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Biomedical subjects

Jennifer D Lundgren

Publications and source records attributed to Jennifer D Lundgren.

12 recordsLinked to original sources

Familial aggregation in the night eating syndrome.

OBJECTIVE: This study examined the extent to which the night eating syndrome (NES) affects first-degree relatives of NES and control probands. METHOD: NES participants and controls were assessed with the Night Eating Questionnaire (NEQ), the Night Eating Syndrome History and Inventory (NESHI), 10 day sleep and food records, the Eating Disorder Examination (EDE), the Structured Clinical Interview for DSM IV Axis I Disorders (SCID I), and a Family History Questionnaire (FHQ) to assess the presence of NES among first-degree relatives. A proband predictive model, using logistic regression analyses and the generalized estimating equation to control for correlation among observations within families was used to assess familial aggregation. RESULTS: The odds of an NES proband having an affected first-degree relative were significantly greater than that of a control proband (odds ratio=4.9, p<.001). A number of covariates were included in the model: proband body mass index (BMI) (kg/m2), proband gender, proband age, proband ethnicity, first-degree relative gender, relationship to proband (i.e., mother, father, or sibling), and the interaction between relationship to proband and proband status (night eater or control); none was statistically significant (p>.05). CONCLUSION: The study showed a strong aggregation of NES in families.

Adult↗

A randomized, placebo-controlled trial of sertraline in the treatment of night eating syndrome.

OBJECTIVE: The authors assessed the efficacy of sertraline in the treatment of night eating syndrome. METHOD: Thirty-four outpatients diagnosed with night eating syndrome were randomly assigned to receive either sertraline (N=17) or placebo (N=17) in an 8-week, double-blind, flexible-dose (50-200 mg/day) study. A mixed effects linear regression model was used to analyze change in the primary outcome measure, Clinical Global Impression (CGI) improvement rating. Secondary outcomes included changes in night eating symptoms, the number of nocturnal awakenings and ingestions, total daily caloric intake after the evening meal, CGI severity ratings, quality of life ratings, and weight. RESULTS: Sertraline was associated with significantly greater improvement than placebo. Twelve subjects in the sertraline group (71%) were classified as having responded (CGI improvement rating < or = 2, indicating much or very much improved) versus only three (18%) in the placebo group. There were also significant improvements in night eating symptoms, CGI severity ratings, quality of life ratings, frequency of nocturnal ingestions and awakenings, and caloric intake after the evening meal. Overweight and obese subjects in the sertraline group (N=14) lost a significant amount of weight by week 8 (mean=-2.9 kg, SD=3.8) compared with overweight and obese subjects receiving placebo (N=14) (mean=-0.3 kg, SD=2.7). CONCLUSIONS: In this 8-week trial, sertraline was effective in the treatment of night eating syndrome and was well tolerated.

Adult↗

Prevalence of the night eating syndrome in a psychiatric population.

OBJECTIVE: This study assessed the prevalence of night eating syndrome and its comorbid psychopathology in a psychiatric population. METHOD: The Night Eating Questionnaire was administered to 399 patients in two psychiatric outpatient clinics. Those scoring above 20 on the questionnaire (N=205) were assessed for night eating syndrome with a semistructured telephone interview. Chart reviews of all participants were performed to determine their psychiatric diagnoses and medications. RESULTS: Forty-nine participants (12.3%) met criteria for night eating syndrome. Greater rates of substance use disorders were found among patients diagnosed with night eating syndrome than among those without the syndrome. Obese patients were more likely than nonobese patients to manifest night eating syndrome. CONCLUSIONS: Night eating syndrome is prevalent among psychiatric clinic outpatients and is likely to co-occur with substance use disorders and obesity.

Adult↗

A paradigm for facilitating pharmacotherapy at a distance: sertraline treatment of the night eating syndrome.

OBJECTIVE: To test a novel method of facilitating pharmacotherapy at a distance and assess the effectiveness of sertraline for the treatment of night eating syndrome (NES). METHOD: The effectiveness of the selective serotonin reuptake inhibitor sertraline in the treatment of NES was assessed at a distance. NES is characterized by a delay in the circadian rhythm of food intake, with evening hyperphagia and/or nighttime awakenings and ingestions. Persons who contacted us through our Web site, e-mail, or telephone for help with their NES completed a Night Eating Questionnaire and received a semistructured interview (Night Eating Syndrome History and Inventory) to determine the presence of NES. Fifty such persons received treatment with sertraline from their own physicians, to whom we offered consultation. Participants completed questionnaires every 2 weeks for 8 weeks and received a final telephone interview to assess their progress. Outcomes were compared with those from an earlier face-to-face open-label trial of sertraline. The study was conducted from September 2003 to May 2005. RESULTS: Both the questionnaires and interviews showed improvements in 5 key aspects of NES: the general Night Eating Symptom Scale, evening hyperphagia, nighttime awakenings, nocturnal ingestions, and the Beck Depression Inventory (all p < .001), and the mean body weight of the 41 overweight and obese subjects, reported by survey, fell 3.0 kg (p = .01). These results are similar to those obtained in an earlier face-to-face trial of sertraline with NES. CONCLUSION: The study confirmed the effectiveness of sertraline in the treatment of NES and introduced a paradigm for facilitating pharmaco-therapy at a distance.

Body Weight↗

Smoking status and weight loss in three weight loss programs.

The purpose of the study was to examine differences in current, former, and never smokers' weight loss in three comprehensive weight loss programs. Archival data from 389 overweight participants enrolled in three comprehensive weight loss programs were analyzed. The programs differed in length and by type of diet (food-based low calorie diet, partial meal replacement low calorie diet, and supplement-based very low calorie diet). Significant differences in weight loss were found among former, current, and never smokers in one weight loss program (partial meal replacement low calorie diet). Post hoc analyses showed that former smokers lost significantly more weight than current smokers. Results suggest that current smokers are not more successful at behavioral weight loss than former smokers, and if anything, are less successful. Former smokers do not appear to have difficulty losing weight compared to current and never smokers.

Adult↗

Cognitive-behavioral therapy for bulimia nervosa: an empirical analysis of clinical significance.

OBJECTIVE: The purpose of this review was to assess the clinical significance of cognitive-behavioral therapy for bulimia nervosa using the reliable change index and normative comparison analyses. METHOD: Fifteen treatment outcome studies using either individual or group cognitive-behavioral therapy for bulimia nervosa were selected for inclusion. RESULTS: Results suggest that cognitive-behavioral therapy for bulimia nervosa produces clinically significant change for many treatment outcome measures when using the reliable change index. However, posttreatment symptomatology is rarely within a normative range when examined with normative comparison analyses. DISCUSSION: This review provides a first step in examining the clinical significance of treatment for bulimia nervosa. Future studies should further this work by comparing the clinical significance of different types of treatment for bulimia nervosa using additional assessment measures.

Adult↗

Fear of negative appearance evaluation: development and evaluation of a new construct for risk factor work in the field of eating disorders.

The psychometric properties and correlates of a measure designed to assess fear of negative appearance evaluation are presented. In Study 1, 165 college females completed the Fear of Negative Appearance Evaluation Scale [FNAES; Thomas, C.M., Keery, H., Williams, R., & Thompson, J. K. (1998, November). The Fear of Negative Appearance Evaluation Scale: Development and preliminary validation. Paper presented at the annual meeting of the Association for the Advancement of Behavior Therapy, Washington, DC] along with measures of body image, eating disturbance, and depression. Results replicated previous analyses indicating the presence of a single factor, good internal consistency, and significant association with measures of body image and eating disturbance. Additionally, the FNAES accounted for unique variance beyond that explained by general fear of negative evaluation, and other measures of body image and eating disturbance, in the prediction of body shape dysphoria, dietary restraint, and trait anxiety. Study 2 further examined the validity of the FNAES, finding it to correlate significantly with measures of social physique anxiety, body image, eating attitude, and mood. The FNAES did not significantly correlate with body mass index (BMI). Regression analyses found the FNAES to predict levels of body image, eating attitude, and mood beyond variance explained by social physique anxiety. The FNAES appears to measure a conceptually unique aspect of body image that has not been indexed by previous measures and may serve a useful role in risk factor and preventive work.

Adolescent↗

Assessment of eating disorders: review and recommendations for clinical use.

Practitioners have come under increasing pressure to provide objective data on assessment and treatment outcome of clients. This article provides a brief summary of assessment of eating disorders for the practicing clinician, with an emphasis on well-validated assessment instruments. The critical domains that should be covered in a thorough assessment of eating disorders are reviewed, as are some shortcomings in the current assessment literature, and also discussed is which assessment instruments for the eating disorders are most useful in a clinical context. Using well-validated, standardized assessment instruments in all phases of the treatment process is a critical part of justifying a treatment plan and providing objective data on client progress and outcome.

Body Weight↗

The freshman year of college as a critical period for weight gain: an initial evaluation.

Prevention of obesity and weight maintenance have become important public health issues. One strategy for prevention of obesity is to identify critical periods of weight gain across the life span. The purpose of this initial evaluation was to determine whether the transition from high school to college is such a critical period. A total of 135 college students were weighed in September and December of their freshman year and a subset also provided data in May. Results showed that statistically significant but modest weight increases occurred during the freshman year for most participants. However, one quarter of participants gained at least 2.3 kg during the first semester of college, and the proportion of participants classified as overweight or obese increased markedly. For this subset of participants, the freshman year of college could be considered a critical period for weight gain. Identifying critical periods for weight gain may be an important first step towards the development of effective obesity prevention programs.

Journal Article↗

Weight goals in a college-age population.

OBJECTIVE: Although a growing body of literature has found unrealistic weight loss goals to be common among older, primarily female, subjects, little is known about weight loss goals of younger adults. RESEARCH METHODS AND PROCEDURES: Three hundred seventy-nine college students had their height and weight taken and reported their "goal," "dream," "happy," "acceptable," and "disappointed" weights. A series of 2 (gender) x 2 (nonoverweight vs. overweight) ANOVAs were conducted with both absolute weight goals and percentage of weight loss needed to obtain those goals as dependent variables. RESULTS: When examined in terms of absolute weight goals, women generally had lower body mass index (BMI) goals than men, and nonoverweight participants had lower BMI goals than overweight participants. Surprisingly, most overweight participants would accept a weight loss that would still place them in the overweight BMI range. When examined in terms of percentage loss needed to reach those goals, only overweight women chose goal and dream weights that would require a loss greater than can be expected from nonsurgical weight-loss treatments, and all overweight participants chose happy and acceptable weights within 15% of current weight. DISCUSSION: Participants in this study had generally reasonable weight-loss goals, and even the most extreme weight loss goals were much more moderate than those found in previous studies. These results are surprising given the extreme social pressures for thinness facing young adults. Future studies should examine the variables that influence selection of goal weights and how goal weights affect actual dieting behavior.

Adolescent↗

Self-reported dietary restraint is associated with elevated levels of salivary cortisol.

Previous studies have found inconsistent relationships between restrained eating, dieting, and cortisol. The present study was designed to clarify the relationship between self-reported restrained eating and cortisol using multiple measures of dietary restraint. Eighty-five college-age women completed the Restraint Scale (RS) and the Cognitive Restraint Scale of the Three Factor Eating Questionnaire (TFEQ-R) and provided a saliva sample for analysis of cortisol. Both measures of restraint were positively associated with elevated levels of salivary cortisol, although the TFEQ-R was more strongly associated than the RS. Restrained eating, characterized by largely unsuccessful efforts to control eating, may lead to elevated cortisol levels.

Adolescent↗