, Supina D, Herman BK, Wadden TA. Impact of binge eating disorder on functional impairment and work productivity in an adult community sample in the United States. Int J Clin Pract 2017; 71:e12970. [PMID: 28741812 PMCID: PMC5601280 DOI: 10.1111/ijcp.12970] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 05/06/2017] [Indexed: 11/22/2022] Open
Abstract
AIM This study compared functioning and productivity in individuals meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for binge eating disorder (BED) to those without BED. METHODS A sample of US adults from the National Health and Wellness Survey completed an Internet survey in October 2013. In addition to BED diagnostic criteria, the survey assessed functional impairment and productivity, respectively, using the Sheehan Disability Scale (SDS) and Work Productivity and Activity Impairment (WPAI) questionnaire. Differences between BED and non-BED respondents were assessed using multivariate models controlling for factors, including age, sex and comorbidities. RESULTS Of 22 397 respondents, 344 were categorised as BED respondents and 20 437 as non-BED respondents. Compared with non-BED respondents, BED respondents exhibited significantly (all P<.001) greater functional impairment on the SDS, as measured by mean±SD total (14.04±9.46 vs 3.41±6.36), work/school (3.86±3.62 vs 1.01±2.21), social life/leisure activities (5.29±3.49 vs 1.22±2.33) and family life/home responsibilities (4.89±3.44 vs 1.18±2.26) scores. Adjusted odds ratios (95% CIs) indicated that BED respondents were more impaired than non-BED respondents on the work/school (4.24 [3.33-5.40]), social life/leisure activities (6.37 [4.97-8.15]) and family life/home responsibilities (5.76 [4.51-7.34]) domains of the SDS. On the WPAI, BED respondents reported significantly (all P<.001) higher percentages (mean±SD) of absenteeism (9.59%±19.97% vs 2.90%±12.95%), presenteeism (30.00%±31.64% vs 10.86%±20.07%), work productivity loss (33.19%±33.85% vs 12.60%±23.22%) and activity impairment (43.52%±34.36% vs 19.94%±27.22%) than non-BED respondents. CONCLUSIONS The findings suggest individuals with BED experience considerable impairment in functioning and work productivity compared with individuals without BED.
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Affiliation(s)
| | | | | | | | - Thomas A. Wadden
- Center for Weight and Eating DisordersPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPA
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Hagan KE, Clark KE, Forbush KT. Incremental validity of weight suppression in predicting clinical impairment in bulimic syndromes. Int J Eat Disord 2017; 50:672-678. [PMID: 28093836 DOI: 10.1002/eat.22673] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 12/24/2016] [Accepted: 12/26/2016] [Indexed: 12/30/2022]
Abstract
Research has shown that weight suppression (WS; the difference between a person's highest and current body weight in pounds) is a robust predictor of weight gain and eating-disorder (ED) symptoms among individuals with bulimic syndromes. Given the important prognostic role that WS plays in ED course and outcome, we hypothesized that WS would represent a clinically useful indicator of impairment for bulimic syndromes. We further posited that WS would demonstrate incremental validity above-and-beyond other proposed indicators in explaining clinical impairment in bulimic syndromes. Participants were community-recruited adults (N = 101; 80.2% female) with full-threshold (n = 51) or subthreshold (n = 50) bulimia nervosa. Other indicators of impairment included body mass index, frequency of inappropriate compensatory behaviors, lifetime history of any internalizing disorder, and multiple purging. Clinical impairment was assessed with the clinical impairment assessment (CIA). Hierarchical linear regression tested whether WS added to the explanation of CIA score variance above-and-beyond other indicators of bulimic-syndrome impairment. WS was significantly associated with clinical impairment (p = .011), but did not demonstrate incremental validity over other independent variables in predicting CIA scores. WS explained an additional 1.7% of the variance in CIA scores above-and-beyond other variables and the independent effect of WS on CIA scores represented a medium-sized effect (Cohen's d = 0.521). Results suggested that WS may be an indicator of ED-related clinical impairment. Inquiring about WS could be an informative component of routine bulimic-syndrome assessment, given that WS explains some of the variance in clinical impairment in bulimic syndromes.
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Affiliation(s)
- Kelsey E Hagan
- Department of Psychology, University of Kansas, 1415 Jayhawk Blvd., Lawrence, KS, 66045
| | - Kelsey E Clark
- Department of Psychology, University of Kansas, 1415 Jayhawk Blvd., Lawrence, KS, 66045
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, 1415 Jayhawk Blvd., Lawrence, KS, 66045
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Ling YL, Rascati KL, Pawaskar M. Direct and indirect costs among patients with binge-eating disorder in the United States. Int J Eat Disord 2017; 50:523-532. [PMID: 27862132 DOI: 10.1002/eat.22631] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/31/2016] [Accepted: 09/08/2016] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To quantify the economic burden of binge-eating disorder (BED) in terms of work productivity loss, healthcare resource utilization, and healthcare costs. METHODS Respondents of the US National Health and Wellness Survey 2013 were invited to participate in a follow-up internet survey to identify adults with BED using DSM-5 criteria. Work productivity loss, healthcare resource utilization, and direct and indirect costs were assessed for BED respondents and matched non-BED respondents using generalized linear models or two-part models as appropriate. RESULTS A total of 1,720 people were included in our analysis (N = 344 with BED; N= 1,376 without BED). BED respondents had higher levels of activity impairment than non-BED respondents (41.29% vs. 23.18%, p < .001). Employed BED respondents (N = 178) had a greater level of work impairment than employed non-BED respondents (N = 686) (36.83% vs. 14.41%, p = .009). Higher healthcare resource utilization in the past 6 months among BED respondents was reported than matched non-BED respondents: numbers of surgeries (0.23 vs. 0.13, p = .021), ER visits (0.26 vs. 0.15, p = .016), and physician visits (6.09 vs. 4.56, p = .002). BED respondents reported higher total direct costs than matched non-BED respondents ($20,194 vs. $14,465, p = .005). The indirect costs among employed BED respondents were also higher than those without BED ($19,327 vs. $9,032, p < .001). DISCUSSION Individuals with BED reported significantly greater economic burden with respect to work productivity loss, level of healthcare resource utilization, and costs compared to non-BED respondents. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:523-532).
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Affiliation(s)
- You-Li Ling
- Health Outcomes and Pharmacy Practice Division, College of Pharmacy, The University of Texas at Austin, 2409 University Avenue, STOP A1930, Austin, Texas
| | - Karen L Rascati
- Health Outcomes and Pharmacy Practice Division, College of Pharmacy, The University of Texas at Austin, 2409 University Avenue, STOP A1930, Austin, Texas
| | - Manjiri Pawaskar
- Shire at the time of this study, Employee of Global Health Economics and Outcomes Research Division, 1200 Morris Drive, Wayne, Pennsylvania
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Chen EY, Cacioppo J, Fettich K, Gallop R, McCloskey MS, Olino T, Zeffiro TA. An adaptive randomized trial of dialectical behavior therapy and cognitive behavior therapy for binge-eating. Psychol Med 2017; 47:703-717. [PMID: 27852348 PMCID: PMC7418949 DOI: 10.1017/s0033291716002543] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Early weak treatment response is one of the few trans-diagnostic, treatment-agnostic predictors of poor outcome following a full treatment course. We sought to improve the outcome of clients with weak initial response to guided self-help cognitive behavior therapy (GSH). METHOD One hundred and nine women with binge-eating disorder (BED) or bulimia nervosa (BN) (DSM-IV-TR) received 4 weeks of GSH. Based on their response, they were grouped into: (1) early strong responders who continued GSH (cGSH), and early weak responders randomized to (2) dialectical behavior therapy (DBT), or (3) individual and additional group cognitive behavior therapy (CBT+). RESULTS Baseline objective binge-eating-day (OBD) frequency was similar between DBT, CBT+ and cGSH. During treatment, OBD frequency reduction was significantly slower in DBT and CBT+ relative to cGSH. Relative to cGSH, OBD frequency was significantly greater at the end of DBT (d = 0.27) and CBT+ (d = 0.31) although these effects were small and within-treatment effects from baseline were large (d = 1.41, 0.95, 1.11, respectively). OBD improvements significantly diminished in all groups during 12 months follow-up but were significantly better sustained in DBT relative to cGSH (d = -0.43). At 6- and 12-month follow-up assessments, DBT, CBT and cGSH did not differ in OBD. CONCLUSIONS Early weak response to GSH may be overcome by additional intensive treatment. Evidence was insufficient to support superiority of either DBT or CBT+ for early weak responders relative to early strong responders in cGSH; both were helpful. Future studies using adaptive designs are needed to assess the use of early response to efficiently deliver care to large heterogeneous client groups.
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Affiliation(s)
- E. Y. Chen
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - J. Cacioppo
- Department of Psychology, The University of Chicago, Chicago, IL, USA
| | - K. Fettich
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - R. Gallop
- Department of Mathematics, West Chester University, West Chester, PA, USA
- Department of Psychiatry, Center for Psychotherapy Research, Perelman School of Medicine, University of Pennsylvania, USA
| | - M. S. McCloskey
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - T. Olino
- Department of Psychology, Temple University, Philadelphia, PA, USA
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Federici S, Bracalenti M, Meloni F, Luciano JV. World Health Organization disability assessment schedule 2.0: An international systematic review. Disabil Rehabil 2016; 39:2347-2380. [PMID: 27820966 DOI: 10.1080/09638288.2016.1223177] [Citation(s) in RCA: 210] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE This systematic review examines research and practical applications of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a basis for establishing specific criteria for evaluating relevant international scientific literature. The aims were to establish the extent of international dissemination and use of WHODAS 2.0 and analyze psychometric research on its various translations and adaptations. In particular, we wanted to highlight which psychometric features have been investigated, focusing on the factor structure, reliability, and validity of this instrument. METHOD Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a search for publications focused on "whodas" using the ProQuest, PubMed, and Google Scholar electronic databases. RESULTS We identified 810 studies from 94 countries published between 1999 and 2015. WHODAS 2.0 has been translated into 47 languages and dialects and used in 27 areas of research (40% in psychiatry). CONCLUSIONS The growing number of studies indicates increasing interest in the WHODAS 2.0 for assessing individual functioning and disability in different settings and individual health conditions. The WHODAS 2.0 shows strong correlations with several other measures of activity limitations; probably due to the fact that it shares the same disability latent variable with them. Implications for Rehabilitation WHODAS 2.0 seems to be a valid, reliable self-report instrument for the assessment of disability. The increasing interest in use of the WHODAS 2.0 extends to rehabilitation and life sciences rather than being limited to psychiatry. WHODAS 2.0 is suitable for assessing health status and disability in a variety of settings and populations. A critical issue for rehabilitation is that a single "minimal clinically important .difference" score for the WHODAS 2.0 has not yet been established.
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Affiliation(s)
- Stefano Federici
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Marco Bracalenti
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Fabio Meloni
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Juan V Luciano
- b Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu , St. Boi De Llobregat , Spain.,c Primary Care Prevention and Health Promotion Research Network (RedIAPP) , Madrid , Spain
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Abstract
BACKGROUND The best treatment options for binge-eating disorder are unclear. PURPOSE To summarize evidence about the benefits and harms of psychological and pharmacologic therapies for adults with binge-eating disorder. DATA SOURCES English-language publications in EMBASE, the Cochrane Library, Academic OneFile, CINAHL, and ClinicalTrials.gov through 18 November 2015, and in MEDLINE through 12 May 2016. STUDY SELECTION 9 waitlist-controlled psychological trials and 25 placebo-controlled trials that evaluated pharmacologic (n = 19) or combination (n = 6) treatment. All were randomized trials with low or medium risk of bias. DATA EXTRACTION 2 reviewers independently extracted trial data, assessed risk of bias, and graded strength of evidence. DATA SYNTHESIS Therapist-led cognitive behavioral therapy, lisdexamfetamine, and second-generation antidepressants (SGAs) decreased binge-eating frequency and increased binge-eating abstinence (relative risk, 4.95 [95% CI, 3.06 to 8.00], 2.61 [CI, 2.04 to 3.33], and 1.67 [CI, 1.24 to 2.26], respectively). Lisdexamfetamine (mean difference [MD], -6.50 [CI, -8.82 to -4.18]) and SGAs (MD, -3.84 [CI, -6.55 to -1.13]) reduced binge-eating-related obsessions and compulsions, and SGAs reduced symptoms of depression (MD, -1.97 [CI, -3.67 to -0.28]). Headache, gastrointestinal upset, sleep disturbance, and sympathetic nervous system arousal occurred more frequently with lisdexamfetamine than placebo (relative risk range, 1.63 to 4.28). Other forms of cognitive behavioral therapy and topiramate also increased abstinence and reduced binge-eating frequency and related psychopathology. Topiramate reduced weight and increased sympathetic nervous system arousal, and lisdexamfetamine reduced weight and appetite. LIMITATIONS Most study participants were overweight or obese white women aged 20 to 40 years. Many treatments were examined only in single studies. Outcomes were measured inconsistently across trials and rarely assessed beyond end of treatment. CONCLUSION Cognitive behavioral therapy, lisdexamfetamine, SGAs, and topiramate reduced binge eating and related psychopathology, and lisdexamfetamine and topiramate reduced weight in adults with binge-eating disorder. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality.
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Affiliation(s)
- Kimberly A Brownley
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Nancy D Berkman
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Christine M Peat
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Kathleen N Lohr
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Katherine E Cullen
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Carla M Bann
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M Bulik
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
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Diedrich A, Schlegl S, Greetfeld M, Fumi M, Voderholzer U. Intensive inpatient treatment for bulimia nervosa: Statistical and clinical significance of symptom changes. Psychother Res 2016; 28:297-312. [DOI: 10.1080/10503307.2016.1210834] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Alice Diedrich
- Department of Psychiatry and Psychotherapy, University of Munich (LMU), Munich, Germany
| | - Sandra Schlegl
- Department of Psychiatry and Psychotherapy, University of Munich (LMU), Munich, Germany
| | | | - Markus Fumi
- Schön Clinic Roseneck, Prien am Chiemsee, Germany
| | - Ulrich Voderholzer
- Schön Clinic Roseneck, Prien am Chiemsee, Germany
- Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, Germany
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Kornstein SG, Kunovac JL, Herman BK, Culpepper L. Recognizing Binge-Eating Disorder in the Clinical Setting: A Review of the Literature. Prim Care Companion CNS Disord 2016; 18:15r01905. [PMID: 27733955 DOI: 10.4088/pcc.15r01905] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/29/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Review the clinical skills needed to recognize, diagnose, and manage binge-eating disorder (BED) in a primary care setting. DATA SOURCES A PubMed search of English-language publications (January 1, 2008-December 11, 2014) was conducted using the term binge-eating disorder. Relevant articles known to the authors were also included. STUDY SELECTION/DATA EXTRACTION Publications focusing on preclinical topics (eg, characterization of receptors and neurotransmitter systems) without discussing clinical relevance were excluded. A total of 101 publications were included in this review. RESULTS Although BED is the most prevalent eating disorder, it is underdiagnosed and undertreated. BED can be associated with medical (eg, type 2 diabetes and metabolic syndrome) and psychiatric (eg, depression and anxiety) comorbidities that, if left untreated, can impair quality of life and functionality. Primary care physicians may find diagnosing and treating BED challenging because of insufficient knowledge of its new diagnostic criteria and available treatment options. Furthermore, individuals with BED may be reluctant to seek treatment because of shame, embarrassment, and a lack of awareness of the disorder. Several short assessment tools are available to screen for BED in primary care settings. Pharmacotherapy and psychotherapy should focus on reducing binge-eating behavior, thereby reducing medical and psychiatric complications. CONCLUSIONS Overcoming primary care physician- and patient-related barriers is critical to accurately diagnose and appropriately treat BED. Primary care physicians should take an active role in the initial recognition and assessment of suspected BED based on case-finding indicators (eg, eating habits and being overweight), the initial treatment selection, and the long-term follow-up of patients who meet DSM-5 BED diagnostic criteria.
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Affiliation(s)
- Susan G Kornstein
- Department of Psychiatry and Institute for Women's Health, Virginia Commonwealth University, Richmond, Virginia
| | | | | | - Larry Culpepper
- Department of Family Medicine, Boston University School of Medicine, Boston, Massachusetts
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Reyes-Rodríguez ML, García M, Silva Y, Sala M, Quaranta M, Bulik CM. [Development of fotonovelas to raise awareness of eating disorders in Latinos in the United States]. ACTA ACUST UNITED AC 2016; 7:17-23. [PMID: 27313838 DOI: 10.1016/j.rmta.2016.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to develop fotonovelas, a popular type of graphic novel in the Latino population, to raise awareness and educate about eating disorders (EDs). Four illustrated cartoons and scripts tailored for adults and adolescents of both sexes were presented in focus groups and an in-depth interview. Seventeen Latino adults (14 females; 3 males) and 10 adolescents (9 females; 1 male) participated in the study. Participants found the fotonovelas interesting, and eye-catching than traditional brochures. The use of Spanglish and clarification of differences across EDs were suggested by adolescent females. Male adults suggested changing the title to focus on the health consequences of EDs in order to catch the male attention in reading the story. Based on the receptivity we found in this study, fotonovela could be a promising avenue to raise awareness and to educate the Latino community in the United States about EDs.
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Affiliation(s)
| | - Marissa García
- Department of Psychology, University of North Carolina, Chapel Hill, NC
| | - Yormeri Silva
- Department of Psychology, North Carolina State University, Raleigh, NC
| | - Margarita Sala
- Department of Psychology, University of North Carolina, Chapel Hill, NC
| | - Michela Quaranta
- Department of Neuroscience, AOU San Giovanni Battista, Turin, Italy
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC; Department of Nutrition, University of North Carolina, Chapel Hill, NC; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Schmidt U, Adan R, Böhm I, Campbell IC, Dingemans A, Ehrlich S, Elzakkers I, Favaro A, Giel K, Harrison A, Himmerich H, Hoek HW, Herpertz-Dahlmann B, Kas MJ, Seitz J, Smeets P, Sternheim L, Tenconi E, van Elburg A, van Furth E, Zipfel S. Eating disorders: the big issue. Lancet Psychiatry 2016; 3:313-5. [PMID: 27063378 DOI: 10.1016/s2215-0366(16)00081-x] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 12/16/2022]
Affiliation(s)
- Ulrike Schmidt
- Department of Psychological Medicine, King's College London, London SE5 8AF, UK.
| | - Roger Adan
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands; Rintveld Hospital, Zeist, Netherlands
| | - Ilka Böhm
- Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Iain C Campbell
- Department of Psychological Medicine, King's College London, London SE5 8AF, UK
| | | | - Stefan Ehrlich
- Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Dresden, Germany
| | | | | | - Katrin Giel
- Eberhard-Karls Universität, Tübingen, Germany
| | | | - Hubertus Himmerich
- Department of Psychological Medicine, King's College London, London SE5 8AF, UK
| | - Hans W Hoek
- Groningen University, Groningen, Netherlands
| | | | - Martien J Kas
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Paul Smeets
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Lot Sternheim
- University Clinics, Utrecht University, Utrecht, Netherlands
| | | | | | - Eric van Furth
- Rivierduinen Eating Disorders Ursula, Leiden, Netherlands; Leiden University Medical Center, Leiden, Netherlands
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Supina D, Herman BK, Frye CB, Shillington AC. Knowledge of binge eating disorder: a cross-sectional survey of physicians in the United States. Postgrad Med 2016; 128:311-6. [DOI: 10.1080/00325481.2016.1157441] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
AIM This paper considers how the three principles of evidence based practice (clinical expertise, scientific evidence, and patient preference) can be applied to the complexity of treatment for anorexia nervosa AN. METHOD A narrative review of the evidence of these three domains is presented. Clinical cases are used to illustrate how the formulation and management can be put into practice at different stages of illness. RESULTS The management of anorexia nervosa is complex. First, individuals with the illness do not regard the manifestations of the illness as a source of concern rather they are embraced and integrated into their identity. This contrasts to the reaction of other people who are terrified by the overt signs of ill health. Thus engagement into treatment is problematic. Second, the core symptom restricted eating, produces malnutrition which impacts on brain, body, and the social network. Thus a mixture of psychological and physical problems gradually accumulates over the course of the illness. This means that the treatment targets increase over time. CONCLUSION Thus treatment has to work with motivation and readiness to change and tackle the various domains of ill health.
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Abstract
The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included "binge eating disorder," DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and "shape and weight concerns." Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors' knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive-compulsive, and impulsive disorders) and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes) comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional eating). Future revisions of the BED diagnostic criteria should consider the inclusion of BED subtypes, perhaps based on the overvaluation of shape/weight, and an evidence-based reassessment of severity criteria.
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Affiliation(s)
- Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO
| | - Leslie Citrome
- Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla, NY
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Abstract
The aim of this study is to evaluate the recent literature on carers/parenting interventions for people with eating disorders. Interesting and important new findings are highlighted as well as the implications that this may have for treatment. We have reviewed and critically analysed the recent literature. Close others often play an important role in recognising the early signs of eating disorders and accessing and implementing treatment. Their role in helping with recovery is to give support and hold a united front themselves and with the professional team to avoid those common interpersonal reactions that adversely impact on outcome such as accommodating to the illness and reacting with high expressed emotion (overprotection and hostility). Managing this role is difficult, and coping resources are often strained. Carers ask for and are now getting expert training in skills to manage this role. There is an overlap between carer/parenting interventions and family therapies. The interface with close others is critical both for early recognition and access and implementation of treatment. Interventions which equip families and close others with the skills to manage eating disorder behaviours are showing potential at improving outcomes.
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Copeland WE, Bulik CM, Zucker N, Wolke D, Lereya ST, Costello EJ. Does childhood bullying predict eating disorder symptoms? A prospective, longitudinal analysis. Int J Eat Disord 2015; 48:1141-9. [PMID: 26337405 PMCID: PMC4715551 DOI: 10.1002/eat.22459] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 08/12/2015] [Accepted: 08/14/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Bullying is a common childhood experience with enduring psychosocial consequences. The aim of this study was to test whether bullying increases risk for eating disorder symptoms. METHOD Ten waves of data on 1,420 participants between ages 9 and 25 were used from the prospective population-based Great Smoky Mountains Study. Structured interviews were used to assess bullying involvement and symptoms of anorexia nervosa and bulimia nervosa as well as associated features. Bullying involvement was categorized as not involved, bully only, victim only, or both bully and victim (bully-victims). RESULTS Within childhood/adolescence, victims of bullying were at increased risk for symptoms of anorexia nervosa and bulimia nervosa as well as associated features. These associations persisted after accounting for prior eating disorder symptom status as well as preexisting psychiatric status and family adversities. Bullies were at increased risk of symptoms of bulimia and associated features of eating disorders, and bully-victims had higher levels of anorexia symptoms. In terms of individual items, victims were at risk for binge eating, and bully-victims had more binge eating and use of vomiting as a compensatory behavior. There was little evidence in this sample that these effects differed by sex. Childhood bullying status was not associated with increased risk for persistent eating disorder symptoms into adulthood (ages 19, 21, and 25). DISCUSSION Bullying predicts eating disorder symptoms for both bullies and victims. Bullying involvement should be a part of risk assessment and treatment planning for children with eating problems.
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Affiliation(s)
| | - Cynthia M. Bulik
- Department of Psychiatry and the Department of Nutrition at the University of North Carolina at Chapel Hill and in the Department of Medical Epidemiology and Biostatistics at the Karolinska Institutet, Stockholm, Sweden
| | - Nancy Zucker
- Department of Psychiatry and Behavioral Sciences at Duke Medical Center
| | - Dieter Wolke
- Department of Psychology and Division of Mental Health and Well-being at the University of Warwick
| | - Suzet Tanya Lereya
- Department of Psychology and Division of Mental Health and Well-being at the University of Warwick
| | - E. Jane Costello
- Department of Psychiatry and Behavioral Sciences at Duke Medical Center
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Micali N, Solmi F, Horton NJ, Crosby RD, Eddy KT, Calzo JP, Sonneville KR, Swanson SA, Field AE. Adolescent Eating Disorders Predict Psychiatric, High-Risk Behaviors and Weight Outcomes in Young Adulthood. J Am Acad Child Adolesc Psychiatry 2015; 54. [PMID: 26210334 PMCID: PMC4515576 DOI: 10.1016/j.jaac.2015.05.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate whether anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED), including purging disorder (PD), subthreshold BN, and BED at ages 14 and 16 years, are prospectively associated with later depression, anxiety disorders, alcohol and substance use, and self-harm. METHOD Eating disorders were ascertained at ages 14 and 16 years in 6,140 youth at age 14 (58% of those eligible) and 5,069 at age 16 (52% of those eligible) as part of the prospective Avon Longitudinal Study of Parents and Children (ALSPAC). Outcomes (depression, anxiety disorders, binge drinking, drug use, deliberate self-harm, weight status) were measured using interviews and questionnaires about 2 years after predictors. Generalized estimating equation models adjusting for gender, socio-demographic variables, and prior outcome were used to examine prospective associations between eating disorders and each outcome. RESULTS All eating disorders were predictive of later anxiety disorders. AN, BN, BED, PD, and OSFED were prospectively associated with depression (respectively AN: odds ratio [OR] = 1.39, 95% CI = 1.00-1.94; BN: OR = 3.39, 95% CI = 1.25-9.20; BED: OR = 2.00, 95% CI = 1.06-3.75; and PD: OR = 2.56, 95% CI = 1.38-4.74). All eating disorders but AN predicted drug use and deliberate self-harm (BN: OR = 5.72, 95% CI = 2.22-14.72; PD: OR = 4.88, 95% CI = 2.78-8.57; subthreshold BN: OR = 3.97, 95% CI = 1.44-10.98; and subthreshold BED: OR = 2.32, 95% CI = 1.43-3.75). Although BED and BN predicted obesity (respectively OR = 3.58, 95% CI = 1.06-12.14 and OR = 6.42, 95% CI = 1.69-24.30), AN was prospectively associated with underweight. CONCLUSIONS Adolescent eating disorders, including subthreshold presentations, predict negative outcomes, including mental health disorders, substance use, deliberate self-harm, and weight outcomes. This study highlights the high public health and clinical burden of eating disorders among adolescents.
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Affiliation(s)
- Nadia Micali
- Institute of Child Health, Child and Adolescent Mental Health Palliative Care and Pediatrics Section, University College London, and Icahn School of Medicine at Mount Sinai, New York.
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Treasure J, Stein D, Maguire S. Has the time come for a staging model to map the course of eating disorders from high risk to severe enduring illness? An examination of the evidence. Early Interv Psychiatry 2015; 9:173-84. [PMID: 25263388 DOI: 10.1111/eip.12170] [Citation(s) in RCA: 181] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 06/22/2014] [Indexed: 12/13/2022]
Abstract
AIM To examine the evidence to support using a staging heuristic for eating disorders, suggesting that the diagnosis of an eating disorder follows a trajectory across the life course. Specifically, to examine whether high-risk markers and prodromal features presenting in childhood and adolescence can later transition to the full manifestation of the illness in early adulthood, and whether over time, the illness can be described as becoming severe and enduring, often resistant to treatment. METHODS We conducted a comprehensive literature search on the MEDLINE, PubMed, PsycINFO, EMBASE and Cochrane databases from using the following terms: staging, duration of illness, early intervention, developmental epidemiology, neurobiological marker, phenotype, partial syndrome, severe enduring, chronic, prospective, longitudinal, cohort, epidemiology, adolescent, adult with anorexia nervosa, bulimia nervosa, binge eating disorder, eating disorder. The evidence was organized according to the staging heuristic defined by McGorry. RESULTS Evidence from epidemiological studies, neuropsychological findings, treatment responsivity and prognosis, support a specific staging trajectory for anorexia nervosa in that there is a longitudinal trajectory with evidence of neurobiological progression and evidence that interventions matched to stage of illness may optimize the benefit. There is less data at the moment to support such a model for bulimia nervosa and binge eating disorder. CONCLUSION The staging heuristic is a useful model for anorexia nervosa in terms of providing prognostic information and stage matched interventions. Although the evidence is encouraging, further research is needed before a similar model could be applied for bulimia nervosa and binge eating disorder.
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Affiliation(s)
- Janet Treasure
- PO59 Eating Disorder Unit, Kings College London, Institute of Psychiatry, London, UK
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Sheehan DV, Herman BK. The Psychological and Medical Factors Associated With Untreated Binge Eating Disorder. Prim Care Companion CNS Disord 2015; 17:14r01732. [PMID: 26445695 DOI: 10.4088/pcc.14r01732] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 12/19/2014] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE Although binge eating disorder (BED) is the most prevalent eating disorder, the impact of untreated BED is underappreciated. This review describes the relationship of BED to physical and mental health, quality of life, and functionality. DATA SOURCES PubMed searches were conducted on March 21, 2014; searches were limited to English-language research articles, meta-analyses, and reviews published between January 1, 2003 and March 21, 2014. Search terms included (binge eating OR binge-eating OR binge eating disorder) AND (cardiovascular OR metabolic OR metabolic syndrome OR gastrointestinal OR health OR rehabilitation OR recovery OR sleep OR pregnancy OR quality of life OR functional impairment OR activities of daily living OR QoL OR SF-12 OR ED-5D OR SF-36 OR psychosocial OR depressive OR anxiety OR self-esteem OR suicidality OR suicide OR productivity OR family). STUDY SELECTION/DATA EXTRACTION Of 326 identified publications, 43 were relevant to the topic and reported on the association of BED with psychiatric and medical comorbidities, quality of life, and functional outcomes. RESULTS Individuals diagnosed with BED have increased rates of mental health comorbidities (eg, depression and anxiety) and more pronounced medical impairments (eg, cardiovascular disorders) compared with individuals without BED. BED is also associated with functional impairment and reduced quality of life. CONCLUSIONS Binge eating disorder is associated with impairments in physical and mental health, which can decrease quality of life and functionality and lead to increased health care utilization and decreased productivity. However, some caution is warranted in interpreting these findings because it remains unclear whether BED is an antecedent condition, a complication associated with a comorbid psychiatric condition, or an unrelated feature that occurs concurrently with these comorbidities and impairments. Much of the research on BED is based on observational or epidemiologic studies. Controlled studies are needed to clearly define the long-term impairments associated with BED.
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Affiliation(s)
- David V Sheehan
- Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa (Dr Sheehan), and Shire Development LLC, Wayne, Pennsylvania (Dr Herman)
| | - Barry K Herman
- Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa (Dr Sheehan), and Shire Development LLC, Wayne, Pennsylvania (Dr Herman)
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Stein KF, Keller C, Corte C. Creando Posibilidades: A Cognitive Model of Risk Behaviors in Mexican American Women. J Food Nutr Disord 2014; 3:144. [PMID: 29911123 PMCID: PMC6003709 DOI: 10.4172/2324-9323.1000144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A prevailing theory within eating disorder literature is that the process of acculturation and the strength of ethnic identity are key determinants of disordered eating and related health risk behaviors for Latinas. In this paper, we describe a longitudinal study to test the theoretical proposition that the configuration of personal identities buffers the effects of acculturation on a triad of modifiable risk behaviors (disordered eating, alcohol use and tobacco use) in college-enrolled Mexican American (MA) women. Using the self-schema model to conceptualize personal identities, we review the causal pathways linking self-schema properties to risk behaviors and describe the longitudinal design and measures used to test the hypothesized relationships. We discuss the causal role of the self-concept in the development of the risk behavior patterns among young Latinas, and the association between socio-cultural factors and properties of the self-concept. We describe our longitudinal study design that enables us to examine the pattern of association among the risk behaviors, and the appropriateness of measures that operationalize the theoretical concepts in the study.
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Affiliation(s)
- Karen Farchaus Stein
- School of Nursing, University of Michigan, 400 N. Ingalls Building, Ann Arbor, MI, USA 48109
| | - Colleen Keller
- Center for Health Outcomes in Aging, College of Nursing and Health Innovation, Arizona State University, 500 N. 3 St., Phoenix, AZ, USA 85004
| | - Colleen Corte
- College of Nursing, University of Illinois at Chicago, 845 S. Damen, M/C 802, Chicago, IL, USA 60612
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Thomas JJ, Koh KA, Eddy KT, Hartmann AS, Murray HB, Gorman MJ, Sogg S, Becker AE. Do DSM-5 eating disorder criteria overpathologize normative eating patterns among individuals with obesity? J Obes 2014; 2014:320803. [PMID: 25057413 PMCID: PMC4098982 DOI: 10.1155/2014/320803] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 05/26/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND DSM-5 revisions have been criticized in the popular press for overpathologizing normative eating patterns-particularly among individuals with obesity. To evaluate the evidence for this and other DSM-5 critiques, we compared the point prevalence and interrater reliability of DSM-IV versus DSM-5 eating disorders (EDs) among adults seeking weight-loss treatment. METHOD Clinicians (n = 2) assigned DSM-IV and DSM-5 ED diagnoses to 100 participants via routine clinical interview. Research assessors (n = 3) independently conferred ED diagnoses via Structured Clinical Interview for DSM-IV and a DSM-5 checklist. RESULTS Research assessors diagnosed a similar proportion of participants with EDs under DSM-IV (29%) versus DSM-5 (32%). DSM-5 research diagnoses included binge eating disorder (9%), bulimia nervosa (2%), subthreshold binge eating disorder (5%), subthreshold bulimia nervosa (2%), purging disorder (1%), night eating syndrome (6%), and other (7%). Interrater reliability between clinicians and research assessors was "substantial" for both DSM-IV (κ = 0.64, 84% agreement) and DSM-5 (κ = 0.63, 83% agreement). CONCLUSION DSM-5 ED criteria can be reliably applied in an obesity treatment setting and appear to yield an overall ED point prevalence comparable to DSM-IV.
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Affiliation(s)
- Jennifer J. Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA
- *Jennifer J. Thomas:
| | - Katherine A. Koh
- Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA
| | - Kamryn T. Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA
| | - Andrea S. Hartmann
- Institute for Psychology, University of Osnabrück, 49074 Osnabrück, Germany
| | - Helen B. Murray
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Mark J. Gorman
- Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA
- Massachusetts General Hospital Weight Center, Boston, MA 02114, USA
| | - Stephanie Sogg
- Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA
- Massachusetts General Hospital Weight Center, Boston, MA 02114, USA
| | - Anne E. Becker
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, MA 02115, USA
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