PubMed Health⌕ Search

Biomedical subjects

R H Striegel-Moore

Publications and source records attributed to R H Striegel-Moore.

At least 19 recordsLinked to original sources

Factors differentiating women and men who successfully maintain weight loss from women and men who do not.

The current study explored the relative contribution of exercise, coping responses, cognitive attributions, and emotional experiences to successful weight-loss maintenance in men and women. The data were collected via a large community-based survey on dieting and weight loss commissioned by Consumer Union. Men and women who met our criteria for successful (n = 277 men, n = 329 women) and unsuccessful (n = 277 men, n = 329 women) weight-loss maintenance were included in the sample. Successful weight-loss maintainers (Maintainers) reported having lost at least 10% of their highest adult weight and having maintained that weight loss for at least the three years immediately prior to the survey. Unsuccessful weight-loss maintainers (Regainers) reported not ever having been able to maintain a significant weight loss and having lost and regained a minimum of 10 to 19 pounds at least once. In response to a dietary lapse, Maintainers, as compared with Regainers, reported being more likely to use direct coping and less likely to seek help. The results imply that the most useful variables for differentiating between successful and unsuccessful weight-loss maintainers may involve how they respond to a dietary lapse.

Adaptation, Psychological↗

Comparison of binge eating disorder and bulimia nervosa in a community sample.

OBJECTIVE: This study examined the relationship between binge eating disorder (BED), a newly proposed eating disorder, and bulimia nervosa (BN). METHOD: Three groups recruited from the community were compared: women with BED (n = 150), women with purging BN (n = 48), and women with nonpurging BN (n = 14). RESULTS: The three groups did not differ significantly in education, weight or shape concern, and current or lifetime prevalence of nine major mental disorders. Women with BED, compared with women with purging BN, were older, less likely to have a history of anorexia nervosa, and less likely to have been treated for an eating disorder. Obesity was more commonly associated with BED than with either subtype of BN. DISCUSSION: Our results lend some support to BED as an eating disorder distinct from purging BN. More research is needed to clarify the position of nonpurging BN relative to BED and purging BN.

Adult↗

Barriers to treatment for eating disorders among ethnically diverse women.

OBJECTIVE: This study examined barriers to treatment in an ethnically diverse community sample of women with eating disorders. METHOD: Participants were 61 women (22 Hispanics, 8 Asians, 12 Blacks, 19 Whites) with eating disorders. Diagnosis was determined using the Eating Disorder Examination. Treatment-seeking history, barriers to treatment seeking, ethnic identity, and acculturation were assessed. RESULTS: Although 85% of the sample reported wanting help for an eating problem, only 57% had ever sought treatment for an eating or weight problem. Individuals who had sought treatment reported being significantly more distressed about their binge eating than those who had not sought treatment and having begun overeating at a younger age. Of those who had sought help, 86% had not received any treatment for their eating problems. The main barriers to treatment seeking were financial reasons. CONCLUSION: Women from minority groups who have eating disorders are underdiagnosed and typically not treated.

Adult↗

Exploring the relationship between timing of menarche and eating disorder symptoms in Black and White adolescent girls.

OBJECTIVE: This study examined the relationship between timing of sexual maturation and eating disorders symptoms in adolescent girls. METHOD: Data were collected over 10 years for a cohort of 1,213 Black girls and 1,166 White girls who were either 9 or 10 years old at study entry. Annually, girls' height and weight were measured and, biannually, girls completed self-report measures of eating disorders symptoms. RESULTS: Early-onset menarche is a risk factor for the development of body image and dieting concerns, but the effect of timing is due to the impact of early and late maturation on body weight. DISCUSSION: Findings underscore the importance of adiposity as a risk factor for poor mental health.

Adolescent↗

Bias in binge eating disorder: how representative are recruited clinic samples?

The aim of this study was to investigate sampling bias as it affects recruited clinic samples of binge eating disorder (BED). Demographic and clinical characteristics of a recruited clinic sample were compared with a community sample. The 2 groups met the same operational definition of BED and were assessed using the same primarily interview-based methods. Ethnicity, severity of binge eating, and social maladjustment were found to increase treatment seeking among participants with BED rather than levels of psychiatric distress or comorbidity. These findings suggest that previous studies using recruited clinic samples have not biased estimates of psychiatric comorbidity in BED.

Adolescent↗

A comparison of black and white women with binge eating disorder.

OBJECTIVE: Binge eating disorder was introduced in DSM-IV as a psychiatric disorder needing further study. This community-based study describes the relationship between race and clinical functioning in black and white women with and without binge eating disorder. METHOD: A group of 150 women with binge eating disorder (52 black, 98 white) and a race-matched group of 150 healthy comparison subjects were recruited from the community. Eating and psychiatric symptoms were assessed through interviews and self-report. RESULTS: Black and white women with binge eating disorder differed significantly on numerous eating disorder features, including binge frequency, restraint, history of other eating disorders, treatment-seeking behavior, and concerns with eating, weight, and shape. Black and white healthy comparison subjects differed significantly in obesity rates. CONCLUSIONS: For both black and white women, binge eating disorder was associated with significant impairment in clinical functioning. Yet, racial differences in clinical presentation underscore the importance of considering race in psychopathology research.

Acculturation↗

Recurrent binge eating in black American women.

CONTEXT: Recurrent binge eating is a core diagnostic feature of bulimia nervosa and binge eating disorder, and in samples of white women has been associated with obesity and psychiatric symptoms. Eating disorders have been believed to occur primarily among white women; in fact, the limited preliminary data available suggest that black women may be as likely as white women to report binge eating. OBJECTIVE: To examine race differences in prevalence of behavioral symptoms of eating disorders and clinically significant recurrent binge eating. DESIGN: Community survey. SETTING: General community in Connecticut and Boston, Mass. PARTICIPANTS: A community sample of 1628 black women and 5741 white women (mean age, 29.7 years) participated in a telephone survey designed to ascertain the presence, during the preceding 3 months, of binge eating and extreme weight control behaviors (vomiting, laxative or diuretic abuse, or fasting). MAIN OUTCOME MEASURE: Interviewer-based phone assessment of recurrent binge eating and behavioral symptoms of eating disorders. RESULTS: Black women were as likely as white women to report binge eating or vomiting during the preceding 3 months, and were more likely to report fasting and the abuse of laxatives or diuretics. Recurrent binge eating was more common among black women than among white women. In both race groups, recurrent binge eating was associated with elevated body weight and increased psychiatric symptoms. CONCLUSION: Results suggest that recurrent binge eating is a significant problem among black and white women. Health professionals need to be ready to respond to this health risk behavior.

Adult↗

Eating disorder symptoms in a cohort of 11 to 16-year-old black and white girls: the NHLBI growth and health study.

OBJECTIVE: This study sought to provide reference data for the Eating Disorder Inventory (EDI) with use of young adolescent black and white girls. Moreover, the study examined the relationship between race, age, socioeconomic status, and adiposity and each of the eight EDI scales. METHOD: To achieve these aims, data were used that had been collected in Years 3, 5, and 7 as part of the National Heart, Lung, and Blood Institute Growth and Health Study, a longitudinal cohort study of risk factors for obesity in black and white girls. For the present report, data were available from 2,228 girls in Year 3, 2,056 girls in Year 5, and 1,902 girls in Year 7. RESULTS: EDI scores were found to vary by race, age, socioeonomic status, and body weight of respondents. Black girls scored different from white girls on all EDI subscales. Scores on all but two subscales (Body Dissatisfaction, Drive for Thinness) decreased significantly with increasing age. Significant inverse associations were found between maximum parental education and all EDI subscales except Body Dissatisfaction and Perfectionism. Elevated body weight was associated significantly with Body Dissatisfaction, Drive for Thinness, Bulimia, Interoceptive Awareness, and Ineffectiveness. DISCUSSION: Our results illustrate the importance of taking into consideration the potentially confounding role of demographic characteristics and body weight when comparing different race or ethnic groups on the EDI.

Adolescent↗

Subthreshold binge eating disorder.

OBJECTIVE: To examine the clinical features of subthreshold binge eating disorder (BED). METHOD: Participants were recruited directly from the community as part of an ongoing study of risk factors for BED. Forty-four women with subthreshold BED were compared with 44 women with BED and 44 healthy controls on demographic characteristics, body mass index (BMI), eating disorder symptomatology, and psychiatric distress. Diagnoses were established using the Eating Disorder Examination (EDE). Participants completed the EDE-Questionnaire, the Brief Symptom Inventory, and were measured and weighed. RESULTS: Adjusting for significant group differences in BMI, the two eating disorder groups did not differ significantly on measures of weight and shape concern, restraint, psychiatric distress, and history of seeking treatment for an eating or weight problem. DISCUSSION: Given the importance of diagnostic status for access to treatment, further evaluation of the severity criterion specified for BED is needed.

Adult↗

One-year use and cost of inpatient and outpatient services among female and male patients with an eating disorder: evidence from a national database of health insurance claims.

OBJECTIVE: This study examined rates and cost of inpatient and outpatient treatment among 1,932 patients with an eating disorder. METHOD: One-year (1995) data were available through MarketScan, a national insurance database containing claims for 1,902,041 male patients and 2,005,760 female patients. RESULTS: Female patients (n = 1,756, 0.14% of all females) were significantly more likely to have been treated for an eating disorder than male patients (n = 176, 0.016% of all males), and females received more days of treatment than males. Outpatient treatment was the norm, regardless of gender or type of eating disorder. Average number of days (inpatient or outpatient) was less than the minimum recommended by standards of care. Age-adjusted costs for the treatment of anorexia nervosa and bulimia nervosa were comparable to the cost of treatment for schizophrenia. DISCUSSION: The utilization data are discussed in terms of barriers to care and treatment guidelines for eating disorders.

Adolescent↗

Epidemiology and natural course of eating disorders in young women from adolescence to young adulthood.

OBJECTIVES: To describe the epidemiology of eating disorders (ED) in a community sample of adolescent girls; to compare the clinical characteristics of full-syndrome (FS) and partial-syndrome (PS) ED cases; and to provide information about the continuity between adolescent ED and young adult psychopathology. METHOD: A randomly selected sample of high school girls were assessed during adolescence (n = 891) and a year later (n = 810), and a stratified subset (n = 538) was assessed during their 24th year. The assessments included the Schedule for Affective Disorders and Schizophrenia for School-Age Children, the Longitudinal Interval Follow-up Evaluation, level of functioning, mental health treatment utilization, history of suicide attempt, and physical symptoms. RESULTS: The incidence of ED was less than 2.8% by age 18, and 1.3% for ages 19 through 23. Comorbidity with other psychopathology (89.5%), but especially depression, was very high. FS- and PS-ED groups differed significantly from a no-disorder comparison group on most outcome measures, and more than 70% of the adolescent FS- and PS-ED cases met criteria for an Axis I disorder in young adulthood. CONCLUSIONS: FS- and PS-ED are associated with substantial comorbidity, treatment seeking, impaired functioning, and risk for psychopathology in young adulthood.

Adolescent↗

Natural course of a community sample of women with binge eating disorder.

OBJECTIVE: A community sample of women with binge eating disorder (BED) was followed for a period of 6 months, in order to examine the natural course of the disorder. METHOD: Baseline, 3-, and 6-month assessments were conducted. The following variables were examined: eating disorder symptomatology, importance of weight or shape, psychopathology, social adjustment, childhood sexual abuse, childhood obesity, parental obesity, and parental psychopathology. RESULTS: After the 3-month follow-up, 10 of the original sample of 31 participants dropped out of the study; drop-outs were more likely to have reported a history of sexual abuse. Of the 21 remaining participants, 11 continued to suffer from full-syndrome BED at 6-month follow-up, while the remaining 10 appeared to be in partial remission. There were no significant baseline predictors of outcome. CONCLUSION: It appears that for some women with BED, the eating disorder improves with a decrease in binge eating and importance of weight or shape. For others, the eating disorder symptoms remain constant.

Adult↗

Emotion-induced eating and sucrose intake in children: the NHLBI Growth and Health Study.

OBJECTIVE: Emotion-induced eating has been implicated as a risk factor for the development of obesity, yet no research has been done on emotion-induced eating in children. The National Heart, Lung, and Blood Institute Growth and Health Study (NGHS), a multicenter collaborative study of risk factors for obesity, developed an instrument for measuring emotion-induced eating in children and tested hypotheses regarding the association of emotion-induced eating with food intake and adiposity in preadolescent children. METHOD: Subjects were 1,213 black girls and 1,166 white girls who were 9 and 10 at study entry. Baseline data were utilized in this report. Girls were assessed by trained female health examiners who recorded height, weight, and indices of sexual maturation. Girls kept a 3-day food diary. Dietary data were coded and analyzed for total caloric and macro nutrient intake. A measure of emotion-induced eating was derived from seven questions about eating in response to emotions (Cronbach's alpha = .78). RESULTS: Black girls had significantly higher emotion-induced eating scores than white girls (10.8 vs. 9.7, p < .0001). For white girls, but not for black girls, emotion-induced eating was associated with increased intake of sucrose. In both races, a modest inverse association was found between body mass index and emotion-induced eating. DISCUSSION: Prospective studies are needed to explore further the role of emotion-induced eating and food intake and the role of emotion-induced eating in the development of obesity.

Affect↗

Psychiatric comorbidity of eating disorders in men: a national study of hospitalized veterans.

OBJECTIVE: This study examined eating disorders and their psychiatric comorbidity in a national sample of hospitalized male veterans. METHOD: Review of discharge summaries for 466,590 male patients from Veterans Affairs medical centers for fiscal year 1996 resulted in the identification of 98 men with a current ICD-9-CM diagnosis of an eating disorder. For the comorbidity analyses, eating disorder cases were matched with controls drawn randomly from the pool of male patients without an eating disorder, using age and race as matching variables. RESULTS: There was a high rate of comorbid substance use and mood disorder for men with anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS). Men with AN were also at high risk for comorbid schizophrenia/psychotic disorder, men with BN were at risk for comorbid personality disorder, and men with EDNOS were at special risk for comorbid organic mental disorder and schizophrenia/psychotic disorder. DISCUSSION: For each eating disorder, there was a distinct pattern of psychiatric comorbidity that deserves further study.

Adult↗

Eating disorders in a national sample of hospitalized female and male veterans: detection rates and psychiatric comorbidity.

OBJECTIVE: Using a national sample of hospitalized female and male veterans, this study examined the point prevalence of detected cases of eating disorders and explored psychiatric comorbidity in cases with an eating disorder. METHODS: Prevalence rates were determined by reviewing the discharge diagnoses of 24,041 women and 466,590 men hospitalized in Veteran Affairs medical centers during fiscal year 1996. Comorbidity was examined by individually matching eating disorder cases (N = 161) with patients without an eating disorder, using sex, race, and age as matching variables. RESULTS: On the basis of routine clinical diagnosis, 0.30% of the female veterans and 0.02% of the male veterans were diagnosed with a current ICD-9-CM eating disorder. Women with eating disorders had significantly elevated rates of comorbid substance, mood, anxiety (particularly posttraumatic stress disorder [PTSD]), adjustment, and personality (particularly borderline personality disorder [BPD]) disorders. Men with eating disorders were found to have high rates of comorbid organic mental, schizophrenic/psychotic, substance, and mood disorder. CONCLUSIONS: Our study illustrates the value of administrative data sets for the investigation of uncommon diseases.

Adult↗

Psychometric properties of the Self-Perception Profile for Children in a biracial cohort of adolescent girls: the NHLBI Growth and Health Study.

The National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) is an epidemiologic study of 1,213 Black and 1,166 White girls (ages 9-10) of risk factors for obesity. NGHS used Harter's Self-Perception Profile for Children (SPPC) to measure domain-specific competence and overall self-worth. This report reviews the psychometric properties of the SPPC in this biracial cohort at baseline and Year 3 visits (ages 11-12). Simple structure yielding unique components for each of the SPPC domains was obtained for White but not Black girls, whether analyzed overall or by parental education level. Internal consistency was higher for White girls in both years. The lack of simple structure was reflected in the higher correlations among the subscales for Black girls. The structure and internal consistency improved in Year 3 for Black girls, indicating that the physical appearance and athletic competence domains were not yet fully differentiated at baseline. Readers should be cautious, however, when interpreting the SPPC in young Black girls.

Black or African American↗