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Gu SJ, Aimufua I, Pagliaccio D, Shankman SA, Steinglass JE, Auerbach RP, Walsh BT, Ranzenhofer LM. Self-referential processing in anorexia nervosa. Int J Eat Disord 2024. [PMID: 38436447 DOI: 10.1002/eat.24176] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE Anorexia nervosa (AN) is a serious psychiatric illness associated with significant medical and psychiatric comorbidity and impairment. Theoretical models of AN and self-report studies suggest that negative self-evaluation (i.e., low self-esteem) is related to the development and maintenance of AN. The goal of this study was to extend findings from self-report methodology using a neurocognitive task that probes self-evaluation implicitly and explicitly. METHOD We compared female adolescent and adult patients with AN (n = 35) and healthy controls (HC, n = 38) on explicit (i.e., endorsement of words as self-relevant), implicit (recall, recognition, reaction time), and composite (i.e., valence index, bias score, drift rates) indices of self-evaluation. We applied a drift-diffusion model to compute the drift rates, reflecting participants' decision-making process as to whether words were self-relevant. The association between self-evaluation indices and eating disorder severity was examined. RESULTS There were significant Group × Condition interaction effects for all explicit and implicit measures (all p's ≤ .01), where the AN group endorsed, recalled, and recognized more negative relative to positive words than HC. The AN group had more negative valence index and bias scores, and slower drift rate away from negative words, reflecting more negative self-evaluation. The finding for recall was attenuated when individuals with depression were excluded. Measures of self-evaluation bias were not related to eating disorder severity. DISCUSSION Using a neurocognitive approach that includes explicit and implicit indices of bias, results suggest that patients with AN have more negative self-evaluation. Due to the cross-sectional design, additional studies are needed to further evaluate directionality. PUBLIC SIGNIFICANCE Negative self-evaluation/low self-esteem is thought to contribute to eating disorder symptoms. Findings of this study using a neurocognitive task to probe self-evaluation suggested that individuals with anorexia nervosa have more negative self-evaluation, reflected by endorsing and remembering more negative (than positive) words compared to healthy controls, and doing so faster. Targeting the construct of negative self-evaluation in treatment of AN may be warranted.
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Affiliation(s)
- Serena J Gu
- New York State Psychiatric Institute, New York, New York, USA
| | - Ivieosa Aimufua
- New York State Psychiatric Institute, New York, New York, USA
| | - David Pagliaccio
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois, USA
| | - Joanna E Steinglass
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Randy P Auerbach
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - B Timothy Walsh
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Lisa M Ranzenhofer
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
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Ranzenhofer LM, Solhjoo S, Crosby RD, Kim BH, Korn R, Koorathota S, Lloyd EC, Walsh BT, Haigney MC. Autonomic indices and loss-of-control eating in adolescents: an ecological momentary assessment study. Psychol Med 2023; 53:4742-4750. [PMID: 35920245 PMCID: PMC10336770 DOI: 10.1017/s0033291722001684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Loss-of-control (LOC) eating commonly develops during adolescence, and it predicts full-syndrome eating disorders and excess weight gain. Although negative emotions and emotion dysregulation are hypothesized to precede and predict LOC eating, they are rarely examined outside the self-report domain. Autonomic indices, including heart rate (HR) and heart rate variability (HRV), may provide information about stress and capacity for emotion regulation in response to stress. METHODS We studied whether autonomic indices predict LOC eating in real-time in adolescents with LOC eating and body mass index (BMI) ⩾70th percentile. Twenty-four adolescents aged 12-18 (67% female; BMI percentile mean ± standard deviation = 92.6 ± 9.4) who reported at least twice-monthly LOC episodes wore biosensors to monitor HR, HRV, and physical activity for 1 week. They reported their degree of LOC after all eating episodes on a visual analog scale (0-100) using a smartphone. RESULTS Adjusting for physical activity and time of day, higher HR and lower HRV predicted higher self-reported LOC after eating. Parsing between- and within-subjects effects, there was a significant, positive, within-subjects association between pre-meal HR and post-meal LOC rating. However, there was no significant within-subjects effect for HRV, nor were there between-subjects effects for either electrophysiologic variable. CONCLUSIONS Findings suggest that autonomic indices may either be a marker of risk for subsequent LOC eating or contribute to LOC eating. Linking physiological markers with behavior in the natural environment can improve knowledge of illness mechanisms and provide new avenues for intervention.
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Affiliation(s)
- Lisa M Ranzenhofer
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Soroosh Solhjoo
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, ND, USA
| | - Brittany H Kim
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Rachel Korn
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | | | - E Caitlin Lloyd
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - B Timothy Walsh
- Columbia University Irving Medical Center, New York, NY, USA
| | - Mark C Haigney
- F. Edward Hébert School of Medicine, Bethesda, MD, USA
- Military Cardiovascular Outcomes Research (MiCOR), Bethesda, MD, USA
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Ranzenhofer LM. Response to Letter to Editor Regarding 'Early Course of Symptom Development in Anorexia Nervosa' by Ranzenhofer et al. (2022). J Adolesc Health 2023; 72:643-644. [PMID: 36933944 DOI: 10.1016/j.jadohealth.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 03/20/2023]
Affiliation(s)
- Lisa M Ranzenhofer
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York; Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, New York
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Ranzenhofer LM, Jablonski M, Davis L, Posner J, Walsh BT, Steinglass JE. Early Course of Symptom Development in Anorexia Nervosa. J Adolesc Health 2022; 71:587-593. [PMID: 35973892 PMCID: PMC10375485 DOI: 10.1016/j.jadohealth.2022.06.010] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/26/2022] [Accepted: 06/13/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Anorexia nervosa (AN) commonly begins in adolescence; however, detailed knowledge of symptom trajectories, including their temporal sequence, is less well elucidated. The purpose of the present study is to describe the onset and duration of disordered eating behaviors prior to a diagnosis of AN, examine concordance between child and parent report, and examine the relationships between timing of symptom onset and illness severity. METHODS Seventy-one adolescents (ages 12-18 years) and their parents were interviewed about dieting, restriction, loss of control/binge eating, purging, excessive/compulsive exercise, weight history, and amenorrhea. Body mass index percentiles were calculated, and adolescents completed the Eating Disorder Examination-Questionnaire. RESULTS Restriction, being underweight, dieting, and excessive exercise were reported by most of the sample; purging, loss-of-control eating, and having been overweight were reported by less than a third. Dieting typically emerged first, on average around age 14; the remainder of behaviors tended to emerge between ages 14 and 14½; and average age of formal diagnosis was slightly over 15 years. Dyads had good agreement regarding presence and timing of all behaviors except for dieting, for which children reported about 6 months earlier onset/longer duration, compared to parents. Although older age at interview was associated with lower body mass index percentile and higher EDE-Q score, neither age of onset nor duration was associated with severity when controlling for current age. DISCUSSION Teens and parents describe a similar sequence of behavior changes leading up to a diagnosis of AN that typically begins with dieting and occurs over an approximate 1- to 1½-year period. Querying teens and parents about eating behavior changes may aid in identification and early intervention in AN; adolescents with normal weight who engage in persistent dieting or restrictive eating may warrant more frequent weight monitoring.
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Affiliation(s)
- Lisa M Ranzenhofer
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York; Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, New York.
| | - Monica Jablonski
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York
| | - Lauren Davis
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York; Department of Psychology, Rutgers University, Highland Park, New Jersey
| | - Jonathan Posner
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York; Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, New York; Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - B Timothy Walsh
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York; Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, New York
| | - Joanna E Steinglass
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York; Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, New York
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Egbert AH, Smith KE, Ranzenhofer LM, Goldschmidt AB, Hilbert A. The Role of Affective Instability in Loss of Control Eating in Youth with Overweight/Obesity Across Development: Findings from Two EMA Studies. Res Child Adolesc Psychopathol 2022; 50:945-957. [PMID: 35039971 PMCID: PMC10375484 DOI: 10.1007/s10802-021-00886-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 11/26/2022]
Abstract
Affective instability is common during adolescence, but at high levels it is associated with a variety of internalizing and externalizing disorders, including eating disorders. Although most models focus on affective intensity as a mechanism for explaining eating disorders in adults, affective instability may be more developmentally relevant at predicting eating behaviors in youth. Using ecological momentary assessment, this manuscript explored the association between loss of control over eating (LOC), a key component of dysregulated eating in youth, and affective instability in youth with overweight/obesity in two separate studies, one with youth in middle childhood and early adolescence (Study 1: ages eight to 13) and one in youth in early through middle adolescence (Study 2: ages 12-17). Overall, there was no association between affective instability and LOC in Study 1, but in Study 2, age moderated the association between positive affective instability and LOC, such that greater between-person positive affective instability (i.e., relative to peers) was associated with lower average LOC for youth earlier in adolescence and higher average LOC for those later in adolescence. Negative affective instability was also associated with LOC in Study 2, such that on days when youth reported less within-person negative affective instability (i.e., relative to their own average), they also reported greater average LOC. Findings across the two studies indicate that the association between affective instability and LOC may not emerge until adolescence, and when it does, both positive and negative affective instability may be important to consider.
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Affiliation(s)
- Amy H Egbert
- Department of Psychiatry and Human Behavior, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI, USA.
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lisa M Ranzenhofer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, University of Leipzig Medical Center, Leipzig, Germany
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Darling KE, Rancourt D, Evans EW, Ranzenhofer LM, Jelalian E. Adolescent Weight Management Intervention in a Nonclinical Setting: Changes in Eating-Related Cognitions and Depressive Symptoms. J Dev Behav Pediatr 2021; 42:579-587. [PMID: 33660668 PMCID: PMC8408271 DOI: 10.1097/dbp.0000000000000929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Received: 06/01/2020] [Accepted: 01/01/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The present study was a secondary data analysis of a randomized controlled trial (RCT) to examine changes in depressive symptoms and eating-related cognitions in teens who participated in a nonclinic-based adolescent behavioral weight control treatment delivered by YMCA coaches. Differences in intervention effects were also examined by sex. METHODS Adolescents (N = 66; 13-17 years; 60.6% girls) with overweight (10.6%) or obesity (53.0% with severe obesity) participated in an RCT comparing 2 versions of an evidence-based intervention. Adolescents completed measures of eating-related cognitions (Eating Disorder Examination Questionnaire) and depressive symptoms (Children's Depressive Inventory-2) at baseline and end of active treatment (16 weeks). RESULTS There were no significant effects of group, time, or group by time interaction for depressive symptoms, global eating-related cognitions, dietary restraint, or eating concerns (ps > 0.05). Shape concerns (p = 0.04) and weight concerns (p = 0.02) significantly decreased over the intervention. Significant interactions between sex and time on global eating-related cognitions (p < 0.001), eating (p = 0.002), shape (p = 0.02), and weight concerns (p = 0.004) were detected such that female participants' scores decreased over the course of the treatment, but male participants' scores did not. CONCLUSION The results demonstrate some positive and no detrimental effects of a nonclinic-based behavioral weight control intervention on adolescents' eating-related cognitions and depressive symptoms. The findings may mitigate concerns that dissemination of structured, nonclinic-based weight management programs for adolescents will produce negative eating and mood outcomes; however, replication of results in larger trials is needed.
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Affiliation(s)
- Katherine E. Darling
- Weight Control and Diabetes Research Center, The Miriam Hospital; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | | | - E. Whitney Evans
- Weight Control and Diabetes Research Center, The Miriam Hospital; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Lisa M. Ranzenhofer
- Department of Psychiatry, Columbia University Irving Medical Center & New York State Psychiatric Institute
| | - Elissa Jelalian
- Weight Control and Diabetes Research Center, The Miriam Hospital; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
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Darling KE, Ranzenhofer LM, Hadley W, Villalta D, Kasper V, Jelalian E. Negative childhood experiences and disordered eating in adolescents in a weight management program: The role of depressive symptoms. Eat Behav 2020; 38:101402. [PMID: 32485589 PMCID: PMC7534901 DOI: 10.1016/j.eatbeh.2020.101402] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Stress negatively impacts adolescent weight status and eating behaviors. Previous research investigating this association has focused on traumatic events in childhood, but little is known about the impact of commonly experienced stressful life events and weight-related outcome. The aim of this cross-sectional study was to examine the association between negative life events and weight-related outcomes (i.e., weight status, disordered eating behaviors, insulin sensitivity) in a sample of treatment-seeking adolescents with overweight and obesity. A further aim of the study was to examine the potential mediating role of depression. METHOD Adolescents (N = 170; M age = 14.8; 62% female) presenting to an interdisciplinary weight management program completed measures related to negative life events, disordered eating patterns, and depressive symptoms prior to initiating treatment. Weight status and insulin sensitivity (using fasting glucose and fasting insulin) were objectively measured. RESULTS Stressful experiences during childhood were significantly related to weight status, F = 2.78, p < .05, and disordered eating, F = 5.51, p < .001, in regression analyses. Stressful life events were not related to insulin sensitivity. Depressive symptoms mediated the association between stressful experiences and disordered eating (b = 0.001, [CI = 0.0002, 0.0011]). Depressive symptoms did not mediate this association for weight status or insulin sensitivity. DISCUSSION Findings from the present study suggest that relatively common stressful events may be associated with development of disordered eating patterns in adolescents with overweight or obesity presenting to treatment. Providers working in weight management settings should consider assessing a range of potentially stressful life events and their potential weight-related implications.
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Affiliation(s)
- Katherine E. Darling
- Alpert Medical School of Brown University & Weight Control and Diabetes Research Center, The Miriam Hospital, United States of America,Corresponding author at: Weight Control & Diabetes Research Center, 196 Richmond Street, Providence, RI 02903, United States of America. (K.E. Darling)
| | - Lisa M. Ranzenhofer
- Department of Psychiatry, Columbia University Irving Medical Center & New York State Psychiatric Institute, United States of America
| | - Wendy Hadley
- Counseling and Human Services, College of Education, University of Oregon, United States of America
| | - Douglas Villalta
- Alpert Medical School of Brown University & Weight Control and Diabetes Research Center, The Miriam Hospital, United States of America
| | - Vania Kasper
- Division of Pediatric Gastroenterology, Nutrition, and Liver Diseases, Hasbro Children’s Hospital, United States of America
| | - Elissa Jelalian
- Alpert Medical School of Brown University & Weight Control and Diabetes Research Center, The Miriam Hospital, United States of America
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Ranzenhofer LM, Wilhelmy M, Hochschild A, Sanzone K, Walsh BT, Attia E. Peer mentorship as an adjunct intervention for the treatment of eating disorders: A pilot randomized trial. Int J Eat Disord 2020; 53:497-509. [PMID: 32159243 PMCID: PMC7383944 DOI: 10.1002/eat.23258] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 11/15/2019] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Peer mentorship has been shown to be helpful for other mental health conditions, but it has been understudied for patients with eating disorders. The goal of the present study was to evaluate the feasibility and efficacy of peer mentorship for individuals with eating disorders by conducting a randomized controlled trial (RCT). TRIAL DESIGN Parallel three-arm pilot RCT with 1:1:1 allocation to peer mentorship, social support mentorship (active comparison intervention), and waiting list. METHOD Sixty outpatients with anorexia nervosa (AN), bulimia nervosa (BN), or binge-eating disorder (BED) were randomly assigned to a condition. Outcome measures, including eating disorder symptoms and general psychopathology, were completed at baseline, mid-, and postintervention. RESULTS Session attendance and acceptability ratings were higher in peer mentorship than social support mentorship. More participants in social support mentorship (39%) dropped out compared to peer mentorship (5%). In intent-to-treat analysis, peer mentorship showed greater reductions in body dissatisfaction and anxiety compared with both control groups. Compared with social support mentorship, peer mentorship had greater reductions in depression. Compared with waiting list, peer mentorship had greater reduction in binge eating days/week in patients with BN/BED and restriction days/week in patients with AN. Peer mentorship did not impact body mass index or reentry into higher level of care. DISCUSSION This pilot RCT provides preliminary evidence that peer mentorship is effective for some cognitive and behavioral symptoms of eating disorders as an adjunct to outpatient treatment. Additional studies are needed to evaluate the efficacy of peer mentorship in absence of treatment.
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Affiliation(s)
- Lisa M. Ranzenhofer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Mylene Wilhelmy
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Annabella Hochschild
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Kaitlin Sanzone
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - B. Timothy Walsh
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Evelyn Attia
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
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Ranzenhofer LM, Mayer LES, Davis HA, Mielke-Maday HK, McInerney H, Korn R, Gupta N, Brown AJ, Schebendach J, Tanofsky-Kraff M, Thaker V, Chung WK, Leibel RL, Walsh BT, Rosenbaum M. The FTO Gene and Measured Food Intake in 5- to 10-Year-Old Children Without Obesity. Obesity (Silver Spring) 2019; 27:1023-1029. [PMID: 31119882 PMCID: PMC6561098 DOI: 10.1002/oby.22464] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/15/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Genetic variation in the first intron of FTO (e.g., single-nucleotide polymorphism [SNP] rs9939609) is strongly associated with adiposity. This effect is thought to be mediated (at least in part) via increasing caloric intake, although the precise molecular genetic mechanisms are not fully understood. Prior pediatric studies of FTO have included youth with overweight and obesity; however, they have not informed whether a genotypic effect on ingestive behavior is present prior to obesity onset. Therefore, this study investigated the association between FTO and caloric intake in children aged 5 to 10 years without obesity (adiposity ≤ 95th percentile). METHODS A total of 122 children were genotyped for rs9939609 and ate ad libitum from a laboratory lunch buffet following a standardized breakfast. Linear regressions, adjusting for body mass, were used to examine the association between FTO "dose" (number of copies of SNP rs9939609) and intake variables. RESULTS There was a significant association between FTO and total intake. Each risk allele predicted an additional 64 calories, accounting for 3% of the variance. There were no associations between FTO and macronutrient preference, energy density, or diet variety. Results were influenced by race. CONCLUSIONS Results corroborate and extend prior work by showing a dose-dependent effect on food intake in children without obesity.
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Affiliation(s)
- Lisa M Ranzenhofer
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Laurel E S Mayer
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Haley A Davis
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Hanna K Mielke-Maday
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Hailey McInerney
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Rachel Korn
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Nikita Gupta
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Amanda J Brown
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Janet Schebendach
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | | | - Vidhu Thaker
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Wendy K Chung
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Rudolph L Leibel
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - B Timothy Walsh
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Michael Rosenbaum
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
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Shomaker LB, Tanofsky-Kraff M, Matherne CE, Mehari RD, Olsen CH, Marwitz SE, Bakalar JL, Ranzenhofer LM, Kelly NR, Schvey NA, Burke NL, Cassidy O, Brady SM, Dietz LJ, Wilfley DE, Yanovski SZ, Yanovski JA. A randomized, comparative pilot trial of family-based interpersonal psychotherapy for reducing psychosocial symptoms, disordered-eating, and excess weight gain in at-risk preadolescents with loss-of-control-eating. Int J Eat Disord 2017; 50:1084-1094. [PMID: 28714097 PMCID: PMC5759342 DOI: 10.1002/eat.22741] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 03/05/2017] [Revised: 06/21/2017] [Accepted: 06/21/2017] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Preadolescent loss-of-control-eating (LOC-eating) is a risk factor for excess weight gain and binge-eating-disorder. We evaluated feasibility and acceptability of a preventive family-based interpersonal psychotherapy (FB-IPT) program. FB-IPT was compared to family-based health education (FB-HE) to evaluate changes in children's psychosocial functioning, LOC-eating, and body mass. METHOD A randomized, controlled pilot trial was conducted with 29 children, 8 to 13 years who had overweight/obesity and LOC-eating. Youth-parent dyads were randomized to 12-week FB-IPT (n = 15) or FB-HE (n = 14) and evaluated at post-treatment, six-months, and one-year. Changes in child psychosocial functioning, LOC-eating, BMI, and adiposity by dual-energy-X-ray-absorptiometry were assessed. Missing follow-up data were multiply imputed. RESULTS FB-IPT feasibility and acceptability were indicated by good attendance (83%) and perceived benefits to social interactions and eating. Follow-up assessments were completed by 73% FB-IPT and 86% FB-HE at post-treatment, 60% and 64% at six-months, and 47% and 57% at one-year. At post-treatment, children in FB-IPT reported greater decreases in depression (95% CI -7.23, -2.01, Cohen's d = 1.23) and anxiety (95% CI -6.08, -0.70, Cohen's d = .79) and less odds of LOC-eating (95% CI -3.93, -0.03, Cohen's d = .38) than FB-HE. At six-months, children in FB-IPT had greater reductions in disordered-eating attitudes (95% CI -0.72, -0.05, Cohen's d = .66) and at one-year, tended to have greater decreases in depressive symptoms (95% CI -8.82, 0.44, Cohen's d = .69) than FB-HE. There was no difference in BMI gain between the groups. DISCUSSION Family-based approaches that address interpersonal and emotional underpinnings of LOC-eating in preadolescents with overweight/obesity show preliminary promise, particularly for reducing internalizing symptoms. Whether observed psychological benefits translate into sustained prevention of disordered-eating or excess weight gain requires further study.
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Affiliation(s)
- Lauren B. Shomaker
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Human Development and Family Studies/Colorado School of Public Health, Colorado State University, Campus Delivery 1570, Fort Collins, Colorado 80523, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Camden E. Matherne
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA,Department of Psychiatry, University of North Carolina School of Medicine, 101 Manning Dr., Chapel Hill, NC 27599, USA
| | - Rim D. Mehari
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Cara H. Olsen
- Department of Preventive Medicine and Biostatistics, USUHS, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Shannon E. Marwitz
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Jennifer L. Bakalar
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Lisa M. Ranzenhofer
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA,Eating Disorder Research Unit, New York State Psychiatric Institute Columbia University Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Nichole R. Kelly
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Counseling Psychology and Human Services and the Prevention Science Institute, College of Education, University of Oregon, College of Education, University of Oregon, Eugene, OR 97403, USA
| | - Natasha A. Schvey
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Natasha L. Burke
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Omni Cassidy
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Laura J. Dietz
- Department of Psychology, University of Pittsburgh at Johnstown, 450 Schoolhouse Road, Johnstown, PA 15904, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, Campus Box 8134, St. Louis, MO 63110, USA
| | - Susan Z. Yanovski
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK), NIH, 6707 Democracy Blvd, Rm 6025, Bethesda, MD 20892-5450, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Hatfield Clinical Research Center, 10 Center Drive, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
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Ranzenhofer LM, Engel SG, Crosby RD, Haigney M, Tanofsky-Kraff M. A pilot study of attachment style and emotional experience in adolescent girls with loss of control eating. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/21662630.2016.1227273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kelly NR, Tanofsky-Kraff M, Vannucci A, Ranzenhofer LM, Altschul AM, Schvey NA, Shank LM, Brady SM, Galescu O, Kozlosky M, Yanovski SZ, Yanovski JA. Emotion dysregulation and loss-of-control eating in children and adolescents. Health Psychol 2016; 35:1110-9. [PMID: 27505194 DOI: 10.1037/hea0000389] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine the associations among self-reported loss-of-control (LOC) eating, emotion dysregulation, body mass, and objective energy intake among youth. Emotion dysregulation may be 1 individual factor that promotes excess energy intake and increases in body mass among youth with LOC eating. METHOD Children and adolescents (N = 230; 8 to 17 years) enrolled in a nonintervention study completed a structured interview to determine the presence or absence of self-reported LOC eating. Children's emotion dysregulation was assessed via parent-report with the Child Behavior Checklist. Youth also completed 2 test meals to capture "binge" and "normal" eating. Body composition was examined using air displacement plethysmography. RESULTS After controlling for relevant covariates, youth with self-reported LOC eating had higher parent-reported emotion dysregulation than those without LOC. Parent-reported emotion dysregulation was also associated with greater observed energy intake (after accounting for body mass), as well as higher fat mass. Emotion dysregulation also moderated associations between LOC status/gender and body mass variables; among youth with self-reported LOC eating and girls, those with high parent-described emotion dysregulation (vs. low) had significantly higher fat mass and BMIz. CONCLUSIONS Data from the current study suggest that emotion dysregulation may play a role in energy intake and obesity, particularly among youth with self-reported LOC eating and girls. Additional studies are needed to identify the prospective mechanisms linking poor emotion regulation and LOC eating. These mechanisms, in turn, may inform future interventions targeting excess energy intake and obesity in pediatric samples. (PsycINFO Database Record
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Affiliation(s)
- Nichole R Kelly
- National Institutes of Health, Department of Health and Human Services
| | | | - Anna Vannucci
- National Institutes of Health, Department of Health and Human Services
| | | | - Annie M Altschul
- National Institutes of Health, Department of Health and Human Services
| | - Natasha A Schvey
- National Institutes of Health, Department of Health and Human Services
| | - Lisa M Shank
- National Institutes of Health, Department of Health and Human Services
| | - Sheila M Brady
- National Institutes of Health, Department of Health and Human Services
| | - Ovidiu Galescu
- National Institutes of Health, Department of Health and Human Services
| | - Merel Kozlosky
- National Institutes of Health, Department of Health and Human Services
| | - Susan Z Yanovski
- National Institutes of Health, Department of Health and Human Services
| | - Jack A Yanovski
- National Institutes of Health, Department of Health and Human Services
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Ranzenhofer LM, Engel SG, Crosby RD, Haigney M, Anderson M, McCaffery JM, Tanofsky-Kraff M. Real-time assessment of heart rate variability and loss of control eating in adolescent girls: A pilot study. Int J Eat Disord 2016; 49:197-201. [PMID: 26401652 PMCID: PMC4733414 DOI: 10.1002/eat.22464] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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] [Accepted: 08/30/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Studying physiologic underpinnings of loss-of-control (LOC) eating may inform its etiology and contribute to intervention efforts. We therefore examined temporal relationships between autonomic indices [heart rate (HR), heart rate variability (HRV)] and LOC-eating in the natural environment. METHOD For two days, adolescents (n = 17, 14.77 ± 1.55 years, BMI-Z 2.17 ± 0.48) with LOC-eating reported on LOC using an electronic device while HR and HRV were assessed continuously using Holter monitoring. RESULTS Higher HR and lower HRV in the 30-minutes before eating were significantly associated with LOC-eating overall (p's < 0.001) and at the within-participants level (p's < 0.001), but not at the between-participants level (p's > 0.44). Examined categorically, HR was significantly higher, and HRV significantly lower, prior to high-LOC compared to low-LOC episodes (p's < 0.001). DISCUSSION This pilot study suggests that LOC-eating may involve physiologic underpinnings. Additional research with larger samples is needed to further investigate this phenomenon.
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Affiliation(s)
- Lisa M. Ranzenhofer
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Weight Control and Diabetes Research Center, The Alpert Medical School of Brown University/The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA
| | - Scott G. Engel
- Neuropsychiatric Research Institute (NRI), 120 South 8 Street, Fargo, ND, 58107-1415, USA,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, 1919 Elm St. North, Fargo, ND, 58102, USA
| | - Ross D. Crosby
- Neuropsychiatric Research Institute (NRI), 120 South 8 Street, Fargo, ND, 58107-1415, USA,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, 1919 Elm St. North, Fargo, ND, 58102, USA
| | | | - Micheline Anderson
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Jeanne M. McCaffery
- Weight Control and Diabetes Research Center, The Alpert Medical School of Brown University/The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
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Shank LM, Tanofsky-Kraff M, Nelson EE, Shomaker LB, Ranzenhofer LM, Hannallah LM, Field SE, Vannucci A, Bongiorno DM, Brady SM, Condarco T, Demidowich A, Kelly NR, Cassidy O, Simmons WK, Engel SG, Pine DS, Yanovski JA. Attentional bias to food cues in youth with loss of control eating. Appetite 2015; 87:68-75. [PMID: 25435490 PMCID: PMC4333006 DOI: 10.1016/j.appet.2014.11.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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: 06/11/2014] [Revised: 11/12/2014] [Accepted: 11/25/2014] [Indexed: 12/14/2022]
Abstract
Emerging data indicate that adults with binge eating may exhibit an attentional bias toward highly palatable foods, which may promote obesogenic eating patterns and excess weight gain. However, it is unknown to what extent youth with loss of control (LOC) eating display a similar bias. We therefore studied 76 youth (14.5 ± 2.3 years; 86.8% female; BMI-z 1.7 ± .73) with (n = 47) and without (n = 29) reported LOC eating. Following a breakfast to reduce hunger, youth participated in a computerized visual probe task of sustained attention that assessed reaction time to pairs of pictures consisting of high palatable foods, low palatable foods, and neutral household objects. Although sustained attentional bias did not differ by LOC eating presence and was unrelated to body weight, a two-way interaction between BMI-z and LOC eating was observed (p = .01), such that only among youth with LOC eating, attentional bias toward high palatable foods versus neutral objects was positively associated with BMI-z. These findings suggest that LOC eating and body weight interact in their association with attentional bias to highly palatable foods cues, and may partially explain the mixed literature linking attentional bias to food cues with excess body weight.
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Affiliation(s)
- Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA.
| | - Eric E Nelson
- Section on Development and Affective Neuroscience of the National Institute of Mental Health, NIH, DHHS, 15K North Drive, Bethesda, MD 20892, USA
| | - Lauren B Shomaker
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; Colorado State University, 303 Behavioral Sciences Building, Campus Delivery 1570, 410 Pitkin Street, Fort Collins, CO 80523, USA
| | - Lisa M Ranzenhofer
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA
| | - Louise M Hannallah
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA
| | - Sara E Field
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA
| | - Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA
| | - Diana M Bongiorno
- Section on Development and Affective Neuroscience of the National Institute of Mental Health, NIH, DHHS, 15K North Drive, Bethesda, MD 20892, USA
| | - Sheila M Brady
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA
| | - Tania Condarco
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA
| | - Andrew Demidowich
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA
| | - Nichole R Kelly
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA
| | - Omni Cassidy
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA
| | - W Kyle Simmons
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK 74136, USA; Faculty of Community Medicine, The University of Tulsa, 4502 E. 41st Street, Tulsa, OK 74135, USA
| | - Scott G Engel
- Neuropsychiatric Research Institute, 700 1st Ave S, Fargo, ND 58103, USA
| | - Daniel S Pine
- Section on Development and Affective Neuroscience of the National Institute of Mental Health, NIH, DHHS, 15K North Drive, Bethesda, MD 20892, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA
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Vannucci A, Tanofsky-Kraff M, Ranzenhofer LM, Kelly NR, Hannallah LM, Pickworth CK, Grygorenko MV, Brady SM, Condarco TA, Kozlosky M, Demidowich AP, Yanovski SZ, Shomaker LB, Yanovski JA. Puberty and the manifestations of loss of control eating in children and adolescents. Int J Eat Disord 2014; 47:738-47. [PMID: 24888295 PMCID: PMC4211942 DOI: 10.1002/eat.22305] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 01/30/2014] [Revised: 05/11/2014] [Accepted: 05/15/2014] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We investigated the manifestations of pediatric loss of control (LOC) eating at different stages of pubertal development. METHOD Participants were a nonclinical sample of 468 youth (8-17 years). Physical examination determined pubertal stage. LOC eating and disordered eating attitudes were assessed with the Eating Disorder Examination. In a randomized crossover design, a subset (n = 244) ate ad libitum from two test meals designed to capture normal and LOC eating. RESULTS There were no differences in the prevalence rates or frequency of reported LOC eating episodes across pubertal stages (ps ≥ 0.50). There were, however, puberty by LOC eating interactions in disordered eating attitudes and palatable food consumption (ps ≤ .05), even after adjusting for age and body composition. LOC eating was associated with elevated global disordered eating attitudes, weight concern, and shape concern in post-pubertal youth (ps ≤ .001), but not pre-pubertal youth (ps ≥ .49). In late-puberty, youth with LOC eating consumed less energy from protein (p < .001) and more from carbohydrate (p = .003) and snack-type foods (p = .02) than those without LOC eating, whereas endorsement of LOC eating in pre- or early-to-mid-puberty was not associated with differences in eating behavior (ps ≥ 0.20). CONCLUSIONS Findings suggest that puberty may be a critical risk period, when LOC eating behaviors in boys and girls may become accompanied by greater weight and shape concerns and more obesogenic food consumption patterns. Interventions for LOC eating during pre-puberty should be evaluated to determine if they are particularly beneficial for the prevention of exacerbated eating disorder psychopathology and adverse weight outcomes.
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Affiliation(s)
- Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Lisa M. Ranzenhofer
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Nichole R. Kelly
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Louise M. Hannallah
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - C. Katherine Pickworth
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Mariya V. Grygorenko
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Tania A. Condarco
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Merel Kozlosky
- Nutrition Department, Clinical Center, NIH, DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA,Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Lauren B. Shomaker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
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Ranzenhofer LM, Engel SG, Crosby RD, Anderson M, Vannucci A, Cohen LA, Cassidy O, Tanofsky-Kraff M. Using ecological momentary assessment to examine interpersonal and affective predictors of loss of control eating in adolescent girls. Int J Eat Disord 2014; 47:748-57. [PMID: 25046850 PMCID: PMC4557873 DOI: 10.1002/eat.22333] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [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: 02/13/2014] [Revised: 07/01/2014] [Accepted: 07/02/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Pediatric loss of control (LOC) eating is predictive of partial- and full-syndrome binge eating disorder. The interpersonal model proposes that LOC eating is used to cope with negative mood states resulting from interpersonal distress, possibly on a momentary level. We therefore examined temporal associations between interpersonal problems, negative affect, and LOC eating among overweight adolescent girls using ecological momentary assessment (EMA). METHOD Thirty overweight and obese (≥85th body mass index (BMI) percentile; BMI: M = 36.13, SD = 7.49 kg/m(2)) adolescent females (Age: M = 14.92, SD = 1.54 y; 60.0% African American) who reported at least two LOC episodes in the past month completed self-report momentary ratings of interpersonal problems, state affect, and LOC eating for 2 weeks. A series of 2-level multilevel models with centering within subjects was conducted. RESULTS Between- and within-subjects interpersonal problems (p's < .05), but not between- (p = .12) or within- (p = .32) subjects negative affect predicted momentary LOC eating. At the between-subjects level, interpersonal problems significantly predicted increases in negative affect (p < 001). DISCUSSION Naturalistic data lend support to the predictive value of interpersonal problems for LOC eating among adolescents. Interventions targeting interpersonal factors on a momentary basis may be useful during this developmental stage.
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Affiliation(s)
- Lisa M. Ranzenhofer
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, Maryland,*Correspondence to: Lisa Ranzenhofer, Uniformed Services University of the Health Sciences, Department of Medical and Clinical Psychology 4301 Jones Bridge Road, Bethesda, MD 20814.
| | - Scott G. Engel
- Neuropsychiatric Research Institute (NRI), Fargo, North Dakota, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Ross D. Crosby
- Neuropsychiatric Research Institute (NRI), Fargo, North Dakota, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Micheline Anderson
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, Maryland
| | - Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, Maryland
| | - L. Adelyn Cohen
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, Maryland
| | - Omni Cassidy
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, Maryland
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, Maryland
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Tanofsky-Kraff M, Shomaker LB, Wilfley DE, Young JF, Sbrocco T, Stephens M, Ranzenhofer LM, Elliott C, Brady S, Radin RM, Vannucci A, Bryant EJ, Osborn R, Berger SS, Olsen C, Kozlosky M, Reynolds JC, Yanovski JA. Targeted prevention of excess weight gain and eating disorders in high-risk adolescent girls: a randomized controlled trial. Am J Clin Nutr 2014; 100:1010-8. [PMID: 25240070 PMCID: PMC4163791 DOI: 10.3945/ajcn.114.092536] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The high prevalence and incidence of obesity and eating disorders in US adolescent girls are serious health problems. Because of the shared risk factors for obesity and eating disorders, a targeted prevention of both conditions is a priority. OBJECTIVE We determined whether an adapted interpersonal psychotherapy prevention program is more efficacious for reducing excess weight gain and worsening disordered eating than health education in adolescent girls at high risk of obesity and eating disorders. DESIGN A parallel-group, randomized controlled trial was conducted between September 2008 and January 2013 in a university-based laboratory and a federal research hospital. The study included 113 adolescent (12-17-y-old) girls deemed at high risk of adult obesity and eating disorders because of a body mass index (BMI) between the 75th and 97th percentiles and reports of episodes of a loss of control over their eating. Girls were randomly assigned to participate in an adapted interpersonal psychotherapy or a health-education group program for 12 weekly 90-min group sessions. Follow-up assessments occurred immediately after group programs and at 6 and 12 mo. RESULTS Participation in both conditions was associated with decreases in expected BMI gain, age-adjusted BMI metrics, the percentage of fat by using dual-energy X-ray absorptiometry, symptoms of depression and anxiety, and the frequency of loss-of-control eating over 12 mo of follow-up (Ps < 0.001) with no group difference. In follow-up analyses, interpersonal psychotherapy was more efficacious than health education at reducing objective binge eating at the 12-mo follow-up (P < 0.05). CONCLUSIONS The intervention with adolescent girls with loss-of-control eating is associated with lower age-adjusted BMI and percentage of adiposity as well as improved mood symptoms over 1 y. Interpersonal psychotherapy further reduced objective binge eating. Additional research is needed to elucidate the mechanisms by which physical and psychological improvements were observed. This trial was registered at clinicaltrials.gov as NCT00680979.
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Affiliation(s)
- Marian Tanofsky-Kraff
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Lauren B Shomaker
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Denise E Wilfley
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Jami F Young
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Tracy Sbrocco
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Mark Stephens
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Lisa M Ranzenhofer
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Camden Elliott
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Sheila Brady
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Rachel M Radin
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Anna Vannucci
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Edny J Bryant
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Robyn Osborn
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Sarah S Berger
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Cara Olsen
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Merel Kozlosky
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - James C Reynolds
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
| | - Jack A Yanovski
- From Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD (MT-K, LBS, TS, MS, LMR, CE, RMR, AV, EJB, RO, SSB, and CO); the Nutrition Department (MK) and Nuclear Medicine Department (JCR), Hatfield Clinical Research Center, and the Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (MT-K, LBS, LMR, CE, SB, RMR, AV, SSB, and JAY), NIH, Bethesda, MD; the Department of Psychiatry, Washington University School of Medicine, St Louis, MO (DEW); and Applied and Professional Psychology, Rutgers University, Piscataway Township, NJ (JFY)
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Berger SS, Elliott C, Ranzenhofer LM, Shomaker LB, Hannallah L, Field SE, Young JF, Sbrocco T, Wilfley DE, Yanovski JA, Tanofsky-Kraff M. Interpersonal problem areas and alexithymia in adolescent girls with loss of control eating. Compr Psychiatry 2014; 55:170-8. [PMID: 24139852 PMCID: PMC3954602 DOI: 10.1016/j.comppsych.2013.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 11/20/2012] [Revised: 07/05/2013] [Accepted: 08/16/2013] [Indexed: 11/26/2022] Open
Abstract
This study investigated the links among interpersonal problem areas, depression, and alexithymia in adolescent girls at high risk for excessive weight gain and binge eating disorder. Participants were 56 girls (Mage = 14.30, SD = 1.56; 53% non-Hispanic White) with a body mass index (BMI, kg/m(2)) between the 75th and 97th percentiles (MBMI z = 1.57, SD = 0.32). By design, all participants reported loss of control eating patterns in the past month. Adolescents were individually interviewed prior to participating in a group interpersonal psychotherapy obesity and eating disorder prevention program, termed IPT for the prevention of excessive weight gain (IPT-WG). Participants' interpersonal problem areas were coded by trained raters. Participants also completed questionnaires assessing depression and alexithymia. Primary interpersonal problem areas were categorized as interpersonal deficits [as defined in the eating disorders (ED) literature] (n = 29), role disputes (n = 22), or role transitions (n = 5). Girls with interpersonal deficits-ED had greater depressive symptoms and alexithymia than girls with role disputes (p's ≤ 0.01). However, girls with role transitions did not differ from girls with interpersonal deficits-ED or role disputes. Interpersonal problem area had an indirect association with depression via alexithymia; interpersonal deficits-ED were related to greater alexithymia, which in turn, was related to greater depressive symptoms (p = 0.01). Among girls at risk for excess weight gain and eating disorders, those with interpersonal deficits-ED appear to have greater distress as compared to girls with role disputes or role transitions. Future research is required to elucidate the impact of interpersonal problem areas on psychotherapy outcomes.
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Affiliation(s)
- Sarah Shafer Berger
- Uniformed Services University of the Health Sciences, Bethesda, MD,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Camden Elliott
- Uniformed Services University of the Health Sciences, Bethesda, MD,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Lisa M. Ranzenhofer
- Uniformed Services University of the Health Sciences, Bethesda, MD,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Lauren B. Shomaker
- Uniformed Services University of the Health Sciences, Bethesda, MD,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Louise Hannallah
- Uniformed Services University of the Health Sciences, Bethesda, MD,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Sara E. Field
- Uniformed Services University of the Health Sciences, Bethesda, MD,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | | | - Tracy Sbrocco
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | | | - Jack A. Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Marian Tanofsky-Kraff
- Uniformed Services University of the Health Sciences, Bethesda, MD,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
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Vannucci A, Tanofsky-Kraff M, Crosby RD, Ranzenhofer LM, Shomaker LB, Field SE, Mooreville M, Reina SA, Kozlosky M, Yanovski SZ, Yanovski JA. Latent profile analysis to determine the typology of disinhibited eating behaviors in children and adolescents. J Consult Clin Psychol 2012; 81:494-507. [PMID: 23276121 DOI: 10.1037/a0031209] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE We used latent profile analysis (LPA) to classify children and adolescents into subtypes based on the overlap of disinhibited eating behaviors-eating in the absence of hunger, emotional eating, and subjective and objective binge eating. METHOD Participants were 411 youths (8-18 years) from the community who reported on their disinhibited eating patterns. A subset (n = 223) ate ad libitum from two test meals. RESULTS LPA produced five subtypes that were most prominently distinguished by objective binge eating (OBE; n = 53), subjective binge eating (SBE; n = 59), emotional eating (EE; n = 62), a mix of emotional eating and eating in the absence of hunger (EE-EAH; n = 172), and no disinhibited eating (No-DE; n = 64). Accounting for age, sex, race, and body mass index z score (BMI-z), the four disinhibited eating groups had more problem behaviors than the no disinhibited eating group (p = .001). OBE and SBE subtypes had greater BMI-z, percent fat mass, disordered eating attitudes, and trait anxiety than EE, EE-EAH, and No-DE subtypes (ps < .01). However, the OBE subtype reported the highest eating concern (p < .001), and the OBE, SBE, and EE subtypes reported higher depressive symptoms than the EE-EAH and No-DE subtypes. Across both test meals, OBE and SBE subtypes consumed a lesser percentage of protein and a higher percentage of carbohydrate than the other subtypes (ps < .02), adjusting for age, sex, race, height, lean mass, percent fat mass, and total intake. EE subtypes also consumed a greater percentage of carbohydrate and a lower percentage of fat than the EE-EAH and No-DE subtypes (ps < .03). The SBE subtype consumed the least total calories (p = .01). DISCUSSION We conclude that behavioral subtypes of disinhibited eating may be distinguished by psychological characteristics and objective eating behavior. Prospective data are required to determine whether subtypes predict the onset of eating disorders and obesity.
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Affiliation(s)
- Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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Vannucci A, Tanofsky-Kraff M, Shomaker LB, Ranzenhofer LM, Matheson BE, Cassidy OL, Zocca JM, Kozlosky M, Yanovski SZ, Yanovski JA. Construct validity of the emotional eating scale adapted for children and adolescents. Int J Obes (Lond) 2011; 36:938-43. [PMID: 22124451 DOI: 10.1038/ijo.2011.225] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Emotional eating, defined as eating in response to a range of negative emotions, is common in youths. Yet, there are few easily administered and well-validated methods to assess emotional eating in pediatric populations. OBJECTIVE The current study tested the construct validity of the Emotional Eating Scale (EES) Adapted for Children and Adolescents (EES-C) by examining its relationship to observed emotional eating at laboratory test meals. METHOD A total of 151 youths (8-18 years) participated in two multi-item lunch buffet meals on separate days. They ate ad libitum after being instructed to 'eat as much as you would at a normal meal' or to 'let yourself go and eat as much as you want'. State negative affect was assessed immediately before each meal. The EES-C was completed 3 months, on average, before the first test meal. RESULTS Among youths with high EES-C total scores, but not low EES-C scores, higher pre-meal state negative affect was related to greater total energy intake at both meals, with and without the inclusion of age, race, sex and body mass index (BMI) standard deviation as covariates (ps<0.03). DISCUSSION The EES-C demonstrates good construct validity for children and adolescents' observed energy intake across laboratory test meals designed to capture both normal and disinhibited eating. Future research is required to evaluate the construct validity of the EES-C in the natural environment and the predictive validity of the EES-C longitudinally.
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Affiliation(s)
- A Vannucci
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA
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Wolkoff LE, Tanofsky-Kraff M, Shomaker LB, Kozlosky M, Columbo KM, Elliott CA, Ranzenhofer LM, Osborn RL, Yanovski SZ, Yanovski JA. Self-reported vs. actual energy intake in youth with and without loss of control eating. Eat Behav 2011; 12:15-20. [PMID: 21184968 PMCID: PMC3053020 DOI: 10.1016/j.eatbeh.2010.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [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] [Received: 05/11/2010] [Revised: 08/23/2010] [Accepted: 09/13/2010] [Indexed: 11/19/2022]
Abstract
Episodes of loss of control over eating (LOC) in children and adolescents--often characterized by the consumption of highly palatable dessert and snack-type foods--have been associated with a lack of awareness while eating that could lead to under- or over-estimation of how much food is consumed. However, little is known about the reporting accuracy of food intake in youth with and without LOC eating. One hundred fifty-six girls and boys were administered the Eating Disorder Examination to assess for the presence of LOC eating. Youth were queried regarding the amounts of foods consumed directly following a multi-item, laboratory buffet test meal. Children with LOC (n=42) did not differ significantly from youth without LOC (n=114) in reporting accuracy of total food intake (reported minus actual energy intake: 153.0 ± 59.6 vs. 96.9 ± 36.0 kcal; p=0.42). However, compared to those without LOC, children with LOC were less accurate at reporting percentage of energy intake from carbohydrate (p=0.01). Youth with LOC were also less accurate at reporting their intake of desserts (p=0.04). Findings point to the possibility that youth with LOC may have poorer recall of sweet food consumption. Future research is required to examine whether poorer recall reflects a lack of awareness while eating palatable, sweet foods.
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Affiliation(s)
- Laura E. Wolkoff
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
- Uniformed Services University of the Health Sciences (USUHS)
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
- Uniformed Services University of the Health Sciences (USUHS)
| | - Lauren B. Shomaker
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
- Uniformed Services University of the Health Sciences (USUHS)
| | | | - Kelli M. Columbo
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
- Uniformed Services University of the Health Sciences (USUHS)
| | - Camden A. Elliott
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
- Uniformed Services University of the Health Sciences (USUHS)
| | - Lisa M. Ranzenhofer
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
- Uniformed Services University of the Health Sciences (USUHS)
| | - Robyn L. Osborn
- Uniformed Services University of the Health Sciences (USUHS)
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, DHHS
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS
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Shomaker LB, Tanofsky-Kraff M, Elliott C, Wolkoff LE, Columbo KM, Ranzenhofer LM, Roza CA, Yanovski SZ, Yanovski JA. Salience of loss of control for pediatric binge episodes: does size really matter? Int J Eat Disord 2010; 43:707-16. [PMID: 19827022 PMCID: PMC2891915 DOI: 10.1002/eat.20767] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.1] [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] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The subjective experience of loss of control (LOC) during eating, independent of overeating, may be a salient marker of disordered eating and risk for overweight in youth. However, few studies have directly tested this notion in an adequately powered sample. METHOD Three-hundred-sixty-seven youth (M ± SD age = 12.7 ± 2.8 y) were categorized as reporting objective binge eating (OBE; 12.5%), subjective binge eating (SBE; 11.4%), objective overeating without LOC (OO; 18.5%), or no episodes (NE; 57.5%). Disordered eating attitudes, general psychopathology, and adiposity were assessed. RESULTS Children with OBE and SBE generally did not differ in their disordered eating attitudes, emotional eating, eating in the absence of hunger, depressive and anxiety symptoms, or adiposity. However, both OBE and SBE youth had significantly greater disordered eating attitudes, emotional eating, eating in the absence of hunger, depressive and anxiety symptoms, and adiposity compared to those with OO or NE (ps < .05). DISCUSSION For non-treatment-seeking youth, LOC during eating episodes, rather than episode size, appears to be the most salient marker of eating and weight problems.
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Affiliation(s)
- Lauren B. Shomaker
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Marian Tanofsky-Kraff
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Camden Elliott
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Laura E. Wolkoff
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Kelli M. Columbo
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Lisa M. Ranzenhofer
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD
| | - Caroline A. Roza
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Susan Z. Yanovski
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD,Division of Digestive Diseases and Nutrition, NIDDK, NIH, DHHS, Bethesda, MD
| | - Jack A. Yanovski
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
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23
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Elliott CA, Tanofsky-Kraff M, Shomaker LB, Columbo KM, Wolkoff LE, Ranzenhofer LM, Yanovski JA. An examination of the interpersonal model of loss of control eating in children and adolescents. Behav Res Ther 2010; 48:424-8. [PMID: 20074702 DOI: 10.1016/j.brat.2009.12.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Revised: 11/16/2009] [Accepted: 12/22/2009] [Indexed: 10/20/2022]
Abstract
The interpersonal model of binge eating disorder proposes that social problems lead to negative affect which, in turn, precipitates binge eating episodes. However, no study to date has examined this model among youth who report loss of control (LOC) eating. Participants were 219 non-treatment-seeking children and adolescent volunteers, age 8-17 years (13.1 +/- 2.8 y; 50% female). Children's social problems were assessed by parent report. Youth completed self-report questionnaires of negative affect that assessed depressive symptoms and anxiety. Participants were interviewed to determine the presence or absence of LOC eating in the month prior to assessment. Structural equation modeling analyses found that social problems were positively related to LOC eating presence (p = .02). Negative affect mediated the relationship between social problems and LOC eating (95% CI Product = .00247, .01336). These preliminary results suggest that the interpersonal model of binge eating may describe one possible pathway for the development of LOC eating among non-treatment-seeking youth.
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Affiliation(s)
- Camden A Elliott
- Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, USA
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24
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Tanofsky-Kraff M, Han JC, Anandalingam K, Shomaker LB, Columbo KM, Wolkoff LE, Kozlosky M, Elliott C, Ranzenhofer LM, Roza CA, Yanovski SZ, Yanovski JA. The FTO gene rs9939609 obesity-risk allele and loss of control over eating. Am J Clin Nutr 2009; 90:1483-8. [PMID: 19828706 PMCID: PMC2777464 DOI: 10.3945/ajcn.2009.28439] [Citation(s) in RCA: 177] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Children with rs9939609 FTO variant alleles (homozygous = AA and heterozygous = AT) are predisposed to greater adiposity than are those with 2 wild-type alleles (TT). OBJECTIVE Because FTO is highly expressed in hypothalamic regions that are important for appetite, FTO genotype may affect energy balance by influencing eating behavior. Loss of control (LOC) eating, a behavior commonly reported by overweight youth, predicts excessive weight gain in children. However, the relation between FTO genotype and LOC eating has not been previously examined. DESIGN Two-hundred eighty-nine youth aged 6-19 y were genotyped for rs9939609, underwent body-composition measurements, and were interviewed to determine the presence or absence of LOC eating. A subset (n = 190) participated in a lunch buffet test meal designed to model an LOC eating episode. Subjects with AA and AT genotypes were grouped together for comparison with wild-type TT subjects. RESULTS Subjects with at least one A allele (67.7%) had significantly greater body mass indexes, body mass index z scores (P < 0.01), and fat mass (P < 0.05). Of the AA/AT subjects, 34.7% reported LOC compared with 18.2% of the TT subjects (P = 0.002). Although total energy intake at the test meal did not differ significantly by genotype (P = 0.61), AA/AT subjects consumed a greater percentage of energy from fat than did the TT subjects (P < 0.01). CONCLUSIONS Children and adolescents with 1 or 2 FTO rs9939609 obesity-risk alleles report more frequent LOC eating episodes and select foods higher in fat at a buffet meal. Both LOC eating and more frequent selection of energy-dense, palatable foods may be mechanisms through which variant FTO alleles lead to excess body weight.
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Affiliation(s)
- Marian Tanofsky-Kraff
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
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25
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Roberts MD, Drinkard B, Ranzenhofer LM, Salaita CG, Sebring NG, Brady SM, Pinchbeck C, Hoehl J, Yanoff LB, Savastano DM, Han JC, Yanovski JA. Prediction of maximal oxygen uptake by bioelectrical impedance analysis in overweight adolescents. J Sports Med Phys Fitness 2009; 49:240-5. [PMID: 19861930 PMCID: PMC3027125] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM Maximal oxygen uptake (VO(2max)), the gold standard for measurement of cardiorespiratory fitness, is frequently difficult to assess in overweight individuals due to physical limitations. Reactance and resistance measures obtained from bioelectrical impedance analysis (BIA) have been suggested as easily obtainable predictors of cardiorespiratory fitness, but the accuracy with which ht(2)/Z can predict VO(2max) has not previously been examined in overweight adolescents. METHODS The impedance index was used as a predictor of VO(2max) in 87 overweight girls and 47 overweight boys ages 12 to 17 with mean BMI of 38.6 + or - 7.3 and 42.5 + or - 8.2 in girls and boys respectively. The Bland Altman procedure assessed agreement between predicted and actual VO(2max). RESULTS Predicted VO(2max) was significantly correlated with measured VO(2max) (r(2)=0.48, P<0.0001). Using the Bland Altman procedure, there was significant magnitude bias (r(2)=0.10; P<0.002). The limits of agreement for predicted relative to actual VO(2max) were -589 to 574 mL O(2)/min. CONCLUSIONS The impedance index was highly correlated with VO(2max) in overweight adolescents. However, using BIA data to predict maximal oxygen uptake over-predicted VO(2max) at low levels of oxygen consumption and under-predicted VO(2max) at high levels of oxygen consumption. This magnitude bias, along with the large limits of agreement of BIA-derived predicted VO(2max), limit its usefulness in the clinical setting for overweight adolescents.
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Affiliation(s)
- Mary D. Roberts
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
| | - Bart Drinkard
- Rehabilitation Medicine Department, Clinical Research Center, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
| | - Lisa M. Ranzenhofer
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
| | - Christine G. Salaita
- Nutrition Department, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
| | - Nancy G. Sebring
- Nutrition Department, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
| | - Sheila M. Brady
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
| | - Carrie Pinchbeck
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
| | - Julie Hoehl
- Rehabilitation Medicine Department, Clinical Research Center, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
| | - Lisa B. Yanoff
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
| | - David M. Savastano
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
| | - Joan C. Han
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
| | - Jack A. Yanovski
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, Hatfield Clinical Research Center, National Institutes of Health, DHHS, Bethesda, MD
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26
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Schvey NA, Tanofsky-Kraff M, Yanoff LB, Checchi JM, Shomaker LB, Brady S, Savastano DM, Ranzenhofer LM, Yanovski SZ, Reynolds JC, Yanovski JA. Disordered-eating attitudes in relation to bone mineral density and markers of bone turnover in overweight adolescents. J Adolesc Health 2009; 45:33-9. [PMID: 19541247 PMCID: PMC2722035 DOI: 10.1016/j.jadohealth.2008.12.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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: 04/10/2008] [Revised: 12/19/2008] [Accepted: 12/29/2008] [Indexed: 10/20/2022]
Abstract
PURPOSE To examine the relationships between cognitive eating restraint and both bone mineral density (BMD) and markers of bone turnover in overweight adolescents. METHODS One hundred thirty-seven overweight (BMI 39.1 +/- 6.8 kg/m(2)) African American and Caucasian adolescent (age = 14.4 +/- 1.4 years) girls (66.4%) and boys were administered the Eating Disorder Examination (EDE) interview and Eating Inventory (EI) questionnaire and underwent dual energy X-ray absorptiometry (DXA) to measure total lumbar spine BMD. Markers of bone formation (serum bone specific alkaline phosphatase and osteocalcin), bone resorption (24-hour urine N-telopeptides), and stress (urine free cortisol) were measured. RESULTS After accounting for the contribution of demographics, height, weight, serum 25-hydroxyvitamin D, and depressive symptoms, adolescents' weight concern, as assessed by interview, was a significant contributor to the model of urine free cortisol (beta = .30, p < .05). Shape concern, as also assessed by interview, was significantly associated with lumbar spine bone mineral density (beta = -.15, p < .05). Dietary restraint was not a significant predictor in any of these models. CONCLUSIONS These findings suggest that among severely overweight adolescents, dissatisfaction with shape and weight may be salient stressors. Future research is required to illuminate the relationship between bone health and disordered-eating attitudes in overweight adolescents.
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Affiliation(s)
- Natasha A. Schvey
- Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS,Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Digestive Kidney Diseases, NIH, DHHS
| | - Marian Tanofsky-Kraff
- Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS,Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Digestive Kidney Diseases, NIH, DHHS
| | - Lisa B. Yanoff
- Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS
| | - Jenna M. Checchi
- Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS,Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive Kidney Diseases, NIH, DHHS
| | - Lauren B. Shomaker
- Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS,Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Digestive Kidney Diseases, NIH, DHHS
| | - Sheila Brady
- Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS
| | - David M. Savastano
- Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS
| | - Lisa M. Ranzenhofer
- Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS,Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Digestive Kidney Diseases, NIH, DHHS,Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive Kidney Diseases, NIH, DHHS
| | - Susan Z. Yanovski
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive Kidney Diseases, NIH, DHHS
| | - James C. Reynolds
- Nuclear Medicine Department, Hatfield Clinical Research Center, NIH, DHHS
| | - Jack A. Yanovski
- Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS
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27
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Ranzenhofer LM, Tanofsky-Kraff M, Menzie CM, Gustafson JK, Rutledge MS, Keil MF, Yanovski SZ, Yanovski JA. Structure analysis of the Children's Eating Attitudes Test in overweight and at-risk for overweight children and adolescents. Eat Behav 2008; 9:218-27. [PMID: 18329601 PMCID: PMC2291293 DOI: 10.1016/j.eatbeh.2007.09.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [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: 03/28/2007] [Revised: 08/07/2007] [Accepted: 09/12/2007] [Indexed: 11/29/2022]
Abstract
BACKGROUND In school-based samples of children, the Children's Eating Attitudes Test (ChEAT) has a four-factor structure; however, previous studies have not examined its factor structure in samples restricted to overweight youth. METHODS The ChEAT was administered to 220 overweight (BMI>or=95th percentile) and 45 at-risk for overweight (BMI 85th-<95th percentile) children and adolescents. Factors were identified by a principal component analysis with varimax rotation. ChEAT factor scores of children with BMI>or=85th percentile were contrasted with those of 152 non-overweight (BMI 5th to <85th percentile) children and adolescents. RESULTS Factor analysis generated four subscales described as 'body/weight concern,' 'food preoccupation,' 'dieting,' and 'eating concern.' ChEAT total score, body/weight concern, and dieting subscale scores were positively related to BMI-Z and body fat mass (p's<.05). Compared to non-overweight children, overweight and at-risk for overweight children had higher ChEAT total (9.9+/-7.4 vs. 6.6+/-7.8, p<.001), body/weight concern (3.2+/-3.1 vs. 1.3+/-3.0, p<.001), and dieting (1.8+/-2.2 vs. .8+/-2.3, p<.001) subscale scores. CONCLUSIONS The previously elucidated factor structure of the ChEAT was primarily supported in a sample of overweight children. The emergence of separate body/weight concern and dieting subscales may relate to these children's experiences with attempted weight reduction.
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Affiliation(s)
- Lisa M. Ranzenhofer
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
| | - Marian Tanofsky-Kraff
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814-4712, USA
| | - Carolyn M. Menzie
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
| | - Jennifer K. Gustafson
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
| | - Margaret S. Rutledge
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
| | - Margaret F. Keil
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
| | - Susan Z. Yanovski
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA,Division of Digestive Diseases and Nutrition, NIDDK, NIH, DHHS,6707 Democracy Blvd., Rm 675, Bethesda, MD 20892-5450, USA
| | - Jack A Yanovski
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
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28
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Tanofsky-Kraff M, Ranzenhofer LM, Yanovski SZ, Schvey NA, Faith M, Gustafson J, Yanovski JA. Psychometric properties of a new questionnaire to assess eating in the absence of hunger in children and adolescents. Appetite 2008; 51:148-55. [PMID: 18342988 DOI: 10.1016/j.appet.2008.01.001] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Revised: 01/23/2008] [Accepted: 01/24/2008] [Indexed: 11/26/2022]
Abstract
BACKGROUND Eating in the absence of hunger (EAH), studied in the context of laboratory paradigms, has been associated with obesity and is predictive of excess weight gain in children. However, no easily administered questionnaire exists to assess for EAH in children. OBJECTIVE We developed an Eating in the Absence of Hunger Questionnaire to be administered to children and adolescents (EAH-C) and examined psychometric properties of the measure. DESIGN Two-hundred and twenty-six obese (BMI > or = 95th percentile for age and sex, n=73) and non-obese (BMI<95th percentile, n=153) youth (mean age+/-S.D., 14.4+/-2.5 y) completed the EAH-C and measures of loss of control and emotional eating, and general psychopathology. Temporal stability was assessed in a subset of participants. RESULTS Factor analysis generated three subscales for the EAH-C: Negative Affect, External Eating, and Fatigue/Boredom. Internal consistency for all subscales was established (Cronbach's alphas: 0.80-0.88). The EAH-C subscales had good convergent validity with emotional eating and loss of control episodes (p's<0.01). Obese children reported higher Negative Affect subscale scores than non-obese children (p</=0.05). All three subscales were positively correlated with measures of general psychopathology. Intra-class correlation coefficients revealed temporal stability for all subscales (ranging from 0.65 to 0.70, p's<0.01). We conclude that the EAH-C had internally consistent subscales with good convergent validity and temporal stability, but may have limited discriminant validity. Further investigations examining the EAH-C in relation to laboratory feeding studies are required to determine whether reported EAH is related to actual energy intake or to the development of excess weight gain.
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Affiliation(s)
- Marian Tanofsky-Kraff
- Program on Developmental Endocrinology and Genetics, NICHD, National Institutes of Health, DHHS, Hatfield Clinical Research Center, Room 1-3330, Bethesda, MD 20892-1862, USA.
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29
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Drinkard B, Roberts MD, Ranzenhofer LM, Han JC, Yanoff LB, Merke DP, Savastano DM, Brady S, Yanovski JA. Oxygen-uptake efficiency slope as a determinant of fitness in overweight adolescents. Med Sci Sports Exerc 2008; 39:1811-6. [PMID: 17909409 PMCID: PMC2266873 DOI: 10.1249/mss.0b013e31812e52b3] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Peak oxygen uptake (VO2peak) is frequently difficult to assess in overweight individuals; therefore, submaximal measures that predict VO2peak are proposed as substitutes. Oxygen uptake efficiency slope (OUES) has been suggested as a submaximal measurement of cardiorespiratory fitness that is independent of exercise intensity. There are few data examining its value as a predictor of V O2peak in severely overweight adolescents. METHODS One hundred seven severely overweight (BMI Z 2.50 +/- 0.34) and 43 nonoverweight (BMI Z 0.13 +/- 0.84) adolescents, performed a maximal cycle ergometer test with respiratory gas-exchange measurements. OUES was calculated through three exercise intensities: lactate inflection point (OUES LI), 150% of lactate inflection point (OUES 150), and VO2peak (OUES PEAK). RESULTS When adjusted for lean body mass, VO2peak and OUES at all exercise intensities were lower in overweight subjects (VO2peak: 35.3 +/- 6.4 vs 46.8 +/- 7.9 mL.kg(-1) LBM.min(-1), P < 0.001; OUES LI: 37.9 +/- 10.0 vs 43.7 +/- 9.2 mL.kg(-1) LBM.min(-1).logL(-1) P < 0.001; OUES 150: 41.6 +/- 9.0 vs 49.8 +/- 11.1 mL.kg(-1) LBM.min(-1).logL(-1) P < 0.001; and OUES PEAK: 45.1 +/- 8.7 vs 52.8 +/- 9.6 mL.kg(-1) LBM.min(-1).logL(-1) P < 0.001). There was a significant increase in OUES with increasing exercise intensity in both groups (P < 0.001). OUES at all exercise intensities was a significant predictor of VO2peak for both groups (r2 = 0.35-0.83, P < 0.0001). However, limits of agreement for predicted VO2peak relative to actual VO2peak were wide (+/- 478 to +/- 670 mL.min(-1)). CONCLUSIONS OUES differs significantly in overweight and nonoverweight adolescents. The wide interindividual variation and the exercise intensity dependence of OUES preclude its use in clinical practice as a predictor of VO2peak.
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Affiliation(s)
- Bart Drinkard
- Rehabilitation Medicine Department, Mark O. Hatfield Clinical Research Center, National Institutes of Health, Bethesda, MD
| | - Mary D. Roberts
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, MD
| | - Lisa M. Ranzenhofer
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, MD
| | - Joan C. Han
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, MD
| | - Lisa B. Yanoff
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, MD
| | - Deborah P. Merke
- Reproductive Biology and Medicine Branch, National Institute of Child Health and Human Development, Bethesda, MD
- NIH Clinical Center, National Institutes of Health, Bethesda, MD
| | - David M. Savastano
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, MD
| | - Sheila Brady
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, MD
| | - Jack A. Yanovski
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, MD
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Theim KR, Tanofsky-Kraff M, Salaita CG, Haynos AF, Mirch MC, Ranzenhofer LM, Yanovski SZ, Wilfley DE, Yanovski JA. Children's descriptions of the foods consumed during loss of control eating episodes. Eat Behav 2007; 8:258-65. [PMID: 17336796 PMCID: PMC1820891 DOI: 10.1016/j.eatbeh.2006.10.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [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] [Received: 05/13/2006] [Revised: 08/14/2006] [Accepted: 10/31/2006] [Indexed: 11/23/2022]
Abstract
Binge and loss of control (LOC) eating appear to be common among youth; however, little is known about the foods consumed during such eating episodes. Two-hundred forty-nine children, age 6-18 years, were interviewed to determine if they engaged in eating episodes with LOC over the past month. In the absence of reported LOC eating, overeating episodes or normal meals without LOC were recorded. Participants were asked to describe the type and quantity of foods eaten during an episode. Eighty-one children reported LOC eating episodes and 168 reported no such episodes (No LOC). Although total energy intake did not differ between LOC and No LOC episodes, LOC episodes consisted of a lower percentage of calories from protein (14.2+/-0.7 v. 18.0+/-0.7%, p<.001) and a higher percentage from carbohydrates (49.8+/-1.6 v. 45.2+/-1.1%, p<.05). Specifically, LOC episodes consisted of a higher percentage of calories from snacks (13.2+/-2.7 v. 7.4+/-1.2%, p<.05) and desserts (18.1+/-3.1 v. 12.8+/-1.5%, p<.05). The quality of LOC episodes may help explain why LOC eating promotes excessive weight gain among children who report such episodes.
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Affiliation(s)
- Kelly R. Theim
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
| | - Marian Tanofsky-Kraff
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814-4712, USA
| | - Christine G. Salaita
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
| | - Ann F. Haynos
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
| | - Margaret C. Mirch
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
| | - Lisa M. Ranzenhofer
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
| | - Susan Z. Yanovski
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
- Division of Digestive Diseases and Nutrition, NIDDK, NIH, DHHS, 6707 Democracy Blvd., Rm 675, Bethesda, MD 20892-5450, USA
| | - Denise E. Wilfley
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology 6363 Alvarado Ct. Suite 103, San Diego, CA 92120-4913, USA
| | - Jack A. Yanovski
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Hatfield CRC, 10 Center Dr., Rm 1-3330 MSC-1103, Bethesda, MD 20892-1103, USA
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Tanofsky-Kraff M, Theim KR, Yanovski SZ, Bassett AM, Burns NP, Ranzenhofer LM, Glasofer DR, Yanovski JA. Validation of the emotional eating scale adapted for use in children and adolescents (EES-C). Int J Eat Disord 2007; 40:232-40. [PMID: 17262813 PMCID: PMC1995096 DOI: 10.1002/eat.20362] [Citation(s) in RCA: 139] [Impact Index Per Article: 8.2] [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: 11/10/2022]
Abstract
OBJECTIVE Eating in response to negative emotions is associated with binge or loss of control (LOC) eating in adults. Although children report engaging in LOC eating, data on emotional eating among youth are limited. METHOD We adapted the adult Emotional Eating Scale (Arnow et al., Int J Eat Disord, 18, 79-90, 1995) to be used with children and adolescents (EES-C). Fifty-nine overweight (BMI > or = 95th percentile for age and sex) and 100 non-overweight (BMI 5th-94th percentile) participants (mean age +/- SD 14.3 +/- 2.4 years) completed the EES-C, and measures of recent LOC eating and general psychopathology. Test-retest reliability was assessed in 64 children over a 3.4 +/- 2.6 month interval. RESULTS A factor analysis generated three subscales: eating in response to anxiety, anger, and frustration (EES-C-AAF), depressive symptoms (EES-C-DEP), and feeling unsettled (EES-C-UNS). Internal consistency for the subscales was established; Cronbach's alphas for the EES-C-AAF, EES-C-DEP, and EES-C-UNS were 0.95, 0.92, and 0.83, respectively. The EES-C had good convergent validity: children reporting recent LOC eating episodes scored higher on all subscales (p's < 0.05). The EES-C-AAF and EES-C-UNS subscales demonstrated good discriminant validity and the EES-C-DEP revealed adequate discriminant validity. Intra-class correlation coefficients revealed good temporal stability for each subscale (EES-C-AAF = 0.59, EES-C-DEP = 0.74, EES-C-UNS = 0.66; p's < 0.001). CONCLUSION The EES-C has good convergent and discriminant validity, and test-retest reliability for assessing emotional eating in children. Further investigation is required to clarify the role emotional eating may play in children's energy intake and body weight.
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Affiliation(s)
- Marian Tanofsky-Kraff
- Unit on Growth and Obesity, Developmental Endocrinology Branch, NICHD, National Institutes of Health, DHHS, Bethesda, Maryland, USA.
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Tanofsky-Kraff M, Rahimi AM, Yanovski SZ, Ranzenhofer LM, Roberts MD, Theim KR, Menzie CM, Mirch MC, Yanovski JA. Differences between the perceived and actual age of overweight onset in children and adolescents. MedGenMed 2006; 8:18. [PMID: 17406158 PMCID: PMC1781270] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVE Little is known about whether children or their parents can accurately recall the age at which they became overweight. DESIGN, SUBJECTS AND MAIN OUTCOME MEASURES: We interviewed 64 overweight children (7-18 years old) about their weight history and compared reported age of overweight onset with actual onset, as determined by the age at which the child's measured BMI first exceeded the 95th percentile. RESULTS Only 28% of children reported overweight onset within 1 year of actual overweight onset. Reported overweight onset age (7.6 +/- 2.5 y) and actual onset age (5.3 +/- 2.5 y; P < .001) were not significantly correlated (r2 = .03, P = .22). Children who became overweight before 8 years of age tended to report becoming overweight at a later age than actual onset, whereas children who became overweight after 8 years of age tended to report becoming overweight at an earlier age than actual onset (P < .001), with 27% of children either underreporting or overreporting their overweight onset by at least 5 years. Similar results were found when analyzing parent reports of their children's overweight onset. CONCLUSIONS Reported and actual overweight onset ages were uncorrelated in our sample, suggesting that families may not be cognizant of children's growth trajectories. Greater efforts should be made to help parents and children understand and track growth patterns with the aim of preventing excessive weight gain.
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Affiliation(s)
- Marian Tanofsky-Kraff
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health & Human Development, National Institutes of Health and Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Amanda M. Rahimi
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health & Human Development, National Institutes of Health, Rockville, Maryland
| | - Susan Z. Yanovski
- Division of Digestive Diseases and Nutrition, NIDDK, National Institutes of Health, DHHS, Rockville, Maryland
| | - Lisa M. Ranzenhofer
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health & Human Development, National Institutes of Health, Rockville, Maryland
| | - Mary D. Roberts
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health & Human Development, National Institutes of Health, Rockville, Maryland
| | - Kelly R. Theim
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health & Human Development, National Institutes of Health, Rockville, Maryland
| | - Carolyn M. Menzie
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health & Human Development, National Institutes of Health, Rockville, Maryland
| | - Margaret C. Mirch
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health & Human Development, National Institutes of Health, Rockville, Maryland
| | - Jack A. Yanovski
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health & Human Development, National Institutes of Health, Rockville, Maryland
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Glasofer DR, Tanofsky-Kraff M, Eddy KT, Yanovski SZ, Theim KR, Mirch MC, Ghorbani S, Ranzenhofer LM, Haaga D, Yanovski JA. Binge eating in overweight treatment-seeking adolescents. J Pediatr Psychol 2006; 32:95-105. [PMID: 16801323 PMCID: PMC1862866 DOI: 10.1093/jpepsy/jsl012] [Citation(s) in RCA: 160] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To examine the frequency and recency of binge eating in relation to psychopathology in overweight, treatment-seeking adolescents. METHODS We investigated psychological correlates of the frequency and recency of reported loss of control (LOC) eating episodes in 160 overweight (body mass index [BMI]: 40.7 +/- 8.8 kg/m(2)) adolescents. On the basis of the responses to the eating disorder examination (EDE), participants were categorized into one of four groups: full-syndrome binge eating disorder (BED); recent but infrequent binge eating (episodes within the 3 months before interview; RECENT-BINGE); remote and infrequent LOC eating (episodes occurring >3 months before assessment; PAST-LOC), or no history of LOC episodes (NE). RESULTS The BED group reported higher EDE scores (global, p < .01), and more negative mood and anxiety than all other groups (p's < .01). Compared with NE, RECENT-BINGE also reported more anxiety and higher EDE scores (p's < .01). CONCLUSIONS Overweight, treatment-seeking adolescents with BED are clearly distinguishable from teens without the disorder on measures of eating-related psychopathology, mood, and anxiety. RECENT-BINGE, but not PAST-LOC, is also associated with significantly greater eating-related and general psychopathology.
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Affiliation(s)
- Deborah R. Glasofer
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, American University
- Department of Psychology, American University
| | - Marian Tanofsky-Kraff
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, American University
| | - Kamryn T. Eddy
- Center for Anxiety and Related Disorders, Boston University
- Optimal Weight for Life Clinic, Children’s Hospital
| | | | - Kelly R. Theim
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, American University
| | - Margaret C. Mirch
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, American University
| | - Samareh Ghorbani
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, American University
- Division of Nutrition Research Coordination, National Institute of Diabetes and Digestive Kidney Diseases, National Institutes of Health, DHHS
| | - Lisa M. Ranzenhofer
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, American University
- Division of Nutrition Research Coordination, National Institute of Diabetes and Digestive Kidney Diseases, National Institutes of Health, DHHS
| | - David Haaga
- Department of Psychology, American University
| | - Jack A. Yanovski
- Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, American University
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