Development and Validation of a Brief Measure of Eating Compulsivity (MEC)

Food addiction is increasingly being recognised as a contributory factor in overweight and obesity. Management of eating compulsivity, a key component of food addiction, may assist greatly in the successful treatment of obesity. Measurement of food addiction and its core characteristic of eating compulsivity is fundamental to increasing understandings of the concept of food addiction, its prevalence among people with and without obesity and its utility within a treatment context. The current study describes the development and initial validation of a brief measure of eating compulsivity that can be used within clinical and research settings to establish a person's level of eating compulsivity. Sixty five participants with a BMI ≥30 (mean BMI 38.1) were recruited from a general population sample within Christchurch, New Zealand. Participants completed the test version of the Measure of Eating Compulsivity (MEC) and the Yale Food Addiction Scale (YFAS) as well as providing self-reported measures of height and weight. The 10-item MEC was developed. This measure was shown to have excellent internal consistency (Cronbach's alpha =.946), based on a single factor accounting for 67.4% of the variance and excellent test-retest reliability (r =.923). MEC10 score was strongly predictive of being categorised as having food addiction based on the YFAS, although not associated with BMI. This brief tool is likely to have high utility in clinical and research settings and requires further validation with a range of populations including those with and without obesity, binge eating disorder and other eating disorders.

Psychosocial enhancement of the Green Prescription for obesity recovery: a randomised controlled trial

AIMS

Kia Ākina is a low-cost obesity recovery network providing ongoing addiction-orientated psychosocial support. This study explored the impact of Kia Ākina when added to the Green Prescription, a key government-funded health promotion programme in New Zealand.

METHODS

A randomised controlled trial (ACTRN12613001160729) involving 108 participants recruited from primary care compared Green Prescription plus Kia Ākina (KA/GRx) with Green Prescription alone (GRx) over 12 months. The primary a priori outcome measure was achieving 5% loss of weight from baseline.

RESULTS

KA/GRx participants lost more weight overall than GRx (3.6kg vs 0.7kg, p=0.03), while 39% of the GRx group gained weight compared with 21% of KA/GRx (p=0.04). However, KA/GRx and GRx had similar proportions with weight loss of 5% or greater (20% vs 17%, p=0.62). KA/GRx participants had greater changes in confidence about recovery (p=0.02), and quality of life measures (p=0.03) and greater overall satisfaction with assistance received (p<0.001) compared with GRx participants.

CONCLUSIONS

Psychosocial support provided through Kia Ākina enhanced treatment outcomes for people with obesity at 12 months when added to GRx, although weight-loss outcomes were modest. Before Kia Ākina is expanded, improved weight-loss outcomes are required, which may be achieved through individualised assessment and targeted dietary assistance.

Addictive overeating: lessons learned from medical students' perceptions of Overeaters Anonymous

AIM

To explore medical students' perceptions of Overeaters Anonymous (OA).

METHOD

72 fifth-year medical students' reports of their experiences of attending OA meetings were analysed using thematic analysis. Students were required to submit these reports in order to complete a compulsory component of the Addiction Medicine run in their medical training at the University of Otago, Christchurch during 2002-2007.

RESULTS

Analysis of the students' reports highlights an emerging understanding of the concepts of addiction in general and addictive overeating in particular. This understanding is reflected in the students' acceptance of addictive overeating as a potential disorder and their increased empathy and confidence in working with patients with this disorder.

CONCLUSIONS

Improving treatment for people with obesity is a major contemporary health challenge. Addictive overeating could be a critical element in understanding the nature of obesity but has not been the subject of extensive research to date. Medical students in this study discovered that addiction to food is not just a theoretical construct but fits with the actual experience of people. The poignancy of these narratives illustrates how such information can promote greater understanding of medical and other life issues which may benefit their identification and treatment.

Profile of young people attending alcohol and other drug treatment services in Aotearoa, New Zealand: clinical file search

OBJECTIVE

The aim of the present study was to provide a profile of young people attending alcohol and other drug (AOD) treatment services in Aotearoa, New Zealand.

METHOD

Data were gathered from a clinical file search of 184 randomly selected young people aged 13-19 years who had attended one of eight youth AOD treatment services in New Zealand during 2003 or 2004. These services represented eight of the 11 youth-specific AOD services available to youth in New Zealand.

RESULTS

Young people who attend youth-specific AOD services in New Zealand present with a range of complex needs including substance use and mental health issues, criminality, family conflict and disengagement from school. A total of 62.0% were male, 56.4% had criminal convictions, 40.6% had spent some time in Child, Youth and Family Services care and 53.8% were reported to have a coexisting substance use and mental health disorder. Low rates of reporting of substance use and mental health diagnoses in treatment files suggest that substance use and mental health disorders among this population are likely to be higher than those reported.

CONCLUSIONS

This paper provides a unique profile of young people attending youth-specific AOD treatments in New Zealand. Such information is useful in informing treatment planning and funding and ensuring that service development occurs to specifically meet the complex needs of this patient group.

Conserved and divergent aspects of terminal patterning in the beetle Tribolium castaneum

To infer similarities and differences in terminal pattern formation in insects, we analyzed several of the key genes of this process in the beetle Tribolium castaneum. We cloned two genes of the terminal pattern cascade, namely tailless (tll) and forkhead (fkh), from Tribolium and studied their expression patterns. In addition, we analyzed the pattern of MAP kinase activation at blastoderm stage as a possible signature for torso-dependent signaling. Further, we analyzed the late expression of the previously cloned Tribolium caudal (Tc-cad) gene. Finally, we used the upstream region of Tc-tll to drive a reporter gene construct in Drosophila. We find that this construct is activated at the terminal regions in Drosophila, suggesting that the torso-dependent pathway is conserved between the species. We show that most of the expression patterns of the genes studied here are similar in Drosophila and Tribolium, suggesting conserved functions. There is, however, one exception, namely the early function of Tc-tll at the posterior pole. In Drosophila, the posterior tll expression is involved in the direct regulation of the target genes of the terminal pathway. In Tribolium, posterior Tc-tll expression occurs only for a short time and ceases before the target genes known from Drosophila are activated. Thus, we infer that Tc-tll does not function as a direct regulator of segmentation genes at the posterior end. It is more likely to be involved in the early specification of a group of "terminal" cells, which begin to differentiate only at a later stage of embryogenesis, when much of the abdominal segmentation process is complete. Thus, there appears to have been a major shift in tll function during the evolutionary transition from short germ to long germ embryogenesis.

First performance results of PTB's atomic caesium fountain and a study of contributions to its frequency instability

At the Physikalisch-Technische Bundesanstalt (PTB), an atomic caesium fountain was constructed. Ramsey fringes with a full width at half maximum (FWHM) of 0.86 Hz were obtained by launching the atoms to a height of 83 cm above the cooling region (40 cm above the microwave cavity center). A first measurement of the homogeneity of the magnetic flux density yields 0.33 nT (rms), only 0.16% of the mean value of 0.205 muT used in normal operation. The inherent elementary noise contributions of the fountain and of a thermal beam atomic clock are compared in some detail.

Recent results of Physikalisch-Technische Bundesanstalt's primary clock CS1

This paper describes the current performance of the Physikalisch-Technische Bundesanstalt's (PTB) primary clock CS1. After major reconstruction during 1995 and 1996, routine clock operation was started in May 1997. An evaluation of the CS1 Type B uncertainty yielded 7.10(-15) (1sigma). The performance of the CS1 is illustrated by results of a comparison lasting 2 yr with other clocks at PTB and with the international Atomic Time (TAI) and free atomic time scales. With reference to TAI, e.g., a frequency instability of 3.9.10(-15) at an averaging time of 30 d was observed.