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PubMed1997

Cognitive avoidance of threat cues: association with Eating Disorder Inventory scores among a non-eating-disordered population.

OBJECTIVE: This two-part study investigated the cognitive processing of food- and threat-related information in a non-eating-disordered population, particularly exploring the mechanisms that might explain the process of cognitive avoidance among women with bulimic attitudes. METHOD: In the first study, 30 female students solved anagrams of neutral, food, and threat words. In the second study, 50 male and female students solved anagrams of words reflecting physical threat, self-directed ego threat, and ego threat directed from others. RESULTS: In this task, there was no association between slower processing of threats and eating characteristics, but there were associations with Eating Disorders Inventory (EDI) scales that reflect "ego development." DISCUSSION: The most reliable evidence of cognitive avoidance was among those participants who show the ego development characteristics that have been identified as important in the development and etiology of eating psychopathology. The implications for models of eating psychopathology and their treatment are discussed.

Adolescent↗

PubMed2004

Reliability of the Eating Disorder Examination in patients with binge eating disorder.

OBJECTIVE: This study examined the interrater and test-retest reliabilities of the Eating Disorder Examination (EDE) in patients with binge eating disorder (BED). METHOD: Interrater reliability and short-term (6-14 days) test-retest reliability of the EDE were examined in two study groups of 18 patients with BED. RESULTS: Interrater reliability was excellent for objective bulimic episodes and days (correlations above .98) and very good for the EDE scales, albeit somewhat variable (correlations range from .65 to .96). Test-retest reliabilities were very good for objective bulimic episodes (.70) and days (.71) and were good (significant) for the EDE scales, albeit somewhat variable (correlations range from .50 to .88). Interrater reliability was excellent for subjective bulimic episodes and days but test-retest reliabilities were unacceptable. CONCLUSIONS: These findings support the reliability of the EDE for patients with BED. The EDE has utility for assessing the number of large binge episodes (objective bulimic episodes), as well as the number of days during which large binge episodes occurred. The EDE also demonstrates very good interrater and test-retest reliabilities for assessing the associated features of eating disorders in patients with BED. The results for subjective bulimic episodes are consistent with previous studies, suggesting that these eating behaviors may not be reliable indicators of eating disorders.

Adult↗

PubMed2005

Eating Disorders Examination versus Eating Disorders Examination-Questionnaire in adolescents with full and partial-syndrome bulimia nervosa and anorexia nervosa.

OBJECTIVE: The current study compared the Eating Disorders Examination (EDE) and the Eating Disorders Examination-Questionnaire (EDE-Q) in adolescents with eating disorders. METHOD: Adolescents (N = 70) with bulimia nervosa (BN; n = 21), partial-syndrome BN (PBN; n = 25), and anorexia nervosa (AN; n = 24) were assessed with the EDE and EDE-Q. RESULTS: Moderate to high correlations were found on all four subscales within and between diagnostic groups. The discrepancy between the EDE and EDE-Q was significantly greater in BN relative to PBN and AN for the Eating Concern subscale. Objective binge episode (OBE) frequency in BN and subjective binge episode (SBE) frequency in BN and PBN were higher with the EDE compared with the EDE-Q. Self-induced vomiting was highly correlated between the two measures. DISCUSSION: Adolescents with BN, PBN, and AN exhibited strong correspondence between the EDE interview and questionnaire formats. However, this consistency was not as pronounced for BN as it was for PBN and AN. The current study lends preliminary credibility to the use of the EDE-Q in adolescent eating disorder samples.

Adolescent↗

PubMed1995

Classification of eating impairments based on eating efficiency in children with cerebral palsy.

Eating impairments in children with cerebral palsy (CP) may vary widely from mild to severe. Accurate diagnosis of the severity of eating has been hampered by the lack of a classification system which would permit stratification of this wide range of problems into mild, moderate, and severe. We propose such a classification system based on measures of (1) growth: weight, height, and skinfold thickness and (2) eating skills: eating efficiency and oral-motor skills. One hundred children, 54 boys and 46 girls from 2 to 16 years, who had various degrees of CP and eating impairments, were studied. Classification, treatment effectiveness, as well as the implications for growth monitoring, based on this classification system are discussed. system are discussed.

Adolescent↗

PubMed1987

Emotional reactivity and eating in binge eating and obesity.

The present study investigated daily mood fluctuations and moods during eating in normal and overweight binge and nonbinge eaters (N = 56) and moods during binge and nonbinge episodes of individuals who binge eat (N = 29). For 2 weeks, subjects completed the Multiple Affect Adjective Checklist each morning and continuously recorded the mood during eating and the type and quantity of food eaten during each eating episode. The results indicated that bingers experience greater fluctuations of anxiety and depression than nonbingers and overweight individuals experience greater fluctuations in anxiety, hostility, and depression than normal-weight individuals. In addition, for bingers, negative mood states are experienced during a significantly greater proportion of binge episodes than nonbinge episodes, although the intensity of the negative mood state was not related to the severity of the binge-eating episode. Theoretical and clinical implications of these findings are discussed.

Adult↗

PubMed2006

First-degree relative history of alcoholism in eating disorder inpatients: relationship to eating and substance use psychopathology.

OBJECTIVE: We examined the influence of family history of alcoholism on the presentation and course of inpatients with eating disorders (ED) by comparing ED behaviors, substance abuse behaviors, and psychopathology of patients with alcoholic first-degree relatives (AFDR+) to those without alcoholic first-degree relatives (AFDR-). METHOD: Female inpatients admitted to a specialty eating disorders service completed demographic, family history, behavioral, and psychological questionnaires (N=217). Body mass index (BMI) at admission and discharge, length of stay, and rates of weight gain were calculated. RESULTS: AFDR+ participants did not differ from AFDR- participants diagnostically, but AFDR+ participants did report higher lifetime frequencies of several ED and substance abuse behaviors. Measures of ED psychopathology and personality vulnerability were also elevated in the AFDR+ group. DISCUSSION: ED inpatients with a first-degree family history of alcoholism demonstrate increased psychopathology in eating behavior, substance use, and personality vulnerability domains. While the genetic diathesis for alcoholism is likely distinct from that for eating disorders, these findings suggest that first-degree relative history of alcoholism may nevertheless exert a negative influence on eating disorder behaviors.

Adolescent↗

PubMed2006

The 196G/A (val66met) polymorphism of the BDNF gene is significantly associated with binge eating behavior in women with bulimia nervosa or binge eating disorder.

The brain-derived neurotrophic factor (BDNF) is involved not only in promoting neuronal outgrowth and differentiation, synaptic connectivity and neuronal repair, but also in modulating eating behavior. Since genetic factors likely contribute to the biological vulnerability to bulimia nervosa (BN) and binge eating disorder (BED), we investigated whether the functional 196G/A single nucleotide polymorphism (SNP) of the BDNF gene was associated to BN and/or BED or to some phenotypic aspects of the disordered eating. Two hundred and ten Caucasian women (126 with BN, 84 with BED and 121 healthy controls) participated into the study. No significant differences were found in the frequencies of the 196G/A variants of the BDNF gene among patients with BN or BED and healthy controls. In both BN and BED groups, subjects carrying the 196A/A genotype exhibited a weekly frequency of bingeing and a severity of binge eating (as assessed by the Bulimia Investigation Test Edinburgh) significantly higher than those with the 196A/G and 196G/G genotypes. These results suggest that the 196G/A SNP of the human BDNF gene does not contribute to the genetic susceptibility to BN and BED, but may predispose those patients to a more severe binge eating behavior.

Amino Acid Substitution↗

PubMed2005

Circulating ghrelin is decreased in non-obese and obese women with binge eating disorder as well as in obese non-binge eating women, but not in patients with bulimia nervosa.

Ghrelin is a peripheral gastric peptide involved in the regulation of eating behavior and energy homeostasis. While changes in ghrelin plasma levels have been found in anorexia nervosa, bulimia nervosa (BN) and obesity, no study has assessed circulating ghrelin in binge eating disorder (BED). Therefore, we measured plasma levels of this peptide in women with BED as compared to women with BN, obesity and healthy controls. One hundred and eighty-two drug-free women (56 bulimics, 13 non-obese and 34 obese BED subjects, 28 obese non-binge eating women and 51 non-obese healthy women) underwent psychopathological and nutritional assessments and blood sample collection for glucose and ghrelin assays in the morning. As compared to non-obese healthy women, both non-obese and obese BED women as well as obese non-binge eating women had significantly increased values of body weight, body mass index and body fat mass. Moreover, plasma ghrelin concentrations were significantly decreased in both non-obese (P<0.01) and obese (P<0.0001) BED women as well as in obese non-binge eating women (P<0.001) but not in women with BN. No significant correlations emerged between plasma ghrelin values and the frequency of binge/vomiting in BN subjects or the frequency of bingeing in BED individuals. The reduction of plasma ghrelin in non-obese and obese binge eaters as well as in obese non-binge eaters may represent a secondary change aiming to counteract their positive energy imbalance.

Adult↗

PubMed2000

Circulating leptin in patients with anorexia nervosa, bulimia nervosa or binge-eating disorder: relationship to body weight, eating patterns, psychopathology and endocrine changes.

A decreased production of leptin has been reported in women with anorexia nervosa (AN) and has been attributed merely to the patients' reduced body fat mass. The extent to which eating patterns, purging behaviors, psychopathology and endocrine changes may contribute to the genesis of leptin alterations has not been deeply investigated. Therefore, we measured plasma levels of leptin, glucose and other hormones in three groups of eating disorder patients with different body weight (BW), eating patterns and purging behaviors. Sixty-seven women, 21 with AN, 32 with bulimia nervosa (BN), 14 with binge-eating disorder (BED) and 25 healthy females volunteered for the study. We found that circulating leptin was significantly reduced in AN and BN patients, but significantly enhanced in women with BED. In anorexics, plasma glucose was decreased, whereas plasma cortisol was enhanced; blood concentrations of 17beta-estradiol and prolactin (PRL) were reduced in both AN, BN and BED patients. In all subject groups, a strong positive correlation emerged between plasma levels of leptin and the subjects' BW or body mass index, but not between leptin and psychopathological measures, plasma glucose, cortisol, PRL and 17beta-estradiol. Since leptin was reduced in both underweight anorexics and normal weight bulimics, but increased in overweight BED women, who compulsively binge without engaging in compensatory behaviors, we suggest that factors other than BW may play a role in the determination of leptin changes in eating disorders.

Adult↗

PubMedDate not supplied

Eating disturbances in women of color: an exploratory study of contextual factors in the development of disordered eating in Mexican American women.

The relationship between ethnocultural identity, eating practices, and cultural expectations is complex. When there are conflicting cultural demands, eating disturbances can occur. These disturbances affect many aspects of a woman's life, including her quality of life, health, relationships, and academic/career success. Contextual variables that may influence eating disorders in women of color include (a) level of acculturation, (b) socioeconomic status (SES), (c) peer socialization, (d) family structure, and (e) immigration status. This study examined these variables in a college sample of 115 Mexican American women. Each completed a demographic questionnaire and standardized instruments to measure acculturation, eating disorder symptoms, and family issues. Multiple regression analysis indicated that family rigidity contributes to an increased susceptibility for bulimic symptoms (p < .0001). Poor peer socialization and family rigidity were related to the preoccupation with body size and slimness, thus placing young Mexican American women at greater risk for developing self-destructive eating patterns such as severe weight control and dieting behaviors (p < .0001). Implications for health, quality of life, and appropriate therapeutic care are discussed.

Acculturation↗

PubMed2005

What not to eat: inequalities in healthy eating behaviour, evidence from the 1998 Scottish Health Survey.

BACKGROUND: The role that healthy eating plays in good health is well documented. Government policy in Scotland recommends reducing salt, refined sugar and saturated fat in the diet and increasing the consumption of fruit and vegetables, carbohydrates, fibre and oily fish. METHODS: Using data from the 1998 Scottish Health Survey a composite measure of healthy eating behaviour was derived by scoring low levels of consumption of salt, refined sugar and saturated fat and higher consumption of fruit and vegetables, carbohydrates, fibre and oily fish. This paper presents results from logistic regression analysis of the risk factors for this measure of healthy eating behaviour. RESULTS: Young people, men, those on low income, those without qualifications, those who take little exercise, who lack access to car, live in deprived areas and women who smoke were less likely to show healthy eating behaviour. CONCLUSION: Healthy eating reflects dietary policy and guidelines for those with higher socio-economic status and who demonstrate other health seeking behaviour. Health education policy needs to be targeted at young people, men, and those of lower socio-economic status, and deprived areas, not just the population or country as a whole.

Adolescent↗

PubMed2005

Response of recurrent binge eating and weight gain to topiramate in patients with binge eating disorder after bariatric surgery.

BACKGROUND: The effectiveness of topiramate was evaluated in the treatment of recurrent binge eating and weight gain in patients with binge eating disorder (BED) and obesity who had undergone initially successful bariatric surgery. METHODS: The records of 3 consecutive patients with BED and obesity who presented to our clinic with recurrent binge eating and weight gain after undergoing initially successful bariatric surgery were reviewed. They were treated with topiramate for an average of 10 months. RESULTS: All three patients reported complete amelioration of their binge eating symptoms and displayed weight loss (31.7 kg in 17 months, 14.5 kg in 9 months, 2 kg in 4 months, respectively) in response to topiramate (mean dose 541 mg). CONCLUSION: Although anecdotal, these observations suggest that topiramate may be an effective treatment for patients with BED and obesity who experience recurrent binge eating and weight gain after initially successful bariatric surgery.

Adult↗

PubMed2002

Personality, perfectionism, and attitudes toward eating in parents of individuals with eating disorders.

OBJECTIVE: This study compares personality and eating-related traits in parents of probands with eating disorders, with age-band matched healthy normal controls. METHOD: Data were abstracted from an international genetic study of anorexia nervosa. Information was available for the Multidimensional Perfectionism Scale (MPS), the Eating Disorders Inventory (EDI), and the Temperament and Character Inventory (TCI). Comparisons were done by multivariate analysis of variance. RESULTS: Mothers of probands showed elevated levels of perfectionism on the MPS and more concerns about weight and shape on the EDI compared with controls. Mothers who had daughters with diagnoses other than the restricting subtype of anorexia nervosa showed elevated levels of perfectionism on the MPS. CONCLUSION: These data are compatible with the notion that some personality traits, such as perfectionism, and weight and shape concerns may cluster in families of probands with eating disorders.

Analysis of Variance↗

PubMed2026

The combined and independent influence of food texture and a 'mindful eating' instruction on eating rate and food intake among Dutch primary schoolchildren.

Eating rate (ER), the amount of food consumed per unit of time, is a key determinant of food intake, with faster ER associated with larger meal size. Research in adults has shown that both sensory properties like texture, and instructions can influence ER and intake. However, their independent and combined effect on ER and intake in children remain poorly understood. This study examined the effects of food texture and a 'mindful eating' instruction on ER and food intake in children. Children (N = 73), 38 boys, aged 4-12 years, participated in a 4-week cluster-randomized incomplete cross-over study conducted during regular school lunches. Using a 2×3 factorial design, children were exposed to two levels of food texture (softer vs. harder whole-grain buns) and three types of instructions (none, control, 'mindful'). Linear mixed models with repeated measures were used, adjusting for sex and group. As the interaction between food-texture and type of instructions was non-significant, it was excluded from the final models. Results revealed a strong main effect of food texture on ER and food intake (all p < 0.001), where compared with softer buns, harder buns were associated with a slower eating rate (Δ = -6.67 g/min, SE = 0.59) and reduced food intake (Δ = -70 g, SE = 8). In contrast, type of instruction had no significant effect on ER or intake (p = 0.85). Our findings demonstrate that food texture exerts a dominant influence on children's eating rate and food intake, highlighting texture modification as a potential leverage point for influencing ER and intake in children.

Humans↗

PubMed1991

Eating concerns on two Christian and two nonsectarian college campuses: a measure of sex and campus differences in attitudes toward eating.

Eating concerns among college men and women on two campuses with an explicitly Christian world view and two nonsectarian campuses, each campus in a different section of the country, were examined in three experiments using the Wellesley Eating Attitudes Survey. Chi-square tests indicated that eating concerns were significantly more frequent among women than men, but men showed a surprisingly high degree of concern. Campuses differed in their level of concern. The relative incidence of overweight in the four sections of the country (Northeast, West, Midwest, and South), as measured by the Centers for Disease Control (1989), appeared more closely related to the level of concern at each of the campuses than the presence or absence of an evangelical Christian world view. Recommendations are made for appropriate support services for students with eating concerns at each campus.

Adolescent↗

PubMed1995

The Emotional Eating Scale: the development of a measure to assess coping with negative affect by eating.

The development of the Emotional Eating Scale (EES) is described. The factor solution replicated the scale's construction, revealing Anger/Frustration, Anxiety, and Depression subscales. All three subscales correlated highly with measures of binge eating, providing evidence of construct validity. None of the EES subscales correlated significantly with general measures of psychopathology. With few exceptions, changes in EES subscales correlated with treatment-related changes in binge eating. In support of the measure's discriminant efficiency, when compared with obese binge eaters, subscale scores of a sample of anxiety-disordered patients were significantly lower. Lack of correlation between a measure of cognitive restraint and EES subscales suggests that emotional eating may precipitate binge episodes among the obese independent of the level of restraint.

Adaptation, Psychological↗

PubMed1996

Effects of stressful noise on eating and non-eating behavior in rats.

Eating and other behaviors were measured in 36 food-deprived rats on 15 consecutive days during 20 min test sessions. During training sessions 1 to 5 all animals were habituated to the test boxes with white noise of 55 dB intensity. For sessions 6 to 10 noise intensity was increased to 95 dB for the experimental rats and to 60 dB for the control rats. The food intake of experimental rats was lower for stress session 1. The duration of eating behavior was lower, and durations of exploring, grooming and resting behaviors were higher for all stress sessions for rats exposed to 95 dB white noise. Speed of eating behavior was higher for all stress sessions in the experimental group. Defecation rate of the experimental rats was higher for all stress sessions. On post-stress sessions 11 to 15 animals were again tested under the stimulus conditions of the training period (55 dB). No significant effects were observed for this period. The results are discussed with respect to models of "stress-induced" eating and behavioral ecology.

Animals↗

PubMed2000

The Eating Disorder Inventory in evaluation of impaired eating behaviour in subjects requesting nutritional consultation.

The present study evaluated impaired eating behaviour in women seeking participation in a diet-based programme of weight reduction or achievement of ideal body weight. Forty-seven obese, 42 overweight and 14 normal-weight subjects, attending an Italian university outpatient clinic completed the Eating Disorder Inventory (EDI). Forty-eight mothers of primary school children (25 normal-weight and 23 overweight) were used as controls. The EDI consists of 8 subscales, 3 evaluating psychopathology related to eating disorders (drive for thinness, bulimia, body dissatisfaction) and 5 evaluating general psychopathology (intereoceptive awareness, ineffectiveness, maturity fears, perfectionism, interpersonal distrust). Significantly altered scores in the first three subscales were observed both in normal-weight and overweight outpatients compared to the controls. The overweight outpatients scored higher than the obese patients in terms of drive for thinness and bulimia and higher than the normal-weight women for terms of bulimia, body dissatisfaction and drive for thinness. The overweight controls scored significantly higher than the normal-weight controls in the first three subscales in the remaining subscales, mean values were also higher in the overweight group, though significance was only reached in the interpersonal distrust and interoceptive awareness subscales. Impaired eating behaviour is frequent in subjects seeking participation in weight reduction or ideal body weight achievement programmes.

Adult↗